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ANEXA 2a

SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILA INCEPAND CU 01 APRILIE 2017

Val. maxima suportata


Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)

1 A02BC01 OMEPRAZOLUM ULTOP CAPS. GASTROREZ. 20mg KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ. P-6L 14 0,531206 0,144508 0,478085 0,197629
2 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ.
GEDEON RICHTER ROMANIA SA P-6L 14 0,531206 0,154508 0,478085 0,207629
3 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 20 0,531206 0,132794 0,478085 0,185915
4 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,531206 0,251460 0,478085 0,304581
5 A02BC01 OMEPRAZOLUM OMEPRAZOL TERAPIA 20 mg CAPS. GASTROREZ. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,531206 0,247794 0,478085 0,300915
6 A02BC01 OMEPRAZOLUM OMEPRAZOL ARENA 20 mg CAPS. GASTROREZ. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,531206 0,230460 0,478085 0,283581
7 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRLROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,531206 0,163794 0,478085 0,216915
8 A02BC01 OMEPRAZOLUM OMEPRAZOL ROMPHARM 20 mgCAPS. GASTROREZ. 20mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,531206 0,207460 0,478085 0,260581
9 A02BC01 OMEPRAZOLUM ORTANOL 20 mg CAPS. GASTROREZ. 20mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS. GASTROREZ.
P-6L 14 0,437857 0,000000 0,394071 0,043786
10 A02BC01 OMEPRAZOLUM OMEZ 20mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L 30 0,531206 0,209460 0,478085 0,262581
11 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mgCAPS. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ. P6L 28 0,331428 0,000000 0,298285 0,033143
12 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 28 0,531206 0,262365 0,478085 0,315486
13 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 14 0,531206 0,262365 0,478085 0,315486
14 A02BC01 OMEPRAZOLUM OMEPRAZOL ATB 20 mg CAPS. GASTROREZ. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L 20 0,531206 0,316294 0,478085 0,369415
15 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L 28 0,376785 0,000000 0,339106 0,037679
16 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 2 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 14 CAPSULE GASTROREZISTENTE P6L 28 0,376785 0,000000 0,339106 0,037679
17 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 4 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 7 CAPSULE GASTROREZISTENTE P6L 28 0,376785 0,000000 0,339106 0,037679
18 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ P-6L 30 0,531206 0,133460 0,478085 0,186581
19 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ.
P6L 28 0,531206 0,262365 0,478085 0,315486
20 A02BC01 OMEPRAZOLUM OMEPRAZOL MYLAN 20 mg CAPS. GASTROREZ. 20mg GENERICS [UK LTD. MAREA BRITANIE CUTIE CU BLIST. AL/OPA/PVC X 30 CAPS. GASTROREZ. P6L 30 0,263333 0,000000 0,236999 0,026334
21 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRLROMANIA CUTIE X 3 BLIST. AL/AL X 10 CAPS. GASTROREZ.
P6L 30 0,531206 0,163794 0,478085 0,216915
22 A02BC01 OMEPRAZOLUM ORTANOL 40 mg CAPS. GASTROREZ. 40mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L 7 1,062412 0,129016 0,956170 0,235258
23 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mgCAPS. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L 14 0,645714 0,000000 0,581142 0,064572
24 A02BC01 OMEPRAZOLUM OMEPRAZOL MYLAN 40 mg CAPS. GASTROREZ. 40mg GENERICS [UK LTD. MAREA BRITANIE CUTIE CU BLIST. AL/OPA/PVC X 7 CAPS. GASTROREZ. P6L 7 0,644285 0,000000 0,579856 0,064429
25 A02BC01 OMEPRAZOLUM OMEDAR 20 mg COMPR. GASTROREZ. 20mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ. P-6L 28 0,531206 0,004151 0,478085 0,057272
26 A02BC01 OMEPRAZOLUM OMEZ 40 mg PULB. PT. SOL. PERF. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF. S/P-RF 1 15,153749 1,676251 13,638374 3,191626
27 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF. 40mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 15,153749 1,686251 13,638374 3,201626
28 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,265603 0,220825 0,239042 0,247386
29 A02BC03 LANSOPRAZOLUM LANZUL CAPS. GASTROREZ. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ. P-6L 14 0,531206 0,441651 0,478085 0,494772
30 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,531206 0,310936 0,478085 0,364057
31 A02BC03 LANSOPRAZOLUM LANZAP 30mg CAPS. GASTROREZ. 30mg ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ.
DR. REDDY'S LABORATORIES P-6L 20 0,531206 0,332294 0,478085 0,385415
32 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA ARENA 100 mg COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,217500 0,012000 0,195750 0,033750
33 A03AD01 PAPAVERINI HYDROCHLORIDUMPAPAVERINA FARMACOM 200 mgCOMPR. 200 mg FARMACOM S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,427000 0,000000 0,384300 0,042700
34 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINE SOPHARMA 20 mg/ml SOL INJ. 20mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 10 FIOLE X 1 ML SOL. INJ. PRF 10 1,772000 0,000000 1,594800 0,177200
35 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,103500 0,000000 0,093150 0,010350
36 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,114812 0,032438 0,103330 0,043920
37 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L 40 0,104000 0,000000 0,093600 0,010400
38 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID BIOFARM 1mg/5ml SIROP 1mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 100 ML SIROP + MASURA DOZATOARE P-RF 1 9,010000 0,000000 8,109000 0,901000
39 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 5mg/ml SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 5 2,742000 0,000000 2,467800 0,274200
40 A05AA02 ACIDUM URSODEOXYCHOLICUM*URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 1,152400 0,000000 1,037160 0,115240
41 A05AA02 ACIDUM URSODEOXYCHOLICUM*URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 1,152400 0,061000 1,037160 0,176240
42 A05AA02 ACIDUM URSODEOXYCHOLICUM*URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 0,788500 0,000000 0,709650 0,078850
43 A05AA02 ACIDUM URSODEOXYCHOLICUM*URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100 2,304800 0,376900 2,074320 0,607380
44 A05AA02 ACIDUM URSODEOXYCHOLICUM*URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 57,620055 39,869945 51,858049 45,631951
45 A06AD11 LACTULOSUM DUPHALAC LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 6,899858 3,850142 6,209872 4,540128
46 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML P-6L 1 10,085999 0,714001 9,077399 1,722601
47 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 3,361999 0,228001 3,025799 0,564201

Pagina 1 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
48 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIACUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 16,809999 0,420001 15,128999 2,101001
49 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIACUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 33,340000 0,000000 30,006000 3,334000
50 A06AD11 LACTULOSUM LACTULAK 660 mg/ml SOL. ORALA 660 mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L 1 6,730000 0,000000 6,057000 0,673000
51 A07AA02 NYSTATINUM NISTATINA ATB 500000 UI COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,480000 0,000000 0,432000 0,048000
52 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0,584200 0,000000 0,525780 0,058420
53 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L 50 0,585200 0,000000 0,526680 0,058520
54 A07EC02 MESALAZINUM ** PENTASA 1 g COMPR. CU ELIB. PREL. 1g FERRING GMBH GERMANIA CUTIE CU 6 BLIST. AL/AL X 10 COMPR. CU ELIB. PREL. P6L 60 1,607155 1,586178 1,446439 1,746894
55 A07EC02 MESALAZINUM ** PENTASA 500mg COMPR. ELIB. PREL. 500mg FERRING GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 100 0,803577 0,579423 0,723219 0,659781
56 A07EC02 MESALAZINUM ** SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 250mg DR. FALK PHARMA GMBH GERMANIACUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0,401787 0,187913 0,361608 0,228092
57 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIACUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0,803577 0,316823 0,723219 0,397181
58 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIACUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 50 0,803577 0,417623 0,723219 0,497981
59 A07EC02 MESALAZINUM ** MESALAZINA SOFARFARM 400 mg COMPR. GASTROREZISTENTE 400mg SOFARFARM S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 0,642861 0,167805 0,578574 0,232092
60 A07EC02 MESALAZINUM ** MESALAZINA SOFARFARM 800 mg COMPR. GASTROREZISTENTE 800mg SOFARFARM S.R.L. ROMANIA CUTIE CU 8 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 120 1,285724 0,142859 1,157151 0,271432
61 A07EC02 MESALAZINUM ** PENTASA 1000mg SUPOZ. 1000mg FERRING GMBH GERMANIACUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI P-6L 28 5,886666 0,320476 5,297999 0,909143
62 A07EC02 MESALAZINUM ** SALOFALK 1 g SUPOZ. 1g DR. FALK PHARMA GMBH GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L 30 5,886666 0,000000 5,297999 0,588667
63 A07EC02 MESALAZINUM ** SALOFALK (R) 250 mg SUPOZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 1,471662 0,702338 1,324495 0,849505
64 A07EC02 MESALAZINUM ** SALOFALK (R) 500 mg SUPOZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 2,943333 0,656667 2,648999 0,951001
65 A07EC02 MESALAZINUM ** SALOFALK 4 g/ 60 ml SUSP. RECTALA 4g/60ml DR. FALK PHARMA GMBH GERMANIA CUTIE X 7 BLIST. AL/PE CONTINAND FIECARE CATE 1 FLACON UNIDOZA X 60 ML SUSPENSIE RECTALA + APLICA P-6L 7 20,875714 0,000000 18,788142 2,087572
66 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,187749 0,038251 0,168974 0,057026
67 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg MERUS LABS LUXCO II S.A.R.L. LUXEMBURG CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,350000 0,000000 0,315000 0,035000
68 B01AC05 TICLOPIDINUM 1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0,257175 1,519325 0,231457 1,545043
69 B01AC05 TICLOPIDINUM 1) IPATON COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P-RF 20 0,257175 0,430825 0,231457 0,456543
70 B02BA01 PHYTOMENADIONUM FITOMENADION 10 mg/ml SOL. INJ. 10mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML S/P-RF 5 3,340000 0,000000 3,006000 0,334000
71 B03AA07 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES COMPR. FILM. 100mg+60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM. P-6L 50 0,307800 0,000000 0,277020 0,030780
72 B03AA07 FERROSI SULFAS FERROGRADUMET (R) COMPR. ELIB. PREL. 105mg TEOFARMA SRL ITALIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 0,282000 0,000000 0,253800 0,028200
73 B03AA07 FERROSI SULFAS TARDYFERON 80 mg DRAJ. ELIB. PREL. 80mg LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L 30 0,228972 0,186694 0,206074 0,209592
74 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT MALTOFER COMPR. MAST. 100mg VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MASTIC. P-6L 30 0,636035 0,107298 0,572431 0,170902
75 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FER ROMPHARM 50 mg/ml PIC. ORALE, SOL. 50mg/ml ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 30 ML PIC. ORALE, SOL.
ROMPHARM COMPANY SRL P6L 1 8,780000 0,000000 7,902000 0,878000
76 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM FORTE 50 mg/ml PICATURI ORALE, SOL. 50mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 ML PICATURI ORALE, SOLUTIE P-6L 1 9,120000 0,000000 8,208000 0,912000
77 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) PICATURI ORALE-SOL. 50mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON CU PICURATOR X 30 MLP-6L 1 9,120000 4,920000 8,208000 5,832000
78 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) SIROP 10mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON X 150 ML + O MASURA DOZATOARE P-6L 1 9,120000 6,860000 8,208000 7,772000
79 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM 50mg/5ml SIROP 50mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE GRADATA DE LA 2,5 - 20 MLP-6L 1 6,080000 4,310000 5,472000 4,918000
80 B03BB01 ACIDUM FOLICUM ACIFOL 5 mg COMPR. FILM. 5mg ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-6L 30 0,255666 0,000000 0,230099 0,025567
81 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,138800 0,000000 0,124920 0,013880
82 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,5 mg/2ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA S/P-RF
CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ROSU SI PORTOCALIU)X 2 ML SOL. INJ. 5 1,652000 0,000000 1,486800 0,165200
83 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,652700 0,034300 0,587430 0,099570
84 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,652700 0,013300 0,587430 0,078570
85 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,639400 0,000000 0,575460 0,063940
86 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,329400 0,011100 0,296460 0,044040
87 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 0,329400 0,000000 0,296460 0,032940
88 C01BC03 PROPAFENONUM RYTMONORM (R) COMPR. FILM. 150mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 0,329400 0,194200 0,296460 0,227140
89 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD PHARMA GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-RF 100 0,329400 0,000000 0,296460 0,032940
90 C01BC03 PROPAFENONUM RYTMONORM 150 mg COMPR. FILM. 150mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM. PRF 50 0,329400 0,194200 0,296460 0,227140
91 C01BC03 PROPAFENONUM RYTMONORM 70 mg/20 ml SOL. INJ. 70mg/20ml MYLAN HEALTHCARE GMBH GERMANIACUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. PRF 5 5,856000 0,000000 5,270400 0,585600
92 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 0,291916 0,177084 0,262724 0,206276
93 C01BD01 AMIODARONUM AMIODARONA LPH 200 mg COMPR. 200mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,291916 0,012750 0,262724 0,041942
94 C01BD01 AMIODARONUM AMIODARONA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,253666 0,000000 0,228299 0,025367
95 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. P-RF 30 0,291916 0,177084 0,262724 0,206276
96 C01DA02 NITROGLYCERINUM NITROMINT 2,6 mg COMPR. ELIB. PREL. 2,6mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL. P-6L 60 0,150882 0,044284 0,135793 0,059373
97 C01DA02 NITROGLYCERINUM NITROGLICERINA 0,5 mg COMPR. SUBLING. 0,5mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE P-6L 20 0,088402 0,112098 0,079561 0,120939
98 C01DA02 NITROGLYCERINUM NITRODERM (R) TTS 5 SIST. TERAP. TRANSDERM. 25mg NOVARTIS PHARMA GMBH GERMANIACUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC P-6L 10 1,557999 0,000001 1,402199 0,155801
99 C01DA02 NITROGLYCERINUM NITROMINT SPRAY SUBLINGUAL 0,4mg/doza EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L 1 12,730000 0,000000 11,457000 1,273000
100 C01DA02 NITROGLYCERINUM NITROMINT SPRAY SUBLINGUAL 0,4mg/doza EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN PLASTIC X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L 1 12,730000 0,000000 11,457000 1,273000
101 C01DA08 ISOSORBIDI DINITRAS ISOSORBID DINITRAT 10 mg COMPR. 10mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3, BLIST. AL/PVC X 20 COMPR. P-6L 60 0,031000 0,000000 0,027900 0,003100
102 C01DA08 ISOSORBIDI DINITRAS ISODINIT(R) RETARD COMPR. ELIB. PREL. 20mg PHARMAKI GENERICS LIMITED MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. ELIB. PREL. P-6L 60 0,068333 0,000000 0,061499 0,006834
103 C01DA14 ISOSORBIDI MONONITRAS MONO ROM SR 40 mg CAPS. ELIB. PREL. 40mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 20 0,290159 0,302841 0,261143 0,331857

Pagina 2 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
104 C01DA14 ISOSORBIDI MONONITRAS OLICARD 40 mg RETARD CAPS. ELIB. PREL. 40mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL.
P-6L 20 0,290159 0,151841 0,261143 0,180857
105 C01DA14 ISOSORBIDI MONONITRAS MONO ROM SR 60 mg CAPS. ELIB. PREL. 60mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 20 0,435238 0,489262 0,391714 0,532786
106 C01DA14 ISOSORBIDI MONONITRAS MONONITRON (R) EP 60 mg COMPR. ELIB. PREL. 60mg ZENTIVA S.A ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 40 0,435238 0,509262 0,391714 0,552786
107 C01EA01 ALPROSTADILUM ** PRIDAX 20mcg CONC. PT. SOL. PERF. 20mcg GEBRO PHARMA GMBH AUSTRIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF S/P-RF 5 42,012500 10,297500 37,811250 14,498750
108 C01EA01 ALPROSTADILUM ** VASAPROSTAN 20 LIOF. PT. SOL. PERF. 20g UCB PHARMA GMBH GERMANIA CUTIE X 10 FIOLE X 5 ML LIOF. PT. SOL. PERF. PRF 10 38,580000 0,000000 34,722000 3,858000
109 C02AB01 METHYLDOPUM DOPEGYT COMPR. 250mg UNGARIA CUTIE X 1 FLAC. X 50 COMPR.
EGIS PHARMACEUTICALS P.L.C. P-6L 50 0,554400 0,000000 0,498960 0,055440
110 C02AC01 CLONIDINUM CLONIDINA SINTOFARM 0,15 mg COMPR. 0,15mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,209008 0,030992 0,188107 0,051893
111 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 0,209008 0,046792 0,188107 0,067693
112 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0,173200 0,000000 0,155880 0,017320
113 C03BA11 INDAPAMIDUM SERDIMID 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 0,279809 0,069857 0,251828 0,097838
114 C03BA11 INDAPAMIDUM INDAPAMIDA SOPHARMA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SOPHARMA PLC BULGARIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0,279809 0,042191 0,251828 0,070172
115 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 1,5 mg 1,5mg
COMPR. CU ELIB. PRELUNGITA TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838
116 C03BA11 INDAPAMIDUM INDAPAMID SR ZENTIVA 1,5 mg COMPR. ELIB. PREL 1,5 mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P6L 30 0,279809 0,069857 0,251828 0,097838
117 C03BA11 INDAPAMIDUM INDAPAMIDA MYLAN 1,5 mg COMPR. ELIB. PREL. 1,5 mg MYLAN S.A.S. FRANTA CUTIE CU BLIST DIN PVC/AL X 30 COMPR. ELIB. PREL. P-6L 30 0,268000 0,000000 0,241200 0,026800
118 C03BA11 INDAPAMIDUM TERTENSIF SR 1,5 mg COMPR. ELIB. PREL. 1,5mg LES LAB. SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-6L 30 0,279809 0,258524 0,251828 0,286505
119 C03BA11 INDAPAMIDUM INDAPAMID LPH 1,5 mg COMPR. ELIB. PREL. 1,5mg LABORMED PHARMA SAROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838
120 C03BA11 INDAPAMIDUM INDAPAMID MCC 1,5 mg COMPR. ELIB. PREL. 1,5mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838
121 C03BA11 INDAPAMIDUM IDUREN SR 1,5 mg COMPR. ELIB. PREL. 1,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838
122 C03BA11 INDAPAMIDUM DIUREMID SR 1,5 mg COMPR. ELIB. PREL. 1,5mg GLENMARK PHARMACEUTICALS SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838
123 C03BA11 INDAPAMIDUM INDAPAMIDA TEVA 1,5 mg COMPR. ELIB. PREL. 1,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-6L 30 0,264666 0,000000 0,238199 0,026467
124 C03BA11 INDAPAMIDUM INDAPAMIDA SR TORRENT 1,5 mg COMPR. ELIB. PREL. 1,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0,279809 0,069857 0,251828 0,097838
125 C03BA11 INDAPAMIDUM INDAPAMIDA ATB 1,5 mg COMPR. ELIB. PREL. 1,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0,279809 0,069857 0,251828 0,097838
126 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,466349 0,054984 0,419714 0,101619
127 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 2,5mg COMPR. FILM. 2,5mg TERAPIA SA ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,466349 0,048651 0,419714 0,095286
128 C03BA11 INDAPAMIDUM SERDIMID 2,5 mg COMPR. FILM. 2,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM. P6L 30 0,466349 0,054984 0,419714 0,101619
129 C03BA11 INDAPAMIDUM RAWEL SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,264666 0,000000 0,238199 0,026467
130 C03BA11 INDAPAMIDUM IMPAMID SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. ELIB. PREL. P-6L 30 0,279809 0,069857 0,251828 0,097838
131 C03BA11 INDAPAMIDUM INDAPAMIDA ACTAVIS 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. CU ELIB. PRELUNGITA
ACTAVIS GROUP PTC EHF. P-6L 30 0,268666 0,000000 0,241799 0,026867
132 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156500 0,000000 0,140850 0,015650
133 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156500 0,000000 0,140850 0,015650
134 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,156750 0,156250 0,141075 0,171925
135 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156750 0,000250 0,141075 0,015925
136 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156750 0,156250 0,141075 0,171925
137 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,156750 0,114250 0,141075 0,129925
138 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATEP-6L 30 0,156750 0,000916 0,141075 0,016591
139 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,260000 0,000000 1,134000 0,126000
140 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,753000 0,000000 0,677700 0,075300
141 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 25 mgCAPS. 25mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L 50 0,220833 0,112567 0,198749 0,134651
142 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 0,220833 0,115500 0,198749 0,137584
143 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,441666 0,000000 0,397499 0,044167
144 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 50 mgCAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L 30 0,441666 0,120334 0,397499 0,164501
145 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,220833 0,001667 0,198749 0,023751
146 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 0,220833 0,148967 0,198749 0,171051
147 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,215000 0,000000 0,193500 0,021500
148 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,441666 0,245334 0,397499 0,289501
149 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUROCARD 50 mg/20 mg CAPS. 50mg/20 mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 1,079083 0,009917 0,971174 0,117826
150 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 mg/20 mg CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-6L 20 1,079083 0,130417 0,971174 0,238326
151 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 1,049333 0,000000 0,944399 0,104934
152 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6L 20 1,079083 0,086417 0,971174 0,194326
153 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. CU ELIB. PREL. P-6L 40 0,426199 0,155551 0,383579 0,198171
154 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,426199 0,104801 0,383579 0,147421
155 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0,426199 0,000001 0,383579 0,042621
156 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0,639299 0,062701 0,575369 0,126631
157 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 100 0,639299 0,039001 0,575369 0,102931
158 C04AD03 PENTOXIFYLLINUM VASONIT RETARD 600 mg COMPR. ELIB. PREL. 600mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL.
P-6L 50 0,639299 0,036501 0,575369 0,100431
159 C04AD03 PENTOXIFYLLINUM ANGIOPENT 400 mg COMPR. FILM. ELIB. PREL. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,318000 0,000000 0,286200 0,031800

Pagina 3 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
160 C04AD03 PENTOXIFYLLINUM OXIFLUX 400 mg COMPR. FILM. ELIB. PREL. 400mg LABORMED PHARMA S.A. ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 60 0,318166 0,000000 0,286349 0,031817
161 C04AD03 PENTOXIFYLLINUM ANGIOPENT 600 mg COMPR. FILM. ELIB. PREL. 600mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,639299 0,183701 0,575369 0,247631
162 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 10 mg COMPR. 10 mg BIO EEL S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 25 COMPR. P6L 50 0,025800 0,041600 0,023220 0,044180
163 C07AA05 PROPRANOLOLUM PROPRANOLOL 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,025800 0,056200 0,023220 0,058780
164 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,099600 0,000000 0,089640 0,009960
165 C07AA05 PROPRANOLOLUM PROPRANOLOL 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,099600 0,000000 0,089640 0,009960
166 C07AA05 PROPRANOLOLUM PROPRANOLOL ARENA 40 mg COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,103200 0,000000 0,092880 0,010320
167 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,412800 0,146000 0,371520 0,187280
168 C07AA07 SOTALOLUM SOTAGAMMA 80 COMPR. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 100 0,206400 0,130100 0,185760 0,150740
169 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,206400 0,120600 0,185760 0,141240
170 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,206400 0,311100 0,185760 0,331740
171 C07AB02 METOPROLOLUM BLOXAN COMPR. 100mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L 30 0,077000 0,000000 0,069300 0,007700
172 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218099 0,078234 0,196289 0,100044
173 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR.
P-6L 20 0,218099 0,078401 0,196289 0,100211
174 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218099 0,027901 0,196289 0,049711
175 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218099 0,078234 0,196289 0,100044
176 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218099 0,078234 0,196289 0,100044
177 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mg COMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,218099 0,078401 0,196289 0,100211
178 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,218099 0,024234 0,196289 0,046044
179 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,218099 0,072401 0,196289 0,094211
180 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
P-6L 30 0,218099 0,078234 0,196289 0,100044
181 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 100 mg COMPR. 100mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE
P6L 30 0,218099 0,078234 0,196289 0,100044
182 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR.
P-6L 20 0,054524 0,043976 0,049071 0,049429
183 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SAROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,054524 0,043976 0,049071 0,049429
184 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,054524 0,044142 0,049071 0,049595
185 C07AB02 METOPROLOLUM METOPROLOL ARENA 25 MG COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,054524 0,044142 0,049071 0,049595
186 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0,054524 0,043809 0,049071 0,049262
187 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109049 0,073284 0,098144 0,084189
188 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR.
P-6L 20 0,109049 0,073451 0,098144 0,084356
189 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109049 0,055284 0,098144 0,066189
190 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109049 0,073284 0,098144 0,084189
191 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109049 0,134951 0,098144 0,145856
192 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,109049 0,063451 0,098144 0,074356
193 C07AB02 METOPROLOLUM METOPROLOL ARENA 50 MG COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,109049 0,073284 0,098144 0,084189
194 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,109049 0,073451 0,098144 0,084356
195 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
P-6L 30 0,109049 0,042617 0,098144 0,053522
196 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 50 mg COMPR. 50mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE
P6L 30 0,109049 0,073284 0,098144 0,084189
197 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mgCOMPR. ELIB. MODIF. 190mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,414389 0,089611 0,372950 0,131050
198 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR. ELIB. MODIF. 47,5mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,103597 0,112069 0,093237 0,122429
199 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR. ELIB. MODIF. 95mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,207194 0,151139 0,186474 0,171859
200 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 0,218099 0,078401 0,196289 0,100211
201 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mgCOMPR. FILM. 100mg MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
AUROBINDO PHARMA (MALTA) LIMITED P6L 30 0,218099 0,078234 0,196289 0,100044
202 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
AUROBINDO PHARMA (MALTA) LIMITED P6L 30 0,109049 0,072284 0,098144 0,083189
203 C07AB02 METOPROLOLUM BETALOC (R) ZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL.P-6L 30 0,218099 0,237901 0,196289 0,259711
204 C07AB02 METOPROLOLUM BETALOC (R) ZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL.P-6L 30 0,109049 0,270951 0,098144 0,281856
205 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mgCOMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIACUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,414389 0,089611 0,372950 0,131050
206 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIACUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,103597 0,112069 0,093237 0,122429
207 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIACUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,207194 0,151139 0,186474 0,171859
208 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,365666 0,000000 0,329099 0,036567
209 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,365000 0,000000 0,328500 0,036500
210 C07AB03 ATENOLOLUM ATENOLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,324500 0,000000 0,292050 0,032450
211 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,204000 0,000000 0,183600 0,020400
212 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,204000 0,000000 0,183600 0,020400
213 C07AB03 ATENOLOLUM ATENOLOL ARENA 50 MG COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,185000 0,000000 0,166500 0,018500
214 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM.P-6L 28 0,327149 0,028922 0,294434 0,061637
215 C07AB07 BISOPROLOLUM BISOBLOCK 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,231000 0,000000 0,207900 0,023100

Pagina 4 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
216 C07AB07 BISOPROLOLUM BISOPROLOL LPH 5mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,163574 0,089092 0,147216 0,105450
217 C07AB07 BISOPROLOLUM BISOBLOCK 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,122333 0,000000 0,110099 0,012234
218 C07AB07 BISOPROLOLUM BOREZ 10 mg COMPR. FILM. 10 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,327149 0,035851 0,294434 0,068566
219 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,327149 0,555851 0,294434 0,588566
220 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 0,327149 0,174051 0,294434 0,206766
221 C07AB07 BISOPROLOLUM BISOTENS 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,327149 0,019517 0,294434 0,052232
222 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,327149 0,758184 0,294434 0,790899
223 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,327149 0,020184 0,294434 0,052899
224 C07AB07 BISOPROLOLUM BOREZ 2,5 mg COMPR. FILM. 2,5 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,081787 0,161546 0,073608 0,169725
225 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,081787 0,292546 0,073608 0,300725
226 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,081787 0,127213 0,073608 0,135392
227 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,163574 0,351426 0,147216 0,367784
228 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-6L 100 0,163574 0,005326 0,147216 0,021684
229 C07AB07 BISOPROLOLUM BISOTENS 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,163574 0,042759 0,147216 0,059117
230 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,163574 0,041759 0,147216 0,058117
231 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,163574 0,225759 0,147216 0,242117
232 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,163574 0,042759 0,147216 0,059117
233 C07AB07 BISOPROLOLUM BISOGAMMA 5 mg COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 100 0,149800 0,000000 0,134820 0,014980
234 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,246149 0,031184 0,221534 0,055799
235 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L.ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.P-6L 28 0,246149 0,588136 0,221534 0,612751
236 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,246149 0,013136 0,221534 0,037751
237 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
P-6L 30 0,246149 0,034851 0,221534 0,059466
238 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,246149 0,216184 0,221534 0,240799
239 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,246149 0,089851 0,221534 0,114466
240 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,246149 0,139184 0,221534 0,163799
241 C07AG02 CARVEDILOLUM MIOCARVIL 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,246149 0,216184 0,221534 0,240799
242 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,2 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,246149 0,205851 0,221534 0,230466
243 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L.ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.P-6L 28 0,492299 0,434486 0,443069 0,483716
244 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 0,355000 0,000000 0,319500 0,035500
245 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
P-6L 30 0,492299 0,031034 0,443069 0,080264
246 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,492299 0,109701 0,443069 0,158931
247 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,492299 0,031701 0,443069 0,080931
248 C07AG02 CARVEDILOLUM MIOCARVIL 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,492299 0,108701 0,443069 0,157931
249 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,492299 0,110201 0,443069 0,159431
250 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,317333 0,000000 0,285599 0,031734
251 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L.ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.P-6L 28 0,123074 0,266568 0,110766 0,278876
252 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,123074 0,075140 0,110766 0,087448
253 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
P-6L 30 0,123074 0,061926 0,110766 0,074234
254 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0,123074 0,115259 0,110766 0,127567
255 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,123074 0,104926 0,110766 0,117234
256 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,123074 0,061926 0,110766 0,074234
257 C07AG02 CARVEDILOLUM MIOCARVIL 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0,123074 0,115259 0,110766 0,127567
258 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,123074 0,057259 0,110766 0,069567
259 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg
COMPR. FILM. 12,5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,246149 0,010993 0,221534 0,035608
260 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,285714 0,000000 0,257142 0,028572
261 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg
COMPR. FILM. 6,25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,123074 0,056926 0,110766 0,069234
262 C08CA01 AMLODIPINUM AMLOHEXAL 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR.
P-6L 30 0,264299 0,029367 0,237869 0,055797
263 C08CA01 AMLODIPINUM TENOX (R) 10 COMPR. 10mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,264299 0,029367 0,237869 0,055797
264 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 10 mgCOMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P-6L 30 0,264299 0,029367 0,237869 0,055797
265 C08CA01 AMLODIPINUM ALMACOR 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,264299 0,029367 0,237869 0,055797
266 C08CA01 AMLODIPINUM AMLODIPINA LPH 10 mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,264299 0,029367 0,237869 0,055797
267 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,264299 0,029367 0,237869 0,055797
268 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0,264299 0,029367 0,237869 0,055797
269 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,255333 0,000000 0,229799 0,025534
270 C08CA01 AMLODIPINUM RECOTENS 10 mg COMPR. 10mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,264299 0,029367 0,237869 0,055797
271 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0,192500 0,000000 0,173250 0,019250

Pagina 5 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
272 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,264299 0,009034 0,237869 0,035464
273 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,264299 0,187701 0,237869 0,214131
274 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 10 mg COMPR. 10mg ROMANIA
A.C. HELCOR PHARMA S.R.L. CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,264299 0,029201 0,237869 0,055631
275 C08CA01 AMLODIPINUM AMLODIPINA ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,264299 0,029367 0,237869 0,055797
276 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 20 0,264299 0,029201 0,237869 0,055631
277 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,264299 0,029367 0,237869 0,055797
278 C08CA01 AMLODIPINUM AMLOHEXAL 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR.
P-6L 30 0,132149 0,238184 0,118934 0,251399
279 C08CA01 AMLODIPINUM TENOX (R) 5 COMPR. 5mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,132149 0,097517 0,118934 0,110732
280 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 5 mgCOMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P-6L 30 0,132149 0,096851 0,118934 0,110066
281 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,132149 0,098851 0,118934 0,112066
282 C08CA01 AMLODIPINUM AMLODIPINA LPH 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,132149 0,238184 0,118934 0,251399
283 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,132149 0,238184 0,118934 0,251399
284 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0,132149 0,238184 0,118934 0,251399
285 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,132149 0,049184 0,118934 0,062399
286 C08CA01 AMLODIPINUM RECOTENS 5 mg COMPR. 5mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,132149 0,131184 0,118934 0,144399
287 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0,121500 0,000000 0,109350 0,012150
288 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 5 mg COMPR. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,132149 0,003851 0,118934 0,017066
289 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,132149 0,437517 0,118934 0,450732
290 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 5 mg COMPR. 5mg ROMANIA
A.C. HELCOR PHARMA S.R.L. CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,132149 0,237851 0,118934 0,251066
291 C08CA01 AMLODIPINUM AMLODIPINA ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,132149 0,140517 0,118934 0,153732
292 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 20 0,132149 0,237851 0,118934 0,251066
293 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,132149 0,238184 0,118934 0,251399
294 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL.
P-6L 30 0,264299 1,030367 0,237869 1,056797
295 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 2,5mg ASTRAZENECA AB SUEDIA CUTIE 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL.P-6L 30 0,066074 0,703926 0,059466 0,710534
296 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X, 30 COMPR. ELIB. PREL.
P-6L 30 0,132149 0,712184 0,118934 0,725399
297 C08CA02 FELODIPINUM SISTAR 10 mg 10mg
COMPR. FILM. ELIB. MODIF. GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,264299 0,605367 0,237869 0,631797
298 C08CA02 FELODIPINUM SISTAR 5 mg 5mg
COMPR. FILM. ELIB. MODIF. GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,132149 0,416851 0,118934 0,430066
299 C08CA02 FELODIPINUM AURONAL 10 mg COMPR. FILM. ELIB. PREL. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0,264299 0,605367 0,237869 0,631797
300 C08CA02 FELODIPINUM FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL. 10mg HEXAL AG GERMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,264299 0,546034 0,237869 0,572464
301 C08CA02 FELODIPINUM AURONAL 2,5 mg COMPR. FILM. ELIB. PREL. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0,066074 0,434592 0,059466 0,441200
302 C08CA02 FELODIPINUM AURONAL 5 mg COMPR. FILM. ELIB. PREL. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0,132149 0,416851 0,118934 0,430066
303 C08CA02 FELODIPINUM FELODIPIN SANDOZ 5 mg COMPR. FILM. ELIB. PREL. 5mg HEXAL AG GERMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,132149 0,251517 0,118934 0,264732
304 C08CA05 NIFEDIPINUM ADALAT CR 30 COMPR. ELIB. MODIF. 30mg BAYER PHARMA AG GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L 28 0,132149 0,409993 0,118934 0,423208
305 C08CA05 NIFEDIPINUM NIFEDIPIN RETARD TERAPIA 20 mg COMPR. ELIB. PREL. 20mg TERAPIA SA ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 50 0,088099 0,135901 0,079289 0,144711
306 C08DA01 VERAPAMILUM VERAPAMIL ARENA 40 mg CAPS. 40mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,098816 0,016184 0,088934 0,026066
307 C08DA01 VERAPAMILUM VERAPAMIL ARENA 80 mg CAPS. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,197633 0,002700 0,177869 0,022464
308 C08DA01 VERAPAMILUM ISOPTIN RR COMPR. ELIB. PREL. 240mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,592899 0,235101 0,533609 0,294391
309 C08DA01 VERAPAMILUM ISOPTIN RR 240 mg COMPR. ELIB. PREL. 240mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,592899 0,235101 0,533609 0,294391
310 C08DA01 VERAPAMILUM CORDAMIL 40 mg COMPR. FILM. 40mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0,098816 0,012184 0,088934 0,022066
311 C08DA01 VERAPAMILUM CORDAMIL 80 mg COMPR. FILM. 80mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0,197633 0,000033 0,177869 0,019797
312 C08DA01 VERAPAMILUM VERAPAMIL 40 mg DRAJ. 40mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 0,098816 0,146384 0,088934 0,156266
313 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 40 mg DRAJ. 40mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE CU 2 BLIST. AL/PVC X 25 DRAJ. P6L 50 0,098816 0,146384 0,088934 0,156266
314 C08DA01 VERAPAMILUM VERAPAMIL 80 mg DRAJ. 80mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 0,197600 0,000000 0,177840 0,019760
315 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 80 mg DRAJ. 80mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE CU 2 BLIST. AL/PVC X 25 DRAJ. P6L 50 0,197600 0,000000 0,177840 0,019760
316 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 80 mg DRAJ. 80mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE CU 5 BLIST. AL/PVC X 10 DRAJ. P6L 50 0,197600 0,000000 0,177840 0,019760
317 C08DB01 DILTIAZEMUM DILTIAZEM SR ROMPHARM 180 mg CAPS. ELIB. PREL. 180mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 0,781541 0,411459 0,703386 0,489614
318 C08DB01 DILTIAZEMUM DILTIAZEM SR ROMPHARM 90 mg CAPS. ELIB. PREL. 90mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 7 CAPS. ELIB. PREL. P6L 21 0,227619 0,000000 0,204857 0,022762
319 C08DB01 DILTIAZEMUM DILTIAZEM EIPICO 60 mg COMPR. 60mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2, BLIST. AL/PVC X 10 COMPR. P-6L 20 0,260513 0,008987 0,234461 0,035039
320 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,260513 0,018987 0,234461 0,045039
321 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L 50 0,260513 0,017087 0,234461 0,043139
322 C08DB01 DILTIAZEMUM DILTIAZEM BIOEEL 60 mg COMPR. 60mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. DIN AL/ PVC X 10 COMPR. P-6L 20 0,260513 0,008987 0,234461 0,035039
323 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SAROMANIA CUTIE X 6 BLIST. DIN PVC/AL X 10 COMPRIMATEP-6L 60 0,260513 0,019153 0,234461 0,045205
324 C08DB01 DILTIAZEMUM DILZEM 90 mg RETARD COMPR. ELIB. PREL. 90mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL.
P-6L 30 0,350333 0,000000 0,315299 0,035034
325 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,037194 0,080472 0,033474 0,084192
326 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074388 0,067278 0,066949 0,074717
327 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,074388 0,076612 0,066949 0,084051

Pagina 6 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
328 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,074388 0,044112 0,066949 0,051551
329 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074388 0,043612 0,066949 0,051051
330 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074388 0,043612 0,066949 0,051051
331 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074388 0,080278 0,066949 0,087717
332 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,074388 0,044112 0,066949 0,051551
333 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,138000 0,000000 0,124200 0,013800
334 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148777 0,081889 0,133899 0,096767
335 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,148777 0,044723 0,133899 0,059601
336 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,138000 0,000000 0,124200 0,013800
337 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148777 0,006889 0,133899 0,021767
338 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,136000 0,000000 0,122400 0,013600
339 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,148777 0,050723 0,133899 0,065601
340 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,148777 0,050556 0,133899 0,065434
341 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 0,148777 0,050223 0,133899 0,065101
342 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,148777 0,050723 0,133899 0,065601
343 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0,148777 0,041723 0,133899 0,056601
344 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,148777 0,157651 0,133899 0,172529
345 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,148777 0,050556 0,133899 0,065434
346 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0,148777 0,050623 0,133899 0,065501
347 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0,148777 0,050423 0,133899 0,065301
348 C09AA02 ENALAPRILUM COMPR.
ENALAPRIL VIM SPECTRUM 10 mg 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0,148777 0,050723 0,133899 0,065601
349 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,148777 0,050223 0,133899 0,065101
350 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,148777 0,050723 0,133899 0,065601
351 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,297554 0,032946 0,267798 0,062702
352 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 0,297554 0,032946 0,267798 0,062702
353 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,297554 0,033112 0,267798 0,062868
354 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,297554 0,032946 0,267798 0,062702
355 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,297554 0,211374 0,267798 0,241130
356 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,297554 0,033112 0,267798 0,062868
357 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0,297554 0,033046 0,267798 0,062802
358 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,297554 0,032946 0,267798 0,062702
359 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,297554 0,032946 0,267798 0,062702
360 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,297554 0,032946 0,267798 0,062702
361 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,074388 0,018612 0,066949 0,026051
362 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,074388 0,019612 0,066949 0,027051
363 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,074388 0,069897 0,066949 0,077336
364 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,074388 0,018945 0,066949 0,026384
365 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 0,074388 0,018612 0,066949 0,026051
366 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074388 0,018945 0,066949 0,026384
367 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 5 mg COMPR. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,074388 0,015612 0,066949 0,023051
368 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,074388 0,015612 0,066949 0,023051
369 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0,074388 0,018612 0,066949 0,026051
370 C09AA02 ENALAPRILUM ENAP 1,25 mg/ml SOL. INJ./PERF. 1,25mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR/PRF 5 3,204000 0,000000 2,883600 0,320400
371 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,148777 0,369556 0,133899 0,384434
372 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,148777 0,388223 0,133899 0,403101
373 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,148777 0,121223 0,133899 0,136101
374 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148777 0,105556 0,133899 0,120434
375 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,148777 0,121223 0,133899 0,136101
376 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148777 0,264556 0,133899 0,279434
377 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,148777 0,237651 0,133899 0,252529
378 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,037194 0,273877 0,033474 0,277597
379 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,297554 0,501779 0,267798 0,531535
380 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,297554 0,484946 0,267798 0,514702
381 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,297554 0,081446 0,267798 0,111202
382 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,297554 0,081446 0,267798 0,111202
383 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,297554 0,514446 0,267798 0,544202

Pagina 7 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
384 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,297554 0,351374 0,267798 0,381130
385 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 0,297554 0,130946 0,267798 0,160702
386 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,595109 0,764224 0,535598 0,823735
387 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,074388 0,190278 0,066949 0,197717
388 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,074388 0,118278 0,066949 0,125717
389 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR.
ACTAVIS GROUP PTC EHF. P-6L 30 0,074388 0,118612 0,066949 0,126051
390 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
GEDEON RICHTER ROMANIA SA P-6L 28 0,074388 0,188826 0,066949 0,196265
391 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,238214 0,000000 0,214392 0,023822
392 C09AA05 RAMIPRILUM PIRAMIL 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 0,302142 0,000000 0,271927 0,030215
393 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,302000 0,000000 0,271800 0,030200
394 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,302000 0,000000 0,271800 0,030200
395 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,302142 0,000000 0,271927 0,030215
396 C09AA05 RAMIPRILUM TRITACE 10 COMPR. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,464285 0,000000 0,417856 0,046429
397 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,302142 0,000000 0,271927 0,030215
398 C09AA05 RAMIPRILUM AMPRIGEN 10 mg COMPR. 10mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.
P6L 30 0,302000 0,000000 0,271800 0,030200
399 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,302000 0,000000 0,271800 0,030200
400 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,302000 0,000000 0,271800 0,030200
401 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,464285 0,000000 0,417856 0,046429
402 C09AA05 RAMIPRILUM RAMIPRIL ATB 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,238333 0,000000 0,214499 0,023834
403 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 0,148777 0,000865 0,133899 0,015743
404 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 0,148777 0,023365 0,133899 0,038243
405 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148777 0,019556 0,133899 0,034434
406 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,148777 0,023223 0,133899 0,038101
407 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,148777 0,017294 0,133899 0,032172
408 C09AA05 RAMIPRILUM TRITACE(R) 2,5 COMPR. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,148777 0,115865 0,133899 0,130743
409 C09AA05 RAMIPRILUM AMPRIGEN 2,5 mg COMPR. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.
P6L 30 0,148777 0,023223 0,133899 0,038101
410 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,148777 0,023223 0,133899 0,038101
411 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,148777 0,023223 0,133899 0,038101
412 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,148777 0,115865 0,133899 0,130743
413 C09AA05 RAMIPRILUM RAMIPRIL ATB 2,5 mg COMPR. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,148777 0,000556 0,133899 0,015434
414 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,172142 0,000000 0,154927 0,017215
415 C09AA05 RAMIPRILUM PIRAMIL 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 0,248214 0,000000 0,223392 0,024822
416 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,248000 0,000000 0,223200 0,024800
417 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,248000 0,000000 0,223200 0,024800
418 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,239285 0,000000 0,215356 0,023929
419 C09AA05 RAMIPRILUM TRITACE 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,297554 0,084231 0,267798 0,113987
420 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,248214 0,000000 0,223392 0,024822
421 C09AA05 RAMIPRILUM AMPRIGEN 5 mg COMPR. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.
P6L 30 0,248000 0,000000 0,223200 0,024800
422 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,248000 0,000000 0,223200 0,024800
423 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,248000 0,000000 0,223200 0,024800
424 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,297554 0,084231 0,267798 0,113987
425 C09AA05 RAMIPRILUM RAMIPRIL ATB 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,172000 0,000000 0,154800 0,017200
426 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM.P-6L 30 0,099184 0,302482 0,089265 0,312401
427 C09AA06 QUINAPRILUM ACCUPRO (R) 20 COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,198369 0,378297 0,178532 0,398134
428 C09AA06 QUINAPRILUM ACCUPRO (R) 5 COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,049592 0,142408 0,044632 0,147368
429 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 0,099184 0,281482 0,089265 0,291401
430 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,099184 0,281482 0,089265 0,291401
431 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,099184 0,486173 0,089265 0,496092
432 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR. P-6L 30 0,198369 0,353631 0,178532 0,373468
433 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,198369 0,353631 0,178532 0,373468
434 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,198369 0,650559 0,178532 0,670396
435 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP HL COMPR. 10mg+12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,427000 0,000000 0,384300 0,042700
436 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP H COMPR. 10mg+25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,433590 0,033410 0,390231 0,076769
437 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP (R) HL 20 mg/12,5 mg COMPR. 20 mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0,412000 0,000000 0,370800 0,041200
438 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 5 mg/25mg COMPR. 5mg/25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 0,374285 0,000000 0,336856 0,037429
439 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 5 PLUS COMPR. 5mg/25mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,433590 0,092481 0,390231 0,135840

Pagina 8 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
440 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 5 PLUS COMPR. 5mg/25mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE CU BLIST. PVC/ AL X 28 COMPR. P6L 28 0,433590 0,092481 0,390231 0,135840
441 C09CA01 LOSARTANUM LODIAL 100mg COMPR. FILM. 100 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 2 BLIST. DIN PVC/AL X 15 COMPR. FILM. P6L 30 0,694285 0,530381 0,624856 0,599810
442 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 0,694285 0,423715 0,624856 0,493144
443 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0,694285 0,423715 0,624856 0,493144
444 C09CA01 LOSARTANUM LORISTA 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM.
P6L 28 0,517857 0,000000 0,466071 0,051786
445 C09CA01 LOSARTANUM LOSARTAN ZENTIVA 100 mg COMPR. FILM. 100mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,445333 0,000000 0,400799 0,044534
446 C09CA01 LOSARTANUM LODIAL 50mg COMPR. FILM. 50 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPR. FILM. P6L 30 0,334333 0,000000 0,300899 0,033434
447 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 0,334333 0,000000 0,300899 0,033434
448 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0,334333 0,000000 0,300899 0,033434
449 C09CA01 LOSARTANUM COZAAR 50 mg COMPR. FILM. 50mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,347142 0,167500 0,312427 0,202215
450 C09CA01 LOSARTANUM LORISTA 50 mg COMPR. FILM. 50mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,334642 0,000000 0,301177 0,033465
451 C09CA01 LOSARTANUM LOSARTAN ZENTIVA 50 mg COMPR. FILM. 50mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,268000 0,000000 0,241200 0,026800
452 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 10 mg COMPR. FILM. 10 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,121524 0,202761 0,109371 0,214914
453 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 10 mg COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,121524 0,025809 0,109371 0,037962
454 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,121524 0,082047 0,109371 0,094200
455 C10AA01 SIMVASTATINUM SINTENAL 10 mg COMPR. FILM. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,121524 0,190142 0,109371 0,202295
456 C10AA01 SIMVASTATINUM VASILIP 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,121524 0,202047 0,109371 0,214200
457 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,121524 0,202476 0,109371 0,214629
458 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 10 mg COMPR. FILM. 10mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,121524 0,020618 0,109371 0,032771
459 C10AA01 SIMVASTATINUM SIMVACARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,121524 0,027047 0,109371 0,039200
460 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 10 mgCOMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,121524 0,026476 0,109371 0,038629
461 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
P6L 30 0,121524 0,025809 0,109371 0,037962
462 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,121524 0,183142 0,109371 0,195295
463 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 20 mg COMPR. FILM. 20 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,243049 0,190165 0,218744 0,214470
464 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 20 mg COMPR. FILM. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,097617 0,218744 0,121922
465 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,243049 0,190165 0,218744 0,214470
466 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 0,243049 0,423379 0,218744 0,447684
467 C10AA01 SIMVASTATINUM SINTENAL 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,189951 0,218744 0,214256
468 C10AA01 SIMVASTATINUM VASILIP 20 mg COMPR. FILM. 20mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,243049 0,190165 0,218744 0,214470
469 C10AA01 SIMVASTATINUM SIMCOR 20 mg COMPR. FILM. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,189951 0,218744 0,214256
470 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,243049 0,189951 0,218744 0,214256
471 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 20 mg COMPR. FILM. 20mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,235000 0,000000 0,211500 0,023500
472 C10AA01 SIMVASTATINUM SIMVACARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,243049 0,002308 0,218744 0,026613
473 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mgCOMPR. FILM. 20mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,243049 0,002951 0,218744 0,027256
474 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
P6L 30 0,118666 0,000000 0,106799 0,011867
475 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
P6L 30 0,243049 0,189951 0,218744 0,214256
476 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 30 mg COMPR. FILM. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,364574 0,118759 0,328116 0,155217
477 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 40 mg COMPR. FILM. 40 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,486099 0,621043 0,437489 0,669653
478 C10AA01 SIMVASTATINUM VASILIP (R) 40 mg COMPR. FILM. 40mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 7 COMPR. FILM P-6L 28 0,486099 0,465329 0,437489 0,513939
479 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,486099 0,064258 0,437489 0,112868
480 C10AA01 SIMVASTATINUM SINTENAL 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,580234 0,437489 0,628844
481 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 40 mg COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,140567 0,437489 0,189177
482 C10AA01 SIMVASTATINUM SIMCOR 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,620234 0,437489 0,668844
483 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,486099 0,620234 0,437489 0,668844
484 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 40 mg COMPR. FILM. 40mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,323571 0,000000 0,291213 0,032358
485 C10AA01 SIMVASTATINUM SIMVACARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,337857 0,000000 0,304071 0,033786
486 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 40 mgCOMPR. FILM. 40mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,338000 0,000000 0,304200 0,033800
487 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
P6L 30 0,237333 0,000000 0,213599 0,023734
488 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
P6L 30 0,486099 0,405901 0,437489 0,454511
489 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 0,162033 0,362967 0,145829 0,379171
490 C10AA02 LOVASTATINUM LOVASTATINA ARENA 20 mg COMPR. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,162033 0,732633 0,145829 0,748837
491 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L 28 0,243049 0,589093 0,218744 0,613398
492 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR.P-6L 28 0,486099 0,829972 0,437489 0,878582
493 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,789000 0,000000 0,710100 0,078900
494 C10AB05 FENOFIBRATUM LIPIVIM CAPS. PULB. MICRONIZATA 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,881000 0,000000 0,792900 0,088100
495 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. CU ELIB. MOD. P-6L 30 0,986400 0,110600 0,887760 0,209240

Pagina 9 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
496 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. ELIB. MODIF. 160mg MYLAN MEDICAL SAS FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,986400 0,110600 0,887760 0,209240
497 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
LABORATOIRES FOURNIER S.A.S. 30 0,986400 0,109600 0,887760 0,208240
498 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg MYLAN MEDICAL SAS FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,986400 0,109600 0,887760 0,208240
499 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 4,633333 2,376667 4,169999 2,840001
500 D07AA02 HYDROCORTISONUM HIDROCORTIZON ATB 10mg/g UNGUENT 10mg/g ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB DIN AL X 20 G UNGUENT P-RF 1 7,670000 0,000000 6,903000 0,767000
501 D07AC01 BETAMETHASONUM EKARZIN 0,5MG/G CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 7,670000 0,000000 6,903000 0,767000
502 D07AC01 BETAMETHASONUM BETADERM 1 mg/g CREMA 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 3,512400 2,247600 3,161160 2,598840
503 D07AC01 BETAMETHASONUM BETADERM 1mg/g UNGUENT 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 3,512400 2,247600 3,161160 2,598840
504 G01AF04 MICONAZOLUM GYNOZOL 200 CAPS. VAG. 200mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI P-RF 6 1,031666 0,000000 0,928499 0,103167
505 G01AF04 MICONAZOLUM GYNOZOL 400 CAPS. VAG. 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI P-RF 3 1,976666 0,000000 1,778999 0,197667
506 G02AB03 ERGOMETRINUM MALEAT DE ERGOMETRINA ZENTIVA 0,2 mg/ml SOL. INJ. 0,2mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE P-RF 5 1,480000 0,000000 1,332000 0,148000
507 G03BA03 TESTOSTERONUM* UNDESTOR TESTOCAPS 40 mg CAPS. MOI 40mg N.V. ORGANON OLANDA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI P-RF 60 0,818333 0,000000 0,736499 0,081834
508 G03BA03 TESTOSTERONUM* ANDROGEL 50 mg GEL 50mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 30 PLICURI DIN FOLIE PET/AL/PE X 5 G GEL P-RF 30 4,574333 0,000000 4,116899 0,457434
509 G03BA03 TESTOSTERONUM* TESTIM 50 mg GEL TRANSDERMIC 50mg FERRING GMBH GERMANIACUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMIC PR/PRF 30 4,832083 0,773250 4,348874 1,256459
510 G03BA03 TESTOSTERONUM* NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER PHARMA AG GERMANIACUTIE CU 1 FIOLA DIN STICLA BRUNA, CU CAPACITATEA DE 5 ML A 4 ML SOL. INJ. S/P-RF 1 434,605000 0,765000 391,144500 44,225500
511 G03BA03 TESTOSTERONUM* NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER PHARMA AG GERMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 6 ML A 4 ML SOL. INJ. PR/PRF 1 434,350000 0,000000 390,915000 43,435000
512 G03CA03 ESTRADIOLUM* OESTROGEL 0,6 mg/g GEL 0,6mg/g LABORATOIRES BESINS INTERNATIONAL FRANTA CUTIE CU 1 TUB AL X 80 G GEL + DISPOZITIV DE DOZARE DIN POLISTIREN P-6L 1 8,423052 5,396948 7,580746 6,239254
513 G03CA03 ESTRADIOLUM* CLIMARA PLASTURE TRANSDERM. 50g/24ore BAYER PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM.P-6L 4 7,755000 0,000000 6,979500 0,775500
514 G03CA03 ESTRADIOLUM* LENZETTO 1,53 mg/doza 1,53mg/doza
SPRAY TRANSDERMIC, SOL. GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU UN FLAC. DIN STICLA CARE CONTINE 8,1 ML SOL., PREVAZUT CU O POMPA DOZATOARE P6L 1 15,035148 33,414852 13,531633 34,918367
515 G04CAN1 DOXAZOSINUM DOXAZOSIN ARENA 1 mg (vezi C02CA04) COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. DIN AL/PVC X 10 COMPR. P-6L 30 0,150224 0,809109 0,135201 0,824132
516 G04CAN1 DOXAZOSINUM DOXAZOSIN ARENA 1 mg (vezi C02CA04) COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. DIN AL/PVC X 10 COMPR. P-6L 30 0,150224 0,809109 0,135201 0,824132
517 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,300449 0,290217 0,270404 0,320262
518 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,300449 0,290217 0,270404 0,320262
519 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 0,600899 0,038101 0,540809 0,098191
520 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 0,600899 0,038101 0,540809 0,098191
521 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0,600899 0,382315 0,540809 0,442405
522 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0,600899 0,382315 0,540809 0,442405
523 H02AB04 METHYLPREDNISOLONUM* SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 16,565000 3,915000 14,908500 5,571500
524 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 125 mg 125mg
PULB+SOLV. PT. SOL. INJ./PERF. STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,282500 0,527500 7,454250 1,355750
525 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 500 mg 500mg
PULB+SOLV. PT. SOL. INJ./PERF. STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 MLS/P-RF 1 31,020000 0,000000 27,918000 3,102000
526 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,090333 0,046667 0,081299 0,055701
527 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,090333 0,000000 0,081299 0,009034
528 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,090333 0,033333 0,081299 0,042367
529 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,090333 0,043167 0,081299 0,052201
530 H02AB09 HYDROCORTISONUM* HYDROCORTISONE SUCCINAT SODIC 100mg
LIOF. + SOLV. PT. SOL. INJ. E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 3,527999 0,382001 3,175199 0,734801
531 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HF 500 mg 500mg
PULB. + SOLV. PT. SOL. INJ./PERF. STADA HEMOFARM S.R.L. ROMANIA PR/PRF
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV. 1 11,910000 0,000000 10,719000 1,191000
532 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HF 100 mg 100mg
PULB. SI SOLV. PT. SOL. INJ./PERF. STADA HEMOFARM S.R.L. ROMANIA PR/PRF
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. 1 3,527999 3,562001 3,175199 3,914801
533 H02AB09 HYDROCORTISONUM* HIDROCORTIZON ZENTIVA 19.6mg/5ml SOL. INJ. 19,6mg/5ml ZENTIVA S.A. ROMANIA S/P-RF
CUTIE CU 5 FIOLE DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 1 ML SOL. A + 5 FIOLE DIN STICLA BRUNA CU CAPACITATEA DE 5ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 4 ML SOL. B 5 0,923983 3,502017 0,831584 3,594416
534 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,376250 0,039750 0,338625 0,077375
535 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,363000 0,000000 0,326700 0,036300
536 J01AA02 DOXYCYCLINUM DOXICICLINA SANDOZ 100 mg CAPS. 100mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,361000 0,000000 0,324900 0,036100
537 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,308000 0,000000 0,277200 0,030800
538 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,314775 0,045225 0,283297 0,076703
539 J01CA04 AMOXICILLINUM OSPAMOX 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL-PVC/PVDC X 6 CAPS. P-RF/S 12 0,314775 0,055225 0,283297 0,086703
540 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,314775 0,004225 0,283297 0,035703
541 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,488729 0,118271 0,439856 0,167144
542 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRLROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,488729 0,103271 0,439856 0,152144
543 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRLROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0,440500 0,000000 0,396450 0,044050
544 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 0,488729 0,101271 0,439856 0,150144
545 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,488729 0,004271 0,439856 0,053144
546 J01CA04 AMOXICILLINUM OSPAMOX 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.P-RF 12 0,910000 0,000000 0,819000 0,091000
547 J01CA04 AMOXICILLINUM OSPAMOX 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM.
P-RF 12 0,488729 0,002937 0,439856 0,051810
548 J01CA04 AMOXICILLINUM DUOMOX 1000 mg 1000mg
COMPR. PT. DISPERSIE ORALA ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 0,975500 0,000000 0,877950 0,097550
549 J01CA04 AMOXICILLINUM DUOMOX 250 mg 250mg
COMPR. PT. DISPERSIE ORALA ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 0,314775 0,115225 0,283297 0,146703
550 J01CA04 AMOXICILLINUM DUOMOX 500 mg 500mg
COMPR. PT. DISPERSIE ORALA ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 0,488729 0,110771 0,439856 0,159644
551 J01CA04 AMOXICILLINUM DUOMOX 750 mg 750mg
COMPR. PT. DISPERSIE ORALA ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 0,733093 0,027907 0,659783 0,101217

Pagina 10 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
552 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 125 mg/5 ml SANDOZ S.R.L.
PULB. PT. SUSP. ORALA 125mg/5ml ROMANIA P-RF 1
CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE 1,888650 4,061350 1,699785 4,250215
553 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg/ 5 ml SANDOZ S.R.L.
PULB. PT. SUSP. ORALA 250mg/5ml ROMANIA P-RF 1
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 20 G PULB. PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE PE CU GRADATII PT. 1,25 ML, 2,5 ML, 5 ML 3,777300 1,232700 3,399570 1,610430
554 J01CA04 AMOXICILLINUM OSPAMOX 250 mg/5 ml SANDOZ GMBH
PULB. PT. SUSP. ORALA 250mg/5ml AUSTRIA CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 3,777300 1,212700 3,399570 1,590430
555 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1000 COMPR. FILM. 1000000ui
SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,299166 0,000000 0,269249 0,029917
556 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 1500 COMPR. FILM. 1500000ui
SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. P-RF 12 0,457031 0,070469 0,411327 0,116173
557 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 500 COMPR. FILM. 500000ui
SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,152343 0,073490 0,137108 0,088725
558 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA P-RF 1
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE 0,203124 8,716876 0,182811 8,737189
559 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. P-RF 1 4,970048 0,619952 4,473043 1,116957
560 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. S/P-RF 100 4,662700 0,000000 4,196430 0,466270
561 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,310790 0,057710 0,279711 0,088789
562 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,310790 0,080710 0,279711 0,111789
563 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,310790 0,089210 0,279711 0,120289
564 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,621580 0,156420 0,559422 0,218578
565 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,621580 0,021420 0,559422 0,083578
566 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRLROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,558500 0,000000 0,502650 0,055850
567 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,621580 0,108420 0,559422 0,170578
568 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,621580 0,128420 0,559422 0,190578
569 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 5,303075 0,226925 4,772767 0,757233
570 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 4,622300 0,000000 4,160070 0,462230
571 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 2,651537 2,448463 2,386383 2,713617
572 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 2,651537 1,668063 2,386383 1,933217
573 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN SR 1000 mg/62,5 mgCOMPR. ELIB. PREL. 1000mg/62,5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU BLIST. AL/PVC-AL-PP X 28 COMPR. ELIB. PREL. P-RF 28 1,160968 0,481889 1,044871 0,597986
574 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg COMPR. FILM. 1000mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM. P-RF 14 0,962142 0,000000 0,865927 0,096215
575 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 500 mg/125mg COMPR. FILM. 500 mg/125 mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM. P-RF 28 0,580484 0,010587 0,522435 0,068636
576 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500/125 mg COMPR. FILM. 500/125mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 0,580484 0,010230 0,522435 0,068279
577 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA BRITANIE P-RF 14
CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT 0,580484 0,328801 0,522435 0,386850
578 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM COMPR. FILM. 500mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM.
AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg P-RF 14 0,580484 0,010230 0,522435 0,068279
579 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 625 mg COMPR. FILM. 625mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 14 COMPR. FILM. P-RF 14 0,580484 0,010230 0,522435 0,068279
580 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 875 mg/125 mg COMPR. FILM. 875mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 0,962142 0,000000 0,865927 0,096215
581 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE P-RF 14
CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT 1,015847 0,463438 0,914262 0,565023
582 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM COMPR. FILM. 875mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM.
AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg P-RF 14 0,962142 0,000000 0,865927 0,096215
583 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg 1000mg SANDOZ S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE
COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 1,015847 0,842010 0,914262 0,943595
584 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg 625mg SANDOZ S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE
COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 0,580484 0,644516 0,522435 0,702565
585 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 156,25mg/5ml PULB. PT. SUSP. ORALA 156,25mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 MG PULB. PT. 100 ML SUSP. ORALA P-RF 1 6,699553 4,120447 6,029597 4,790403
586 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 35 ML SUSP.ORALA + SERINGA DOZATOARE 6,700000 0,000000 6,030000 0,670000
587 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE 13,410000 0,000000 12,069000 1,341000
588 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM PULB. PT. SUSP. ORALA 400mg/57mg/5ml AUROBINDO PHARMA (MALTA) LIMITED MALTA
AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml PRF 1
CUTIE CU 1 FLAC. PEID CARE CONTINE PULB. PT. SUSP. ORALA PT. OBTINEREA A 35 ML SUSP. RECONSTITUITA + 1 SERINGA DE POLISTIREN CU GRADATII LA INTERVALE DE 0,5 ML 6,700000 0,000000 6,030000 0,670000
589 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE P-RF 1
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALA 7,503500 2,816500 6,753150 3,566850
590 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE P-RF 1
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE 7,503500 2,816500 6,753150 3,566850
591 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE PRF 1
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA +LINGURITA DOZATOARE 7,503500 2,756500 6,753150 3,506850
592 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE P-RF 1
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE 15,007000 5,503000 13,506300 7,003700
593 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE PRF 1
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA +LINGURITA DOZATOARE 15,007000 5,503000 13,506300 7,003700
594 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN (R) ES PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE P-RF 1
CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CONTINND PULB. PENTRU 100 ML SUSPENSIE SI O LINGURITA DOZATOARE DIN POLISTIREN, MARCAT CU GRADATII PT. MASURAREA VOLUMELOR 2,5 ML SI 5,0 ML 32,157857 3,422143 28,942071 6,637929
595 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 312,5mg/5ml PULB. PT.SUSP. ORALA 312,5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE 13,399107 5,600893 12,059196 6,940804
596 J01DB01 CEFALEXINUM CEFALEXINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,467549 0,150451 0,420794 0,197206
597 J01DB01 CEFALEXINUM CEFALEXINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0,467549 0,155951 0,420794 0,202706
598 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 CAPS. P-RF 12 0,467549 0,149951 0,420794 0,196706
599 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 250 mg CAPSULE CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,467549 0,153451 0,420794 0,200206
600 J01DB01 CEFALEXINUM CEFALEXINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,935099 0,155901 0,841589 0,249411
601 J01DB01 CEFALEXINUM CEFALEXINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,934000 0,000000 0,840600 0,093400
602 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,935099 0,103901 0,841589 0,197411
603 J01DB01 CEFALEXINUM OSPEXIN 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 1,365000 0,000000 1,228500 0,136500
604 J01DB01 CEFALEXINUM OSPEXIN 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF 12 0,935099 0,092401 0,841589 0,185911
605 J01DB01 CEFALEXINUM KEFLEX (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA P-RF 1
CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE 5,307500 1,122500 4,776750 1,653250
606 J01DB01 CEFALEXINUM OSPEXIN (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33 G GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA PP P-RF 1 5,307500 1,842500 4,776750 2,373250
607 J01DB01 CEFALEXINUM GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL
CEFALEXIN SANDOZ 125 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA ROMANIA P-RF 1
CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE 5,307500 1,842500 4,776750 2,373250

Pagina 11 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
608 J01DB01 CEFALEXINUM KEFLEX (R) 250 mg/5 ml 250mg/5ml
GRAN. PT. SUSP. ORALA ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 10,615000 0,265000 9,553500 1,326500
609 J01DB01 CEFALEXINUM GRAN. PT. SUSP. ORALA
CEFALEXIN SANDOZ 250 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 9,820000 0,000000 8,838000 0,982000
610 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33G GRANULE PT. 60ML SUSP.+ LINGURITA DOZATOARE X 5ML P-RF 1 9,820000 0,000000 8,838000 0,982000
611 J01DB05 CEFADROXILUM CEXYL 250 mg CAPS. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,467549 1,456451 0,420794 1,503206
612 J01DB05 CEFADROXILUM CEXYL 500 mg CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,935099 0,460901 0,841589 0,554411
613 J01DB05 CEFADROXILUM CEFORAN 500 mg CAPS. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,935099 0,415901 0,841589 0,509411
614 J01DB05 CEFADROXILUM CEXYL 1000 mg COMPR. FILM. 1000mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/PVDC X 10. COMPR. FILM.P-RF 10 1,870199 0,842801 1,683179 1,029821
615 J01DB05 CEFADROXILUM CEXYL 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 5,307500 7,192500 4,776750 7,723250
616 J01DB05 CEFADROXILUM CEXYL 250 mg/5 ml GRAN. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 10,615000 0,955000 9,553500 2,016500
617 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 0,982800 0,109200 0,884520 0,207480
618 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 0,982800 0,109200 0,884520 0,207480
619 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 250 mg COMPR. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. PRF 10 0,982800 0,109200 0,884520 0,207480
620 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 1,863000 0,000000 1,676700 0,186300
621 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 1,863000 0,000000 1,676700 0,186300
622 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 500 mg COMPR. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. PRF 10 1,863000 0,000000 1,676700 0,186300
623 J01DC02 CEFUROXIMUM ZINNAT (R) 125 mg COMPR. FILM. 125mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 1,131000 0,000000 1,017900 0,113100
624 J01DC02 CEFUROXIMUM ZINNAT (R) 250 mg COMPR. FILM. 250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X, 10 COMPR.FILM P-RF 10 0,982800 0,698200 0,884520 0,796480
625 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 0,982800 0,109200 0,884520 0,207480
626 J01DC02 CEFUROXIMUM ZINNAT (R) 500 mg COMPR. FILM. 500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR.FILM P-RF 10 1,965600 0,900400 1,769040 1,096960
627 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 1,863000 0,000000 1,676700 0,186300
628 J01DC02 CEFUROXIMUM ZINNAT GRAN. PT. SUSP. ORALA 125mg/5ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA BRUNA CONTINAND GRANULE PT. 50 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 11,995000 8,145000 10,795500 9,344500
629 J01DC04 CEFACLORUM CEFACLOR ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,491400 1,081600 0,442260 1,130740
630 J01DC04 CEFACLORUM CLORACEF (R) 250 CAPS. 250mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 0,491400 0,896100 0,442260 0,945240
631 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250 mg CAPS. 250mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 0,491400 0,463933 0,442260 0,513073
632 J01DC04 CEFACLORUM CLORACEF (R) FORTE 500 CAPS. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 0,982800 0,782200 0,884520 0,880480
633 J01DC04 CEFACLORUM CEFACLOR ARENA 500 mg CAPS. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,982800 1,911200 0,884520 2,009480
634 J01DC04 CEFACLORUM CEFACLOR TERAPIA 500 mg CAPS. 500mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 0,982800 0,783200 0,884520 0,881480
635 J01DC04 CEFACLORUM CECLOR MR 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,982800 1,733200 0,884520 1,831480
636 J01DC04 CEFACLORUM CECLOR MR 750 mg COMPR. CU ELIB. PREL. 750mg ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1,474200 2,238800 1,326780 2,386220
637 J01DC04 CEFACLORUM CECLODYNE (R) MR 375 mg 375mg
COMPR. FILM. ELIB. MODIF. SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 0,737100 2,811900 0,663390 2,885610
638 J01DC04 CEFACLORUM CECLODYNE (R) MR 500 mg 500mg
COMPR. FILM. ELIB. MODIF. SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 0,982800 0,783200 0,884520 0,881480
639 J01DC04 CEFACLORUM CECLODYNE (R) MR 750 mg 750mg
COMPR. FILM. ELIB. MODIF. SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 1,474200 1,020800 1,326780 1,168220
640 J01DC04 CEFACLORUM CECLOR (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 8,996250 4,933750 8,096625 5,833375
641 J01DC04 CEFACLORUM CEFACLOR TERAPIA 125mg/5ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA P-RF 1 8,996250 0,063750 8,096625 0,963375
642 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250mg/5ml GRAN. PT. SUSP. ORALA 250 mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA P-RF 1 17,950000 0,000000 16,155000 1,795000
643 J01DC04 CEFACLORUM CECLOR (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 17,992500 9,617500 16,193250 11,416750
644 J01DC04 CEFACLORUM CLORACEF (R) 125 PULB. PT. SUSP. ORALA 125mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE P-RF 1 8,996250 0,063750 8,096625 0,963375
645 J01DC04 CEFACLORUM CEFAKLOR 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 7,197000 1,863000 6,477300 2,582700
646 J01DC04 CEFACLORUM CLORACEF (R) 250 PULB. PT. SUSP. ORALA 250mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE P-RF 1 17,940000 0,000000 16,146000 1,794000
647 J01DC04 CEFACLORUM CEFAKLOR 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 14,394000 2,136000 12,954600 3,575400
648 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 2,013300 0,223700 1,811970 0,425030
649 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,609000 0,000000 3,248100 0,360900
650 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE PRF 5 8,053200 1,966800 7,247880 2,772120
651 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF 10 8,053200 1,462800 7,247880 2,268120
652 J01DD08 CEFIXIMUM XIFIA 100 mg/5 ml 100mg/5ml
GRANULE PT. SUSP. ORALA INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPCITATEA DE 150 ML CARE CONTINE 53 G GRAN. PT. SUSP. ORALA+1 MASURA DOZATOARE DIN PP PT. MASURAREA VOLUMULUI DE SOLVENT GRADATA LA 66 ML+1 SERINGA DOZATOARE DIN PLASTIC A 5 ML, GRADATA DE LA 0,5 ML PANA LA 5 ML PRF 1 40,266000 34,354000 36,239400 38,380600
653 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,360750 0,039750 0,324675 0,075825
654 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,348000 0,000000 0,313200 0,034800
655 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,360750 0,004250 0,324675 0,040325
656 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,360750 0,039750 0,324675 0,075825
657 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML P-RF 1 4,710000 0,000000 4,239000 0,471000
658 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SUSP. ORALA 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 4,205531 5,654469 3,784977 6,075023
659 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,367500 0,000000 0,330750 0,036750
660 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,376617 0,045383 0,338955 0,083045
661 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,376617 0,120883 0,338955 0,158545
662 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL. PRF 7 1,883089 0,551196 1,694780 0,739505
663 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg BGP PRODUCTS LTD. MAREA BRITANIE CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 1,883089 1,864911 1,694780 2,053220

Pagina 12 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
664 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 0,941544 0,230598 0,847389 0,324753
665 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 0,941544 0,145598 0,847389 0,239753
666 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.
P-RF 14 0,941544 0,294170 0,847389 0,388325
667 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.
PRF 14 0,842142 0,000000 0,757927 0,084215
668 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM.
PRF 14 0,756428 0,000000 0,680785 0,075643
669 J01FA09 CLARITHROMYCINUM KLACID 250 mg COMPR. FILM. 250mg BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 0,941544 1,005598 0,847389 1,099753
670 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 1,883089 0,028339 1,694780 0,216648
671 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 1,883089 0,156196 1,694780 0,344505
672 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.
P-RF 14 1,883089 0,038339 1,694780 0,226648
673 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 1,849000 0,000000 1,664100 0,184900
674 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF
REPUBLICA CEHA 20 1,883089 0,472911 1,694780 0,661220
675 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.
PRF 14 1,883089 0,028339 1,694780 0,216648
676 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM.
PRF 14 1,642142 0,000000 1,477927 0,164215
677 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB. PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 1,883089 0,551196 1,694780 0,739505
678 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALAP-RF 1 12,820000 0,000000 11,538000 1,282000
679 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 14,488650 5,231350 13,039785 6,680215
680 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 24,147750 2,122250 21,732975 4,537025
681 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 28,977300 3,892700 26,079570 6,790430
682 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA PRF 1 28,977300 0,882700 26,079570 3,780430
683 J01FA09 CLARITHROMYCINUM KLACID I.V. PULB. PT. SOL. PERF. 500mg FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. PERF.
ABBOTT LABORATORIES LTD. S/P-RF 1 39,530000 0,000000 35,577000 3,953000
684 J01FA09 CLARITHROMYCINUM KLACID I.V. 500 mg PULB. PT. SOL. PERF. 500mg MYLAN MEDICAL SAS FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA I, DE CAPACITATE 15 ML CONTINAND PULB. PT. SOL. PERF. PRF 1 39,530000 0,000000 35,577000 3,953000
685 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,179000 0,000000 1,061100 0,117900
686 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,851200 1,103220 0,973780
687 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mgCOMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,245160 3,625840 0,220644 3,650356
688 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mgCOMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,245160 3,158840 0,220644 3,183356
689 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,612900 0,070100 0,551610 0,131390
690 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,612900 0,094100 0,551610 0,155390
691 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,612900 0,070100 0,551610 0,131390
692 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,612900 0,096100 0,551610 0,157390
693 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,612900 0,107100 0,551610 0,168390
694 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mgCOMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,612900 0,068100 0,551610 0,129390
695 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mgCOMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,612900 0,025100 0,551610 0,086390
696 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
PRF 10 0,612900 0,087100 0,551610 0,148390
697 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1,183000 0,000000 1,064700 0,118300
698 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,920000 0,000000 0,828000 0,092000
699 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,096200 1,103220 0,218780
700 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,145200 1,103220 0,267780
701 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,911000 0,000000 0,819900 0,091100
702 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,145200 1,103220 0,267780
703 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,957000 0,000000 0,861300 0,095700
704 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,852000 0,000000 0,766800 0,085200
705 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
PRF 10 0,844000 0,000000 0,759600 0,084400
706 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1,031000 0,000000 0,927900 0,103100
707 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mgCOMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,838700 2,032300 1,654830 2,216170
708 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 750 mg COMPR. FILM. 750mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
PRF 10 1,200000 0,000000 1,080000 0,120000
709 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER PHARMA AG GERMANIACUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,451600 10,102685 2,206440 10,347845
710 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER PHARMA AG GERMANIACUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 1,225800 8,327533 1,103220 8,450113
711 J01MA03 PEFLOXACINUM PEFLOXACIN LAROPHARM COMPR. FILM. 400mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 1,665200 1,103220 1,787780
712 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,809999 0,006001 0,728999 0,087001
713 J01MA06 NORFLOXACINUM NOLICIN 400 mg COMPR. FILM. 400mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,792000 0,000000 0,712800 0,079200
714 J01MA06 NORFLOXACINUM NORFLOXACIN HELCOR 400 mg COMPR. FILM. 400mg ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
A.C. HELCOR PHARMA S.R.L. P-RF 20 0,809999 0,070001 0,728999 0,151001
715 J01MA06 NORFLOXACINUM NORFLOXACINA ATB 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,809999 0,070001 0,728999 0,151001
716 J01MB02 ACIDUM NALIDIXICUM NALIXID 500 mg CAPS. 500mg ZENTIVA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 1,013000 0,000000 0,911700 0,101300
717 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,238666 0,000000 0,214799 0,023867
718 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,238666 0,000000 0,214799 0,023867
719 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,301762 0,065738 0,271585 0,095915

Pagina 13 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
720 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,301762 0,065738 0,271585 0,095915
721 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 8,667500 0,000000 7,800750 0,866750
722 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 8,953750 0,496250 8,058375 1,391625
723 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 8,499166 0,000000 7,649249 0,849917
724 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 8,953750 0,286250 8,058375 1,181625
725 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIACUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 10 4,476875 0,530125 4,029187 0,977813
726 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL. PERF.
S/P-RF 10 4,476875 0,530125 4,029187 0,977813
727 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL. PERF.
S/P-RF 20 4,476875 0,278625 4,029187 0,726313
728 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 3,027150 3,375350 2,724435 3,678065
729 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 2,178750 0,000000 1,960875 0,217875
730 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 3,027150 1,644278 2,724435 1,946993
731 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 3,027150 0,392850 2,724435 0,695565
732 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 4,540725 2,619275 4,086652 3,073348
733 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,540725 6,489275 4,086652 6,943348
734 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.P-RF 1 4,540725 2,619275 4,086652 3,073348
735 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150mg CAPS. 150mg SANDOZ SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. P-RF 1 4,540725 2,619275 4,086652 3,073348
736 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,540725 1,779275 4,086652 2,233348
737 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,540725 2,619275 4,086652 3,073348
738 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,540725 2,619275 4,086652 3,073348
739 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,540725 2,039275 4,086652 2,493348
740 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,540725 2,619275 4,086652 3,073348
741 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 4,540725 2,619275 4,086652 3,073348
742 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4,540725 2,619275 4,086652 3,073348
743 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4,540725 2,619275 4,086652 3,073348
744 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,540725 1,699275 4,086652 2,153348
745 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 1 CAPS. P-RF 1 4,540725 2,619275 4,086652 3,073348
746 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,540725 2,619275 4,086652 3,073348
747 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 5,834285 0,000000 5,250856 0,583429
748 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,513575 1,266425 1,362217 1,417783
749 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,513575 2,763567 1,362217 2,914925
750 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.P-RF 7 1,513575 1,266425 1,362217 1,417783
751 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50mg CAPS. 50mg SANDOZ SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. P-RF 7 1,513575 0,013567 1,362217 0,164925
752 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,513575 0,452139 1,362217 0,603497
753 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,513575 1,264996 1,362217 1,416354
754 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,513575 0,879282 1,362217 1,030640
755 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,513575 1,266425 1,362217 1,417783
756 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mgCAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,513575 0,196425 1,362217 0,347783
757 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA PRF 1 10,595025 18,974975 9,535522 20,034478
758 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 22,050000 25,400000 19,845000 27,605000
759 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,803362 0,245138 0,723025 0,325475
760 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,803362 0,307638 0,723025 0,387975
761 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,803362 0,267638 0,723025 0,347975
762 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,606725 0,413275 1,446052 0,573948
763 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,803362 0,086638 0,723025 0,166975
764 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR.P-RF 20 0,716500 0,000000 0,644850 0,071650
765 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,803362 0,090138 0,723025 0,170475
766 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,803362 0,090138 0,723025 0,170475
767 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR.P-RF 10 1,606725 1,151275 1,446052 1,311948
768 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 47,124000 0,000000 42,411600 4,712400
769 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 0,066599 0,017401 0,059939 0,024061
770 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MG CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,066599 0,007401 0,059939 0,014061
771 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,133199 0,050301 0,119879 0,063621
772 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ.
P-6L 6 0,326250 0,387083 0,293625 0,419708
773 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,326250 0,360750 0,293625 0,393375
774 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0,326250 0,357750 0,293625 0,390375
775 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL.
P-6L 20 0,399599 2,074901 0,359639 2,114861

Pagina 14 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
776 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,199799 0,381201 0,179819 0,401181
777 M01AB05 DICLOFENACUM DICLOTARD 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 0,266399 0,088101 0,239759 0,114741
778 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF.
P-6L 10 0,163000 0,000000 0,146700 0,016300
779 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIACUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL.
P-6L 10 0,266399 0,278601 0,239759 0,305241
780 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,266399 0,088101 0,239759 0,114741
781 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIACUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,133199 0,047301 0,119879 0,060621
782 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,117000 0,000000 0,105300 0,011700
783 M01AB05 DICLOFENACUM DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,117000 0,000000 0,105300 0,011700
784 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 0,133199 0,109801 0,119879 0,123121
785 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 0,066599 0,131067 0,059939 0,137727
786 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 0,117000 0,000000 0,105300 0,011700
787 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 0,117000 0,000000 0,105300 0,011700
788 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 MLP-RF 5 0,984600 0,697400 0,886140 0,795860
789 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 1,094000 0,000000 0,984600 0,109400
790 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 0,984600 0,109400 0,886140 0,207860
791 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF. P-RF 5 0,842000 0,000000 0,757800 0,084200
792 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0,570000 0,000000 0,513000 0,057000
793 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 0,652500 0,225500 0,587250 0,290750
794 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,570000 0,000000 0,513000 0,057000
795 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0,572000 0,000000 0,514800 0,057200
796 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 3 SUPOZITOARE P6L 6 0,081562 0,525104 0,073405 0,533261
797 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 5 SUPOZITOARE P6L 10 0,081562 0,519438 0,073405 0,527595
798 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 0,326250 0,633750 0,293625 0,666375
799 M01AB15 KETOROLACUM TROMETHAMIN KETOROL COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,088799 0,261201 0,079919 0,270081
800 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L 20 0,088799 0,437201 0,079919 0,446081
801 M01AB15 KETOROLACUM TROMETHAMIN KETANOV SOL. INJ. 30mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML P-RF 10 1,312800 1,254200 1,181520 1,385480
802 M01AB15 KETOROLACUM TROMETHAMIN KETOROL SOL. INJ. 30mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-RF 10 1,312800 0,721200 1,181520 0,852480
803 M01AB15 KETOROLACUM TROMETHAMIN KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml SOL. INJ. 30mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ. PRF 5 1,312800 0,721200 1,181520 0,852480
804 M01AB15 KETOROLACUM TROMETHAMIN KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml SOL. INJ. 30mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ. PRF 10 1,312800 0,721200 1,181520 0,852480
805 M01AB16 ACECLOFENACUM AFLAMIL 100mg COMPR. FILM. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR. P-6L 20 0,133199 0,602301 0,119879 0,615621
806 M01AB16 ACECLOFENACUM ACE-TAB 100 mg COMPR. FILM. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L 20 0,133199 0,345301 0,119879 0,358621
807 M01AB16 ACECLOFENACUM AFLAMIL 100 mg PULB. PT.SUSP. ORALA 100mg GEDEON RICHTER ROMANIA S.A. ROMANIA P6L
CUTIE CU 20 PLICURI UNIDOZA DIN MATERIAL COMPLEX DIN HARTIE DE TIP OPALINA LAMINATA PE UN STRAT DE ALUMINIU (20 M) SI FILM DIN PEJD 20 0,133199 1,204801 0,119879 1,218121
808 M01AC02 TENOXICAMUM TENOXICAM ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,324000 0,408000 0,291600 0,440400
809 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) COMPR. FILM. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 0,324000 0,334000 0,291600 0,366400
810 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) LIOF. + SOLV. PT. SOL. INJ. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF 1 1,964999 3,675001 1,768499 3,871501
811 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,324000 0,230000 0,291600 0,262400
812 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 0,324000 0,231000 0,291600 0,263400
813 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,324000 0,036000 0,291600 0,068400
814 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 15 mg COMPR. 15mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,324000 0,036000 0,291600 0,068400
815 M01AC06 MELOXICAMUM MELOXICAM MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,324000 0,036000 0,291600 0,068400
816 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 15 mg COMPR. 15mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,324000 0,036000 0,291600 0,068400
817 M01AC06 MELOXICAMUM Meloxicam Zentiva 15 mg comprimate COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,324000 0,026500 0,291600 0,058900
818 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0,324000 0,036000 0,291600 0,068400
819 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 0,162000 0,285000 0,145800 0,301200
820 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,162000 0,285000 0,145800 0,301200
821 M01AC06 MELOXICAMUM MELOXICAM LPH 7,5 mg COMPR. 7,5mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,162000 0,128500 0,145800 0,144700
822 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 7,5 mg COMPR. 7,5mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,162000 0,128500 0,145800 0,144700
823 M01AC06 MELOXICAMUM MELOXICAM MCC 7,5 mg COMPR. 7,5mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIAT. AL/PVC X 10 COMPR. P-6L 20 0,162000 0,128500 0,145800 0,144700
824 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 7,5 mg COMPR. 7,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,162000 0,128500 0,145800 0,144700
825 M01AC06 MELOXICAMUM MELOXICAM LPH 7,5 mg COMPR. 7,5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0,162000 0,128333 0,145800 0,144533
826 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA PRF
CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. 3 1,963333 0,000000 1,766999 0,196334
827 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA PRF
CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. 5 1,964000 0,000000 1,767600 0,196400
828 M01AC06 MELOXICAMUM MELOX 15 mg/1,5 ml SOL. INJ. 10mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC A 5 FIOLE TRANSPARENTE DIN STICLA CU CAPACITATEA DE 2 ML, CONTINAND 1,5 ML PRF 5 1,964999 0,001001 1,768499 0,197501
829 M01AC06 MELOXICAMUM MOVALIS 15mg/1,5ml SOL. INJ. 15mg/1,5ml BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIACUTIE X 5 FIOLE DIN STICLA INCOLORA X 1,5 ML SIL. INJ. P-RF 5 1,964999 1,059001 1,768499 1,255501
830 M01AC06 MELOXICAMUM MELOXICAM 15 mg SUPOZ. 15mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 0,759249 0,877417 0,683324 0,953342
831 M01AE03 KETOPROFENUM KETOPROFEN SR TERAPIA 100 MG CAPS. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 0,297000 0,000000 0,267300 0,029700

Pagina 15 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
832 M01AE03 KETOPROFENUM KETONAL (R) DUO 150 mg CAPS. ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 0,712800 0,133700 0,641520 0,204980
833 M01AE03 KETOPROFENUM KETOPROFEN SR TERAPIA 200 MG CAPS. ELIB. PREL. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 0,644000 0,000000 0,579600 0,064400
834 M01AE03 KETOPROFENUM KETONAL RETARD COMPR. ELIB. PREL. 150mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L 20 0,712800 0,066700 0,641520 0,137980
835 M01AE03 KETOPROFENUM PROFENID (R) 100 mg COMPR. FILM. 100mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM. P-6L 30 0,431333 0,000000 0,388199 0,043134
836 M01AE03 KETOPROFENUM KETOPROXIN 100 mg COMPR. FILM. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM.P-6L 20 0,280500 0,000000 0,252450 0,028050
837 M01AE03 KETOPROFENUM KETOPROXIN 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM.P-6L 20 0,237599 0,119901 0,213839 0,143661
838 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 5 1,138000 0,002000 1,024200 0,115800
839 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 10 1,136000 0,000000 1,022400 0,113600
840 M01AE03 KETOPROFENUM KETONAL 100 mg/ 2 ml SOL. INJ. 100mg/2ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF. P-RF 10 0,971000 0,000000 0,873900 0,097100
841 M01AE03 KETOPROFENUM KETOPROFEN TERAPIA 100MG/2ML 100mg/2ml
SOL. INJ./CONC. SOL. PERF. TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 1,138000 0,858000 1,024200 0,971800
842 M01AE03 KETOPROFENUM KETOMAG SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L 10 0,678000 0,000000 0,610200 0,067800
843 M04AA01 ALLOPURINOLUM* MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 0,151450 0,019350 0,136305 0,034495
844 M04AA01 ALLOPURINOLUM* MILURIT 300 mg COMPR. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 0,435000 0,000000 0,391500 0,043500
845 M04AC01 COLCHICINUM COLCHICINA COMPR. 1mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-RF 40 0,149500 0,000000 0,134550 0,014950
846 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,263832 0,035668 0,237448 0,062052
847 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,263832 0,134668 0,237448 0,161052
848 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,263832 0,203168 0,237448 0,229552
849 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,263832 0,121168 0,237448 0,147552
850 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,263832 0,020668 0,237448 0,047052
851 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,263832 0,134668 0,237448 0,161052
852 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,263832 0,119668 0,237448 0,146052
853 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0,527666 0,126000 0,474899 0,178767
854 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL.
P-RF 30 0,527666 0,102667 0,474899 0,155434
855 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,527000 0,000000 0,474300 0,052700
856 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,527666 0,000334 0,474899 0,053101
857 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,527000 0,000000 0,474300 0,052700
858 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,527666 0,000334 0,474899 0,053101
859 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,791500 0,326500 0,712350 0,405650
860 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL.
P-RF 30 0,791500 0,112833 0,712350 0,191983
861 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,791500 0,000500 0,712350 0,079650
862 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,791333 0,000000 0,712199 0,079134
863 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,791500 0,000500 0,712350 0,079650
864 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,791333 0,000000 0,712199 0,079134
865 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,055333 0,115333 0,949799 0,220867
866 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1,055000 0,000000 0,949500 0,105500
867 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,055333 0,000000 0,949799 0,105534
868 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1,055000 0,000000 0,949500 0,105500
869 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,055333 0,000000 0,949799 0,105534
870 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-RF 30 0,263832 0,066501 0,237448 0,092885
871 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 0,791500 0,493833 0,712350 0,572983
872 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1,055333 0,640667 0,949799 0,746201
873 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg 50mg
COMPR. ORODISPERSABILE ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 0,263832 0,134168 0,237448 0,160552
874 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg 50mg
COMPR. ORODISPERSABILE ZENTIVA, A.S. REPUBLICA SLOVACA PRF
CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE 10 0,263832 0,134168 0,237448 0,160552
875 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 5 1,580422 0,295578 1,422379 0,453621
876 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 1,396100 0,000000 1,256490 0,139610
877 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 0,790208 0,233792 0,711187 0,312813
878 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 1,580422 1,137578 1,422379 1,295621
879 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 1,158000 0,000000 1,042200 0,115800
880 N02CC01 SUMATRIPTANUM* IMIGRAN DR 100 mg COMPR. DISP. 100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 8,246250 8,653750 7,421625 9,478375
881 N02CC01 SUMATRIPTANUM* IMIGRAN DR 50 mg COMPR. DISP. 50mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 4,123125 4,391875 3,710812 4,804188
882 N02CC01 SUMATRIPTANUM* XIBIMER 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.
P-RF 6 8,246250 1,803750 7,421625 2,628375
883 N02CC01 SUMATRIPTANUM* SUMACTA 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 7,645000 0,000000 6,880500 0,764500
884 N02CC01 SUMATRIPTANUM* XIBIMER 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.
P-RF 6 4,123125 1,408541 3,710812 1,820854
885 N02CC01 SUMATRIPTANUM* SUMACTA 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 1,315000 0,000000 1,183500 0,131500
886 N03AF01 CARBAMAZEPINUM TEGRETOL (R) 200 COMPR. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P-6L 50 0,141800 0,076400 0,127620 0,090580
887 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH (R) 200 mg COMPR. 200mg LABORMED PHARMA SAROMANIA CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE P-6L/S 60 0,141800 0,000033 0,127620 0,014213

Pagina 16 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
888 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH 200 mg COMPR. 200mg LABORMED PHARMA SAROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,141800 0,000000 0,127620 0,014180
889 N03AF01 CARBAMAZEPINUM CARBAVIM COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,141800 0,000000 0,127620 0,014180
890 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,141800 0,000000 0,127620 0,014180
891 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,140000 0,000000 0,126000 0,014000
892 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,141800 0,000200 0,127620 0,014380
893 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mgCOMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,141800 0,000200 0,127620 0,014380
894 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA SLAVIA 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,141800 0,000000 0,127620 0,014180
895 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA TERAPIA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,141800 0,000000 0,127620 0,014180
896 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,283600 0,108600 0,255240 0,136960
897 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 400 mg COMPR. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,283600 0,108400 0,255240 0,136760
898 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 150 mg COMPR. CU ELIB. PRELUNGITA 150mg DESITIN ARZNEIMITTEL GMBH GERMANIACUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA P6L 50 0,106349 0,197451 0,095714 0,208086
899 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 300 mg 300mg
COMPR. CU ELIBERARE PRELUNGITA DESITIN ARZNEIMITTEL GMBH GERMANIACUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,212699 0,199901 0,191429 0,221171
900 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 600 mg 600mg
COMPR. CU ELIBERARE PRELUNGITA DESITIN ARZNEIMITTEL GMBH GERMANIACUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,425399 0,306201 0,382859 0,348741
901 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L 50 0,212699 0,143301 0,191429 0,164571
902 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P-6L 50 0,425399 0,260601 0,382859 0,303141
903 N03AF01 CARBAMAZEPINUM TEGRETOL CR 200 COMPR. FILM. ELIB. PREL. 200mg NOVARTIS PHARMA GMBH GERMANIACUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL.P-6L 50 0,141800 0,205600 0,127620 0,219780
904 N03AF01 CARBAMAZEPINUM TEGRETOL CR 400 COMPR. FILM. ELIB. PREL. 400mg NOVARTIS PHARMA GMBH GERMANIACUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL.P-6L 30 0,283600 0,320400 0,255240 0,348760
905 N03AF01 CARBAMAZEPINUM TIMONIL SIROP SUSP. ORALA 100mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIACUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 23,360000 0,000000 21,024000 2,336000
906 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,149200 0,000000 0,134280 0,014920
907 N03AX12 GABAPENTINUM GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,182859 0,011241 0,164573 0,029527
908 N03AX12 GABAPENTINUM GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,182859 0,393641 0,164573 0,411927
909 N03AX12 GABAPENTINUM GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,182859 0,224474 0,164573 0,242760
910 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,447800 0,000000 0,403020 0,044780
911 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,548582 0,207518 0,493723 0,262377
912 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,548582 0,798018 0,493723 0,852877
913 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,519700 0,000000 0,467730 0,051970
914 N03AX12 GABAPENTINUM GRIMODIN 300 mg CAPS. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,548582 0,026918 0,493723 0,081777
915 N03AX12 GABAPENTINUM GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,548582 0,348751 0,493723 0,403610
916 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,597600 0,000000 0,537840 0,059760
917 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,731445 0,461655 0,658300 0,534800
918 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,731445 0,777555 0,658300 0,850700
919 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,692500 0,000000 0,623250 0,069250
920 N03AX12 GABAPENTINUM GRIMODIN 400 mg CAPS. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,731445 0,297888 0,658300 0,371033
921 N03AX12 GABAPENTINUM GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,731445 0,390221 0,658300 0,463366
922 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 1,097168 1,082832 0,987451 1,192549
923 N03AX12 GABAPENTINUM GRIMODIN 600 mg COMPR. FILM. 600mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM.
P-6L 60 1,097168 0,770665 0,987451 0,880382
924 N03AX12 GABAPENTINUM GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 1,462891 2,142109 1,316601 2,288399
925 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,093037 0,074963 0,083733 0,084267
926 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,186074 0,080926 0,167466 0,099534
927 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATEPRF 30 0,372149 0,001184 0,334934 0,038399
928 N05AD01 HALOPERIDOLUM HALDOL COMPR. 5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,299600 0,000000 0,269640 0,029960
929 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF 1 3,721497 1,668503 3,349347 2,040653
930 N05AD01 HALOPERIDOLUM HALOPERIDOL - RICHTER 2mg/mlPIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 FLAC. PICURATOR DIN STICLA BRUNA X 10 ML PICATURI ORALE, SOLUTIE P-RF 1 3,721497 3,178503 3,349347 3,550653
931 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/ml SOL. INJ. 5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 5 2,206000 0,000000 1,985400 0,220600
932 N05BA01 DIAZEPAMUM DIAZEPAM RICHTER 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,103000 0,000000 0,092700 0,010300
933 N05BA01 DIAZEPAMUM DIAZEPAM COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 0,138666 0,000000 0,124799 0,013867
934 N05BA01 DIAZEPAMUM DIAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,108000 0,000000 0,097200 0,010800
935 N05BA01 DIAZEPAMUM DIAZEPAM 5 mg/ml SOL. INJ. 10mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 2,392000 0,000000 2,152800 0,239200
936 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 10 mg SOL. RECTALA 10mg/2,5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF 5 5,178000 0,000000 4,660200 0,517800
937 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 5 mg SOL. RECTALA 5mg/2,5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF 5 4,530000 0,000000 4,077000 0,453000
938 N05BA03 MEDAZEPAMUM* MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLISTERE PVC/AL X 10 COMPRIMATEP-RF 20 0,127000 0,000000 0,114300 0,012700
939 N05BA03 MEDAZEPAMUM* MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 5 BLISTERE PVC/AL X 10 COMPRIMATEP-RF 50 0,116400 0,000000 0,104760 0,011640
940 N05BA03 MEDAZEPAMUM* MEDAZEPAM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 20 COMPR. P-RF 20 0,131875 0,026125 0,118687 0,039313
941 N05BA03 MEDAZEPAMUM* MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,128000 0,000000 0,115200 0,012800
942 N05BA03 MEDAZEPAMUM* MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SAROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF/S 30 0,128000 0,000000 0,115200 0,012800
943 N05BA06 LORAZEPAMUM* ANXIAR (R) 1 mg COMPR. 1 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0,105500 0,033500 0,094950 0,044050

Pagina 17 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
944 N05BA08 BROMAZEPAMUM* BROMAZEPAM LPH 1,5 mg COMPR. 1,5mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,039562 0,071438 0,035605 0,075395
945 N05BA08 BROMAZEPAMUM* BROMAZEPAM LPH 1,5 mg COMPR. 1,5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 0,039562 0,071438 0,035605 0,075395
946 N05BA08 BROMAZEPAMUM* BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,079125 0,028875 0,071212 0,036788
947 N05BA08 BROMAZEPAMUM* BROMAZEPAM SLAVIA 3 mg COMPR. 3mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,079125 0,020875 0,071212 0,028788
948 N05BA08 BROMAZEPAMUM* BROMAZEPAM ARENA 3 mg COMPR. 3mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0,079125 0,028875 0,071212 0,036788
949 N05BA08 BROMAZEPAMUM* BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 0,079125 0,028875 0,071212 0,036788
950 N05BA12 ALPRAZOLAMUM* XANAX 0,25 mg COMPR. 0,25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,065937 0,126729 0,059343 0,133323
951 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 0,25 mg COMPR. 0,25mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,065937 0,059063 0,059343 0,065657
952 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 0,25 mg COMPR. 0,25mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,065937 0,058729 0,059343 0,065323
953 N05BA12 ALPRAZOLAMUM* PRAZOLEX (R) 0,25 mg COMPR. 0,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,065937 0,059396 0,059343 0,065990
954 N05BA12 ALPRAZOLAMUM* FRONTIN 0,25 mg COMPR. 0,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,065937 0,059396 0,059343 0,065990
955 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0,065937 0,059063 0,059343 0,065657
956 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,065937 0,059563 0,059343 0,066157
957 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,065937 0,059396 0,059343 0,065990
958 N05BA12 ALPRAZOLAMUM* XANAX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,131875 0,174791 0,118687 0,187979
959 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 0,5 mg COMPR. 0,5mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,131875 0,066791 0,118687 0,079979
960 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 0,5 mg COMPR. 0,5mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,131875 0,067125 0,118687 0,080313
961 N05BA12 ALPRAZOLAMUM* FRONTIN 0,5 mg COMPR. 0,5mg UNGARIA
EGIS PHARMACEUTICALS P.L.C. CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,131875 0,067458 0,118687 0,080646
962 N05BA12 ALPRAZOLAMUM* PRAZOLEX (R) 0,5 mg COMPR. 0,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,131875 0,067458 0,118687 0,080646
963 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0,131875 0,068125 0,118687 0,081313
964 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,131875 0,068625 0,118687 0,081813
965 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,131875 0,067458 0,118687 0,080646
966 N05BA12 ALPRAZOLAMUM* XANAX 1 mg COMPR. 1mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,263750 0,141916 0,237375 0,168291
967 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,263333 0,000000 0,236999 0,026334
968 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,263500 0,000000 0,237150 0,026350
969 N05BA12 ALPRAZOLAMUM* PRAZOLEX (R) 1 mg COMPR. 1mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,263750 0,000250 0,237375 0,026625
970 N05BA12 ALPRAZOLAMUM* FRONTIN 1mg COMPR. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,263750 0,000250 0,237375 0,026625
971 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0,263000 0,000000 0,236700 0,026300
972 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,263750 0,000750 0,237375 0,027125
973 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,263750 0,000250 0,237375 0,026625
974 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH (R) 2,5 mg COMPR. 2,5mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,046499 0,024501 0,041849 0,029151
975 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH 2,5 mg COMPR. 2.5mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,046499 0,024834 0,041849 0,029484
976 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,081500 0,000000 0,073350 0,008150
977 N05CD02 NITRAZEPAMUM NITRAZEPAM - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,092999 0,032001 0,083699 0,041301
978 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH 5 mg COMPR. 5mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,081666 0,000000 0,073499 0,008167
979 N05CF01 ZOPICLONUM* IMOVANE 7,5 mg COMPR. FILM. 7,5mg SANOFI AVENTIS FRANTA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. FILM. P-RF 20 0,363000 0,000000 0,326700 0,036300
980 N05CF02 ZOLPIDEMUM* SANVAL (R) 10 mg COMPR. FILM. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,225000 0,000000 0,202500 0,022500
981 N05CF02 ZOLPIDEMUM* SANVAL (R) 10 mg COMPR. FILM. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0,224000 0,000000 0,201600 0,022400
982 N05CF02 ZOLPIDEMUM* ZOLPIDEM ATB 10 MG COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,225000 0,000000 0,202500 0,022500
983 N05CF02 ZOLPIDEMUM* STILNOX 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 0,225000 0,120000 0,202500 0,142500
984 N05CF02 ZOLPIDEMUM* STILNOX 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 20 0,225000 0,120000 0,202500 0,142500
985 N05CF02 ZOLPIDEMUM* ZOLPIDEM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
PRF 10 0,225000 0,000000 0,202500 0,022500
986 N05CF02 ZOLPIDEMUM* STILNOX 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 0,225000 0,120000 0,202500 0,142500
987 N05CF02 ZOLPIDEMUM* STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 0,225000 0,120000 0,202500 0,142500
988 N05CF02 ZOLPIDEMUM* STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 20 0,225000 0,120000 0,202500 0,142500
989 N05CF02 ZOLPIDEMUM* STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L.ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 0,225000 0,120000 0,202500 0,142500
990 N06AA04 CLOMIPRAMINUM* ANAFRANIL (R) 10 mg DRAJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,145412 0,099588 0,130870 0,114130
991 N06AA04 CLOMIPRAMINUM* ANAFRANIL (R) 25 mg DRAJ. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,363532 0,097134 0,327178 0,133488
992 N06AA09 AMITRIPTYLINUM* AMITRIPTILINA ARENA 25 mg COMPR. FILM. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 50 0,311600 0,000000 0,280440 0,031160
993 N06AA12 DOXEPINUM* DOXEPIN 25 mg DRAJ. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,363532 0,396134 0,327178 0,432488
994 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,288562 0,407438 0,259705 0,436295
995 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,288562 0,362938 0,259705 0,391795
996 N06AB03 FLUOXETINUM* FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 CAPS. P-RF 14 0,577125 0,228589 0,519412 0,286302
997 N06AB03 FLUOXETINUM* FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS. P-RF 28 0,577125 0,210732 0,519412 0,268445
998 N06AB03 FLUOXETINUM* MAGRILAN 20 mg CAPS. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 0,422333 0,000000 0,380099 0,042234
999 N06AB03 FLUOXETINUM* ROFLUXIN 20 mg CAPS. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,577125 0,207375 0,519412 0,265088

Pagina 18 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
1.000 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,577125 0,223875 0,519412 0,281588
1.001 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,577125 0,143575 0,519412 0,201288
1.002 N06AB03 FLUOXETINUM* PROZAC 20 mg COMPR. DISP. 20mg ELI LILLY SA SPANIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 14 COMPR. DISP. P-RF 28 0,577125 0,737875 0,519412 0,795588
1.003 N06AB04 CITALOPRAMUM ** LINISAN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 0,246000 0,000000 0,221400 0,024600
1.004 N06AB04 CITALOPRAMUM ** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 0,577125 0,790875 0,519412 0,848588
1.005 N06AB05 PAROXETINUM* ARKETIS COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-RF 30 0,519666 0,000000 0,467699 0,051967
1.006 N06AB05 PAROXETINUM* PAROXETINA ATB 20 mg COMPR. FILM. 20 mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 0,577125 0,039875 0,519412 0,097588
1.007 N06AB05 PAROXETINUM* SEROXAT 20 mg COMPR. FILM. 20mg SMITHKLINE BEECHAM MAREA BRITANIE CUTIE CU 3 BLIST. PVC/AL-HARTIE X 10 COMPR. FILM. P-RF 30 0,577125 0,371541 0,519412 0,429254
1.008 N06AB05 PAROXETINUM* PAXETIN 20 mg COMPR. FILM. 20mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-RF 30 0,519666 0,000000 0,467699 0,051967
1.009 N06AB05 PAROXETINUM* PALUXETIL 40 mg COMPR. FILM. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR.FILM.P-RF 30 1,154250 0,071416 1,038825 0,186841
1.010 N06AB06 SERTRALINUM* SERLIFT 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 1,154250 0,128250 1,038825 0,243675
1.011 N06AB06 SERTRALINUM* ASENTRA (R) COMPR. FILM. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 1,076428 0,000000 0,968785 0,107643
1.012 N06AB06 SERTRALINUM* SETALOFT 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,719642 0,000000 0,647677 0,071965
1.013 N06AB06 SERTRALINUM* ZOLOFT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X BLISTERE DIN AL/PVC X 28 COMPRIMATE FILMATE P-RF 28 1,154250 0,818964 1,038825 0,934389
1.014 N06AB06 SERTRALINUM* ADJUVIN 100 mg COMPR. FILM. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 1,154250 0,108750 1,038825 0,224175
1.015 N06AB06 SERTRALINUM* STIMULOTON 100 mg COMPR. FILM. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 1,154250 0,128250 1,038825 0,243675
1.016 N06AB06 SERTRALINUM* SERTRALINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,154250 0,128083 1,038825 0,243508
1.017 N06AB06 SERTRALINUM* SERTRALINA AUROBINDO 100 mgCOMPR. FILM. 100mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,372333 0,000000 0,335099 0,037234
1.018 N06AB06 SERTRALINUM* SERLIFT 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 0,577125 0,147160 0,519412 0,204873
1.019 N06AB06 SERTRALINUM* ASENTRA (R) COMPR. FILM. 50mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 0,438571 0,000000 0,394713 0,043858
1.020 N06AB06 SERTRALINUM* SETALOFT 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,355000 0,000000 0,319500 0,035500
1.021 N06AB06 SERTRALINUM* ZOLOFT 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X BLIST. DIN AL/PVC X 28 COMPR. FILM. P-RF 28 0,577125 0,615732 0,519412 0,673445
1.022 N06AB06 SERTRALINUM* ADJUVIN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 0,577125 0,116875 0,519412 0,174588
1.023 N06AB06 SERTRALINUM* STIMULOTON 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-RF 30 0,533666 0,000000 0,480299 0,053367
1.024 N06AB06 SERTRALINUM* SERTRALINA ARENA 50 mg COMPR. FILM. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,577125 0,123875 0,519412 0,181588
1.025 N06AB06 SERTRALINUM* SERTRALINA AUROBINDO 50 mgCOMPR. FILM. 50mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,366666 0,000000 0,329999 0,036667
1.026 N06AB06 SERTRALINUM* ZOLOFT 20 mg/ml CONC. PT. SOL. ORALA 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA + 1 PIPETA GRADATA P-RF 1 13,850999 37,739001 12,465899 39,124101
1.027 N06AB08 FLUVOXAMINUM* FEVARIN 100mg COMPR. FILM. 100mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.P-RF 30 0,577125 0,539541 0,519412 0,597254
1.028 N06AB08 FLUVOXAMINUM* FEVARIN 50mg COMPR. FILM. 50mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.P-RF 30 0,288562 0,269771 0,259705 0,298628
1.029 N06AX11 MIRTAZAPINUM* REMERON SOLTAB 30 mg COMPR. DISP. 30mg NV ORGANON OLANDA CUTIE X 5 BLIST. AL/PVC-PA-POLIESTER PERFORAT PT. ELIB. UNEI UNIT. DOZATE X 6 COMPR. DISP. P-RF 30 0,490166 1,695167 0,441149 1,744184
1.030 N06AX11 MIRTAZAPINUM* MIRTAZAPIN ARENA 15 mg COMPR. FILM. 15mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0,245083 0,606583 0,220574 0,631092
1.031 N06AX11 MIRTAZAPINUM* MIRZATEN (R) 30 mg COMPR. FILM. 30mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,481666 0,000000 0,433499 0,048167
1.032 N06AX11 MIRTAZAPINUM* PHARMATAZ 30 mg COMPR. FILM. 30mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL, X 10 COMPR. FILM. P-RF 30 0,490166 0,327500 0,441149 0,376517
1.033 N06AX11 MIRTAZAPINUM* ESPRITAL (R) 30 COMPR. FILM. 30mg ZENTIVA KS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,481333 0,000000 0,433199 0,048134
1.034 N06AX11 MIRTAZAPINUM* MIRTAZAPIN ARENA 45 mg COMPR. FILM. 45mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0,735249 1,388417 0,661724 1,461942
1.035 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 15 mgCOMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 0,245083 0,605583 0,220574 0,630092
1.036 N06AX11 MIRTAZAPINUM* MIRZATEN Q-TAB 30 mg COMPR. ORODISPERSABILE 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 30 COMPR. ORODISPERSABILE P-RF 30 0,490166 0,004834 0,441149 0,053851
1.037 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 30 mgCOMPR. ORODISPERSABILE 30mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 0,490166 0,385500 0,441149 0,434517
1.038 N06AX11 MIRTAZAPINUM* ZULIN 30 mg COMPR. ORODISPERSABILE 30mg ANTIBIOTICE S.A. ROMANIA CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE P-RF 30 0,485333 0,000000 0,436799 0,048534
1.039 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 45 mgCOMPR. ORODISPERSABILE 45mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 0,735249 0,522751 0,661724 0,596276
1.040 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,838321 1,174536 0,754488 1,258369
1.041 N06AX16 VENLAFAXINUM ** ELIFY EP 150 mg CAPS. ELIB. PREL. 150 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF 30 0,838321 0,160012 0,754488 0,243845
1.042 N06AX16 VENLAFAXINUM ** IVRYX 150mg CAPS. ELIB. PREL. 150 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,838321 0,022393 0,754488 0,106226
1.043 N06AX16 VENLAFAXINUM ** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,838321 0,470250 0,754488 0,554083
1.044 N06AX16 VENLAFAXINUM ** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,554666 0,000000 0,499199 0,055467
1.045 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,838321 0,018107 0,754488 0,101940
1.046 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 150 mgCAPS. ELIB. PREL. 150mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,838321 0,470345 0,754488 0,554178
1.047 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 0,838321 0,470345 0,754488 0,554178
1.048 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,838321 0,470345 0,754488 0,554178
1.049 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,668333 0,000000 0,601499 0,066834
1.050 N06AX16 VENLAFAXINUM ** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,209580 0,386753 0,188622 0,407711
1.051 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 37,5 mgCAPS. ELIB. PREL. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,209580 0,622086 0,188622 0,643044
1.052 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,419160 0,899054 0,377244 0,940970
1.053 N06AX16 VENLAFAXINUM ** ELIFY EP 75 mg CAPS. ELIB. PREL. 75 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 0,419160 0,330173 0,377244 0,372089
1.054 N06AX16 VENLAFAXINUM ** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,391428 0,000000 0,352285 0,039143
1.055 N06AX16 VENLAFAXINUM ** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 0,419160 0,465840 0,377244 0,507756

Pagina 19 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
1.056 N06AX16 VENLAFAXINUM ** ALVENTA 75 mg 75mg
CAPS. ELIB. PREL. KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,326000 0,000000 0,293400 0,032600
1.057 N06AX16 VENLAFAXINUM ** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,419160 0,243506 0,377244 0,285422
1.058 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 75 mgCAPS. ELIB. PREL. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,419160 0,237268 0,377244 0,279184
1.059 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,419160 0,460173 0,377244 0,502089
1.060 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 75 mgCAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 0,419160 0,466173 0,377244 0,508089
1.061 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 75 mgCAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,419160 0,466173 0,377244 0,508089
1.062 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,392000 0,000000 0,352800 0,039200
1.063 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 37,5 mg COMPR. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR.
P-RF 30 0,209580 0,622086 0,188622 0,643044
1.064 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR.
P-RF 30 0,279440 0,567893 0,251496 0,595837
1.065 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 75 mg COMPR. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR.
P-RF 30 0,419160 0,460173 0,377244 0,502089
1.066 N06AX16 VENLAFAXINUM ** ARGOFAN 150 SR COMPR. ELIB. PREL. 150mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,665000 0,000000 0,598500 0,066500
1.067 N06AX16 VENLAFAXINUM ** ARGOFAN 75 SR COMPR. ELIB. PREL. 75mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,391000 0,000000 0,351900 0,039100
1.068 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SAROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,694624 0,017376 0,625161 0,086839
1.069 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SAROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. P-6L 60 0,688833 0,000000 0,619949 0,068884
1.070 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 0,603524 0,356476 0,543171 0,416829
1.071 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0,603524 0,316476 0,543171 0,376829
1.072 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 0,603524 0,356476 0,543171 0,416829
1.073 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0,603524 0,316476 0,543171 0,376829
1.074 P02CA03 ALBENDAZOLUM ALBENDAZOL VIM SPECTRUM 200 mg COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. P-RF 2 3,110000 0,000000 2,799000 0,311000
1.075 P02CA03 ALBENDAZOLUM ESKAZOLE COMPR. 400mg GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 12 BLIST. PVC-PVDC/AL X 1 COMPR. P-RF 12 6,198333 0,000000 5,578499 0,619834
1.076 P02CA03 ALBENDAZOLUM DUADOR 200 mg COMPR. FILM. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. X 2 COMPR. FILM. P-RF 2 3,110000 0,205000 2,799000 0,516000
1.077 P02CA03 ALBENDAZOLUM VERMIGAL NOVO 200 mg COMPR. FILM. 200mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC-PVDC TRANSPARENT X 2 COMPR. FILM. PRF 2 3,110000 0,205000 2,799000 0,516000
1.078 P02CA03 ALBENDAZOLUM ALBENDAZOL LPH 200 mg COMPR.FILM 200 mg LABORMED PHARMA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. FILM. P-RF 2 3,110000 0,210000 2,799000 0,521000
1.079 P02CA03 ALBENDAZOLUM ZENTEL 0,4 g/10 ml SUSP. ORALA 0,4g/10ml GLAXOSMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 1 FLACON UNIDOZA DIN PVC X 10 ML SUSP. ORALA P-RF 1 3,951000 1,999000 3,555900 2,394100
1.080 P02CA03 ALBENDAZOLUM VERMIGAL NOVO 400 mg/10 ml SUSP. ORALA 400mg/10ml BIOFARM S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA PRF 1 3,870000 0,000000 3,483000 0,387000
1.081 P02CE01 LEVAMISOLUM DECARIS 150 mg COMPR. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 COMPR. P-RF 1 3,540000 0,000000 3,186000 0,354000
1.082 P02CE01 LEVAMISOLUM LEVAMISOL ARENA 150 mg COMPR. 150mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 COMPR. P-RF 1 3,540000 0,000000 3,186000 0,354000
1.083 P02CE01 LEVAMISOLUM DECARIS 50 mg COMPR. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. P-RF 2 1,179988 0,385012 1,061989 0,503011
1.084 P02CE01 LEVAMISOLUM LEVAMISOL ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. P-RF 2 1,179988 0,385012 1,061989 0,503011
1.085 R03AC02 SALBUTAMOLUM VENTOLIN (R) SOL. INHAL. 5mg/ml GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FALC. DIN STICLA BRUNA X 10 ML SOL. DE INHAL. P-6L 1 1,616400 6,183600 1,454760 6,345240
1.086 R03AC02 SALBUTAMOLUM VENTOLIN 100 INHALER CFC-FREE SUSP. INHAL. PRESURIZATA 100mcg/doza GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE X 200 DOZE + DISPOZITIV DE ADMINISTRA P-RF 1 8,082000 2,808000 7,273800 3,616200
1.087 R03AC02 SALBUTAMOLUM ASTHALIN INHALER SUSP. INHAL. PRESURIZATA 100mcg/doza CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLAC. AL + VALVA DOZATOARE + DISP. ADM. X 200 DOZE SUSP. INHAL. PRESURIZATA P-6L 1 7,070000 0,000000 6,363000 0,707000
1.088 R03BA01 BECLOMETASONUM* CLENIL (R) JET 250 mcg SOL. INHALAT PRESURIZATA 250mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON PRESURIZAT DIN AL X 200 DOZE, PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM., "SPASER JET" CU CAPAC P-RF 1 101,960000 0,000000 91,764000 10,196000
1.089 R03BA02 BUDESONIDUM* FRENOLYN 200 PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA, X 1 INHALATOR X 100 DOZE P-RF 1 26,670000 0,000000 24,003000 2,667000
1.090 R03BA02 BUDESONIDUM* FRENOLYN 200 PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 200 DOZE P-RF 1 66,167500 11,652500 59,550750 18,269250
1.091 R03BA02 BUDESONIDUM* PULMICORT TURBUHALER 200 mcg/doza PULB. INHAL. 200mcg/doza ASTRAZENECA AB SUEDIA CUTIE X 1 FLACON MULTIDOZA DIN PEID X 100 DOZE PULB. INHAL. P-RF 1 33,083750 6,626250 29,775375 9,934625
1.092 R03BA02 BUDESONIDUM* FRENOLYN 400 PULB. INHAL. 400 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 100 DOZE P-RF 1 66,167500 21,192500 59,550750 27,809250
1.093 R03BA02 BUDESONIDUM* BUDIAIR 200 mcg SOL. DE INHALAT PRESURIZATA 200 mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA + VALVA DOZATOARE + DISPOZITIV DE ADMINISTRA P-RF 1 63,460000 0,000000 57,114000 6,346000
1.094 R03BA02 BUDESONIDUM* BUDIAIR 200 mcg JET SOL. DE INHALAT PRESURIZATA 200mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA = VALVA DOZATOARE + DISPOZITIV JET DE ACTION P-RF 1 66,167500 8,122500 59,550750 14,739250
1.095 R03BB01 IPRATROPII BROMIDUM* 20mcg/doza
IPRAVENT INHALER 20mcg/doza SUSP. INHAL. PRESURIZATA CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLACON AL PRESURIZAT X 200 DOZE SUSP.DE INHALAT PRESURIZATA P-6L 1 13,080000 0,000000 11,772000 1,308000
1.096 R03CC02 SALBUTAMOLUM SALBUTAMOL EIPICO 2mg/5ml SIROP 2mg/5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 125 ML SIROP P-6L 1 3,050000 0,000000 2,745000 0,305000
1.097 R03CC02 SALBUTAMOLUM VENTOLIN (R) SOL. INJ. 0,5mg/ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 5 FIOLE DIN STICLA X 1 ML P-6L 5 0,740000 0,000000 0,666000 0,074000
1.098 R03DA04 THEOPHYLLINUM TEOTARD (R) 200 mg CAPS. ELIB. PREL. 200mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.
P-RF 40 0,243500 0,000000 0,219150 0,024350
1.099 R03DA04 THEOPHYLLINUM TEOTARD (R) 350 mg CAPS. ELIB. PREL. 350mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.
P-RF 40 0,362500 0,000000 0,326250 0,036250
1.100 R03DX05 OMALIZUMABUM ** XOLAIR 150 mg SOL INJ. 150mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOLUTIE INJECTABILAPR/PRF 1 1.536,080000 0,000000 1.382,472000 153,608000
1.101 R03DX05 OMALIZUMABUM ** XOLAIR 75 mg SOL INJ. 75mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 0.5ML SOLUTIE INJECTABILA PR/PRF 1 789,875000 65,505000 710,887500 144,492500
1.102 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,169500 0,030833 0,152550 0,047783
1.103 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,169500 0,035700 0,152550 0,052650
1.104 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,151000 0,000000 0,135900 0,015100
1.105 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,169500 0,004000 0,152550 0,020950
1.106 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SAROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 0,165500 0,000000 0,148950 0,016550
1.107 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,169500 0,020000 0,152550 0,036950
1.108 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,169500 0,004000 0,152550 0,020950
1.109 R06AB04 CHLORPHENAMINUM CLORFENIRAMIN COMPR. 4mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,120000 0,000000 0,108000 0,012000
1.110 R06AE07 CETIRIZINUM CELERG COMPR. FILM. 10 mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 0,504900 0,593100 0,454410 0,643590
1.111 R06AE07 CETIRIZINUM LETIZEN (R) 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 0,504900 0,045100 0,454410 0,095590

Pagina 20 din 21
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
1.112 R06AE07 CETIRIZINUM CETIRIZINA LAROPHARM 10 mg COMPR. FILM. 10mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,504900 0,592100 0,454410 0,642590
1.113 R06AE07 CETIRIZINUM ZYRTEC 10 mg/ml 10mg/ml
PICATURI ORALE, SOL. UCB PHARMA GMBH GERMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA + PICURATOR DIN PEJD X 20 ML PIC. ORALE, SOL. P6L 1 10,098000 3,062000 9,088200 4,071800
1.114 R06AX17 KETOTIFENUM H - KETOTIFEN COMPR. 1mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,175250 0,007250 0,157725 0,024775
1.115 R06AX17 KETOTIFENUM KETOTIFEN COMPR. 1mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,175250 0,003250 0,157725 0,020775
1.116 R06AX17 KETOTIFENUM KETOTIFEN LAROPHARM 1 mg COMPR. 1mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,175250 0,003250 0,157725 0,020775
1.117 R06AX17 KETOTIFENUM KETOTIFEN LPH 1 mg COMPR. 1mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. PVC X 10 COMPR P6L 20 0,172000 0,000000 0,154800 0,017200
1.118 R06AX17 KETOTIFENUM KETOTIFEN LPH 1 mg COMPR. 1mg LABORMED PHARMA SAROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR P6L 30 0,172000 0,000000 0,154800 0,017200
1.119 R06AX17 KETOTIFENUM KETOF 1 mg/5 ml SIROP 1mg/5ml HEXAL AG GERMANIACUTIE X 1 FLACON X 100 ML SIROP + MASURA DOZATOARE P-6L 1 11,860000 0,000000 10,674000 1,186000
1.120 S01BC03 DICLOFENACUM DICLOFENAC ROMPHARM PIC. OFT.-SOL. 1mg/ml ROMPHARM COMPANY SRL ROMANIA FLACON PICURATOR DIN PEJD X 5 ML PIC. OFT., SOL. P-6L 1 8,678750 0,951250 7,810875 1,819125
1.121 S01BC03 DICLOFENACUM UNICLOPHEN (R) 0,1% PICATURI OFT.-SOL. 0,1% UNIMED PHARMA LTD. SLOVACIA CUTIE X 1 FLACON DIN PE X 10 ML PIC. OFTALMICE, SOL., PREVAZUT CU PICURATOR P-6L 1 11,650000 0,000000 10,485000 1,165000
1.122 S01BC03 DICLOFENACUM VOLTAREN OPHTHA CD PICATURI OFT.-SOL. 0,1% LABORATOIRES THEA FRANTA P-6L
CUTIE X 1 FLAC. PEJD X 5 ML PICATURI OFT.-SOL. + PICURATOR PEJD + CAPAC CU INEL DE SIGURANTA 1 8,678750 6,141250 7,810875 7,009125
1.123 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL PICATURI OFT.SUSP. 0,2g+0,5g/100ml THEA FARMA S.P.A. ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.,SUSP. + APLICATOR PT. PICURARE P-RF 1 13,940000 0,000000 12,546000 1,394000
1.124 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL UNG. OFT. 0,2g+0,5g/100g THEA FARMA S.P.A. ITALIA CUTIE X 1 TUB AL X 5 G P-RF 1 14,459999 1,560001 13,013999 3,006001

NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (*) se iniiaz de ctre medicul de specialitate n limita competenei i poate fi prescris n continuare de medicul de familie pe baza
scrisorii medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (1) se efectueaz pentru pacienii cu intoleran la acidum acetylsalicylicum.

Pagina 21 din 21
ANEXA 2b
SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE PERSONALA
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILA INCEPAND CU 01 APRILIE 2017

Val. maxima suportata Val. maxima suportata


Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)

1 A02BC02 PANTOPRAZOLUM SELTRAZ 40 mg COMPR. FILM. GASTROREZ. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. FILM. GASTROREZISTENTE P-6L 28 0,608214 0,000000 0,304107 0,304107 0,547392 0,060822
2 A02BC02 PANTOPRAZOLUM ZENCOPAN 20 mg COMPR. GASTROREZ. 20 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ. P6L 28 0,236785 0,000000 0,118392 0,118393 0,213106 0,023679
3 A02BC02 PANTOPRAZOLUM PANTEXEL 20 mg COMPR. GASTROREZ. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ P-6L 28 0,330714 0,000000 0,165357 0,165357 0,297642 0,033072
4 A02BC02 PANTOPRAZOLUM NOLPAZA 20 mg COMPR. GASTROREZ. 20mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L 30 0,273666 0,000000 0,136833 0,136833 0,246299 0,027367
5 A02BC02 PANTOPRAZOLUM AZATOL 20 mg COMPR. GASTROREZ. 20mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ. P6L 28 0,330714 0,000000 0,165357 0,165357 0,297642 0,033072
6 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 20 mg COMPR. GASTROREZ. 20mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0,330666 0,000000 0,165333 0,165333 0,297599 0,033067
7 A02BC02 PANTOPRAZOLUM PANTOPRAZOL MACLEODS 20 mg COMPR. GASTROREZ. 20mg MACLEODS PHARMA UK LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. GASTROREZ. P6L 28 0,330714 0,000000 0,165357 0,165357 0,297642 0,033072
8 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TORRENT 20 mg COMPR. GASTROREZ. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0,330666 0,000000 0,165333 0,165333 0,297599 0,033067
9 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 20 mg COMPR. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,212666 0,000000 0,106333 0,106333 0,191399 0,021267
10 A02BC02 PANTOPRAZOLUM CONTROLOC 20 mg COMPR. GASTROREZ. 20mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,508333 0,000000 0,254166 0,254167 0,457499 0,050834
11 A02BC02 PANTOPRAZOLUM ZENCOPAN 40 mg COMPR. GASTROREZ. 40 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ. P6L 28 0,430714 0,000000 0,215357 0,215357 0,387642 0,043072
12 A02BC02 PANTOPRAZOLUM PANTEXEL 40 mg COMPR. GASTROREZ. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ P-6L 28 0,608214 0,000000 0,304107 0,304107 0,547392 0,060822
13 A02BC02 PANTOPRAZOLUM NOLPAZA 40mg COMPR. GASTROREZ. 40mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L 30 0,576666 0,000000 0,288333 0,288333 0,518999 0,057667
14 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 40 mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L 10 0,609000 0,000000 0,304500 0,304500 0,548100 0,060900
15 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 40 mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L 30 0,608000 0,000000 0,304000 0,304000 0,547200 0,060800
16 A02BC02 PANTOPRAZOLUM PANTOPRAZOL MACLEODS 40 mg COMPR. GASTROREZ. 40mg MACLEODS PHARMA UK LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. GASTROREZ. P6L 28 0,608214 0,000000 0,304107 0,304107 0,547392 0,060822
17 A02BC02 PANTOPRAZOLUM PANTOPRAZOL ATB 40 mg COMPR. GASTROREZ. 40mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ. P6L 30 0,608000 0,000000 0,304000 0,304000 0,547200 0,060800
18 A02BC02 PANTOPRAZOLUM AZATOL 40 mg COMPR. GASTROREZ. 40mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ. P6L 28 0,608214 0,000000 0,304107 0,304107 0,547392 0,060822
19 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TORRENT 40 mg COMPR. GASTROREZ. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0,608000 0,000000 0,304000 0,304000 0,547200 0,060800
20 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 40 mg COMPR. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,387666 0,000000 0,193833 0,193833 0,348899 0,038767
21 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg COMPR. GASTROREZ. 40mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,935666 0,000000 0,467833 0,467833 0,842099 0,093567
22 A02BC02 PANTOPRAZOLUM GESOFLUX 20 mg COMPR. GASTROREZISTENTE 20mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L 30 0,177333 0,000000 0,088666 0,088667 0,159599 0,017734
23 A02BC02 PANTOPRAZOLUM GESOFLUX 40 mg COMPR. GASTROREZISTENTE 40mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L 30 0,246000 0,000000 0,123000 0,123000 0,221400 0,024600
24 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg PULB. PT. SOL. INJ. 40mg TAKEDA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, CU CAPSA DIN AL SI DOP DIN CAUCIUC A 40 MG CU PULB. PT. SOL. INJ. PRF 1 13,560000 0,000000 6,780000 6,780000 12,204000 1,356000
25 A02BC05 ESOMEPRAZOLUM EMANERA 20 mg CAPS. GASTROREZ. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ. P-6L 28 0,644285 0,000000 0,322142 0,322143 0,579856 0,064429
26 A02BC05 ESOMEPRAZOLUM HELIDES 20 mg CAPS. GASTROREZ. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P-6L 28 0,480000 0,000000 0,240000 0,240000 0,432000 0,048000
27 A02BC05 ESOMEPRAZOLUM EMANERA 40 mg CAPS. GASTROREZ. 40mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ. P-6L 28 1,038571 0,000000 0,519285 0,519286 0,934713 0,103858
28 A02BC05 ESOMEPRAZOLUM HELIDES 40 mg CAPS. GASTROREZ. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P-6L 28 0,878928 0,000000 0,439464 0,439464 0,791035 0,087893
29 A02BC05 ESOMEPRAZOLUM NEXIUM 20 mg COMPR. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTE P-6L 14 0,708274 0,809583 0,354137 1,163720 0,637446 0,880411
30 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SANDOZ 20 mg COMPR. GASTROREZ. 20mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ. P-6L 14 0,555000 0,000000 0,277500 0,277500 0,499500 0,055500
31 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 20 mg COMPR. GASTROREZ. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR. GASTROREZ. P6L 56 0,554642 0,000000 0,277321 0,277321 0,499177 0,055465
32 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 20 mg COMPR. GASTROREZ. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. GASTROREZ. P6L 90 0,536777 0,000000 0,268388 0,268389 0,483099 0,053678
33 A02BC05 ESOMEPRAZOLUM PRAGASTROL 20 mg COMPR. GASTROREZ. 20mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ. P6L 30 0,708274 0,011726 0,354137 0,365863 0,637446 0,082554
34 A02BC05 ESOMEPRAZOLUM NEXIUM 40 mg COMPR. GASTROREZ. 40mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTE P-6L 14 1,416549 0,714165 0,708274 1,422440 1,274894 0,855820
35 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SANDOZ 40 mg COMPR. GASTROREZ. 40mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ. P-6L 14 1,057857 0,000000 0,528928 0,528929 0,952071 0,105786
36 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 40 mg COMPR. GASTROREZ. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR. GASTROREZ. P6L 56 0,835000 0,000000 0,417500 0,417500 0,751500 0,083500
37 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 40 mg COMPR. GASTROREZ. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. GASTROREZ. P6L 90 0,793000 0,000000 0,396500 0,396500 0,713700 0,079300
38 A02BC05 ESOMEPRAZOLUM PRAGASTROL 40 mg COMPR. GASTROREZ. 40mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ. P6L 30 1,156000 0,000000 0,578000 0,578000 1,040400 0,115600
39 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZISTENTE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 0,708274 0,229583 0,354137 0,583720 0,637446 0,300411
40 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg COMPR. GASTROREZISTENTE 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 1,384285 0,000000 0,692142 0,692143 1,245856 0,138429
41 A02BC05 ESOMEPRAZOLUM NEXIUM 10 mg GRAN. GASTROREZ. PT. SUSP.ORALA 10mg ASTRAZENECA AB SUEDIA CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA P-6L 28 2,539642 0,000000 1,269821 1,269821 2,285677 0,253965
42 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SANDOZ 40 mg PULB. PT. SOL. INJ./PERF. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF. PRF 10 20,061000 0,000000 10,030500 10,030500 18,054900 2,006100
43 A02BX05 BISMUTHI OXIDE ULCAMED 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,320300 0,678533 0,160150 0,838683 0,288270 0,710563
44 A02BX05 BISMUTHI OXIDE ULCAMED 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,320300 0,678450 0,160150 0,838600 0,288270 0,710480
45 A03AB06 OTILONIUM BROMIDUM SPASMOMEN (R) COMPR. FILM. 40mg A. MENARINI IND. FARM. RIUNITE SRL ITALIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 1,103333 0,000000 0,551666 0,551667 0,992999 0,110334
46 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM. P-RF 12 2,519583 0,106250 1,259791 1,366042 2,267624 0,358209
47 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF 36 2,413333 0,000000 1,206666 1,206667 2,171999 0,241334
48 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFA WASSERMANN SPA ITALIA CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML P-RF 1 15,117513 4,692487 7,558756 12,251244 13,605761 6,204239
49 A07EA06 BUDESONIDUM ** # BUDENOFALK CAPS. GASTROREZ. 3mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ. P-RF 100 3,516900 0,000000 1,758450 1,758450 3,165210 0,351690
50 A07EA06 BUDESONIDUM ** # BUDENOFALK 2 mg/doza SPUMA RECTALA 2mg/doza DR. FALK PHARMA GMBH GERMANIA CUTIE X 1 FLAC. DIN AL X 14 DOZE X 1,2G SPUMA RECTALA, 14 APLICATOARE LUBREFIANTE PVC SI 14 PUNGI PL P-RF 1 303,800000 0,000000 151,900000 151,900000 273,420000 30,380000
51 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS. P-RF 20 2,076500 0,000000 1,038250 1,038250 1,868850 0,207650
52 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. PT. SOL. ORALA 10mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 16 PLICURI X 1 G P-RF 16 2,307000 0,353000 1,153500 1,506500 2,076300 0,583700
53 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. PT. SOL. ORALA 30mg LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 3 G P-RF 16 2,307000 0,230500 1,153500 1,384000 2,076300 0,461200
54 A08AB01 ORLISTATUM **1 XENICAL 120mg CAPS. 120mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 21 CAPS. TARI (BLISTER PVC/PE/PVDC)P-RF 21 2,029672 1,056518 1,014836 2,071354 1,826704 1,259486
55 A08AB01 ORLISTATUM **1 XENICAL 120mg CAPS. 120mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC)P-RF 84 1,677500 0,000000 0,838750 0,838750 1,509750 0,167750
56 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 0,543166 0,045834 0,271583 0,317417 0,488849 0,100151
57 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25g SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,543166 0,222500 0,271583 0,494083 0,488849 0,276817

Pagina 1 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
58 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI 30 P-RF 1,086333 0,000000 0,543166 0,543167 0,977699 0,108634
59 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5g SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 1,086333 0,047333 0,543166 0,590500 0,977699 0,155967
60 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOCTACID (R) 600 HR (vezi N07XN03) COMPR. FILM. 600mg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 100 COMPR. FILM. P-6L 100 1,899050 0,307050 0,949525 1,256575 1,709145 0,496955
61 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOCTACID (R) 600 HR (vezi N07XN03) COMPR. FILM. 600mg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 30 COMPR. FILM. P-6L 30 1,899050 0,468616 0,949525 1,418141 1,709145 0,658521
62 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOSSEN 600 (vezi N07XN03) COMPR. FILM. 600mg AAA - PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 30 1,592000 0,000000 0,796000 0,796000 1,432800 0,159200
63 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOCTACID 600T (vezi N07XN03) SOL. INJ. 25mg/ml MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 5 FIOLE X 24 ML SOL.INJ. S/P-RF 5 24,924000 0,000000 12,462000 12,462000 22,431600 2,492400
64 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE S/P-RF 10
CUTIE CU 10 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA 11,451000 0,000000 5,725500 5,725500 10,305900 1,145100
65 B01AB05 ENOXAPARINUM ** # CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti-Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ. PR/PRF 10 5,725500 0,701500 2,862750 3,564250 5,152950 1,274050
66 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI anti-Xa/0,2ml SOL. INJ. 2000UI anti-Xa/0,2ml SANOFI ROMANIA S.R.L. ROMANIA PR/PRF 10
CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,2 ML SOL INJ. 5,725500 0,701500 2,862750 3,564250 5,152950 1,274050
67 B01AB05 ENOXAPARINUM ** # CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti-Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ. PR/PRF 10 11,451000 0,209000 5,725500 5,934500 10,305900 1,354100
68 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI anti-Xa/0,4ml SOL. INJ. 4000UI anti-Xa/0,4ml SANOFI ROMANIA S.R.L. ROMANIA PR/PRF 10
CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,4 ML SOL INJ. 11,451000 0,209000 5,725500 5,934500 10,305900 1,354100
69 B01AB05 ENOXAPARINUM ** # CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti-Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. PR/PRF 10 14,988000 0,000000 7,494000 7,494000 13,489200 1,498800
70 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI anti-Xa/0,6ml SOL. INJ. 6000UIanti-Xa/0,6ml SANOFI ROMANIA S.R.L. ROMANIA PR/PRF 10
CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,6 ML SOL INJ. 14,988000 0,000000 7,494000 7,494000 13,489200 1,498800
71 B01AB05 ENOXAPARINUM ** # CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml LABORATOIRE AVENTIS FRANTA PR/PRF 6
CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. 19,778333 0,000000 9,889166 9,889167 17,800499 1,977834
72 B01AB05 ENOXAPARINUM ** # CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml SANOFI ROMANIA S.R.L. ROMANIA PR/PRF 6
CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. 19,778333 0,000000 9,889166 9,889167 17,800499 1,977834
73 B01AB06 NADROPARINUM ** # FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ. S/P-RF 10 5,725500 0,719500 2,862750 3,582250 5,152950 1,292050
74 B01AB06 NADROPARINUM ** # FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 7,633998 0,863002 3,816999 4,680001 6,870598 1,626402
75 B01AB06 NADROPARINUM ** # FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 11,451000 1,734000 5,725500 7,459500 10,305900 2,879100
76 B01AB06 NADROPARINUM ** # FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 15,267996 0,750004 7,633998 8,384002 13,741196 2,276804
77 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA PR/PRF 10
CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT IN AURIU SI CAPSA DE SIGURANTA DIN PP DE CULOARE PORTOCALIE 32,717138 20,093862 16,358569 36,452431 29,445424 23,365576
78 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE 20000 UI anti-Xa/ml LEO PHARMA A/S DANEMARCA PR/PRF 10
CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT CU LAC DE CULOARE VERDE SI CAPSA DE SIGURANTA DIN PP DE CULOARE VERDE INCHIS 65,434283 47,450717 32,717141 80,167859 58,890854 53,994146
79 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA PR/PRF 10
CUTIE CU 10 SERINGI PREUMPLUTE X 0.35 ML (3500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC VERDE 5,725500 6,602500 2,862750 9,465250 5,152950 7,175050
80 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA PR/PRF 10
CUTIE CU 10 SERINGI PREUMPLUTE X 0.45 ML (4500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU 7,361355 8,492645 3,680677 12,173323 6,625219 9,228781
81 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/mlLEO PHARMA A/S DANEMARCA PR/PRF 2
CUTIE CU 2 SERINGI PREUMPLUTE X 0,50 ML (10000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ROSU 8,179283 28,810717 4,089641 32,900359 7,361354 29,628646
82 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/mlLEO PHARMA A/S DANEMARCA PR/PRF 2
CUTIE CU 2 SERINGI PREUMPLUTE X 0,70 ML (14000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC GALBEN 22,902000 27,518000 11,451000 38,969000 20,611800 29,808200
83 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/mlLEO PHARMA A/S DANEMARCA PR/PRF 2
CUTIE CU 2 SERINGI PREUMPLUTE X 0,90 ML (18000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU 29,445427 30,329573 14,722713 45,052287 26,500884 33,274116
84 B01AB11 SULODEXIDUM ** VESSEL DUE F CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. PVDC-PVC/AL-PVDC X 25 CAPS. MOI P-RF 50 1,854700 0,209700 0,927350 1,137050 1,669230 0,395170
85 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P-RF 60 1,854700 0,209800 0,927350 1,137150 1,669230 0,395270
86 B01AB11 SULODEXIDUM ** COREFLUX 250 ULS CAPS. MOI 250ULS SANIENCE S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. MOI PRF 50 1,645000 0,000000 0,822500 0,822500 1,480500 0,164500
87 B01AB11 SULODEXIDUM ** COREFLUX 600 ULS/2 ml SOL INJ. 600ULS/2ml SANIENCE S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ.PRF 10 6,486000 0,000000 3,243000 3,243000 5,837400 0,648600
88 B01AB11 SULODEXIDUM ** VESSEL DUE F SOL. INJ. 600ULS/2ml ALFA WASSERMANN SPA ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML P-RF 10 6,841749 1,067251 3,420874 4,488126 6,157574 1,751426
89 B01AC04 CLOPIDOGRELUM ** PLAVIX 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 4,114800 5,227533 2,057400 7,284933 3,703320 5,639013
90 B01AC04 CLOPIDOGRELUM ** ZYLLT COMPR. FILM. 75 mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA/AL/PVC-AL X 28 COMPR. FILM. P-RF 28 0,460714 0,000000 0,230357 0,230357 0,414642 0,046072
91 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 COMPR. FILM. P-RF 30 0,581000 0,000000 0,290500 0,290500 0,522900 0,058100
92 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 90 COMPR. FILM. P-RF 90 0,562000 0,000000 0,281000 0,281000 0,505800 0,056200
93 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL MYLAN 75mg COMPR. FILM. 75mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM. P-RF 28 0,545714 0,000000 0,272857 0,272857 0,491142 0,054572
94 B01AC04 CLOPIDOGRELUM ** TROGRAN 75 mg COMPR. FILM. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 1,028700 0,078085 0,514350 0,592435 0,925830 0,180955
95 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL ACTAVIS 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,422142 0,000000 0,211071 0,211071 0,379927 0,042215
96 B01AC04 CLOPIDOGRELUM ** TESSYRON 75 mg COMPR. FILM. 75mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM. P-RF 30 0,688666 0,000000 0,344333 0,344333 0,619799 0,068867
97 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL DR. REDDY'S 75 mg COMPR. FILM. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 1,028700 0,077633 0,514350 0,591983 0,925830 0,180503
98 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 30 1,028700 0,077633 0,514350 0,591983 0,925830 0,180503
99 B01AC04 CLOPIDOGRELUM ** DEPLATT 75 mg COMPR. FILM. 75mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,919333 0,000000 0,459666 0,459667 0,827399 0,091934
100 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA P-RF
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 30 COMPRIMATE FILMATE 30 0,581000 0,000000 0,290500 0,290500 0,522900 0,058100
101 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA P-RF
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 90 COMPRIMATE FILMATE 90 0,562000 0,000000 0,281000 0,281000 0,505800 0,056200
102 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,593928 0,000000 0,296964 0,296964 0,534535 0,059393
103 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 1,028700 0,619157 0,514350 1,133507 0,925830 0,722027
104 B01AC18 TRIFLUSALUM PLATROX 300 mg CAPS. 300 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 5 BLIST. AL-PVC/PVDC X 10 CAPS. PRF 50 0,514350 0,183250 0,257175 0,440425 0,462915 0,234685
105 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 0,514350 0,558650 0,257175 0,815825 0,462915 0,610085
106 B01AC30 COMBINATII (ACID ACETYLSALICYLICUM+DIPYRIDAMOLUM) ** AGGRENOX 200mg/25mg CAPS. ELIB. MODIF. 25mg/200mg GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 60
CUTIE X 1 FLAC. DIN PP X 60 CAPS. CU ELIB.MODIF. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII +DESICAN 0,880833 0,000000 0,440416 0,440417 0,792749 0,088084
107 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg GERMANIA CUTIE X 3 BLIST. (AL/AL) X 10 CAPS. (30X1 BLISTER PERFORAT UNIDOZA ) P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 30 5,664666 0,000000 2,832333 2,832333 5,098199 0,566467
108 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg GERMANIA CUTIE X 6 BLIST. (AL/AL) X 10 CAPS. (60X1 BLISTER PERFORAT UNIDOZA ) P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 60 5,664666 0,000000 2,832333 2,832333 5,098199 0,566467
109 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. P-RF 10 11,170250 0,450750 5,585125 6,035875 10,053225 1,567775
110 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. P-RF 30 11,020000 0,000000 5,510000 5,510000 9,918000 1,102000
111 B01AF02 APIXABANUM ** ELIQUIS COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG MAREA BRITANIE CUTIE CU BLIST. PERFORATE DINPVC/PVDC/AL A 60 X 1 COMPR. FILM. PRF 60 5,387333 0,000000 2,693666 2,693667 4,848599 0,538734
112 B01AF02 APIXABANUM ** ELIQUIS COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 5,387333 0,000000 2,693666 2,693667 4,848599 0,538734
113 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 2,5mg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 2,5mg/0,5ml ASPEN PHARMA TRADING LIMITED IRLANDA P-RF 10
CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA 19,409000 0,000000 9,704500 9,704500 17,468100 1,940900
114 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 7,5mg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 7,5mg/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA P-RF 10
CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE 51,021874 7,498126 25,510937 33,009063 45,919686 12,600314
115 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 31,080000 0,000000 15,540000 15,540000 27,972000 3,108000
116 C01EB17 IVABRADINUM ** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 1,647120 2,345380 0,823560 3,168940 1,482408 2,510092
117 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,647120 0,793058 0,823560 1,616618 1,482408 0,957770
118 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA P6L 56
CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. 1,647120 0,793058 0,823560 1,616618 1,482408 0,957770
119 C01EB17 IVABRADINUM ** CORLENTOR 7,5mg COMPR. FILM. 7,5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 2,470680 1,385391 1,235340 2,620731 2,223612 1,632459
120 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 2,440178 0,000000 1,220089 1,220089 2,196160 0,244018

Pagina 2 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
121 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. P6L 56 2,440178 0,000000 1,220089 1,220089 2,196160 0,244018
122 C02AC05 MOXONIDINUM MOXOGAMMA 0,2 mg COMPR. FILM. 0,2mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,483666 0,000000 0,241833 0,241833 0,435299 0,048367
123 C02AC05 MOXONIDINUM MOXONIDINA MYLAN 0,2 mg COMPR. FILM. 0,2mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,383571 0,000000 0,191785 0,191786 0,345213 0,038358
124 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 mg COMPR. FILM. 0,2mg ABBOTT LABORATORIES GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,836034 0,243608 0,418017 0,661625 0,752430 0,327212
125 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 mg COMPR. FILM. 0,2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,836034 0,243608 0,418017 0,661625 0,752430 0,327212
126 C02AC05 MOXONIDINUM MOXOGAMMA 0,3 mg COMPR. FILM. 0,3mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,697000 0,000000 0,348500 0,348500 0,627300 0,069700
127 C02AC05 MOXONIDINUM MOXONIDINA MYLAN 0,3 mg COMPR. FILM. 0,3mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,575000 0,000000 0,287500 0,287500 0,517500 0,057500
128 C02AC05 MOXONIDINUM MOXOGAMMA 0,4 mg COMPR. FILM. 0,4mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,772000 0,000000 0,386000 0,386000 0,694800 0,077200
129 C02AC05 MOXONIDINUM MOXONIDINA MYLAN 0,4 mg COMPR. FILM. 0,4mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,928928 0,000000 0,464464 0,464464 0,836035 0,092893
130 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 mg COMPR. FILM. 0,4mg ABBOTT LABORATORIES GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 1,602857 0,000000 0,801428 0,801429 1,442571 0,160286
131 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 mg COMPR. FILM. 0,4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 1,602857 0,000000 0,801428 0,801429 1,442571 0,160286
132 C02AC06 RILMENIDINUM TENAXUM COMPR. 1mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 1,003000 0,000000 0,501500 0,501500 0,902700 0,100300
133 C03DA04 EPLERENONUM *# INSPRA 25 mg COMPR. FILM. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 3,016791 1,716875 1,508395 3,225271 2,715111 2,018555
134 C03DA04 EPLERENONUM *# INSPRA 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 4,889000 0,000000 2,444500 2,444500 4,400100 0,488900
135 C07AB12 NEBIVOLOLUM NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,647142 0,000000 0,323571 0,323571 0,582427 0,064715
136 C07AB12 NEBIVOLOLUM NEBIVOLOL ACTAVIS 5 mg COMPR. 5mg ACTAVIS S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,363000 0,000000 0,181500 0,181500 0,326700 0,036300
137 C07AB12 NEBIVOLOLUM X-PRESSOL 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P6L 30 0,420666 0,000000 0,210333 0,210333 0,378599 0,042067
138 C07AB12 NEBIVOLOLUM NOLET 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC- PE- PVDC/AL X 10 COMPR. P-6L 30 0,420666 0,000000 0,210333 0,210333 0,378599 0,042067
139 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P-6L 28 0,420357 0,000000 0,210178 0,210179 0,378321 0,042036
140 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,229000 0,000000 0,114500 0,114500 0,206100 0,022900
141 C07AB12 NEBIVOLOLUM NEBINORM 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,229000 0,000000 0,114500 0,114500 0,206100 0,022900
142 C07AB12 NEBIVOLOLUM NEBIVOLOL SANDOZ 5 mg COMPR. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,420357 0,000000 0,210178 0,210179 0,378321 0,042036
143 C07AB12 NEBIVOLOLUM NEBIVOLOL TERAPIA 5mg COMPR. 5mg TERAPIA S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L 28 0,420357 0,000000 0,210178 0,210179 0,378321 0,042036
144 C07AB12 NEBIVOLOLUM NEBIVOLOL TORRENT 5 mg COMPR. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L 30 0,420666 0,000000 0,210333 0,210333 0,378599 0,042067
145 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 0,722000 0,000000 0,361000 0,361000 0,649800 0,072200
146 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0,722000 0,000000 0,361000 0,361000 0,649800 0,072200
147 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 0,722000 0,000000 0,361000 0,361000 0,649800 0,072200
148 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0,722000 0,000000 0,361000 0,361000 0,649800 0,072200
149 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L 14 0,264299 0,397129 0,132149 0,529279 0,237869 0,423559
150 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 0,264299 0,165034 0,132149 0,297184 0,237869 0,191464
151 C08CA13 LERCANIDIPINUM LERIDIP COMPR. FILM. 10mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR.FILM. P-6L 60 0,264299 0,374867 0,132149 0,507017 0,237869 0,401297
152 C08CA13 LERCANIDIPINUM LERPIN 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-6L 50 0,264299 0,167101 0,132149 0,299251 0,237869 0,193531
153 C08CA13 LERCANIDIPINUM LERPIN 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 98 COMPR. FILM. P-6L 98 0,264299 0,153252 0,132149 0,285402 0,237869 0,179682
154 C08CA13 LERCANIDIPINUM PEGFEL 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVCDC/AL X 28 COMPR. FILM. P -6L 28 0,264299 0,164986 0,132149 0,297136 0,237869 0,191416
155 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L 30 0,264299 0,165034 0,132149 0,297184 0,237869 0,191464
156 C08CA13 LERCANIDIPINUM LERCANIDIPINA ZENTIVA 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L 30 0,264299 0,165034 0,132149 0,297184 0,237869 0,191464
157 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 0,528598 0,113402 0,264299 0,377701 0,475738 0,166262
158 C08CA13 LERCANIDIPINUM LERIDIP 20 COMPR. FILM. 20mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 0,528598 0,515402 0,264299 0,779701 0,475738 0,568262
159 C08CA13 LERCANIDIPINUM LERPIN 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-6L 50 0,528598 0,157402 0,264299 0,421701 0,475738 0,210262
160 C08CA13 LERCANIDIPINUM LERPIN 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 98 COMPR. FILM. P-6L 98 0,528598 0,117116 0,264299 0,381415 0,475738 0,169976
161 C08CA13 LERCANIDIPINUM PEGFEL 20 mg COMPR. FILM. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVCDC/AL X 28 COMPR. FILM. P -6L 28 0,528598 0,172473 0,264299 0,436772 0,475738 0,225333
162 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L 30 0,528598 0,113402 0,264299 0,377701 0,475738 0,166262
163 C09AA04 PERINDOPRILUM VIDOTIN 4 mg COMPR. 4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,297554 0,080112 0,148777 0,228889 0,267798 0,109868
164 C09AA04 PERINDOPRILUM STOPRESS 4 mg COMPR. 4mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L 30 0,297554 0,217112 0,148777 0,365889 0,267798 0,246868
165 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,297554 0,597112 0,148777 0,745889 0,267798 0,626868
166 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,297554 0,597112 0,148777 0,745889 0,267798 0,626868
167 C09AA04 PERINDOPRILUM PRENESSA 4 mg COMPR. 4mg KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 0,297554 0,190446 0,148777 0,339223 0,267798 0,220202
168 C09AA04 PERINDOPRILUM PRINDEX 4 mg COMPR. 4mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L 30 0,297554 0,097446 0,148777 0,246223 0,267798 0,127202
169 C09AA04 PERINDOPRILUM ERNYOM 4 mg COMPR. 4mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,297554 0,216112 0,148777 0,364889 0,267798 0,245868
170 C09AA04 PERINDOPRILUM VIDOTIN 8 mg COMPR. 8mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,595109 0,095224 0,297554 0,392779 0,535598 0,154735
171 C09AA04 PERINDOPRILUM STOPRESS 8 mg COMPR. 8mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L 30 0,595109 0,315557 0,297554 0,613112 0,535598 0,375068
172 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,595109 1,103891 0,297554 1,401446 0,535598 1,163402
173 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,595109 1,103891 0,297554 1,401446 0,535598 1,163402
174 C09AA04 PERINDOPRILUM PRINDEX 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L 30 0,595109 0,029557 0,297554 0,327112 0,535598 0,089068
175 C09AA04 PERINDOPRILUM PRENESSA 8 mg COMPR. 8mg KRKA POLSKA SP Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,595109 0,214891 0,297554 0,512446 0,535598 0,274402
176 C09AA04 PERINDOPRILUM ERNYOM 8 mg COMPR. 8mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,595109 0,164891 0,297554 0,462446 0,535598 0,224402
177 C09AA04 PERINDOPRILUM PRESTARIUM 10 mg COMPR. FILM. 10 mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,743887 0,951113 0,371943 1,323057 0,669498 1,025502
178 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,743887 0,121113 0,371943 0,493057 0,669498 0,195502
179 C09AA04 PERINDOPRILUM PRESTARIUM 5 mg COMPR. FILM. 5mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,371943 0,617723 0,185971 0,803695 0,334748 0,654918
180 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 5 mg COMPR. FILM. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,371943 0,271723 0,185971 0,457695 0,334748 0,308918
181 C09AA07 BENAZEPRILUM CIBACEN 10mg COMPR. FILM. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. TIP CALENDAR X 14 COMPR. FILM. P-6L 28 0,396739 0,183975 0,198369 0,382345 0,357065 0,223649
182 C09AA07 BENAZEPRILUM CIBACEN (R) 20 mg COMPR. FILM. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 0,793479 1,325092 0,396739 1,721832 0,714131 1,404440
183 C09AA07 BENAZEPRILUM CIBACEN (R) 5 mg COMPR. FILM. 5mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 0,198369 0,584845 0,099184 0,684030 0,178532 0,604682

Pagina 3 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
184 C09AA10 TRANDOLAPRILUM GOPTEN (R) 0,5 mg CAPS. 0,5mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0,074388 0,271612 0,037194 0,308806 0,066949 0,279051
185 C09AA10 TRANDOLAPRILUM GOPTEN 0,5 mg CAPS. 0,5mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0,074388 0,271612 0,037194 0,308806 0,066949 0,279051
186 C09AA10 TRANDOLAPRILUM GOPTEN (R) 2 mg CAPS. 2mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,297554 0,315303 0,148777 0,464080 0,267798 0,345059
187 C09AA10 TRANDOLAPRILUM GOPTEN 2 mg CAPS. 2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,297554 0,315303 0,148777 0,464080 0,267798 0,345059
188 C09AA10 TRANDOLAPRILUM GOPTEN (R) 4 mg CAPS. 4mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,595109 0,547391 0,297554 0,844946 0,535598 0,606902
189 C09AA10 TRANDOLAPRILUM GOPTEN 4 mg CAPS. 4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,595109 0,547391 0,297554 0,844946 0,535598 0,606902
190 C09AA15 ZOFENOPRILUM ZOMEN (R) 30 mg COMPR. FILM. 30mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,297554 1,251017 0,148777 1,399794 0,267798 1,280773
191 C09AA15 ZOFENOPRILUM ZOMEN (R) 7,5 mg COMPR. FILM. 7,5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,074388 0,655254 0,037194 0,692448 0,066949 0,662693
192 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 2 mg/0,625 mg COMPR. 2 mg/0,625 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR. P6L 30 0,543333 0,000000 0,271666 0,271667 0,488999 0,054334
193 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 2 mg/0,625 mg COMPR. 2 mg/0,625mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L 30 0,559333 0,000000 0,279666 0,279667 0,503399 0,055934
194 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg COMPR. 2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,372333 0,000000 0,186166 0,186167 0,335099 0,037234
195 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) DANURIT 2 mg/0,625 mg COMPR. 2mg/0,625mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,559333 0,000000 0,279666 0,279667 0,503399 0,055934
196 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 4 mg/1,25 mg COMPR. 4 mg/1,25 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR. P6L 30 0,837333 0,000000 0,418666 0,418667 0,753599 0,083734
197 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 4 mg/1,25mg COMPR. 4 mg/1,25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L 30 0,758000 0,000000 0,379000 0,379000 0,682200 0,075800
198 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg COMPR. 4mg/1,25mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,694000 0,000000 0,347000 0,347000 0,624600 0,069400
199 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) DANURIT 4 mg/1,25mg COMPR. 4mg/1,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,795000 0,000000 0,397500 0,397500 0,715500 0,079500
200 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg COMPR. 8mg/2,5mg KRKA-POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,867181 0,131152 0,433590 0,564743 0,780462 0,217871
201 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLITERAX 10 mg/2,5mg COMPR. FILM. 10mg/2,5mg LES LAB. SERVIER FRANTA CUTIE X 1 FLAC. DIN PP CU CAPAC PEJD CU SILICAGEL X 30 COMPR. FILM. P-6L 30 0,867181 0,908152 0,433590 1,341743 0,780462 0,994871
202 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG 2,5mg/0,625mg COMPR. FILM. 2,5mg/0,625mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 0,867181 0,461819 0,433590 0,895410 0,780462 0,548538
203 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 2,5 mg/0,625 mg COMPR. FILM. 2,5mg/0,625mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L 30 0,339333 0,000000 0,169666 0,169667 0,305399 0,033934
204 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG FORTE 5mg/1,25mg COMPR. FILM. 5mg/1,25mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 0,867181 0,300819 0,433590 0,734410 0,780462 0,387538
205 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 5 mg/1,25 mg COMPR. FILM. 5mg/1,25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L 30 0,679666 0,000000 0,339833 0,339833 0,611699 0,067967
206 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE COMPR. FILM. 10mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,536666 0,000000 0,268333 0,268333 0,482999 0,053667
207 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE FORTE COMPR. FILM. 20mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,867181 0,115819 0,433590 0,549410 0,780462 0,202538
208 C09BB02 COMBINATII (NITRENDIPINUM+ENALAPRILUM) ENEAS COMPR. 20mg+10mg GALENICA S.A. GRECIA CUTIE X 3 BLIST. PA-PVC-AL/AL X 10 COMPR. P-6L 30 2,927000 0,000000 1,463500 1,463500 2,634300 0,292700
209 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 4 mg/ 10 mg COMPR. 4mg/10 mg GEDEON RICHTER ROMNIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,731000 0,000000 0,365500 0,365500 0,657900 0,073100
210 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/10 mg COMPR. 4mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,732000 0,000000 0,366000 0,366000 0,658800 0,073200
211 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/5 mg COMPR. 4mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,475103 0,189897 0,237551 0,427449 0,427592 0,237408
212 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 4 mg/ 5 mg COMPR. 4mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,475103 0,135563 0,237551 0,373115 0,427592 0,183074
213 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/10 mg COMPR. 8mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,950207 0,233126 0,475103 0,708230 0,855186 0,328147
214 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 8 mg/ 10 mg COMPR. 8mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,950207 0,143793 0,475103 0,618897 0,855186 0,238814
215 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/5 mg COMPR. 8mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,686260 0,432740 0,343130 0,775870 0,617634 0,501366
216 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 8 mg/ 5 mg COMPR. 8mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,686260 0,239740 0,343130 0,582870 0,617634 0,308366
217 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg COMPR. CU ELIB. MODIF. 240mg/2mg ABBOTT GMBH & CO.KG GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,885624 0,169018 0,942812 1,111830 1,697061 0,357581
218 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg COMPR. CU ELIB. MODIF. 240mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,885624 0,169018 0,942812 1,111830 1,697061 0,357581
219 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg COMPR. CU ELIB. MODIF. 240mg/4mg ABBOTT GMBH & CO.KG GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,885624 0,799376 0,942812 1,742188 1,697061 0,987939
220 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg COMPR. CU ELIB. MODIF. 240mg/4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,885624 0,799376 0,942812 1,742188 1,697061 0,987939
221 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA COMPR. ELIB. MOD. 180mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. ELIB. MODIF. P-6L 28 1,829285 0,000000 0,914642 0,914643 1,646356 0,182929
222 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA COMPR.FILM.ELIB.MODIF. 180mg/2mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. FILM. CU ELIB. PREL. P-6L 28 1,829285 0,000000 0,914642 0,914643 1,646356 0,182929
223 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 4mg/10mg/1,25mg COMPR. 4mg/10mg/1,25mgKRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,967000 0,000000 0,483500 0,483500 0,870300 0,096700
224 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 4 mg/5mg/1,25 mg COMPR. 4mg/5mg/1,25mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,738326 0,151674 0,369163 0,520837 0,664493 0,225507
225 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 8 mg/10 mg/2,5 mg COMPR. 8mg/10mg/2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 1,252666 0,000000 0,626333 0,626333 1,127399 0,125267
226 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 8 mg/5 mg/2,5 mg COMPR. 8mg/5mg/2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 1,091706 0,050627 0,545853 0,596480 0,982535 0,159798
227 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 10mg/2,5mg/10mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,485121 0,659212 0,742560 1,401773 1,336608 0,807725
228 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 10mg/2,5mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,100174 0,938159 0,550087 1,488246 0,990156 1,048177
229 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 5mg/1,25mg/10mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,127506 0,301827 0,563753 0,865580 1,014755 0,414578
230 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 5mg/1,25mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 0,742560 0,570773 0,371280 0,942053 0,668304 0,645029
231 C09CA03 VALSARTANUM DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 1,388570 0,205358 0,694285 0,899643 1,249713 0,344215
232 C09CA03 VALSARTANUM AVASSAN 160 mg COMPR. FILM. 160mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,070357 0,000000 0,535178 0,535179 0,963321 0,107036
233 C09CA03 VALSARTANUM VALSARTAN TORRENT 160 mg COMPR. FILM. 160mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,462244 0,000000 0,231122 0,231122 0,416019 0,046225
234 C09CA03 VALSARTANUM VALSARTAN ZENTIVA 160 mg COMPR. FILM. 160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM. P-6L 28 0,561785 0,000000 0,280892 0,280893 0,505606 0,056179
235 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,772142 0,000000 0,386071 0,386071 0,694927 0,077215
236 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,772142 0,000000 0,386071 0,386071 0,694927 0,077215
237 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L 28 0,347142 2,221072 0,173571 2,394643 0,312427 2,255787
238 C09CA03 VALSARTANUM AVASSAN 40 mg COMPR. FILM. 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,347142 1,232500 0,173571 1,406071 0,312427 1,267215
239 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,347142 0,066072 0,173571 0,239643 0,312427 0,100787
240 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,347142 0,066072 0,173571 0,239643 0,312427 0,100787
241 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 0,694285 0,500715 0,347142 0,847858 0,624856 0,570144
242 C09CA03 VALSARTANUM VALSARTAN TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,292755 0,000000 0,146377 0,146378 0,263479 0,029276
243 C09CA03 VALSARTANUM VALSARTAN ZENTIVA 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM. P-6L 28 0,522857 0,000000 0,261428 0,261429 0,470571 0,052286
244 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,385714 0,000000 0,192857 0,192857 0,347142 0,038572
245 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,385714 0,000000 0,192857 0,192857 0,347142 0,038572
246 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA P-6L
CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) 1 4,165711 37,254289 2,082855 39,337145 3,749139 37,670861

Pagina 4 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
247 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,368571 0,000000 0,184285 0,184286 0,331713 0,036858
248 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,516071 0,000000 0,258035 0,258036 0,464463 0,051608
249 C09CA04 IRBESARTANUM IRBESARTAN GALENICA 150 mg COMPR. FILM. 150 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 0,368571 0,000000 0,184285 0,184286 0,331713 0,036858
250 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,694285 0,089286 0,347142 0,436429 0,624856 0,158715
251 C09CA04 IRBESARTANUM IRBESARTAN SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,616785 0,000000 0,308392 0,308393 0,555106 0,061679
252 C09CA04 IRBESARTANUM IRPRESTAN 150 mg COMPR. FILM. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 0,299333 0,000000 0,149666 0,149667 0,269399 0,029934
253 C09CA04 IRBESARTANUM IFIRMASTA 150 mg COMPR. FILM. 150mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,537500 0,000000 0,268750 0,268750 0,483750 0,053750
254 C09CA04 IRBESARTANUM IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,597500 0,000000 0,298750 0,298750 0,537750 0,059750
255 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,567500 0,000000 0,283750 0,283750 0,510750 0,056750
256 C09CA04 IRBESARTANUM IRBESARTAN HF 150 mg COMPR. FILM. 150mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,694285 0,065715 0,347142 0,412858 0,624856 0,135144
257 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,694285 0,511429 0,347142 0,858572 0,624856 0,580858
258 C09CA04 IRBESARTANUM ATOKKEN 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,694285 0,089286 0,347142 0,436429 0,624856 0,158715
259 C09CA04 IRBESARTANUM IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,597500 0,000000 0,298750 0,298750 0,537750 0,059750
260 C09CA04 IRBESARTANUM IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,812142 0,000000 0,406071 0,406071 0,730927 0,081215
261 C09CA04 IRBESARTANUM IRBESARTAN GALENICA 300 mg COMPR. FILM. 300 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 0,576785 0,000000 0,288392 0,288393 0,519106 0,057679
262 C09CA04 IRBESARTANUM IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,812142 0,000000 0,406071 0,406071 0,730927 0,081215
263 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 300 mg COMPR. FILM. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 1,075357 0,000000 0,537678 0,537679 0,967821 0,107536
264 C09CA04 IRBESARTANUM IRBESARTAN SANDOZ 300 mg COMPR. FILM. 300mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,802500 0,000000 0,401250 0,401250 0,722250 0,080250
265 C09CA04 IRBESARTANUM IFIRMASTA 300mg COMPR. FILM. 300mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,863571 0,000000 0,431785 0,431786 0,777213 0,086358
266 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,887142 0,000000 0,443571 0,443571 0,798427 0,088715
267 C09CA04 IRBESARTANUM IRBESARTAN HF 300 mg COMPR. FILM. 300mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,036000 0,000000 0,518000 0,518000 0,932400 0,103600
268 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 1,388570 0,212144 0,694285 0,906429 1,249713 0,351001
269 C09CA04 IRBESARTANUM ATOKKEN 300 mg COMPR. FILM. 300mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 1,075357 0,000000 0,537678 0,537679 0,967821 0,107536
270 C09CA04 IRBESARTANUM ATOKKEN 75 mg COMPR. FILM. 75mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,347142 0,509286 0,173571 0,682857 0,312427 0,544001
271 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 1,062500 0,000000 0,531250 0,531250 0,956250 0,106250
272 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P-6L 28 0,998928 0,000000 0,499464 0,499464 0,899035 0,099893
273 C09CA06 CANDESARTANUM CILEXETIL KARBIS 16 mg COMPR. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 1,062000 0,000000 0,531000 0,531000 0,955800 0,106200
274 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN TORRENT 16 mg COMPR. 16mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,700000 0,000000 0,350000 0,350000 0,630000 0,070000
275 C09CA06 CANDESARTANUM CILEXETIL ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,388570 0,193215 0,694285 0,887500 1,249713 0,332072
276 C09CA06 CANDESARTANUM CILEXETIL CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,866000 0,000000 0,433000 0,433000 0,779400 0,086600
277 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN LABORMED 16 mg COMPR. 16mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR. P6L 28 1,062142 0,000000 0,531071 0,531071 0,955927 0,106215
278 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,670666 0,000000 0,335333 0,335333 0,603599 0,067067
279 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 16 mg COMPR. 16mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 1,062000 0,000000 0,531000 0,531000 0,955800 0,106200
280 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN VIM SPECTRUM 16 mg COMPR. 16mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,866071 0,000000 0,433035 0,433036 0,779463 0,086608
281 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN ATB 16 mg COMPR. 16mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,693333 0,000000 0,346666 0,346667 0,623999 0,069334
282 C09CA06 CANDESARTANUM CILEXETIL KARBIS 32 mg COMPR. 32mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 1,449000 0,000000 0,724500 0,724500 1,304100 0,144900
283 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN TORRENT 32 mg COMPR. 32mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,603000 0,000000 0,301500 0,301500 0,542700 0,060300
284 C09CA06 CANDESARTANUM CILEXETIL ATACAND 32 mg COMPR. 32mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 2,229285 0,000000 1,114642 1,114643 2,006356 0,222929
285 C09CA06 CANDESARTANUM CILEXETIL CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,963000 0,000000 0,481500 0,481500 0,866700 0,096300
286 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 32 mg COMPR. 32mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 1,449000 0,000000 0,724500 0,724500 1,304100 0,144900
287 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN VIM SPECTRUM 32 mg COMPR. 32mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,962857 0,000000 0,481428 0,481429 0,866571 0,096286
288 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 8 mg COMPR. 8mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 0,531071 0,000000 0,265535 0,265536 0,477963 0,053108
289 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P-6L 28 0,531071 0,000000 0,265535 0,265536 0,477963 0,053108
290 C09CA06 CANDESARTANUM CILEXETIL KARBIS 8 mg COMPR. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,531000 0,000000 0,265500 0,265500 0,477900 0,053100
291 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN TORRENT 8 mg COMPR. 8mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,531000 0,000000 0,265500 0,265500 0,477900 0,053100
292 C09CA06 CANDESARTANUM CILEXETIL ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,694285 0,122857 0,347142 0,470000 0,624856 0,192286
293 C09CA06 CANDESARTANUM CILEXETIL CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,531000 0,000000 0,265500 0,265500 0,477900 0,053100
294 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN LABORMED 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L 28 0,531071 0,000000 0,265535 0,265536 0,477963 0,053108
295 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,490000 0,000000 0,245000 0,245000 0,441000 0,049000
296 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 8 mg COMPR. 8mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,531000 0,000000 0,265500 0,265500 0,477900 0,053100
297 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN VIM SPECTRUM 8 mg COMPR. 8mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,531071 0,000000 0,265535 0,265536 0,477963 0,053108
298 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN ATB 8 mg COMPR. 8mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,531000 0,000000 0,265500 0,265500 0,477900 0,053100
299 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 40mg COMPR. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,546428 0,000000 0,273214 0,273214 0,491785 0,054643
300 C09CA07 TELMISARTANUM TOLURA 40 mg COMPR. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,593214 0,000000 0,296607 0,296607 0,533892 0,059322
301 C09CA07 TELMISARTANUM TEZEO 40 mg COMPR. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,594666 0,000000 0,297333 0,297333 0,535199 0,059467
302 C09CA07 TELMISARTANUM TELMISARTAN MYLAN 40 mg COMPR. 40mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. OPA-AL/PVC/AL X 30 COMPR. P6L 30 0,589666 0,000000 0,294833 0,294833 0,530699 0,058967
303 C09CA07 TELMISARTANUM TELMISARTAN RANBAXY 40 mg COMPR. 40mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. P6L 28 0,694285 0,767500 0,347142 1,114643 0,624856 0,836929
304 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 40 mg COMPR. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR. P6L 56 0,694285 0,115893 0,347142 0,463036 0,624856 0,185322
305 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 80mg COMPR. 80 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,914642 0,000000 0,457321 0,457321 0,823177 0,091465
306 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 1,388570 0,065358 0,694285 0,759643 1,249713 0,204215
307 C09CA07 TELMISARTANUM TOLURA 80 mg COMPR. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,861785 0,000000 0,430892 0,430893 0,775606 0,086179
308 C09CA07 TELMISARTANUM TEZEO 80 mg COMPR. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,788000 0,000000 0,394000 0,394000 0,709200 0,078800
309 C09CA07 TELMISARTANUM TELMISARTAN MYLAN 80 mg COMPR. 80mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. OPA-AL/PVC/AL X 30 COMPR. P6L 30 0,749333 0,000000 0,374666 0,374667 0,674399 0,074934

Pagina 5 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
310 C09CA07 TELMISARTANUM TELMISARTAN RANBAXY 80 mg COMPR. 80mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. P6L 28 0,976785 0,000000 0,488392 0,488393 0,879106 0,097679
311 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 80 mg COMPR. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR. P6L 56 0,939464 0,000000 0,469732 0,469732 0,845517 0,093947
312 C09CA07 TELMISARTANUM TELMARK 40 mg COMPR. FILM. 40mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,593214 0,000000 0,296607 0,296607 0,533892 0,059322
313 C09CA07 TELMISARTANUM TANYDON 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,694285 0,398048 0,347142 0,745191 0,624856 0,467477
314 C09CA07 TELMISARTANUM TELMISARTAN EGIS 40 mg COMPR. FILM. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,547500 0,000000 0,273750 0,273750 0,492750 0,054750
315 C09CA07 TELMISARTANUM TELMOTENS 40mg COMPR. FILM. 40mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,694285 0,714715 0,347142 1,061858 0,624856 0,784144
316 C09CA07 TELMISARTANUM TELMARK 80 mg COMPR. FILM. 80mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,914642 0,000000 0,457321 0,457321 0,823177 0,091465
317 C09CA07 TELMISARTANUM TANYDON 80 mg COMPR. FILM. 80mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,976333 0,000000 0,488166 0,488167 0,878699 0,097634
318 C09CA07 TELMISARTANUM TELMISARTAN EGIS 80 mg COMPR. FILM. 80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,892500 0,000000 0,446250 0,446250 0,803250 0,089250
319 C09CA07 TELMISARTANUM TELMOTENS 80mg COMPR. FILM. 80mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,976333 0,000000 0,488166 0,488167 0,878699 0,097634
320 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA HL 100 mg/12,5 mg COMPR.FILM 100mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,618571 0,000000 0,309285 0,309286 0,556713 0,061858
321 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA H COMPR.FILM50mg+ 12,50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,455000 0,000000 0,227500 0,227500 0,409500 0,045500
322 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 160 mg/12,5 mg COMPR. FILM. 160mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 2,366037 0,346981 2,713019 0,624566 2,435434
323 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 80 mg/12,5 mg COMPR. FILM. 80mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 1,943537 0,346981 2,290519 0,624566 2,012934
324 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. 150mg/12,5mg FRANTA
SANOFI PHARMA - BRISTOL MYERS SQUIBB CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,693963 0,492465 0,346981 0,839447 0,624566 0,561862
325 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. 300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,693963 0,756037 0,346981 1,103019 0,624566 0,825434
326 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,610714 0,000000 0,305357 0,305357 0,549642 0,061072
327 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362
328 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 0,659642 0,000000 0,329821 0,329821 0,593677 0,065965
329 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505
330 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505
331 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. FILM. 150mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,492465 0,346981 0,839447 0,624566 0,561862
332 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505
333 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,077108 0,346981 0,424090 0,624566 0,146505
334 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 300 mg/12,5 mg COMPR. FILM. 300 mg/12,5mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362
335 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362
336 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362
337 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. FILM. 300mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,756037 0,346981 1,103019 0,624566 0,825434
338 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362
339 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,279965 0,346981 0,626947 0,624566 0,349362
340 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM. 300mg/25mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,281751 0,346981 0,628733 0,624566 0,351148
341 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM. 300mg/25mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L 28 0,693963 0,281751 0,346981 0,628733 0,624566 0,351148
342 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg COMPR. FILM. 300mg/25mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,693963 0,758179 0,346981 1,105161 0,624566 0,827576
343 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,281037 0,346981 0,628019 0,624566 0,350434
344 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,693963 0,281037 0,346981 0,628019 0,624566 0,350434
345 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN HIDROCLOROTIAZIDA TORRENT 16 mg/12,5 mg COMPR. 16mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR.
P6L 56 0,641250 0,000000 0,320625 0,320625 0,577125 0,064125
346 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 16mg/12,5mg COMPR. 16mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,693963 0,041037 0,346981 0,388019 0,624566 0,110434
347 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 8 mg/12,5 mg COMPR. 8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIT. PVC-PVDC/AL X 30 COMPR. P6L 30 0,441333 0,000000 0,220666 0,220667 0,397199 0,044134
348 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 8 mg/12,5 mg COMPR. 8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,441333 0,000000 0,220666 0,220667 0,397199 0,044134
349 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 8mg/12,5mg COMPR. 8mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,441333 0,000000 0,220666 0,220667 0,397199 0,044134
350 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/12,5 mg COMPR. 80 mg/12,5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,693963 0,400679 0,346981 0,747661 0,624566 0,470076
351 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/12,5mg COMPR. 80 mg/12,5mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767
352 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/25mg COMPR. 80 mg/25mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767
353 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/25mg COMPR. 80 mg/25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,693963 0,403894 0,346981 0,750876 0,624566 0,473291
354 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/12,5mg COMPR. 80/12,5mg GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 28 0,693963 0,941037 0,346981 1,288019 0,624566 1,010434
355 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/25mg COMPR. 80/25mg GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 28 0,693963 0,941037 0,346981 1,288019 0,624566 1,010434
356 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TANYDON HCT 80 mg/12,5 mg COMPR. 80mg/12,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767
357 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg COMPR. 80mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,693963 0,395679 0,346981 0,742661 0,624566 0,465076
358 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/12,5 mg COMPR. 80mg/12,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,690333 0,000000 0,345166 0,345167 0,621299 0,069034
359 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMARK PLUS 80mg/12,5mg COMPR. 80mg/12,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE P-6L 30 0,693963 0,402703 0,346981 0,749685 0,624566 0,472100
360 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg COMPR. 80mg/12,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648
361 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg COMPR. 80mg/12,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648
362 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TANYDON HCT 80 mg/25 mg COMPR. 80mg/25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR.
P6L 30 0,693963 0,314370 0,346981 0,661352 0,624566 0,383767
363 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/25 mg COMPR. 80mg/25mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,693963 0,403037 0,346981 0,750019 0,624566 0,472434
364 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMARK PLUS 80mg/25mg COMPR. 80mg/25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE P-6L 30 0,693963 0,404703 0,346981 0,751685 0,624566 0,474100
365 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg COMPR. 80mg/25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648
366 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg COMPR. 80mg/25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L 28 0,693963 0,404251 0,346981 0,751233 0,624566 0,473648
367 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 3,194642 0,000000 1,597321 1,597321 2,875177 0,319465
368 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 3,003750 0,000000 1,501875 1,501875 2,703375 0,300375
369 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L 56 1,669285 1,524643 0,834642 2,359286 1,502356 1,691572
370 C09DB02 COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA) SEVIKAR 20 mg/5 mg COMPR. FILM. 20mg/5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,669285 1,770357 0,834642 2,605000 1,502356 1,937286
371 C09DB02 COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA) SEVIKAR 40 mg/10 mg COMPR. FILM. 40mg/10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 3,338570 0,431787 1,669285 2,101072 3,004713 0,765644
372 C09DB02 COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA) SEVIKAR 40 mg/5 mg COMPR. FILM. 40mg/5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 3,004713 0,434929 1,502356 1,937286 2,704241 0,735401

Pagina 6 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
373 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,125344 0,243584 1,562672 1,806256 2,812809 0,556119
374 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,339410 0,029518 1,669705 1,699223 3,005469 0,363459
375 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,039719 0,127781 1,519859 1,647641 2,735747 0,431753
376 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,167500 0,000000 1,583750 1,583750 2,850750 0,316750
377 C10AA04 FLUVASTATINUM LESCOL 20 mg CAPS. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 0,243049 0,349093 0,121524 0,470618 0,218744 0,373398
378 C10AA04 FLUVASTATINUM LESCOL 40 mg CAPS. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 0,486099 0,484615 0,243049 0,727665 0,437489 0,533225
379 C10AA04 FLUVASTATINUM LESCOL XL 80 mg COMPR. ELIB. PREL. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 (4X7) COMPR. ELIB. PREL. P-6L 28 0,967500 0,000000 0,483750 0,483750 0,870750 0,096750
380 C10AA05 ATORVASTATINUM TORVALIPIN 10 mg COMPR. FILM. 10 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P-6L 30 0,129333 0,000000 0,064666 0,064667 0,116399 0,012934
381 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 0,364574 0,722759 0,182287 0,905046 0,328116 0,759217
382 C10AA05 ATORVASTATINUM ATORIS 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,364574 0,001092 0,182287 0,183379 0,328116 0,037550
383 C10AA05 ATORVASTATINUM GLETOR 10 mg COMPR. FILM. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,364574 0,141759 0,182287 0,324046 0,328116 0,178217
384 C10AA05 ATORVASTATINUM ASCORD 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,364574 0,342092 0,182287 0,524379 0,328116 0,378550
385 C10AA05 ATORVASTATINUM TORVAZIN 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,364574 0,284759 0,182287 0,467046 0,328116 0,321217
386 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 10 mg COMPR. FILM. 10mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,222333 0,000000 0,111166 0,111167 0,200099 0,022234
387 C10AA05 ATORVASTATINUM STAVRA 10 mg COMPR. FILM. 10mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,364574 0,342092 0,182287 0,524379 0,328116 0,378550
388 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,221000 0,000000 0,110500 0,110500 0,198900 0,022100
389 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,334000 0,000000 0,167000 0,167000 0,300600 0,033400
390 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,236333 0,000000 0,118166 0,118167 0,212699 0,023634
391 C10AA05 ATORVASTATINUM TORVACARD 10 mg COMPR. FILM. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,277000 0,000000 0,138500 0,138500 0,249300 0,027700
392 C10AA05 ATORVASTATINUM TORVALIPIN 20 mg COMPR. FILM. 20 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P-6L 30 0,227000 0,000000 0,113500 0,113500 0,204300 0,022700
393 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 0,729149 0,637184 0,364574 1,001759 0,656234 0,710099
394 C10AA05 ATORVASTATINUM ATORIS 20 mg COMPR. FILM. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,501333 0,000000 0,250666 0,250667 0,451199 0,050134
395 C10AA05 ATORVASTATINUM GLETOR 20 mg COMPR. FILM. 20mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,404333 0,000000 0,202166 0,202167 0,363899 0,040434
396 C10AA05 ATORVASTATINUM ASCORD 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,729149 0,188517 0,364574 0,553092 0,656234 0,261432
397 C10AA05 ATORVASTATINUM TORVAZIN 20 mg COMPR. FILM. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,334000 0,000000 0,167000 0,167000 0,300600 0,033400
398 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 20 mg COMPR. FILM. 20mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,267000 0,000000 0,133500 0,133500 0,240300 0,026700
399 C10AA05 ATORVASTATINUM STAVRA 20 mg COMPR. FILM. 20mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,729149 0,188517 0,364574 0,553092 0,656234 0,261432
400 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,306000 0,000000 0,153000 0,153000 0,275400 0,030600
401 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,278333 0,000000 0,139166 0,139167 0,250499 0,027834
402 C10AA05 ATORVASTATINUM TORVACARD 20 mg COMPR. FILM. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,408666 0,000000 0,204333 0,204333 0,367799 0,040867
403 C10AA05 ATORVASTATINUM ATORIS 30 mg COMPR. FILM. 30mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,608000 0,000000 0,304000 0,304000 0,547200 0,060800
404 C10AA05 ATORVASTATINUM TORVALIPIN 40 mg COMPR. FILM. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P-6L 30 0,531000 0,000000 0,265500 0,265500 0,477900 0,053100
405 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM.P-6L 14 1,458299 0,237415 0,729149 0,966565 1,312469 0,383245
406 C10AA05 ATORVASTATINUM ATORIS 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 14 COMPR.FILM. P-6L 14 1,102857 0,000000 0,551428 0,551429 0,992571 0,110286
407 C10AA05 ATORVASTATINUM ATORIS 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,647000 0,000000 0,323500 0,323500 0,582300 0,064700
408 C10AA05 ATORVASTATINUM GLETOR 40 mg COMPR. FILM. 40mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,514666 0,000000 0,257333 0,257333 0,463199 0,051467
409 C10AA05 ATORVASTATINUM ASCORD 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 1,102666 0,000000 0,551333 0,551333 0,992399 0,110267
410 C10AA05 ATORVASTATINUM TORVAZIN 40 mg COMPR. FILM. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,102666 0,000000 0,551333 0,551333 0,992399 0,110267
411 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 40 mg COMPR. FILM. 40mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,053000 0,000000 0,526500 0,526500 0,947700 0,105300
412 C10AA05 ATORVASTATINUM STAVRA 40 mg COMPR. FILM. 40mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 1,102666 0,000000 0,551333 0,551333 0,992399 0,110267
413 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 40 mg COMPR. FILM. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,606000 0,000000 0,303000 0,303000 0,545400 0,060600
414 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 40 mg COMPR. FILM. 40mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,633333 0,000000 0,316666 0,316667 0,569999 0,063334
415 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,478666 0,000000 0,239333 0,239333 0,430799 0,047867
416 C10AA05 ATORVASTATINUM TORVACARD 40 mg COMPR. FILM. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,871666 0,000000 0,435833 0,435833 0,784499 0,087167
417 C10AA05 ATORVASTATINUM ATORIS 60 mg COMPR. FILM. 60mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,001666 0,000000 0,500833 0,500833 0,901499 0,100167
418 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM.P-6L 14 1,677142 0,000000 0,838571 0,838571 1,509427 0,167715
419 C10AA05 ATORVASTATINUM ASCORD 80 mg COMPR. FILM. 80mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 1,090333 0,000000 0,545166 0,545167 0,981299 0,109034
420 C10AA05 ATORVASTATINUM ATORIS 80 mg COMPR. FILM. 80mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,017333 0,000000 0,508666 0,508667 0,915599 0,101734
421 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 80 mg COMPR. FILM. 80mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,090333 0,000000 0,545166 0,545167 0,981299 0,109034
422 C10AA05 ATORVASTATINUM STAVRA 80 mg COMPR. FILM. 80mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 1,090333 0,000000 0,545166 0,545167 0,981299 0,109034
423 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,090333 0,000000 0,545166 0,545167 0,981299 0,109034
424 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 80 mg COMPR. FILM. 80mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,091000 0,000000 0,545500 0,545500 0,981900 0,109100
425 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,768000 0,000000 0,384000 0,384000 0,691200 0,076800
426 C10AA05 ATORVASTATINUM TORVACARD 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,090333 0,000000 0,545166 0,545167 0,981299 0,109034
427 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBHGERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,711000 0,000000 0,355500 0,355500 0,639900 0,071100
428 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 0,729149 2,597279 0,364574 2,961854 0,656234 2,670194
429 C10AA07 ROSUVASTATINUM ROSUCARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,729149 0,103851 0,364574 0,468426 0,656234 0,176766
430 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM. P-6L 30 0,577666 0,000000 0,288833 0,288833 0,519899 0,057767
431 C10AA07 ROSUVASTATINUM ROXARDIO 10 mg COMPR. FILM. 10mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,311071 0,000000 0,155535 0,155536 0,279963 0,031108
432 C10AA07 ROSUVASTATINUM ROSWERA 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,629333 0,000000 0,314666 0,314667 0,566399 0,062934
433 C10AA07 ROSUVASTATINUM ROSTAT 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,729149 0,024851 0,364574 0,389426 0,656234 0,097766
434 C10AA07 ROSUVASTATINUM TINTAROS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 0,680714 0,000000 0,340357 0,340357 0,612642 0,068072
435 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,729149 0,512636 0,364574 0,877211 0,656234 0,585551

Pagina 7 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
436 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,729149 0,512636 0,364574 0,877211 0,656234 0,585551
437 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,729149 0,092517 0,364574 0,457092 0,656234 0,165432
438 C10AA07 ROSUVASTATINUM ROVASTAMED 10mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,711071 0,000000 0,355535 0,355536 0,639963 0,071108
439 C10AA07 ROSUVASTATINUM ROZUCOR 10 mg COMPR. FILM. 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,729149 0,036184 0,364574 0,400759 0,656234 0,109099
440 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,729149 0,118184 0,364574 0,482759 0,656234 0,191099
441 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBHGERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,094000 0,000000 0,547000 0,547000 0,984600 0,109400
442 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 1,458299 3,406701 0,729149 4,135851 1,312469 3,552531
443 C10AA07 ROSUVASTATINUM ROSUCARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,907666 0,000000 0,453833 0,453833 0,816899 0,090767
444 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM. P-6L 30 0,907666 0,000000 0,453833 0,453833 0,816899 0,090767
445 C10AA07 ROSUVASTATINUM ROXARDIO 20 mg COMPR. FILM. 20mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,621428 0,000000 0,310714 0,310714 0,559285 0,062143
446 C10AA07 ROSUVASTATINUM ROSWERA 20 mg COMPR. FILM. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,930666 0,000000 0,465333 0,465333 0,837599 0,093067
447 C10AA07 ROSUVASTATINUM ROSTAT 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,109333 0,000000 0,554666 0,554667 0,998399 0,110934
448 C10AA07 ROSUVASTATINUM TINTAROS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 0,907500 0,000000 0,453750 0,453750 0,816750 0,090750
449 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,458299 0,326343 0,729149 1,055493 1,312469 0,472173
450 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 1,458299 0,326343 0,729149 1,055493 1,312469 0,472173
451 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,976000 0,000000 0,488000 0,488000 0,878400 0,097600
452 C10AA07 ROSUVASTATINUM ROVASTAMED 20mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,093928 0,000000 0,546964 0,546964 0,984535 0,109393
453 C10AA07 ROSUVASTATINUM ROZUCOR 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,143333 0,000000 0,571666 0,571667 1,028999 0,114334
454 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 1,001666 0,000000 0,500833 0,500833 0,901499 0,100167
455 C10AA07 ROSUVASTATINUM ROSUCARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,748666 0,000000 0,874333 0,874333 1,573799 0,174867
456 C10AA07 ROSUVASTATINUM ROSWERA 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,522333 0,000000 0,761166 0,761167 1,370099 0,152234
457 C10AA07 ROSUVASTATINUM ROSTAT 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,096000 0,000000 0,548000 0,548000 0,986400 0,109600
458 C10AA07 ROSUVASTATINUM TINTAROS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 1,746785 0,000000 0,873392 0,873393 1,572106 0,174679
459 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 2,784285 0,000000 1,392142 1,392143 2,505856 0,278429
460 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,784285 0,000000 1,392142 1,392143 2,505856 0,278429
461 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,739666 0,000000 0,869833 0,869833 1,565699 0,173967
462 C10AA07 ROSUVASTATINUM ROVASTAMED 40mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,640357 0,000000 0,820178 0,820179 1,476321 0,164036
463 C10AA07 ROSUVASTATINUM ROZUCOR 40 mg COMPR. FILM. 40mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,590666 0,000000 0,795333 0,795333 1,431599 0,159067
464 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 2,498000 0,000000 1,249000 1,249000 2,248200 0,249800
465 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 0,364574 2,271497 0,182287 2,453784 0,328116 2,307955
466 C10AA07 ROSUVASTATINUM ROXARDIO 5 mg COMPR. FILM. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,364574 0,838997 0,182287 1,021284 0,328116 0,875455
467 C10AA07 ROSUVASTATINUM ROSWERA 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,327333 0,000000 0,163666 0,163667 0,294599 0,032734
468 C10AA07 ROSUVASTATINUM ROSTAT 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,364574 0,407759 0,182287 0,590046 0,328116 0,444217
469 C10AA07 ROSUVASTATINUM TINTAROS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 0,364574 0,018997 0,182287 0,201284 0,328116 0,055455
470 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,364574 1,439711 0,182287 1,621998 0,328116 1,476169
471 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,364574 1,439711 0,182287 1,621998 0,328116 1,476169
472 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 5 mg COMPR. FILM. 5mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,364574 0,251759 0,182287 0,434046 0,328116 0,288217
473 C10AA07 ROSUVASTATINUM ROVASTAMED 5mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,364574 0,661854 0,182287 0,844141 0,328116 0,698312
474 C10AA07 ROSUVASTATINUM ROZUCOR 5 mg COMPR. FILM. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,364574 0,032426 0,182287 0,214713 0,328116 0,068884
475 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,364574 0,405759 0,182287 0,588046 0,328116 0,442217
476 C10AB02 BEZAFIBRATUM BEZAFIBRAT SLAVIA 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,381500 0,000000 0,190750 0,190750 0,343350 0,038150
477 C10AB02 BEZAFIBRATUM BEZAFIBRAT ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC/AL X 10 COMPR. P-6L 20 0,383500 0,000000 0,191750 0,191750 0,345150 0,038350
478 C10AB02 BEZAFIBRATUM BEZAFIBRAT FARMEX 200 mg COMPR. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,370000 0,000000 0,185000 0,185000 0,333000 0,037000
479 C10AX09 EZETIMIBUM EZETROL (R) COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 28 4,156410 1,283232 2,078205 3,361437 3,740769 1,698873
480 C10AX09 EZETIMIBUM COLTOWAN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-PE-PVC/AL X 30 COMPR. PRF 30 3,728666 0,000000 1,864333 1,864333 3,355799 0,372867
481 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** LIPOCOMB 10 mg/10 mg CAPS. 10mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 4,033666 0,000000 2,016833 2,016833 3,630299 0,403367
482 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** LIPOCOMB 20 mg/10 mg CAPS. 20mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 4,111916 0,234750 2,055958 2,290708 3,700724 0,645942
483 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/10mg COMPR. FILM. 10mg/10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,571332 0,465001 0,285666 0,750667 0,514198 0,522135
484 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 10 mg/10 mg COMPR. FILM. 10mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,571332 0,102668 0,285666 0,388334 0,514198 0,159802
485 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) ATORDAPIN 10 mg/10 mg COMPR. FILM. 10mg/10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,571332 0,102668 0,285666 0,388334 0,514198 0,159802
486 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) TORVALIPIN PLUS 10 mg/10 mg COMPR. FILM. 10mg/10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,571332 0,068001 0,285666 0,353667 0,514198 0,125135
487 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/5mg COMPR. FILM. 10mg/5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,571332 0,272668 0,285666 0,558334 0,514198 0,329802
488 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 10 mg/5 mg COMPR. FILM. 10mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,548666 0,000000 0,274333 0,274333 0,493799 0,054867
489 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) TORVALIPIN PLUS 5mg/10mg COMPR. FILM. 10mg/5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,548666 0,000000 0,274333 0,274333 0,493799 0,054867
490 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) ATORDAPIN 10mg/5mg COMPR. FILM. 10mg/5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE P6L 30 0,548666 0,000000 0,274333 0,274333 0,493799 0,054867
491 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 20 mg/10 mg COMPR. FILM. 20mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,571332 0,587668 0,285666 0,873334 0,514198 0,644802
492 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 20 mg/5 mg COMPR. FILM. 20mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,571332 0,327334 0,285666 0,613000 0,514198 0,384468
493 D01BA02 TERBINAFINUM LAMISIL (R) COMPR. 250mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. X 14 COMPR. P-RF 14 1,267321 1,170536 0,633660 1,804197 1,140588 1,297269
494 D01BA02 TERBINAFINUM TERBINARAN COMPR. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF 30 1,267321 0,317345 0,633660 0,951006 1,140588 0,444078
495 D01BA02 TERBINAFINUM TERBINARAN COMPR. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-RF 28 1,267321 0,317679 0,633660 0,951340 1,140588 0,444412
496 D01BA02 TERBINAFINUM TERBINAFINE 250 mg COMPR. 250mg ACTAVIS GROUP HFISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 28 0,712142 0,000000 0,356071 0,356071 0,640927 0,071215
497 D01BA02 TERBINAFINUM TERBINAFINA SLAVIA 250mg COMPR. 250mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR. P-RF 14 1,267321 0,081964 0,633660 0,715625 1,140588 0,208697
498 D01BA02 TERBINAFINUM TERBISIL 250 mg COMPR. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. P-RF 28 1,267321 0,317679 0,633660 0,951340 1,140588 0,444412

Pagina 8 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
499 D01BA02 TERBINAFINUM TERBINAFINA ARENA 250 mg COMPR. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-RF 28 1,185357 0,000000 0,592678 0,592679 1,066821 0,118536
500 D05AX52 DAIVOBET 50 micrograme/0,5 mg/g
COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * GEL 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLAC. PEID CU DUZA DIN PEJD SI CAPAC DIN PEID X 15 G GEL PRF 1 53,860000 0,000000 26,930000 26,930000 48,474000 5,386000
501 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * DAIVOBET 50 micrograme/0,5mg/g UNGUENT 50micrograme/0,5mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE CU 1 TUB DIN AL/EPOXIFENOL X 15 G UNGUENT P-RF 1 53,945000 0,255000 26,972500 27,227500 48,550500 5,649500
502 D05BB02 ACITRETINUM ** NEOTIGASON 10 mg CAPS. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 CAPS. P-RF 30 1,581666 0,000000 0,790833 0,790833 1,423499 0,158167
503 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g CREMA 20mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 11,170000 0,000000 5,585000 5,585000 10,053000 1,117000
504 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g UNGUENT 20mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 11,170000 0,000000 5,585000 5,585000 10,053000 1,117000
505 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA CUTIE X 500 G CREMA PRF 1 101,420000 0,000000 50,710000 50,710000 91,278000 10,142000
506 D06BB04 PODOPHYLLOTOXINUM * WARTEC 1,5 mg/g CREMA 1,5 mg/g GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 44,916785 33,423215 22,458392 55,881608 40,425106 37,914894
507 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA P-RF
CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE 1 78,810000 0,000000 39,405000 39,405000 70,929000 7,881000
508 D06BB10 IMIQUIMODUM * ALDARA 5% CREMA 5% MEDA AB SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA P-RF 12 21,387500 0,000000 10,693750 10,693750 19,248750 2,138750
509 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) crema 0,1% CREMA 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 11,799999 0,220001 5,899999 6,120001 10,619999 1,400001
510 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) LIPOCREAM 0,1% CREMA 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 11,799999 0,190001 5,899999 6,090001 10,619999 1,370001
511 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID CRELO (R) 0,1% EMULSIE CUT. 0.1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON X 30 G P-RF 1 11,799999 1,000001 5,899999 6,900001 10,619999 2,180001
512 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) SOL. CUT. 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON PICURATOR DIN PP X 30 ML P-RF 1 11,230000 0,000000 5,615000 5,615000 10,107000 1,123000
513 D07AC13 MOMETASONUM ELOCOM CREMA 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3,530000 1,910000 1,765000 3,675000 3,177000 2,263000
514 D07AC13 MOMETASONUM MOMETAZONA ATB 1 mg/g CREMA 1mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG. P6L 1 3,530000 0,000000 1,765000 1,765000 3,177000 0,353000
515 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3,530000 1,910000 1,765000 3,675000 3,177000 2,263000
516 D07AC13 MOMETASONUM MOMETAZONA ATB 1 mg/g UNGUENT 1mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG. P6L 1 3,530000 0,000000 1,765000 1,765000 3,177000 0,353000
517 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 21,552000 3,518000 10,776000 14,294000 19,396800 5,673200
518 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G CREMA P-RF 1 35,920000 0,000000 17,960000 17,960000 32,328000 3,592000
519 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA PRF 1 33,540000 0,000000 16,770000 16,770000 30,186000 3,354000
520 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT P-RF 1 21,552000 3,518000 10,776000 14,294000 19,396800 5,673200
521 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G UNGUENT P-RF 1 35,920000 0,000000 17,960000 17,960000 32,328000 3,592000
522 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE CREMA 0,05% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 10,080000 0,000000 5,040000 5,040000 9,072000 1,008000
523 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE UNGUENT 0,005% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 10,080000 0,000000 5,040000 5,040000 9,072000 1,008000
524 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g CREMA 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G CREMA P-RF 1 5,860000 6,610000 2,930000 9,540000 5,274000 7,196000
525 D07AD01 CLOBETASOLUM * DERMOVATE (R) SOL. CUT. 0,05% GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON CU PICURATOR DIN PP X 25 ML P-RF 1 5,410000 0,000000 2,705000 2,705000 4,869000 0,541000
526 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g UNGUENT 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G UNGUENT P-RF 1 5,860000 3,380000 2,930000 6,310000 5,274000 3,966000
527 D07AD01 CLOBETASOLUM * CLOBETAZOL ATB 0,5 mg/g UNGUENT 0,5mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 25 G UNGUENT PRF 1 5,860000 0,150000 2,930000 3,080000 5,274000 0,736000
528 D07CA01 COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H CREMA 20mg/g+10mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 21,030000 0,000000 10,515000 10,515000 18,927000 2,103000
529 D07CC01 COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg pe gram LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 15,445000 6,815000 7,722500 14,537500 13,900500 8,359500
530 D07XC03 COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC 1mg+5mg/gram UNGUENT 1mg+50mg/gram MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 16,387500 0,402500 8,193750 8,596250 14,748750 2,041250
531 D07XC03 COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC 1mg+5mg/gram UNGUENT 1mg+50mg/gram MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 45 G P-RF 1 48,760000 0,000000 24,380000 24,380000 43,884000 4,876000
532 D10AD54 COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL GEL 0.5mg/g+20mg/g GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 TUB DIN AL X 30 G GEL P-RF 1 37,580000 0,000000 18,790000 18,790000 33,822000 3,758000
533 D10AX03 ACIDUM AZELAICUM SKINOREN CREMA 200mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 30,710000 0,000000 15,355000 15,355000 27,639000 3,071000
534 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB AL X 50 G GEL P-RF 1 40,903125 7,546875 20,451562 27,998438 36,812812 11,637188
535 D10BA01 ISOTRETINOINUM ** ROACCUTANE 10 mg CAPS. MOI 10mg ROCHE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. MOI P-RF 30 1,070583 0,518083 0,535291 1,053375 0,963524 0,625142
536 D10BA01 ISOTRETINOINUM ** SOTRET 10 mg CAPS. MOI 10mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF 30 1,066666 0,000000 0,533333 0,533333 0,959999 0,106667
537 D10BA01 ISOTRETINOINUM ** SOTRET 20 mg CAPS. MOI 20mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF 30 2,141166 0,007834 1,070583 1,078417 1,927049 0,221951
538 FARA COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 25 mg/5 mg COMPR. FILM. 25mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,985133 0,094867 1,992566 2,087434 3,586619 0,493381
539 FARA COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 25 mg/7,5 mg COMPR. FILM. 25mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,940000 0,000000 1,970000 1,970000 3,546000 0,394000
540 FARA COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 50 mg/5 mg COMPR. FILM. 50mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,985133 0,154688 1,992566 2,147255 3,586619 0,553202
541 FARA COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 50 mg/7,5 mg COMPR. FILM. 50mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,985133 0,015045 1,992566 2,007612 3,586619 0,413559
542 G01AA51 COMBINATII MACMIROR COMPLEX CAPS. MOI VAG. 500mg/200000UI POLICHEM SA LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG. P-RF 12 1,860416 1,360417 0,930208 2,290625 1,674374 1,546459
543 G01AA51 COMBINATII POLYGYNAX CAPS. MOI VAG. LAB. INNOTECH INT.FRANTA CUTIE CU 2 BLIST. PVC-PVDC/AL X 6 CAPS. MOI. VAG.
FARA CONCENTRATIE P-RF 12 1,860416 0,705417 0,930208 1,635625 1,674374 0,891459
544 G01AA51 COMBINATII MACMIROR COMPLEX CREMA VAG. 10g/400000UI POLICHEM SA LUXEMBURG CUTIE X 1 TUB DIN AL CREMA VAG. X 30 G + APLICATOR P-RF 1 34,650000 0,000000 17,325000 17,325000 31,185000 3,465000
545 G01AF12 FENTICONAZOLUM LOMEXIN 1000 mg CAPS. MOI VAG. 1000mg RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 2 CAPS. VAG. MOI P-RF 2 17,380091 9,184909 8,690045 17,874955 15,642081 10,922919
546 G01AF12 FENTICONAZOLUM LOMEXIN 600 mg CAPS. MOI VAG. 600mg RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE P-RF 1 10,428054 4,621946 5,214027 9,835973 9,385248 5,664752
547 G01AF12 FENTICONAZOLUM LOMEXIN CREMA VAGINALA CREMA VAG. 2% RECORDATI SPA ITALIA CUTIE X 1 TUB AL + APLICATOR X 78 G CREMA P-RF 1 27,112942 8,997058 13,556471 22,553529 24,401647 11,708353
548 G01AF15 BUTOCONAZOLUM GYNOFORT 2% CREMA VAG. 20mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 APLICATOR PREUMPLUT UNIDOZA DIN PP CU 5 G CREMA VAG. P-RF 1 1,738009 32,241991 0,869004 33,110996 1,564208 32,415792
549 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLODIN COMPR. VAG. 500mg/200mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. TRANSPARENT DIN AL/PVC X 5 COMPR. VAG. P-RF 10 1,386642 0,171358 0,693321 0,864679 1,247977 0,310023
550 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON CREMA FARA CONCENTRATIE ALFA WASSERMANN SPA ITALIA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 9,980000 0,000000 4,990000 4,990000 8,982000 0,998000
551 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON CREMA VAG. FARA CONCENTRATIE ALFA WASSERMAN SPA ITALIA P-RF
CUTIE X 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN POLIPROPILENA 1 13,340000 0,000000 6,670000 6,670000 12,006000 1,334000
552 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON OVULE 500mg/100mg ALFA WASSERMAN SPA ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULEP-RF 10 1,386642 2,448358 0,693321 3,141679 1,247977 2,587023
553 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC-PE X 7 OVULE PRF 7 1,386642 0,154786 0,693321 0,848107 1,247977 0,293451
554 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC X 7 OVULE PRF 7 1,386642 0,154786 0,693321 0,848107 1,247977 0,293451
555 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE DIN PVC-PE X 7 OVULE PRF 14 1,386642 0,154072 0,693321 0,847393 1,247977 0,292737
556 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE DIN PVC X 7 OVULE PRF 14 1,386642 0,154072 0,693321 0,847393 1,247977 0,292737
557 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE ALFA WASSERMAN SPA ITALIA P-RF
CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE 5 1,386642 3,177358 0,693321 3,870679 1,247977 3,316023
558 G02BA03 LEVONORGESTRELUM ** # DONASERT 20 micrograme/24 ore SISTEM CU CEDARE INTRAUTERINA 20micrograme/24ore GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 PUNGA TERMOSUDATA CARE CONTINE UN SISTEM CU ELIBERARE INTRAUTERINA SI UN DISPOZITIV DE INSERTIE PRF 1 306,750000 0,000000 153,375000 153,375000 276,075000 30,675000
559 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore SISTEM CU CEDARE INTRAUTERINA 20micrograme/24ore BAYER OY FINLANDA CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR P-RF 1 343,540000 110,370000 171,770000 282,140000 309,186000 144,724000
560 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 5,505249 5,289751 2,752624 8,042376 4,954724 5,840276
561 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 5,505249 4,407251 2,752624 7,159876 4,954724 4,957776

Pagina 9 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
562 G03CA09 PROMESTRIENUM * COLPOTROPHINE 10 mg CAPS. VAG. 10mg LABORATOIRE THERAMEX MONACO CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. VAG. PRF 10 0,967250 0,023750 0,483625 0,507375 0,870525 0,120475
563 G03CA09 PROMESTRIENUM * COLPOTROPHINE 10mg/g CREMA VAG. 10mg/g LABORATOIRE THERAMEX MONACO CUTIE CU 1 TUB DIN AL X 15 G CREMA VAGINALA PRF 1 14,390000 0,000000 7,195000 7,195000 12,951000 1,439000
564 G03CX01 TIBOLONUM ** LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 1,586071 0,000000 0,793035 0,793036 1,427463 0,158608
565 G03DA04 PROGESTERONUM * UTROGESTAN (R) 100 mg CAPS. MOI 100mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI P-6L 30 0,597999 0,247001 0,298999 0,546001 0,538199 0,306801
566 G03DA04 PROGESTERONUM * AREFAM 100 mg CAPS. MOI 100mg PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L 30 0,549000 0,000000 0,274500 0,274500 0,494100 0,054900
567 G03DA04 PROGESTERONUM * UTROGESTAN (R) 200 mg CAPS. MOI 200mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. AL/PVC X 7 CAPS. MOI P-6L 14 1,195999 0,757572 0,597999 1,355572 1,076399 0,877172
568 G03DA04 PROGESTERONUM * AREFAM 200 mg CAPS. MOI 200mg PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L 30 1,195999 0,032667 0,597999 0,630667 1,076399 0,152267
569 G03DA04 PROGESTERONUM * PROGESTOGEL 10 mg/g GEL 10mg/g LABORATOIRES BESINS INTERNATIONAL FRANTA CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE PRF 1 14,239999 7,690001 7,119999 14,810001 12,815999 9,114001
570 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE (APLICATOR GRADAT DIN PP, PREVAZUT CU FANTA DOZATOARE PT. ETALAREA A 2,5 G GEL 1 14,239999 0,010001 7,119999 7,130001 12,815999 1,434001
571 G03DA04 PROGESTERONUM * MASTOPROFEN 10 mg/g GEL 10mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GELP6L 1 7,119999 0,000001 3,559999 3,560001 6,407999 0,712001
572 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 TUB DIN AL X 45 G GEL + DISPOZITIV DE DOZARE (APLICATOR GRADAT DIN PP, PREVAZUT CU FANTA DOZATOARE PT. ETALAREA A 2,5 G GEL 1 8,010000 0,000000 4,005000 4,005000 7,209000 0,801000
573 G03DA04 PROGESTERONUM * CRINONE 80 mg/g GEL VAGINAL 80mg/g MERCK ROMANIA SRL ROMANIA P6L
CUTIE CU 6 APLICATOARE DOZA UNICA DIN PE, CONTINND GEL VAGINAL, PREVAZUTE CU VRF CARE SE DESFACE PRIN RASUCIRE, AMBALATE SEPARAT NTR-O FOLIE DIN HRTIE/AL/RASINA IONOMERICA 6 12,005000 0,000000 6,002500 6,002500 10,804500 1,200500
574 G03DB01 DYDROGESTERONUM * DUPHASTON 10 mg COMPR. FILM. 10mg BGP PRODUCTS B.V.OLANDA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. PRF 20 1,113000 0,000000 0,556500 0,556500 1,001700 0,111300
575 G03DC03 LYNESTRENOLUM * ORGAMETRIL 5 mg COMPR. 5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 30 COMPR. P-6L 30 0,258333 0,000000 0,129166 0,129167 0,232499 0,025834
576 G03FA17 COMBINATII ** ANGELIQ COMPR. FILM. 1mg+2mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P6L 28 2,062500 0,000000 1,031250 1,031250 1,856250 0,206250
577 G03FB01 COMBINATII ** CYCLO-PROGYNOVA DRAJ. FARA CONCENTRATIE BAYER PHARMA AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P-6L 21 0,383809 0,000000 0,191904 0,191905 0,345428 0,038381
578 G03FB08 ESTRADIOL + DIDROGESTERON **FEMOSTON 2/10, comprimate filmate COMPR. FILM. 2 mg/10 mg BGP PRODUCTS B.V.OLANDA P-RF
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) 28 0,536963 0,459465 0,268481 0,727947 0,483266 0,513162
579 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 g) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE P-RF/R
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. 1 101,015406 31,514594 50,507703 82,022297 90,913865 41,616135
580 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 300 UI/0,5 ml SOL INJ. 300UI/0,5ml TEVA B.V. OLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.5 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 404,061624 10,118376 202,030812 212,149188 363,655461 50,524539
581 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 450UI/0,75ml SOL INJ. 450UI/0,75ml TEVA B.V. OLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.75 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 585,840000 0,000000 292,920000 292,920000 527,256000 58,584000
582 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 900UI/1,5ml SOL INJ. 900UI/1,5ml TEVA B.V. OLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 1.5ML SOLUTIE INJECTABILA + 20 ACE PENTRU INJECTIE 1 1.100,850000 0,000000 550,425000 550,425000 990,765000 110,085000
583 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 150 UI/0,25 ml 150UI/0,25ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 1 202,030812 9,029188 101,015406 110,044594 181,827730 29,232270
584 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 225 UI/0,375 ml 225UI/0,375ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 1 303,046218 12,303782 151,523109 163,826891 272,741596 42,608404
585 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 300 UI/0,50 ml 300UI/0,50ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 1 404,061624 6,598376 202,030812 208,629188 363,655461 47,004539
586 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 450 UI/0,75 ml 450UI/0,75ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 1 584,410000 0,000000 292,205000 292,205000 525,969000 58,441000
587 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 75 UI/0,125 ml 75UI/0,125ml FINOX BIOTECH AG LIECHTENSTEIN. CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 1 101,015406 7,994594 50,507703 58,502297 90,913865 18,096135
588 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 300 UI/0,5 ml ( 22 g/0,5 ml) 300UI/0,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE
SOL. INJ. IN STILOU INJECTOR PREUMPLUT P-RF/R
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. 1 404,061624 101,588376 202,030812 303,619188 363,655461 141,994539
589 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 450 UI/0,75 ml (33 g/0,75 ml) 450UI/0,75ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE
SOL. INJ. IN STILOU INJECTOR PREUMPLUT P-RF/R
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA 1 606,092436 129,687564 303,046218 432,733782 545,483192 190,296808
590 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 900 UI/1,5ml (66 g/1,5 ml) 900UI/1,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE
SOL. INJ. IN STILOU INJECTOR PREUMPLUT P-RF/R
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA 1 1.212,184873 172,235127 606,092436 778,327564 1.090,966385 293,453615
591 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS + 6 ACE PR/PRF 1 403,900000 0,000000 201,950000 201,950000 363,510000 40,390000
592 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS + 6 ACE PR/PRF 1 403,900000 0,000000 201,950000 201,950000 363,510000 40,390000
593 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.211,699999 68,560001 605,849999 674,410001 1.090,529999 189,730001
594 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.211,699999 68,560001 605,849999 674,410001 1.090,529999 189,730001
595 G03GA07 LUTROPINUM ALFA **1 # LUVERIS 75UI PULB+SOLV.PT.SOL.INJ 75UI SERONO EUROPE LTD. MAREA BRITANIE P-RF/R
CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ.+ 1 FLAC. A 2 ML SAU 3 ML X 1 ML SOLV. 1 131,710000 0,000000 65,855000 65,855000 118,539000 13,171000
596 G03GB02 CLOMIFENUM CLOSTILBEGYT COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. P-RF 10 1,770000 0,000000 0,885000 0,885000 1,593000 0,177000
597 G03XC01 RALOXIFENUM EVISTA 60mg COMPR. FILM. 60mg DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR) P-RF 28 2,345357 0,000000 1,172678 1,172679 2,110821 0,234536
598 G04BD04 OXYBUTYNINUM DRIPTANE ( R ) 5 mg COMPR. 5mg LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. P-6L 60 0,357500 0,000000 0,178750 0,178750 0,321750 0,035750
599 G04BD04 OXYBUTYNINUM DRIPTANE 5 mg COMPR. 5mg MYLAN MEDICAL SAS FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. P-6L 60 0,357500 0,000000 0,178750 0,178750 0,321750 0,035750
600 G04BD07 TOLTERODINUM ** # UROFLOW 1 COMPR. FILM. 1mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,361687 0,454384 0,180843 0,635228 0,325518 0,490553
601 G04BD07 TOLTERODINUM ** # UROFLOW 2 COMPR. FILM. 2mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,723375 0,135196 0,361687 0,496884 0,651037 0,207534
602 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 10 mg COMPR. FILM. 10 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 2,893500 0,321500 1,446750 1,768250 2,604150 0,610850
603 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 10 mg COMPR. FILM. 10mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 2,893500 1,796833 1,446750 3,243583 2,604150 2,086183
604 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 2,893500 0,321500 1,446750 1,768250 2,604150 0,610850
605 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 2,893500 0,321500 1,446750 1,768250 2,604150 0,610850
606 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 5 mg COMPR. FILM. 5 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 1,446750 1,444916 0,723375 2,168291 1,302075 1,589591
607 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 5 mg COMPR. FILM. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 1,446750 3,128583 0,723375 3,851958 1,302075 3,273258
608 G04BD08 SOLIFENACINUM SUCCINATE ** # ASOLFENA 5 mg COMPR. FILM. 5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,446750 1,444916 0,723375 2,168291 1,302075 1,589591
609 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN ACTAVIS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 1,446750 1,443250 0,723375 2,166625 1,302075 1,587925
610 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 1,446750 1,443250 0,723375 2,166625 1,302075 1,587925
611 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. 30 0,542531 0,775469 0,271265 1,046735 0,488277 0,829723
612 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. 30 1,085062 1,038604 0,542531 1,581135 0,976555 1,147111
613 G04CA01 ALFUZOSINUM ALFURAN MR 10 mg COMPR. ELIB. PREL. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,706666 0,000000 0,353333 0,353333 0,635999 0,070667
614 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-6L 30 1,087333 0,000000 0,543666 0,543667 0,978599 0,108734
615 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL CU 30 COMPR. ELIB. PREL. P-6L 30 1,087333 0,000000 0,543666 0,543667 0,978599 0,108734
616 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-6L 30 1,087333 0,000000 0,543666 0,543667 0,978599 0,108734
617 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL CU 30 COMPR. ELIB. PREL. P-6L 30 1,087333 0,000000 0,543666 0,543667 0,978599 0,108734
618 G04CA01 ALFUZOSINUM XATRAL LP 5 mg COMPR. ELIB. PREL. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. ELIB. PREL. P-6L 28 0,582142 0,000000 0,291071 0,291071 0,523927 0,058215
619 G04CA01 ALFUZOSINUM XATRAL LP 5 mg COMPR. FILM. ELIB. PREL. 5mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. FILM. ELIB. PREL. P-6L 28 0,582142 0,000000 0,291071 0,291071 0,523927 0,058215
620 G04CA02 TAMSULOSINUM TAMSOL 0,4 mg CAPS. ELIB. MODIF. 0,4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-6L 30 0,916666 0,000000 0,458333 0,458333 0,824999 0,091667
621 G04CA02 TAMSULOSINUM FOKUSIN CAPS. ELIB. MODIF. 0,4mg ZENTIVA KS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF. P-6L 30 0,726333 0,000000 0,363166 0,363167 0,653699 0,072634
622 G04CA02 TAMSULOSINUM CONTIFLO MR CAPS. ELIB. PREL.0,4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,496666 0,000000 0,248333 0,248333 0,446999 0,049667
623 G04CA02 TAMSULOSINUM TAMSULOSIN AUROBINDO 400 micrograme CAPS. ELIB. PREL.400micrograme AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 CAPS. ELIB. PREL. P6L 30 0,667666 0,000000 0,333833 0,333833 0,600899 0,066767
624 G04CA02 TAMSULOSINUM TAMSULOSIN TEVA 400 g COMPR. CU ELIB. PRELUNGITA 400 g TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. CU ELIB. PRELUNG. P6L 30 0,565333 0,000000 0,282666 0,282667 0,508799 0,056534

Pagina 10 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
625 G04CA02 TAMSULOSINUM OMNIC TOCAS (R) 0,4 0,4mg
COMPR. FILM. ELIB. PREL. ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 FOLII AL/AL X 10 COMPR. FILM. ELIB. PREL. 30 P-6L 1,201798 0,311202 0,600899 0,912101 1,081618 0,431382
626 G04CB01 FINASTERIDUM * PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM. 28 P-6L 0,983124 0,321161 0,491562 0,812723 0,884811 0,419474
627 G04CB01 FINASTERIDUM * FINASTERIDA ARENA 5 mg COMPR. FILM. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,876071 0,000000 0,438035 0,438036 0,788463 0,087608
628 G04CB02 DUTASTERIDUM * AVODART 0,5 mg CAPS. MOI 0,5mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 3 BLIST.PVC-PVDC/AL X 10 CAPS. MOI P-6L 30 3,160666 0,000000 1,580333 1,580333 2,844599 0,316067
629 H01AC01 SOMATROPINUM ** # GENOTROPIN 16 UI/ml (5,3 mg/ml) PULB. + SOLV. PT. SOL. INJ. 16UI/ml (5,3mg/ml) PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ.P-RF 1 423,587000 40,873000 211,793500 252,666500 381,228300 83,231700
630 H01AC01 SOMATROPINUM ** # ZOMACTON PULB. + SOLV. PT. SOL. INJ. 4mg (12ui) FERRING GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV. PR/PRF 1 317,690250 130,819750 158,845125 289,664875 285,921225 162,588775
631 H01AC01 SOMATROPINUM ** # NUTROPINAq 10 mg/2 ml SOL. INJ. 10mg/2ml IPSEN PHARMA FRANTA CUTIE X 1 CARTUS X 2 ML. SOL. INJ. P-RF/R 1 794,225625 157,414375 397,112812 554,527188 714,803062 236,836938
632 H01AC01 SOMATROPINUM ** # OMNITROPE 3,3mg/ml SOL. INJ. 3,3mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ. P-RF/R 1 384,340000 0,000000 192,170000 192,170000 345,906000 38,434000
633 H01AC01 SOMATROPINUM ** # OMNITROPE 6,7mg/ml SOL. INJ. 6,7mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ. P-RF/R 1 712,690000 0,000000 356,345000 356,345000 641,421000 71,269000
634 H01AC01 SOMATROPINUM ** # NORDITROPIN SIMPLEXx 10 mg/1,5ml SOL. INJ. IN CARTUS 10mg/1,5ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ. P-RF 1 794,225625 365,654375 397,112812 762,767188 714,803062 445,076938
635 H01CC01 GANIRELIXUM ** # ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml N. V. ORGANON OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT P-RF/R 1 127,422857 16,207143 63,711428 79,918572 114,680571 28,949429
636 H01CC01 GANIRELIXUM ** # ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT P-RF/R 1 127,422857 16,207143 63,711428 79,918572 114,680571 28,949429
637 H01CC02 CETRORELIXUM ** # CETROTIDE 0,25 mg PULB+SOLV. PT. SOL. INJ. 0,25mg SERONO EUROPE LTD. MAREA BRITANIE P-RF 7
CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII + 7 ACE PT. INJECTII SUBCUTANATE + 14 TAMPOANE IMBIBATE IN ALCOOL 111,215714 0,000000 55,607857 55,607857 100,094142 11,121572
638 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 0,403000 0,000000 0,201500 0,201500 0,362700 0,040300
639 H02AB01 BETAMETHASONUM DIPROPHOS SUSP. INJ. I.M. 7mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 5,366000 0,000000 2,683000 2,683000 4,829400 0,536600
640 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,312165 0,116835 0,156082 0,272918 0,280948 0,148052
641 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,529400 0,000000 0,264700 0,264700 0,476460 0,052940
642 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 0,156082 0,164118 0,078041 0,242159 0,140473 0,179727
643 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/500mg ANTIBIOTICE S.A. ROMANIA 50
CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 15,073600 0,000000 7,536800 7,536800 13,566240 1,507360
644 J01CR04 SULTAMICILLINUM UNASYN COMPR. FILM. 375mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC/PVDC X 6 COMPR. P-RF 12 2,861666 0,000000 1,430833 1,430833 2,575499 0,286167
645 J01CR04 SULTAMICILLINUM UNASYN PULB. PT. SUSP. ORALA 250mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID CU PULBERE PT. 60 ML SUSP. ORALA P-RF 1 23,499996 1,820004 11,749998 13,570002 21,149996 4,170004
646 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 1,5 Mil. UI COMPR. FILM. 1,5 M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF 16 0,627693 0,011057 0,313846 0,324904 0,564923 0,073827
647 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 3 Mil. UI COMPR. FILM. 3M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 10 1,255391 1,357609 0,627695 1,985305 1,129851 1,483149
648 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. LABORATOIRES AVENTIS FRANTA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM. PRF 10 1,255391 1,357609 0,627695 1,985305 1,129851 1,483149
649 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS.P-RF 6 3,138480 0,153186 1,569240 1,722426 2,824632 0,467034
650 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,138480 1,928186 1,569240 3,497426 2,824632 2,242034
651 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM. P-RF 6 1,569238 2,577428 0,784619 3,362047 1,412314 2,734352
652 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 6 COMPR. FILM.P-RF 6 3,138480 0,153186 1,569240 1,722426 2,824632 0,467034
653 J01FA10 AZITHROMYCINUM AZIBIOT 250 mg COMPR. FILM. 250mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR.FILM. PRF 6 3,138480 0,153186 1,569240 1,722426 2,824632 0,467034
654 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 6,276961 2,306372 3,138480 5,444853 5,649264 2,934069
655 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 COMPR. FILM.P-RF 3 4,063333 0,000000 2,031666 2,031667 3,656999 0,406334
656 J01FA10 AZITHROMYCINUM AZIBIOT 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 5,316666 0,000000 2,658333 2,658333 4,784999 0,531667
657 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 5,576666 0,000000 2,788333 2,788333 5,018999 0,557667
658 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF 3 5,576666 0,000000 2,788333 2,788333 5,018999 0,557667
659 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 5,576666 0,000000 2,788333 2,788333 5,018999 0,557667
660 J01FA10 AZITHROMYCINUM AZATRIL 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF 3 5,130000 0,000000 2,565000 2,565000 4,617000 0,513000
661 J01FA10 AZITHROMYCINUM AZITROMICINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF 3 5,576666 0,000000 2,788333 2,788333 5,018999 0,557667
662 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 7,532356 7,894310 3,766178 11,660488 6,779120 8,647546
663 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA P-RF 1
CUTIE X 1 FLACON DIN PE CU PULBERE PENTRU 15ML SUSPENSIE ORALA RECONSTITUITA + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENTRU ADMINISTRAREA ORALA + O LINGURITA DOZATOARE 14,470000 0,000000 7,235000 7,235000 13,023000 1,447000
664 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA 12,878796 6,461204 6,439398 12,900602 11,590916 7,749084
665 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (800 MG) SUSP. ORALA 19,290000 0,000000 9,645000 9,645000 17,361000 1,929000
666 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 19,318200 2,941800 9,659100 12,600900 17,386380 4,873620
667 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 38,636400 1,043600 19,318200 20,361800 34,772760 4,907240
668 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 48,295500 12,064500 24,147750 36,212250 43,465950 16,894050
669 J01FF01 CLINDAMYCINUM DALACIN C 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 8 CAPS.P-RF 16 0,497046 0,290454 0,248523 0,538977 0,447341 0,340159
670 J01FF01 CLINDAMYCINUM DALACIN C 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 8 CAPS.P-RF 16 0,994093 0,365907 0,497046 0,862954 0,894683 0,465317
671 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 300 mg COMPR. FILM. 300mg MIP PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF 16 0,883750 0,000000 0,441875 0,441875 0,795375 0,088375
672 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 300 mg COMPR. FILM. 300mg MIP PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM. P-RF 30 0,884000 0,000000 0,442000 0,442000 0,795600 0,088400
673 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 600 mg COMPR. FILM. 600mg MIP PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF 16 1,988187 0,660563 0,994093 1,654657 1,789368 0,859382
674 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 600 mg COMPR. FILM. 600mg MIP PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM. P-RF 30 1,988187 0,747146 0,994093 1,741240 1,789368 0,945965
675 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 250 mg COMPR. FILM. 250mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 1,555714 0,000000 0,777857 0,777857 1,400142 0,155572
676 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 2,451600 1,399828 1,225800 2,625628 2,206440 1,644988
677 J01MA12 LEVOFLOXACINUM LEVOTOR 250 mg COMPR. FILM. 250mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF 7 1,555714 0,000000 0,777857 0,777857 1,400142 0,155572
678 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 1,562000 0,000000 0,781000 0,781000 1,405800 0,156200
679 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 1,541000 0,000000 0,770500 0,770500 1,386900 0,154100
680 J01MA12 LEVOFLOXACINUM LEVALOX 250 mg COMPR. FILM. 250mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 2,451600 0,052685 1,225800 1,278485 2,206440 0,297845
681 J01MA12 LEVOFLOXACINUM FLERADAY 500 mg COMPR. FILM. 500 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/PVDC - AL X 7 COMPR. FILM. PRF 7 4,427142 0,000000 2,213571 2,213571 3,984427 0,442715
682 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 3,280000 0,000000 1,640000 1,640000 2,952000 0,328000
683 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 4,903200 1,688228 2,451600 4,139828 4,412880 2,178548
684 J01MA12 LEVOFLOXACINUM LEVOTOR 500 mg COMPR. FILM. 500mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF 7 3,228571 0,000000 1,614285 1,614286 2,905713 0,322858
685 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 4,422000 0,000000 2,211000 2,211000 3,979800 0,442200
686 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 4,175000 0,000000 2,087500 2,087500 3,757500 0,417500
687 J01MA12 LEVOFLOXACINUM LEVALOX 500 mg COMPR. FILM. 500mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 4,274285 0,000000 2,137142 2,137143 3,846856 0,427429

Pagina 11 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
688 J01MA14 MOXIFLOXACINUM AVELOX 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF 5 4,903200 6,180800 2,451600 8,632400 4,412880 6,671120
689 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA AUROBINDO 400 mg COMPR. FILM. 400mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
690 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
691 J01MA14 MOXIFLOXACINUM MOFIL 400 mg COMPR. FILM. 400mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR. FILM. PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
692 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINND 5 COMPRIMATE FILMATE PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
693 J02AC02 ITRACONAZOLUM * ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 3,194000 0,000000 1,597000 1,597000 2,874600 0,319400
694 J02AC02 ITRACONAZOLUM * ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS.P-RF 15 2,144666 0,000000 1,072333 1,072333 1,930199 0,214467
695 J02AC02 ITRACONAZOLUM * MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 2,144666 0,000000 1,072333 1,072333 1,930199 0,214467
696 J02AC02 ITRACONAZOLUM * ITRACONAZOL ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS.P-RF 15 2,144666 0,000000 1,072333 1,072333 1,930199 0,214467
697 J02AC02 ITRACONAZOLUM * OMICRAL 100 mg CAPS. 100mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 2,144666 0,000000 1,072333 1,072333 1,930199 0,214467
698 J02AC02 ITRACONAZOLUM * ITRACONAZOL FARMEX 100 mg CAPS. 100mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. PVCA/AL X 5 CAPS. PRF 15 2,144666 0,000000 1,072333 1,072333 1,930199 0,214467
699 J05AB11 VALACYCLOVIRUM * VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF 10 4,661000 0,000000 2,330500 2,330500 4,194900 0,466100
700 J05AB11 VALACYCLOVIRUM * VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM. PRF 10 3,131000 0,000000 1,565500 1,565500 2,817900 0,313100
701 J05AB15 BRIVUDINUM *# BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF 7 48,002857 0,000000 24,001428 24,001429 43,202571 4,800286
702 L01AA01 CYCLOPHOSPHAMIDUM * ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,542400 0,000000 0,271200 0,271200 0,488160 0,054240
703 L02AE03 GOSERELINUM ** # ZOLADEX (R) IMPLANT 3,6mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG S/P-RF 1 200,194996 102,965004 100,097498 203,062502 180,175496 122,984504
704 L02AE03 GOSERELINUM ** # RESELIGO 3,6 mg IMPLANT IN SERINGA PREUMPLUTA 3,6mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 PUNGA CU UN IMPLANT IN SERINGA PREUMPLUTA PR/PRF 1 197,040000 0,000000 98,520000 98,520000 177,336000 19,704000
705 L02AE04 TRIPTORELINUM ** # DIPHERELINE 0,1 mg LIOF. + SOLV. PT. SOL. INJ. 0,1mg IPSEN PHARMA FRANTA CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF 7 12,313285 1,368143 6,156642 7,524786 11,081956 2,599472
706 L02AE04 TRIPTORELINUM ** # DIPHERELINE PR 11,25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 11,25mg IPSEN PHARMA FRANTA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU 1 SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE S/P-RF 1 886,880000 0,000000 443,440000 443,440000 798,192000 88,688000
707 L02AE04 TRIPTORELINUM ** # DIPHERELINE 3,75 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 3,75mg IPSEN PHARMA FRANTA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU O SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE S/P-RF 1 371,770000 0,000000 185,885000 185,885000 334,593000 37,177000
708 L02AE04 TRIPTORELINUM ** # GONAPEPTYL ZILNIC 0,1 mg/ml SOL. INJ. 0,1mg/ml FERRING GMBH GERMANIA CUTIE X 28 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF 28 1,649981 20,522876 0,824990 21,347867 1,484982 20,687875
709 L04AX01 AZATHIOPRINUM * IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,000000 0,351150 0,351150 0,632070 0,070230
710 M01AC05 LORNOXICAMUM XEFO RAPID 8 mg COMPR. FILM. 8mg TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 10 0,431999 0,540001 0,215999 0,756001 0,388799 0,583201
711 M01AC05 LORNOXICAMUM XEFO 8 mg/ 2 ml PULB. + SOLV. PT. SOL. INJ. 8mg/2ml TAKEDA AUSTRIA GMBH AUSTRIA PRF
CUTIE CU 10 FLAC. DIN STICLA BRUNA CU PULB. PT. SOL. INJ. + 10 FIOLE DIN STICLA INCOLORA X 2 ML SOLV. PT. SOL. INJ. 10 1,309998 7,790002 0,654999 8,445001 1,178998 7,921002
712 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 0,475199 0,396801 0,237599 0,634401 0,427679 0,444321
713 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN TROMETAMOL SANDOZ 25mg COMPR. FILM. 25mg SANDOZ S.R.L. ROMANIA CUTIE BLIST. DIN PVC-PVDC/AL X 20 COMPRIMATE FILMATE P6L 20 0,475199 0,091801 0,237599 0,329401 0,427679 0,139321
714 M01AE17 DEXKETOPROFENUM TADOR INJECT SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF. P-RF 5 2,276000 1,788000 1,138000 2,926000 2,048400 2,015600
715 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA (UN SUPORT A 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF. PRF 5 2,276000 0,364000 1,138000 1,502000 2,048400 0,591600
716 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA (DOUA SUPORTURI A CATE 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF. PRF 10 2,276000 0,365000 1,138000 1,503000 2,048400 0,592600
717 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA PRF
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 30 COMPR. ELIB. MODIF. 30 1,611749 0,081251 0,805874 0,887126 1,450574 0,242426
718 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA PRF
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 60 COMPR. ELIB. MODIF. 60 1,584666 0,000000 0,792333 0,792333 1,426199 0,158467
719 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/ACLAR/AL X 10 CAPS. P-RF 30 0,589166 0,309167 0,294583 0,603750 0,530249 0,368084
720 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL X 10 CAPS. P-RF 30 0,589166 0,309167 0,294583 0,603750 0,530249 0,368084
721 M01AH01 CELECOXIBUM ALGOXIB 100 mg CAPS. 100mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 0,584000 0,000000 0,292000 0,292000 0,525600 0,058400
722 M01AH01 CELECOXIBUM ACLEXA 100 mg CAPS. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,584000 0,000000 0,292000 0,292000 0,525600 0,058400
723 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,584000 0,000000 0,292000 0,292000 0,525600 0,058400
724 M01AH01 CELECOXIBUM CELETOR 100 mg CAPS. 100mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 0,584000 0,000000 0,292000 0,292000 0,525600 0,058400
725 M01AH01 CELECOXIBUM CALIDEM 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,584000 0,000000 0,292000 0,292000 0,525600 0,058400
726 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 0,584000 0,000000 0,292000 0,292000 0,525600 0,058400
727 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL X 10 CAPS. P-RF 30 1,178333 0,635000 0,589166 1,224167 1,060499 0,752834
728 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. PVC/ACLAR/AL X 10 CAPS. P-RF 10 1,178333 0,967667 0,589166 1,556834 1,060499 1,085501
729 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 1,178333 0,967667 0,589166 1,556834 1,060499 1,085501
730 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/ACLAR/AL X 10 CAPS. P-RF 30 1,178333 0,635000 0,589166 1,224167 1,060499 0,752834
731 M01AH01 CELECOXIBUM ALGOXIB 200 mg CAPS. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 1,178333 0,000000 0,589166 0,589167 1,060499 0,117834
732 M01AH01 CELECOXIBUM ACLEXA 200 mg CAPS. 200mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,178333 0,000000 0,589166 0,589167 1,060499 0,117834
733 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 200 mg CAPS. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,178333 0,000000 0,589166 0,589167 1,060499 0,117834
734 M01AH01 CELECOXIBUM CELETOR 200 mg CAPS. 200mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 1,178333 0,000000 0,589166 0,589167 1,060499 0,117834
735 M01AH01 CELECOXIBUM CALIDEM 200 mg CAPS. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 10 CAPS. PRF 10 1,178333 0,215667 0,589166 0,804834 1,060499 0,333501
736 M01AH01 CELECOXIBUM CALIDEM 200 mg CAPS. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,178333 0,000000 0,589166 0,589167 1,060499 0,117834
737 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 200 mg CAPS. 200mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 1,178333 0,000000 0,589166 0,589167 1,060499 0,117834
738 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 2,356666 2,201905 1,178333 3,380238 2,120999 2,437572
739 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL, X 14 COMPR. FILM. P-RF 14 2,356666 2,054762 1,178333 3,233095 2,120999 2,290429
740 M01AH05 ETORICOXIBUM ARCOXIA 30 mg COMPR. FILM. 30mg MERCK SHARP & DOHME ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 28 0,589166 2,220834 0,294583 2,515417 0,530249 2,279751
741 M01AH05 ETORICOXIBUM ARCOXIA 30 mg COMPR. FILM. 30mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. DIN PA-AL-PVC/AL X 14 COMPRIMATE FILMATE PRF 28 0,589166 2,220834 0,294583 2,515417 0,530249 2,279751
742 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1,178333 2,018095 0,589166 2,607262 1,060499 2,135929
743 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 1,178333 2,018095 0,589166 2,607262 1,060499 2,135929
744 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 1,767499 1,749643 0,883749 2,633393 1,590749 1,926393
745 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1,767499 1,749643 0,883749 2,633393 1,590749 1,926393
746 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,304079 0,109121 0,152039 0,261161 0,273671 0,139529
747 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,666000 0,000000 0,333000 0,333000 0,599400 0,066600
748 M05BA04 ACIDUM ALENDRONICUM * TEVANAT 70 mg COMPR. 70 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L 4 2,705000 0,000000 1,352500 1,352500 2,434500 0,270500
749 M05BA04 ACIDUM ALENDRONICUM * ACID ALENDRONIC AUROBINDO 70 mgCOMPR. 70mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR. P6L 4 2,487500 0,000000 1,243750 1,243750 2,238750 0,248750
750 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 6,638587 6,981413 3,319293 10,300707 5,974728 7,645272

Pagina 12 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
751 M05BA04 ACIDUM ALENDRONICUM * ALENDRONAT SANDOZ 70 mg COMPR. FILM. 70mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM P-6L 2 4,890000 0,000000 2,445000 2,445000 4,401000 0,489000
752 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L 12 6,638587 1,497246 3,319293 4,816540 5,974728 2,161105
753 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM. P-6L 2 6,638587 2,211413 3,319293 5,530707 5,974728 2,875272
754 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 6,638587 1,928913 3,319293 5,248207 5,974728 2,592772
755 M05BA07 ACIDUM RISEDRONICUM * LORINE 35mg COMPR. FILM. 35mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L 4 6,638587 0,583913 3,319293 3,903207 5,974728 1,247772
756 M05BA07 ACIDUM RISEDRONICUM * OSODENS 35 mg COMPR. FILM. 35mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 6,638587 0,583913 3,319293 3,903207 5,974728 1,247772
757 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT SODIC ZENTIVA 35mg COMPR. FILM. 35mg ZENTIVA KS REPUBLICA CEHA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE P-6L 4 3,712500 0,000000 1,856250 1,856250 3,341250 0,371250
758 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 35 mg COMPR. FILM. 35mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L 4 3,712500 0,000000 1,856250 1,856250 3,341250 0,371250
759 M05BA07 ACIDUM RISEDRONICUM * ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 6,638587 4,111413 3,319293 7,430707 5,974728 4,775272
760 M05BA07 ACIDUM RISEDRONICUM * ACTONEL 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 14,225544 18,969456 7,112772 26,082228 12,802989 20,392011
761 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 14,225544 6,979456 7,112772 14,092228 12,802989 8,402011
762 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UIMERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 6,638587 11,851413 3,319293 15,170707 5,974728 12,515272
763 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UIMERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 6,638587 11,036413 3,319293 14,355707 5,974728 11,700272
764 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UITEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR., AMBALAJ TIP CALENDAR P6L 4 6,638587 0,663913 3,319293 3,983207 5,974728 1,327772
765 N02AA05 OXYCODONUM *# OXYCONTIN 10 mg COMPR. CU ELIB. MODIF. 10 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 0,437249 0,608584 0,218624 0,827209 0,393524 0,652309
766 N02AA05 OXYCODONUM *# OXYCONTIN 20 mg COMPR. CU ELIB. MODIF. 20 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 0,874498 0,971835 0,437249 1,409084 0,787048 1,059285
767 N02AA05 OXYCODONUM *# OXYCONTIN 40 mg COMPR. CU ELIB. MODIF. 40 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 1,748999 1,086334 0,874499 1,960834 1,574099 1,261234
768 N02AA05 OXYCODONUM *# OXYCONTIN 80 mg COMPR. CU ELIB. MODIF. 80mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 3,497999 1,584834 1,748999 3,333834 3,148199 1,934634
769 N02AA05 OXYCODONUM *# RELTEBON 10 mg COMPR. CU ELIB. PREL. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 0,437249 0,242417 0,218624 0,461042 0,393524 0,286142
770 N02AA05 OXYCODONUM *# RELTEBON 20 mg COMPR. CU ELIB. PREL. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 0,874498 0,325668 0,437249 0,762917 0,787048 0,413118
771 N02AA05 OXYCODONUM *# CLORHIDRAT DE OXICODONA TORRENT 20 mg COMPR. CU ELIB. PREL. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL. PR, PS 60 0,874498 0,325668 0,437249 0,762917 0,787048 0,413118
772 N02AA05 OXYCODONUM *# RELTEBON 40 mg COMPR. CU ELIB. PREL. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 1,748999 0,194334 0,874499 1,068834 1,574099 0,369234
773 N02AA05 OXYCODONUM *# CLORHIDRAT DE OXICODONA TORRENT 40 mg COMPR. CU ELIB. PREL. 40mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL. PR, PS 60 1,748999 0,194334 0,874499 1,068834 1,574099 0,369234
774 N02AA05 OXYCODONUM *# RELTEBON 80 mg COMPR. CU ELIB. PREL. 80mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 3,303666 0,000000 1,651833 1,651833 2,973299 0,330367
775 N02AA05 OXYCODONUM *# CLORHIDRAT DE OXICODONA TORRENT 80 mg COMPR. CU ELIB. PREL. 80mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL. PR, PS 60 3,304000 0,000000 1,652000 1,652000 2,973600 0,330400
776 N02AA05 OXYCODONUM *# OXIDOLOR 10 mg COMPR. ELIB. PREL. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 0,437249 0,242417 0,218624 0,461042 0,393524 0,286142
777 N02AA05 OXYCODONUM *# OXIDOLOR 20 mg COMPR. ELIB. PREL. 20mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 0,874498 0,325668 0,437249 0,762917 0,787048 0,413118
778 N02AA05 OXYCODONUM *# OXIDOLOR 40 mg COMPR. ELIB. PREL. 40mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 1,748999 0,194334 0,874499 1,068834 1,574099 0,369234
779 N02AA05 OXYCODONUM *# OXICODONA SANDOZ 40 mg COMPR. ELIB. PREL. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 1,748999 0,297001 0,874499 1,171501 1,574099 0,471901
780 N02AA05 OXYCODONUM *# OXICODONA SANDOZ 60 mg COMPR. ELIB. PREL. 60mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 2,623501 4,606499 1,311750 5,918250 2,361150 4,868850
781 N02AA05 OXYCODONUM *# OXIDOLOR 80 mg COMPR. ELIB. PREL. 80mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 3,303666 0,000000 1,651833 1,651833 2,973299 0,330367
782 N02AA05 OXYCODONUM *# OXICODONA SANDOZ 80 mg COMPR. ELIB. PREL. 80mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 3,497999 0,048501 1,748999 1,797501 3,148199 0,398301
783 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 120 mg COMPR. ELIB. PREL. 120mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1,366660 0,792447 0,683330 1,475777 1,229994 0,929113
784 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 0,543750 0,000000 0,271875 0,271875 0,489375 0,054375
785 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1,024995 0,437147 0,512497 0,949645 0,922495 0,539647
786 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAUMOBOL 37,5mg/325mg CAPS. 37,5mg/325mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 2 BLISTERE PVC/PE/PVDC/AL X 15 CAPSULE PRF 30 0,272666 0,241000 0,136333 0,377333 0,245399 0,268267
787 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAUMOBOL 37,5mg/325mg CAPS. 37,5mg/325mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU 1 BLIST. DIN PVC/PE/PVDC/AL A 15 CAPS. PRF 15 0,272666 0,253334 0,136333 0,389667 0,245399 0,280601
788 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA EP 75 mg/650 mg COMPR. ELIB. PREL. 75mg/650mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. ELIB. PREL. PRF 20 0,545332 0,380668 0,272666 0,653334 0,490798 0,435202
789 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA EP 75 mg/650 mg COMPR. ELIB. PREL. 75mg/650mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. PRF 30 0,545332 0,379001 0,272666 0,651667 0,490798 0,433535
790 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 10 0,272666 0,534334 0,136333 0,670667 0,245399 0,561601
791 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 2 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 20 0,272666 0,533834 0,136333 0,670167 0,245399 0,561101
792 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 3 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 30 0,272666 0,517334 0,136333 0,653667 0,245399 0,544601
793 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 5 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 50 0,272666 0,387534 0,136333 0,523867 0,245399 0,414801
794 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 10 0,272666 0,000334 0,136333 0,136667 0,245399 0,027601
795 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-RF 20 0,272500 0,000000 0,136250 0,136250 0,245250 0,027250
796 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 0,272666 0,000000 0,136333 0,136333 0,245399 0,027267
797 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) LINEROL 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 0,272666 0,251834 0,136333 0,388167 0,245399 0,279101
798 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAMADOL/PARACETAMOL AUROBINDO 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. PRF 20 0,272500 0,000000 0,136250 0,136250 0,245250 0,027250
799 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF 10 0,545000 0,000000 0,272500 0,272500 0,490500 0,054500
800 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF 20 0,545332 0,000168 0,272666 0,272834 0,490798 0,054702
801 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMP. FILM. PRF 30 0,545332 0,000001 0,272666 0,272667 0,490798 0,054535
802 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) PALGOTAL 75 mg/650 mg COMPR. FILM. 75mg/650mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVCDC/AL X 30 COMPR. FILM. PRF 30 0,537333 0,000000 0,268666 0,268667 0,483599 0,053734
803 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 3,291508 1,089206 1,645754 2,734960 2,962357 1,418357
804 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 3,291508 0,604742 1,645754 2,250496 2,962357 0,933893
805 N03AX16 PREGABALINUM ** # LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 6,045000 0,000000 3,022500 3,022500 5,440500 0,604500
806 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 1,645754 0,987103 0,822877 1,809980 1,481178 1,151679
807 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 1,645754 0,768174 0,822877 1,591051 1,481178 0,932750
808 N04BC05 PRAMIPEXOLUM * PRAMIPEXOLE ACCORD 0,088 mg COMPR. 0,088 mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 0,087075 0,436258 0,043537 0,479796 0,078367 0,444966
809 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,088mg COMPR. 0,088mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,087075 0,442925 0,043537 0,486463 0,078367 0,451633
810 N04BC05 PRAMIPEXOLUM * PRAMIPEXOLE ACCORD 0,18 mg COMPR. 0,18 mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 0,178109 0,144557 0,089054 0,233612 0,160298 0,162368
811 N04BC05 PRAMIPEXOLUM * PRAMIPEXOLE ACCORD 0,18 mg COMPR. 0,18 mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 10 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 100 0,178109 0,144391 0,089054 0,233446 0,160298 0,162202
812 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL ZENTIVA 0,18 mg COMPR. 0,18 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.PRF 30 0,178109 0,208557 0,089054 0,297612 0,160298 0,226368
813 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,178109 0,248557 0,089054 0,337612 0,160298 0,266368

Pagina 13 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
814 N04BC05 PRAMIPEXOLUM * MEDOPEXOL 0,18 mg COMPR. 0,18mg MEDOCHEMIE LTD. CIPRU 30
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 0,178109 0,473224 0,089054 0,562279 0,160298 0,491035
815 N04BC05 PRAMIPEXOLUM * GLEPARK 0,18 mg COMPR. 0,18mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR.
P-RF 30 0,178109 0,144557 0,089054 0,233612 0,160298 0,162368
816 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL TORRENT 0,18 mg COMPR. 0,18mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 0,178109 0,412557 0,089054 0,501612 0,160298 0,430368
817 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL AUROBINDO 0,18 mg COMPR. 0,18mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 0,178109 0,345224 0,089054 0,434279 0,160298 0,363035
818 N04BC05 PRAMIPEXOLUM * MIGLASEN 0,18 mg COMPR. 0,18mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,178109 0,335891 0,089054 0,424946 0,160298 0,353702
819 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL AUROBINDO 0,7 mg COMPR. 0,7 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 0,692649 1,196684 0,346324 1,543009 0,623384 1,265949
820 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL ZENTIVA 0,7 mg COMPR. 0,7 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.PRF 30 0,692649 1,416351 0,346324 1,762676 0,623384 1,485616
821 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,692649 1,335351 0,346324 1,681676 0,623384 1,404616
822 N04BC05 PRAMIPEXOLUM * MEDOPEXOL 0,7 mg COMPR. 0,7mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 0,692649 1,341684 0,346324 1,688009 0,623384 1,410949
823 N04BC05 PRAMIPEXOLUM * GLEPARK 0,7 mg COMPR. 0,7mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 0,692649 1,564017 0,346324 1,910342 0,623384 1,633282
824 N04BC05 PRAMIPEXOLUM * PRAMIPEXOLE ACCORD 0,7mg COMPR. 0,7mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 0,692649 1,196684 0,346324 1,543009 0,623384 1,265949
825 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL TORRENT 0,7 mg COMPR. 0,7mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 0,692649 1,745351 0,346324 2,091676 0,623384 1,814616
826 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL STADA 0,7 mg COMPR. 0,7mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR. P-RF 30 0,692649 1,334684 0,346324 1,681009 0,623384 1,403949
827 N04BC05 PRAMIPEXOLUM * PRAMIPEXOLE ACCORD 0,7mg COMPR. 0,7mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 10 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 100 0,692649 1,008751 0,346324 1,355076 0,623384 1,078016
828 N04BC05 PRAMIPEXOLUM * MIGLASEN 0,7 mg COMPR. 0,7mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,692649 1,755017 0,346324 2,101342 0,623384 1,824282
829 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,26 mg COMPR. ELIB. PREL. 0,26mg GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 10 0,257269 1,261731 0,128634 1,390366 0,231542 1,287458
830 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA P-RF 30
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 0,257269 0,378731 0,128634 0,507366 0,231542 0,404458
831 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,26 mg COMPR. ELIB. PREL. 0,26mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF 10 0,257269 0,378731 0,128634 0,507366 0,231542 0,404458
832 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,52 mg COMPR. ELIB. PREL. 0,52mg GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 30 0,514539 1,638794 0,257269 1,896064 0,463085 1,690248
833 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,52mg COMPR. ELIB. PREL. 0,52mg KRKA D.D. SLOVENIA P-RF 30
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 0,514539 0,885127 0,257269 1,142397 0,463085 0,936581
834 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,52 mg COMPR. ELIB. PREL. 0,52mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 0,514539 0,885127 0,257269 1,142397 0,463085 0,936581
835 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 1,05 mg COMPR. ELIB. PREL. 1,05mg GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 30 1,038974 3,063026 0,519487 3,582513 0,935076 3,166924
836 N04BC05 PRAMIPEXOLUM * OPRYMEA 1,05mg COMPR. ELIB. PREL. 1,05mg KRKA D.D. SLOVENIA P-RF 30
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 1,038974 1,086026 0,519487 1,605513 0,935076 1,189924
837 N04BC05 PRAMIPEXOLUM * OPRYMEA 1,57mg COMPR. ELIB. PREL. 1,57mg KRKA D.D. SLOVENIA P-RF 30
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 1,553513 3,495820 0,776756 4,272577 1,398161 3,651172
838 N04BC05 PRAMIPEXOLUM * OPRYMEA 2,10mg COMPR. ELIB. PREL. 2,10mg KRKA D.D. SLOVENIA P-RF 30
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 2,077948 2,644385 1,038974 3,683359 1,870153 2,852180
839 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 2,1 mg COMPR. ELIB. PREL. 2,1mg GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 30 2,077948 5,187052 1,038974 6,226026 1,870153 5,394847
840 N04BC05 PRAMIPEXOLUM * CALMOLAN 2,1 mg COMPR. ELIB. PREL. 2,1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 2,077948 2,644385 1,038974 3,683359 1,870153 2,852180
841 N04BC05 PRAMIPEXOLUM * OPRYMEA 2,62 mg COMPR. ELIB. PREL. 2,62mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 2,592487 5,834179 1,296243 7,130423 2,333238 6,093428
842 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 3,15 mg COMPR. ELIB. PREL. 3,15mg GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 30 3,116922 8,833078 1,558461 10,391539 2,805229 9,144771
843 N04BC05 PRAMIPEXOLUM * OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 3,116922 4,650411 1,558461 6,208872 2,805229 4,962104
844 N04BC08 PIRIBEDILUM ** PRONORAN 50 mg DRAJ. ELIB. PREL. 50mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL. P-RF 30 0,618436 0,316897 0,309218 0,626115 0,556592 0,378741
845 N05AL03 TIAPRIDUM TIAPRIDAL (R) 100 mg COMPR. 100mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,402000 0,000000 0,201000 0,201000 0,361800 0,040200
846 N05BE01 BUSPIRONUM SPITOMIN 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF 60 0,246333 0,000000 0,123166 0,123167 0,221699 0,024634
847 N05BE01 BUSPIRONUM SPITOMIN 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF 60 0,129916 0,020250 0,064958 0,085208 0,116924 0,033242
848 N06AB10 ESCITALOPRAMUM ** DEPRESINAL 10 mg COMPR. FILM. 10 mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 0,778666 0,000000 0,389333 0,389333 0,700799 0,077867
849 N06AB10 ESCITALOPRAMUM ** CIPRALEX 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 1,154250 0,110035 0,577125 0,687160 1,038825 0,225460
850 N06AB10 ESCITALOPRAMUM ** ESCITIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,848928 0,000000 0,424464 0,424464 0,764035 0,084893
851 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM-TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 0,776000 0,000000 0,388000 0,388000 0,698400 0,077600
852 N06AB10 ESCITALOPRAMUM ** LENUXIN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,848928 0,000000 0,424464 0,424464 0,764035 0,084893
853 N06AB10 ESCITALOPRAMUM ** ESLOREX 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,780666 0,000000 0,390333 0,390333 0,702599 0,078067
854 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0,780357 0,000000 0,390178 0,390179 0,702321 0,078036
855 N06AB10 ESCITALOPRAMUM ** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. PRF 14 0,848571 0,000000 0,424285 0,424286 0,763713 0,084858
856 N06AB10 ESCITALOPRAMUM ** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,000000 0,424464 0,424464 0,764035 0,084893
857 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0,778214 0,000000 0,389107 0,389107 0,700392 0,077822
858 N06AB10 ESCITALOPRAMUM ** ELICEA 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,780666 0,000000 0,390333 0,390333 0,702599 0,078067
859 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,778214 0,000000 0,389107 0,389107 0,700392 0,077822
860 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 0,765000 0,000000 0,382500 0,382500 0,688500 0,076500
861 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,000000 0,424464 0,424464 0,764035 0,084893
862 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM-TEVA 15 mg COMPR. FILM. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 1,130333 0,000000 0,565166 0,565167 1,017299 0,113034
863 N06AB10 ESCITALOPRAMUM ** ELICEA 15 mg COMPR. FILM. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,369000 0,000000 0,684500 0,684500 1,232100 0,136900
864 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM-TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 1,370000 0,000000 0,685000 0,685000 1,233000 0,137000
865 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 2,268571 0,000000 1,134285 1,134286 2,041713 0,226858
866 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 1,399642 0,000000 0,699821 0,699821 1,259677 0,139965
867 N06AB10 ESCITALOPRAMUM ** ELICEA 20 mg COMPR. FILM. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,406000 0,000000 0,703000 0,703000 1,265400 0,140600
868 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 10 mg COMPR. ORODISPERSABILE 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 0,780357 0,000000 0,390178 0,390179 0,702321 0,078036
869 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 10 mg COMPR. ORODISPERSABILE 10mg KRKA, D.D., NOVO MESTO SLOVENIA PRF 28
CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE 0,780357 0,000000 0,390178 0,390179 0,702321 0,078036
870 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA PRF 30
CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE 0,933666 0,000000 0,466833 0,466833 0,840299 0,093367
871 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 15 mg COMPR. ORODISPERSABILE 15mg KRKA, D.D., NOVO MESTO SLOVENIA PRF 28
CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE 1,369285 0,000000 0,684642 0,684643 1,232356 0,136929
872 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 15 mg COMPR. ORODISPERSABILE 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 1,351071 0,000000 0,675535 0,675536 1,215963 0,135108
873 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 20 mg COMPR. ORODISPERSABILE 20mg KRKA, D.D., NOVO MESTO SLOVENIA PRF 28
CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE 1,576785 0,000000 0,788392 0,788393 1,419106 0,157679
874 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 20 mg COMPR. ORODISPERSABILE 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 1,576785 0,000000 0,788392 0,788393 1,419106 0,157679
875 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 20 mg COMPR. ORODISPERSABILE 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA PRF 30
CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE 1,369000 0,000000 0,684500 0,684500 1,232100 0,136900
876 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 1,137124 0,126876 0,568562 0,695438 1,023411 0,240589

Pagina 14 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
877 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 60 1,094833 0,000000 0,547416 0,547417 0,985349 0,109484
878 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 60 1,094833 0,000000 0,547416 0,547417 0,985349 0,109484
879 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF 20 1,137124 0,126876 0,568562 0,695438 1,023411 0,240589
880 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-RF 30 0,568562 0,076104 0,284281 0,360385 0,511705 0,132961
881 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. ELIB. PREL. P-RF 30 0,568562 0,076104 0,284281 0,360385 0,511705 0,132961
882 N06AX12 BUPROPIONUM ** # ELONTRIL 150 mg COMPR. ELIB. MODIF. 150mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 1 FLAC. PEID CU DESICANT X 30 COMPR. ELIB. MODIF. P-RF 30 1,950333 0,000000 0,975166 0,975167 1,755299 0,195034
883 N06AX14 TIANEPTINUM ** LYXIT 12,5 mg COMPR. FILM. 12,5 mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 0,460333 0,000000 0,230166 0,230167 0,414299 0,046034
884 N06AX14 TIANEPTINUM ** LYXIT 12,5 mg COMPR. FILM. 12,5 mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 0,445222 0,000000 0,222611 0,222611 0,400699 0,044523
885 N06AX14 TIANEPTINUM ** NOBIXAL 12,5 mg COMPR. FILM. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF 30 0,460333 0,000000 0,230166 0,230167 0,414299 0,046034
886 N06AX14 TIANEPTINUM ** NOBIXAL 12,5 mg COMPR. FILM. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. PRF 30 0,460333 0,000000 0,230166 0,230167 0,414299 0,046034
887 N06AX14 TIANEPTINUM ** COAXIL (R) DRAJ. 12,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 0,460333 0,247333 0,230166 0,477500 0,414299 0,293367
888 N06AX21 DULOXETINUM ** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 1,192624 1,747376 0,596312 2,343688 1,073361 1,866639
889 N06AX21 DULOXETINUM ** DULSEVIA 30 mg CAPS. GASTROREZ. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 1,192624 0,007376 0,596312 0,603688 1,073361 0,126639
890 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 1,192624 0,745947 0,596312 1,342259 1,073361 0,865210
891 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1,192624 0,745947 0,596312 1,342259 1,073361 0,865210
892 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 30 mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 1,192624 0,350590 0,596312 0,946902 1,073361 0,469853
893 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 30 mg CAPS. GASTROREZ. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,192624 0,719042 0,596312 1,315354 1,073361 0,838305
894 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,179642 0,000000 0,589821 0,589821 1,061677 0,117965
895 N06AX21 DULOXETINUM ** DULOXETINA TEVA 30 mg CAPS. GASTROREZ. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,072333 0,000000 0,536166 0,536167 0,965099 0,107234
896 N06AX21 DULOXETINUM ** DULOXGAMMA 30 mg CAPS. GASTROREZ. 30mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,192624 0,819161 0,596312 1,415473 1,073361 0,938424
897 N06AX21 DULOXETINUM ** DULOXGAMMA 30 mg CAPS. GASTROREZ. 30mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1,192624 0,819161 0,596312 1,415473 1,073361 0,938424
898 N06AX21 DULOXETINUM ** DULASOLAN 30 mg CAPS. GASTROREZ. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 1,157666 0,000000 0,578833 0,578833 1,041899 0,115767
899 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1,192624 0,634161 0,596312 1,230473 1,073361 0,753424
900 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 1,192624 0,634161 0,596312 1,230473 1,073361 0,753424
901 N06AX21 DULOXETINUM ** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 2,385249 2,177608 1,192624 3,370233 2,146724 2,416133
902 N06AX21 DULOXETINUM ** DULSEVIA 60 mg CAPS. GASTROREZ. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 2,385249 0,114751 1,192624 1,307376 2,146724 0,353276
903 N06AX21 DULOXETINUM ** ZATINEX 60 mg CAPS. GASTROREZ. 60mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 2,385249 0,659393 1,192624 1,852018 2,146724 0,897918
904 N06AX21 DULOXETINUM ** ZATINEX 60 mg CAPS. GASTROREZ. 60mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 2,385249 0,659393 1,192624 1,852018 2,146724 0,897918
905 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 60 mg CAPS. GASTROREZ. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 2,385249 0,659393 1,192624 1,852018 2,146724 0,897918
906 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 60 mg CAPS. GASTROREZ. 60mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 2,385249 0,020822 1,192624 1,213447 2,146724 0,259347
907 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 60 mg CAPS. GASTROREZ. 60mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 2,385249 0,533084 1,192624 1,725709 2,146724 0,771609
908 N06AX21 DULOXETINUM ** DULOXETINA TEVA 60 mg CAPS. GASTROREZ. 60mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 2,116000 0,000000 1,058000 1,058000 1,904400 0,211600
909 N06AX21 DULOXETINUM ** DULOXGAMMA 60 mg CAPS. GASTROREZ. 60mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 2,385249 0,686893 1,192624 1,879518 2,146724 0,925418
910 N06AX21 DULOXETINUM ** DULOXGAMMA 60 mg CAPS. GASTROREZ. 60mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 2,385249 0,686893 1,192624 1,879518 2,146724 0,925418
911 N06AX21 DULOXETINUM ** DULASOLAN 60 mg CAPS. GASTROREZ. 60mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 2,240333 0,000000 1,120166 1,120167 2,016299 0,224034
912 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. GASTROREZ. PRF 30 2,380333 0,000000 1,190166 1,190167 2,142299 0,238034
913 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 2,380333 0,000000 1,190166 1,190167 2,142299 0,238034
914 N06BX16 PRAMIRACETAMUM ** # PRAMISTAR COMPR. FILM. 600mg F.I.R.M.A. S.P.A. (MENARINI GROUP) ITALIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR.FILM. P-6L 20 3,661500 0,000000 1,830750 1,830750 3,295350 0,366150
915 N06BX18 VINPOCETINUM VINPOCETINA VIM SPECTRUM 5 mg CAPS. 5mg VIM SPECTRUM SRLROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L 50 0,163400 0,000000 0,081700 0,081700 0,147060 0,016340
916 N06BX18 VINPOCETINUM CAVINTON(R) FORTE COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-6L 30 0,362232 0,035434 0,181116 0,216550 0,326008 0,071658
917 N06BX18 VINPOCETINUM CAVINTON(R) COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-6L 50 0,181116 0,070084 0,090558 0,160642 0,163004 0,088196
918 N07CA01 BETAHISTINUM VERTIMED 16 mg COMPR. 16mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR.P6L 30 0,317360 0,041640 0,158680 0,200320 0,285624 0,073376
919 N07CA01 BETAHISTINUM BETAHISTINA LPH 16 mg COMPR. 16mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,317360 0,264973 0,158680 0,423653 0,285624 0,296709
920 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,276000 0,000000 0,138000 0,138000 0,248400 0,027600
921 N07CA01 BETAHISTINUM EMPERIN 24 mg COMPR. 24 mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. P6L 60 0,432500 0,000000 0,216250 0,216250 0,389250 0,043250
922 N07CA01 BETAHISTINUM BETAHISTINA LPH 24 mg COMPR. 24 mg LABORMED PHARMA SA ROMANIA CUTIE CU 6 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 60 0,476041 0,000125 0,238020 0,238146 0,428436 0,047730
923 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 20 0,476000 0,000000 0,238000 0,238000 0,428400 0,047600
924 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 5 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 50 0,476041 0,000159 0,238020 0,238180 0,428436 0,047764
925 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR.P6L 30 0,437000 0,000000 0,218500 0,218500 0,393300 0,043700
926 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 60 COMPR.P6L 60 0,437333 0,000000 0,218666 0,218667 0,393599 0,043734
927 N07CA01 BETAHISTINUM VESTIBO 24 mg COMPR. 24mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,424333 0,000000 0,212166 0,212167 0,381899 0,042434
928 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 6 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 60 0,476041 0,000125 0,238020 0,238146 0,428436 0,047730
929 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 24 mg COMPR. 24mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,354166 0,000000 0,177083 0,177083 0,318749 0,035417
930 N07CA01 BETAHISTINUM MARBETA 24 mg COMPR. 24mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 60 0,476041 0,000125 0,238020 0,238146 0,428436 0,047730
931 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg BGP PRODUCTS B.V.OLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 60 0,476041 0,232959 0,238020 0,470980 0,428436 0,280564
932 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg BGP PRODUCTS B.V.OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0,476041 0,256459 0,238020 0,494480 0,428436 0,304064
933 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 30 0,158680 0,031320 0,079340 0,110660 0,142812 0,047188
934 N07CA01 BETAHISTINUM BETAHISTINA LPH 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,158680 0,030986 0,079340 0,110326 0,142812 0,046854
935 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 10 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 100 0,158680 0,031120 0,079340 0,110460 0,142812 0,046988
936 N07CA01 BETAHISTINUM VERTIMED 8 mg COMPR. 8mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 100 COMPR. P6L 100 0,158680 0,031120 0,079340 0,110460 0,142812 0,046988
937 N07CA01 BETAHISTINUM BETAHISTINA LPH 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 90 0,158680 0,031208 0,079340 0,110548 0,142812 0,047076
938 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 0,158680 0,021020 0,079340 0,100360 0,142812 0,036888
939 N07CA01 BETAHISTINUM MARBETA 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 100 0,158680 0,031120 0,079340 0,110460 0,142812 0,046988

Pagina 15 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
940 N07CA01 BETAHISTINUM BETASERC 8 mg COMPR. 8mg BGP PRODUCTS B.V.OLANDA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 0,158680 0,115720 0,079340 0,195060 0,142812 0,131588
941 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. ORODISPERSABILE 24mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ORODISPERSABILE P6L 60 0,476041 0,307959 0,238020 0,545980 0,428436 0,355564
942 N07CA01 BETAHISTINUM ACUVER 8 mg/doza SOL. ORALA 8mg/doza AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 60 ML SOL. ORALA
CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH P-6L 1 11,901037 17,048963 5,950518 22,999482 10,710933 18,239067
943 N07CA01 BETAHISTINUM ACUVER 8 mg/doza SOL. ORALA 8mg/doza AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 120 ML SOL. ORALA
CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH P-6L 1 23,802075 16,477925 11,901037 28,378963 21,421867 18,858133
944 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT COMPR. FARA CONCENTRATIE HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-RF 100 1,504600 0,000000 0,752300 0,752300 1,354140 0,150460
945 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT COMPR. FARA CONCENTRATIE HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 24 COMPR. P-RF 48 1,525116 0,061550 0,762558 0,824108 1,372604 0,214062
946 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA
SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 25,828000
CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF. 0,000000 12,914000 12,914000 23,245200 2,582800
947 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA
SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 15,321000
CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML SOL. INJ./CONC. PT. SOL. PERF. 2,407000 7,660500 10,067500 13,788900 3,939100
948 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA
SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 10 3,064200
CUTIE CU 10 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 1 ML SOL. INJ./CONC. PT. SOL. PERF. 1,004800 1,532100 2,536900 2,757780 1,311220
949 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 0,542833 0,000000 0,271416 0,271417 0,488549 0,054284
950 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL 200 mg COMPR. FILM. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM. P-6L 60 0,542833 0,000000 0,271416 0,271417 0,488549 0,054284
951 R01AD05 BUDESONIDUM * RHINOCORT AQUA 32 micrograme/doza SPRAY NAZAL SUSP. 32micrograme/doza ASTRAZENECA AB SUEDIA PRF 1 26,220000
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SPRAY NAZAL, SUSP. ECHIVALENT CU 120 DOZE, PREVAZUT CU POMPA DOZATOARE, APLICATOR SI CAPAC DE PROTECTIE 0,000000 13,110000 13,110000 23,598000 2,622000
952 R01AD08 FLUTICASONUM * FLIXONASE 0,05g/100g SPRAY NAZAL SUSP. 0,05g/100g GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON X 120 DOZE, PREVAZUT CU POMPA DOZATOARE P-RF 1 28,340000 0,000000 14,170000 14,170000 25,506000 2,834000
953 R01AD09 MOMETASONUM * MOMETAZONA FUROAT CIPLA 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza CIPLA (EU) LIMITED MAREA BRITANIE PRF 1 22,707500
CUTIE CU UN FLAC. DIN PEID, PREVAZUT CU POMPA DOZATOARE MANUALA DIN PP CARE CONTINE 18 G SUSPENSIE, ECHIVALENT CU 140 DOZE 0,002500 11,353750 11,356250 20,436750 2,273250
954 R01AD09 MOMETASONUM * KALMENTE 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza ALVOGEN IPCO S.AR.L. LUXEMBURG PRF 1 22,700000
CUTIE CU 1 FLAC. PEID PREVAZUT CU POMPA DOZATOARE SI APLICATOR NAZAL CARE CONTINE SPRAY NAZAL, SUSP. PT. 140 PULVERIZARI 0,000000 11,350000 11,350000 20,430000 2,270000
955 R01AD09 MOMETASONUM * MOMETAZONA FUROAT SANDOZ 50 micrograme/doza SPRAY NAZ.,SUSP. 50micrograme/doza SANDOZ S.R.L. ROMANIA PRF 1 22,707500
CUTIE CU 1 FLAC. PEID PREVAZUT CU O POMPA PULVERIZATOARE NAZALA DIN PE/PP CARE CONTINE 18 G SUSP. NAZALA CORESPUNZATOR LA 140 DOZE MASURATE 0,002500 11,353750 11,356250 20,436750 2,273250
956 R01AD09 MOMETASONUM * NASONEX 50mcg/doza SPRAY NAZAL SUSP. 50mcg/doza MERCK SHARP & DOHME ROMANIA P-RF 1 22,707500
CUTIE X 1 FLACON DIN PE PREVAZUT CU POMPA DOZATOARE, DISPOZITIV DE ACTIONARE DIN PP SI CAPAC, CU UN VOLUM DE 23,5 ML SUSPENSIE PT. 140 PULVERIZARI SPRAY NAZAL, SUSPENSIE 11,092500 11,353750 22,446250 20,436750 13,363250
957 R03AC04 FENOTEROLUM BEROTEC N - 100 mcg 100mcg/doza
SOL. DE INHALAT PRESURIZATA GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 1 16,660000
CUTIE X 1 FLACON PRESURIZAT X 200 DOZE SOL. DE INHALAT PRESURIZATA 0,000000 8,330000 8,330000 14,994000 1,666000
958 R03AC13 FORMOTEROLUM ** ATIMOS 0,012mg/doza 0,012mg/doza TORREX CHIESI PHARMA GMBH
SOL. DE INHALAT PRESURIZATA AUSTRIA CUTIE X 1 FLACON X 100 DOZE + VALVA DOZATOARE P-6L 1 127,460000 0,000000 63,730000 63,730000 114,714000 12,746000
959 R03AC18 INDACATEROLUM ** ONBREZ BREEZHALER 150 g CAPS. CU PULB.INHAL. 150 g NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIECU BLIST. DIN PA/AL/PVC X 30 CAPSULE (3 BIST X10)+ UN INHALATOR PRF 30 2,685625 1,611375 1,342812 2,954188 2,417062 1,879938
960 R03AC18 INDACATEROLUM ** ONBREZ BREEZHALER 300 g CAPS. CU PULB.INHAL. 300 g NOVARTIS EUROPHARM LTD. MAREA BRITANIE PRF 30 4,297000
CUTIE CU BLIST. DIN PA/AL/PVC X 30 CAPSULE (1 BLIST. X10)+ UN INHALATOR 0,000000 2,148500 2,148500 3,867300 0,429700
961 R03AK03 COMBINATII (FENOTEROLUM + IPRATROPIUM) * BERODUAL (R) N AEROSOL SOL. INHAL. 0,020mg+0,050mg GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 1 33,540000
CUTIE X 1 FLACON PRESURIZAT DIN OTEL X 200 DOZE SOLUTIE DE INHALAT PRESURIZATA 0,000000 16,770000 16,770000 30,186000 3,354000
962 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/100 micrograme PULB. INHAL. GLAXO WELLCOME UK LIMITED
50micrograme/100micrograme MAREA BRITANIE P6L 1 36,388000
CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL. 70,572000 18,194000 88,766000 32,749200 74,210800
963 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/250 micrograme PULB. INHAL. GLAXOWELLCOME UK LTD. MAREA BRITANIE
50micrograme/250micrograme P6L 1 90,970000
CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL. 45,080000 45,485000 90,565000 81,873000 54,177000
964 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/500 micrograme PULB. INHAL. GLAXOWELLCOME UK LTD. MAREA BRITANIE
50micrograme/500micrograme P6L 1 181,940000
CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL. 0,170000 90,970000 91,140000 163,746000 18,364000
965 R03AK06 SALMETEROLUM+FLUTICASONUM * AIRFLUSAL FORSPIRO 50 micrograme/500 micrograme/doza PULB. UNIDOZA DE INHAL. SANDOZ S.R.L.
50micrograme/500micrograme/doz ROMANIA P6L 1 124,830000
CUTIE CU BLISTER OPA-AL-PVC/AL CONTINAND 1 DISPOZITIV X 60 DOZE CU PULB. DE INHALAT 0,000000 62,415000 62,415000 112,347000 12,483000
966 R03AK06 SALMETEROLUM+FLUTICASONUM * AIRFLUSAL FORSPIRO 50 micrograme/250 micrograme/doza PULB. UNIDOZA DE INHALAT SANDOZ S.R.L.
50micrograme/250micrograme/doz ROMANIA P6L 1 90,970000
CUTIE CU 1 DISPOZITIV INHALATOR DIN PLASTIC CONTINAND BLISTERE DIN OPA-AL-PVC/AL X 60 UNIDOZE PULBERE DE INHALAT 2,280000 45,485000 47,765000 81,873000 11,377000
967 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE 25 mcg/125 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/125mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE P-6L 1 90,970000
CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA 44,160000 45,485000 89,645000 81,873000 53,257000
968 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE 25 mcg/50 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/50mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE P-6L 1 36,388000
CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA 70,992000 18,194000 89,186000 32,749200 74,630800
969 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/125 micrograme/doza SUSP. INHAL. PRESURIZATA CIPLA EUROPE NV BELGIA
25micrograme/125micrograme/doz PRF 1 90,970000
CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS NTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA 0,000000 45,485000 45,485000 81,873000 9,097000
970 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/250 micrograme/doza SUSP. INHAL. PRESURIZATA CIPLA EUROPE NV BELGIA
25micrograme/250micrograme/doz PRF 1 116,890000
CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS NTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA 0,000000 58,445000 58,445000 105,201000 11,689000
971 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. ASTRAZENECA AB SUEDIA
160micrograme/4,5micrograme/in P6L 1 74,496666
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 16,763334 37,248333 54,011667 67,046999 24,213001
972 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie PULB. DE INHAL. ASTRAZENECA AB SUEDIA
320micrograme/9micrograme/inha P6L 1 148,993333
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 14,796667 74,496666 89,293334 134,093999 29,696001
973 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. ASTRAZENECA AB SUEDIA
80micrograme/4,5micrograme/inh P6L 1 74,496666
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 0,823334 37,248333 38,071667 67,046999 8,273001
974 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER 100/6 micrograme pe doza 100/6micrograme pe doza
SOL. DE INHALAT PRESURIZATA CHIESI PHARMACEUTICALS GMBH AUSTRIA PRF 1 216,080000
CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS IN DISPOZITIVUL DE ADMINISTRARE DIN PE CU CAPAC PROTECTOR DIN PLASTIC A 180 DOZE SOL. DE INHALAT 0,000000 108,040000 108,040000 194,472000 21,608000
975 R03AL04 COMBINATII (INDACATEROLUM+GLICOPIRONIUM) ** ULTIBRO BREEZHALER 85 micrograme/43 micrograme CAPS. CU PULB. DE INHAL. NOVARTIS EUROPHARM LTD. MAREA BRITANIE
85micrograme/43micrograme PR/PRF 30 8,954333
CUTIE X 30 BLISTERE PERFORATE PA-AL-PVC/AL PENTRU ELIBERAREA UNEI UNITATI DOZATE X 1 CAPSULA CU PULBERE DE INHALAT + 1 INHALATOR 0,000000 4,477166 4,477167 8,058899 0,895434
976 R03AL05 ACLIDINIUM BROMIDUM+FORMOTEROLUM FUMARAT ** DUAKLIR GENUAIR 340 micrograme/12 micrograme PULB. DE INHAL. ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR A 60 DE DOZE PRF
340 micrograme/12 micrograme 1 241,990000 0,000000 120,995000 120,995000 217,791000 24,199000
977 R03AL05 ACLIDINIUM BROMIDUM+FORMOTEROLUM FUMARAT ** BRIMICA GENUAIR 340 micrograme/12 micrograme PULB. DE INHAL. ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR A 60 DE DOZE PRF
340 micrograme/12 micrograme 1 241,990000 0,000000 120,995000 120,995000 217,791000 24,199000
978 R03AL06 COMBINATII (TIOTROPIUM+OLODATEROLUM) ** SPIOLTO RESPIMAT 2,5 micrograme/2,5 micrograme SOL. DE INHALAT 2,5 micrograme/2,5 micrograme GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH PRF 1 268,880000
CUTIE CU AMBALAJ UNIC FORMAT DINTR-UN INHALATOR RESPIMAT SI UN CARTUS, CARE FURNIZEAZA 60 DE PUFURI SOLUTIE PENTRU INHALAT (30 DE DOZE TERAPEUTICE) 0,000000 134,440000 134,440000 241,992000 26,888000
979 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 100 mcg PULB. INHAL.100mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE P-RF 1 21,272400
CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE 13,857600 10,636200 24,493800 19,145160 15,984840
980 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 250 mcg PULB. INHAL.250mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE P-RF 1 53,181000
CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE 13,899000 26,590500 40,489500 47,862900 19,217100
981 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 500 mcg PULB. INHAL.500mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE P-RF 1 106,362000
CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE 11,818000 53,181000 64,999000 95,725800 22,454200
982 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE 125 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 125mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE P-RF 1 26,590500
CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA 7,419500 13,295250 20,714750 23,931450 10,078550
983 R03BA05 FLUTICASONUM PROPIONAT * TRUFLO 125 micrograme SUSP. INHAL. PRESURIZATA 125micrograme CIPLA (EU) LIMITED MAREA BRITANIE PRF 1 44,210000
CUTIE CU 1 RECIPIENT DIN AL SUB PRESIUNE PREVAZUT CU O VALVA DE MASURARE, UN DOZATOR DIN PP CU CAPAC, INTRODUS NTR-O PUNGA DE AL CU SACULET DE SILICAGEL CARE CONTINE 120 DOZE SUSP. DE INHALAT PRESURIZATA 0,000000 22,105000 22,105000 39,789000 4,421000
984 R03BA05 FLUTICASONUM PROPIONAT * TRUFLO 250 micrograme SUSP. INHAL. PRESURIZATA 250micrograme CIPLA (EU) LIMITED MAREA BRITANIE PRF 1 75,920000
CUTIE CU 1 RECIPIENT DIN AL SUB PRESIUNE PREVAZUT CU O VALVA DE MASURARE, UN DOZATOR DIN PP CU CAPAC, INTRODUS NTR-O PUNGA DE AL CU SACULET DE SILICAGEL CARE CONTINE 120 DOZE SUSP. DE INHALAT PRESURIZATA 0,000000 37,960000 37,960000 68,328000 7,592000
985 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE (R) 50 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 50mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE P-RF 1 21,272400
CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE 13,947600 10,636200 24,583800 19,145160 16,074840
986 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 0,5 mg/2 ml 0,5mg/2ml GLAXO WELLCOME UK LIMITED
SUSP. INHAL. PRIN NEBULIZATOR MAREA BRITANIE PRF 10 0,709079
CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP 2,096921 0,354539 2,451461 0,638171 2,167829
987 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 2 mg/2 ml 2mg/2ml
SUSP. INHAL. PRIN NEBULIZATOR GLAXO WELLCOME UK LIMITED MAREA BRITANIE PRF 10 2,836319
CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP 5,369681 1,418159 6,787841 2,552687 5,653313
988 R03BA07 MOMETASONUM * ASMANEX TWISTHALER 200 g PULB. INHAL.200g/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L 1 33,613750 7,016250 16,806875 23,823125 30,252375 10,377625
989 R03BA07 MOMETASONUM * ASMANEX TWISTHALER 400 g PULB. INHAL.400g/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L 1 62,550000 0,000000 31,275000 31,275000 56,295000 6,255000
990 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER 160g/doza NYCOMED GMBH GERMANIA
SOL. DE INHALAT PRESURIZATA P-RF 1 86,070000
CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA 0,000000 43,035000 43,035000 77,463000 8,607000
991 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER 160g/doza TAKEDA GMBH
SOL. DE INHALAT PRESURIZATA GERMANIA P-RF 1 86,070000
CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA 0,000000 43,035000 43,035000 77,463000 8,607000
992 R03BA08 CICLESONIDUM * ALVESCO 80 INHALER 80g/doza NYCOMED GMBH GERMANIA
SOL. DE INHALAT PRESURIZATA P-RF 1 43,035000
CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA 21,085000 21,517500 42,602500 38,731500 25,388500
993 R03BA08 CICLESONIDUM * ALVESCO 80 INHALER 80g/doza TAKEDA GMBH
SOL. DE INHALAT PRESURIZATA GERMANIA P-RF 1 43,035000
CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA 21,085000 21,517500 42,602500 38,731500 25,388500
994 R03BB04 TIOTROPIUM * SPIRIVA 18 micrograme CAPS. CU PULB. INHAL. 18micrograme GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH PRF 30 5,127666
CUTIE CU 3 BLIST. AL/PVC/AL X 10 CAPS. CU PULB. DE INHALAT + 1 DISPOZITIV HANDIHALER 0,236334 2,563833 2,800167 4,614899 0,749101
995 R03BB04 TIOTROPIUM * SPIRIVA RESPIMAT 2,5 micrograme SOL. DE INHALAT 2,5micrograme GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH PRF 1 153,829999
CUTIE CU 1 AMBALAJ UNIC CU UN INHALATOR RESPIMAT SI UN CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. PT. INHALAT 4,250001 76,914999 81,165001 138,446999 19,633001
996 R03BB06 GLICOPIRONIUM BROMIDUM ** SEEBRI BREEZHALER CAPS. CU PULB. INHAL. 44 micrograme NOVARTIS EUROPHARM LTD. MAREA BRITANIE PRF 30 4,986000
CUTIE CU BLIST. PERFORATE PA-AL-PVC/AL CE CONTINE 30 X 1 CAPSULA CU PULBERE PENTRU INHALAT INSOTITE DE UN INHALATOR 0,000000 2,493000 2,493000 4,487400 0,498600
997 R03DA05 AMINOPHYLLINUM MIOFILIN 100 mg CAPS. 100mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,172934 0,015066 0,086467 0,101533 0,155640 0,032360
998 R03DA05 AMINOPHYLLINUM AMINOFILINA EEL COMPR. 100mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0,140800 0,000000 0,070400 0,070400 0,126720 0,014080
999 R03DA05 AMINOPHYLLINUM AMINOFILINA ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-RF 40 0,172934 0,007316 0,086467 0,093783 0,155640 0,024610
1.000 R03DA05 AMINOPHYLLINUM AMINOFILINA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,345870 0,054630 0,172935 0,227565 0,311283 0,089217
1.001 R03DA05 AMINOPHYLLINUM MIOFILIN 24mg/ml SOL. INJ. 24mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU INEL DE RUPERE X 10 ML SOL.INJ. S/P-RF 5 2,452000 0,000000 1,226000 1,226000 2,206800 0,245200
1.002 R03DC03 MONTELUKASTUM * ASTHATOR 10 mg COMPR. 10 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,773666 0,942762 0,386833 1,329595 0,696299 1,020129

Pagina 16 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
1.003 R03DC03 MONTELUKASTUM * SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L 28 0,773666 1,779191 0,386833 2,166024 0,696299 1,856558
1.004 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. FILM. P6L 28 0,720714 0,000000 0,360357 0,360357 0,648642 0,072072
1.005 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P6L 30 0,721000 0,000000 0,360500 0,360500 0,648900 0,072100
1.006 R03DC03 MONTELUKASTUM * MONTELUKAST ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,773666 0,052667 0,386833 0,439500 0,696299 0,130034
1.007 R03DC03 MONTELUKASTUM * MONKASTA 10 mg COMPR. FILM. 10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. FILM. P6L 28 0,773666 0,225619 0,386833 0,612452 0,696299 0,302986
1.008 R03DC03 MONTELUKASTUM * STANGEN 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. FILM. P6L 28 0,773666 0,225619 0,386833 0,612452 0,696299 0,302986
1.009 R03DC03 MONTELUKASTUM * SOLOK 10 mg COMPR. FILM. 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,773666 0,942762 0,386833 1,329595 0,696299 1,020129
1.010 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,773666 0,168476 0,386833 0,555309 0,696299 0,245843
1.011 R03DC03 MONTELUKASTUM * MONTELUKAST ABBOTT 10 mg COMPR. FILM. 10mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,773666 0,942762 0,386833 1,329595 0,696299 1,020129
1.012 R03DC03 MONTELUKASTUM * MONTELUKAST CIPLA 10 mg COMPR. FILM. 10mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. LAMINATE FORMATE DIN 3 STRATURI AL/AL SI AL (NYLON-AL-PVC/AL) X 28 COMPR. FILM. P6L 28 0,540000 0,000000 0,270000 0,270000 0,486000 0,054000
1.013 R03DC03 MONTELUKASTUM * ASTHATOR 4 mg COMPR. MAST. 4 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 0,513714 1,074500 0,256857 1,331357 0,462342 1,125872
1.014 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 4 mg COMPR. MAST. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L 28 0,513714 0,014143 0,256857 0,271000 0,462342 0,065515
1.015 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 4 mg COMPR. MAST. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L 30 0,513714 0,013619 0,256857 0,270476 0,462342 0,064991
1.016 R03DC03 MONTELUKASTUM * MONTELUKAST ACTAVIS 4 mg COMPR. MAST. 4mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L 30 0,434000 0,000000 0,217000 0,217000 0,390600 0,043400
1.017 R03DC03 MONTELUKASTUM * MONKASTA 4 mg COMPR. MAST. 4mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L 28 0,513714 0,234857 0,256857 0,491714 0,462342 0,286229
1.018 R03DC03 MONTELUKASTUM * STANGEN 4 mg COMPR. MAST. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST. P6L 28 0,513714 0,014143 0,256857 0,271000 0,462342 0,065515
1.019 R03DC03 MONTELUKASTUM * SOLOK 4 mg COMPR. MAST. 4mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PAPVC/AL X 28 COMPR. MAST. P6L 28 0,513714 1,054500 0,256857 1,311357 0,462342 1,105872
1.020 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 4 mg COMPR. MAST. 4mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,513714 0,204857 0,256857 0,461714 0,462342 0,256229
1.021 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,513714 1,848071 0,256857 2,104928 0,462342 1,899443
1.022 R03DC03 MONTELUKASTUM * MONTELUKAST ABBOTT 4 mg COMPR. MAST. 4mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,513714 1,073786 0,256857 1,330643 0,462342 1,125158
1.023 R03DC03 MONTELUKASTUM * MONTELUKAST CIPLA 4 mg COMPR. MAST. 4mg CIPLA (EU) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-PVC/AL X 28 COMPR. MAST. P6L 28 0,472857 0,000000 0,236428 0,236429 0,425571 0,047286
1.024 R03DC03 MONTELUKASTUM * ASTHATOR 5 mg COMPR. MAST. 5 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 0,642142 1,074286 0,321071 1,395357 0,577927 1,138501
1.025 R03DC03 MONTELUKASTUM * SINGULAIR (R) COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 28 0,642142 1,910715 0,321071 2,231786 0,577927 1,974930
1.026 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 5 mg COMPR. MAST. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L 28 0,542500 0,000000 0,271250 0,271250 0,488250 0,054250
1.027 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 5 mg COMPR. MAST. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L 30 0,542333 0,000000 0,271166 0,271167 0,488099 0,054234
1.028 R03DC03 MONTELUKASTUM * MONTELUKAST ACTAVIS 5 mg COMPR. MAST. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L 30 0,483666 0,000000 0,241833 0,241833 0,435299 0,048367
1.029 R03DC03 MONTELUKASTUM * MONKASTA 5 mg COMPR. MAST. 5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L 28 0,642142 0,138215 0,321071 0,459286 0,577927 0,202430
1.030 R03DC03 MONTELUKASTUM * STANGEN 5 mg COMPR. MAST. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST. P6L 28 0,642142 0,017500 0,321071 0,338571 0,577927 0,081715
1.031 R03DC03 MONTELUKASTUM * SOLOK 5 mg COMPR. MAST. 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA/PVC/AL X 28 COMPR. MAST.P6L 28 0,642142 1,074286 0,321071 1,395357 0,577927 1,138501
1.032 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 5 mg COMPR. MAST. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,642142 0,131429 0,321071 0,452500 0,577927 0,195644
1.033 R03DC03 MONTELUKASTUM * MONTELUKAST ABBOTT 5 mg COMPR. MAST. 5mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,642142 1,074286 0,321071 1,395357 0,577927 1,138501
1.034 R03DC03 MONTELUKASTUM * MONTELUKAST CIPLA 5 mg COMPR. MAST. 5mg CIPLA (EU) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-PVC/AL X 28 COMPR. MAST. P6L 28 0,500357 0,000000 0,250178 0,250179 0,450321 0,050036
1.035 R03DC03 MONTELUKASTUM * ASTMASAN 4 mg GRANULE 4mg SANDOZ S.R.L. ROMANIA CUTIE CU 28 PLICURI PET/AL/PE CONTINAND GRANULE P6L 28 0,513714 1,074500 0,256857 1,331357 0,462342 1,125872
1.036 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg GRANULE 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 0,513714 1,848071 0,256857 2,104928 0,462342 1,899443
1.037 R03DX03 FENSPIRIDUM EURESPAL 80 mg 80mg
COMPR. CU ELIBERARE PRELUNGITA LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.CU ELIBERARE PRELUGITA P-6L 30 0,952666 0,000000 0,476333 0,476333 0,857399 0,095267
1.038 R03DX03 FENSPIRIDUM EURESPAL 2 mg/ml SIROP 2mg/ml LES LAB. SERVIER IND. FRANTA CUTIE X 1 FLACON PVC DE CULOARE BRUNA X 150 ML P-6L 1 20,370000 0,000000 10,185000 10,185000 18,333000 2,037000
1.039 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE 20 mg COMPR. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,352000 0,000000 0,176000 0,176000 0,316800 0,035200
1.040 R05DA09 DEXTROMETHORPHANUM ROFEDEX SIROP 15mg/5ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOARE P-RF 1 5,470000 0,000000 2,735000 2,735000 4,923000 0,547000
1.041 R05DA09 DEXTROMETHORPHANUM HUMISEC pentru adulti 20mg/15 ml SIROP 20mg/15 ml LAB. URGO SA FRANTA CUTIE X 1 FLACON X 200 ML + O MASURA DOZATOARE DIN POLIPROPILENA P-RF 1 4,850066 5,969934 2,425033 8,394967 4,365059 6,454941
1.042 R05DA09 DEXTROMETHORPHANUM HUMISEC pentru copii 5mg/5ml SIROP 5mg/5ml LAB. URGO SA FRANTA CUTIE X 1 FLACON X 125 ML SIROP + O MASURA DOZATOARE PENTRU MASURAREA VOLUMELOR 2,5ML; 5ML; 7,5ML; 15ML P-RF 1 8,460000 0,000000 4,230000 4,230000 7,614000 0,846000
1.043 R05DA09 DEXTROMETHORPHANUM TUSSIN 6,5mg/5ml SIROP 6,5mg/5ml ROPHARMA S.A. ROMANIA CUTIE X 1 FLAC. X 115ML SIROP + O LINGURITA DOZATOARE GRADATA LA 1,25ML; 2,5ML SI 5 ML P-RF 1 2,725883 5,444117 1,362941 6,807059 2,453294 5,716706
1.044 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN JUNIOR SOL. ORALA 3,75mg/5ml PFIZER CORPORATION AUSTRIA GMBH AUSTRIA CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M P-RF 1 6,042000 2,898000 3,021000 5,919000 5,437800 3,502200
1.045 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN ANTITUSSICUM SOL. ORALA 7,5mg/5ml PFIZER CORPORATION AUSTRIA GMBH AUSTRIA CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M P-RF 1 2,734999 6,205001 1,367499 7,572501 2,461499 6,478501
1.046 R06AE09 LEVOCETIRIZINUM XYZAL (R) COMPR. FILM. 5mg U.C.B. GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM.
P-6L 30 0,863333 0,000000 0,431666 0,431667 0,776999 0,086334
1.047 R06AE09 LEVOCETIRIZINUM LEVOCETIRIZINA SANDOZ 5 mg COMPR. FILM. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 0,561000 0,000000 0,280500 0,280500 0,504900 0,056100
1.048 R06AE09 LEVOCETIRIZINUM CETIZAL 5 mg COMPR. FILM. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 0,561000 0,000000 0,280500 0,280500 0,504900 0,056100
1.049 R06AE09 LEVOCETIRIZINUM LEVOCETIRIZINA ACTAVIS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 10 0,362000 0,000000 0,181000 0,181000 0,325800 0,036200
1.050 R06AE09 LEVOCETIRIZINUM ZENARO 5 mg COMPR. FILM. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 20 COMPR. FILM. P6L 20 0,561000 0,000000 0,280500 0,280500 0,504900 0,056100
1.051 R06AE09 LEVOCETIRIZINUM ZENARO 5 mg COMPR. FILM. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L 20 0,561000 0,000000 0,280500 0,280500 0,504900 0,056100
1.052 R06AE09 LEVOCETIRIZINUM XYZAL PIC. ORALE, SOL. 5mg/ml UCB PHARMA GMBHGERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR P-6L 1 20,196000 5,534000 10,098000 15,632000 18,176400 7,553600
1.053 R06AE09 LEVOCETIRIZINUM ZENARO 0,5 mg/ml SIROP 0,5mg/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPAC DIN PP PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 200ML SIROP + 1 LINGURITA DOZATOARE DE 5ML P6L 1 20,196000 3,644000 10,098000 13,742000 18,176400 5,663600
1.054 R06AX27 DESLORATADINUM DYNID 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU BLIST. AL/AL X 30 COMPR.
REPUBLICA CEHA P6L 30 0,402833 0,119500 0,201416 0,320917 0,362549 0,159784
1.055 R06AX27 DESLORATADINUM DESLORATADINA ACTAVIS COMPR. FILM. 5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 10 PRF 10 0,322000 0,000000 0,161000 0,161000 0,289800 0,032200
1.056 R06AX27 DESLORATADINUM DESLORATADINA ACTAVIS COMPR. FILM. 5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X30 PRF 30 0,322666 0,000000 0,161333 0,161333 0,290399 0,032267
1.057 R06AX27 DESLORATADINUM DASSELTA COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE PRF 30 0,363000 0,000000 0,181500 0,181500 0,326700 0,036300
1.058 R06AX27 DESLORATADINUM DESLORATADINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. PCTFE-PVC/AL X 30 COMPR. FILM. P6L 30 0,402833 0,150167 0,201416 0,351584 0,362549 0,190451
1.059 R06AX27 DESLORATADINUM LORDESTIN 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,402833 0,136500 0,201416 0,337917 0,362549 0,176784
1.060 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 10 0,402833 0,444167 0,201416 0,645584 0,362549 0,484451
1.061 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 30 0,402833 0,448167 0,201416 0,649584 0,362549 0,488451
1.062 R06AX27 DESLORATADINUM AERIUS 2,5mg COMPR. ORODISPERSABILE 2,5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF 30 0,201416 0,786250 0,100708 0,886958 0,181274 0,806392
1.063 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. ORODISPERSABILE 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF 30 0,402833 0,584833 0,201416 0,786250 0,362549 0,625117
1.064 R06AX27 DESLORATADINUM DESLORATADINA SANDOZ 0.5 mg/ml SOL. ORALA 0,5 mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 125 ML X 120 ML, SOL. ORALA + LINGURITA DOZATOARE DE 2,5 ML SI 5 ML SAU CU SERINGA DOZATOARE DE 5 ML, MARCATA LA FIECARE 0,5ML P6L 1 10,630000 0,000000 5,315000 5,315000 9,567000 1,063000
1.065 R06AX27 DESLORATADINUM DYNID 0,5 mg/ml SOL. ORALA 0,5mg/ml GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOARE ( SERINGA DOZATOARE ARE GRADATII DE 2,5 ML SI 5 ML; LINGURITA DOZATOARE ARE CAPACITATEA DE 2,5 ML SI 5 ML P6L 1 10,630000 0,000000 5,315000 5,315000 9,567000 1,063000

Pagina 17 din 18
Val. maxima suportata Val. maxima suportata
Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care

Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
1.066 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SOL. ORALA 0,5mg/ml MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML P-RF 1 10,630000 5,720000 5,315000 11,035000 9,567000 6,783000
1.067 R06AX27 DESLORATADINUM LORDESTIN 0,5 mg/ml SOL. ORALA 0,5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU O LINGURITA DOZATOARE GRADATA LA 2,5 ML SI 5 ML X 120 ML SOL. P6L 1 10,630000 0,000000 5,315000 5,315000 9,567000 1,063000
1.068 S01AA11 GENTAMICINUM GENTAMICIN SULPHATE PIC. OFT., SOL 0,3% E.I.P.I.CO. MED S.R.L.ROMANIA CUTIE X 1 FLACON X 10ML P-RF 1 4,710000 0,000000 2,355000 2,355000 4,239000 0,471000
1.069 S01AA12 TOBRAMYCINUM TOBROM 3 mg/ml PIC. OFT., SOL 3mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE C 1 FLAC. PEJD X 5 ML PIC. OFT. SOL P-RF 1 4,080000 0,000000 2,040000 2,040000 3,672000 0,408000
1.070 S01AA12 TOBRAMYCINUM TOBREX PIC. OFT.,SOL. 3mg/ml ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD CU PICURATOR X 5 ML PIC. OFTALMICE, SOL. P-RF 1 4,080000 3,810000 2,040000 5,850000 3,672000 4,218000
1.071 S01AA12 TOBRAMYCINUM TOBREX 2 X PICATURI OFT.-SOL. 0,3% ALCON COUVREUR NV BELGIA CUTIE CU 1 FLAC. DIN PEJD, PREVAZUT CU PICURATOR DIN PEJD CARE CONTINE 5 ML PIC. OFT., SOL. P-RF 1 4,080000 15,810000 2,040000 17,850000 3,672000 16,218000
1.072 S01AA12 TOBRAMYCINUM TOBREX (R) UNG. OFT. 0,3% ALCON COUVREUR NV BELGIA CUTIE X 1 TUB DIN AL X 3,5 G UNGUENT OFTALMIC P-RF 1 3,060000 5,580000 1,530000 7,110000 2,754000 5,886000
1.073 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 14,710000 0,000000 7,355000 7,355000 13,239000 1,471000
1.074 S01AA23 NETILMICINUM NETTACIN (R) PICATURI OFT.-SOL. 0,3% S.I.F.I. SPA ITALIA CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML P-RF 15 1,297769 0,703564 0,648884 1,352449 1,167992 0,833341
1.075 S01AA23 NETILMICINUM NETTAVISC 3mg/g UNG. OFT. 3mg/g S.I.F.I. SPA ITALIA CUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR P-RF 1 21,629497 12,080503 10,814748 22,895252 19,466547 14,243453
1.076 S01AE01 OFLOXACINUM FLOXAL (R) PICATURI OFT.-SOL. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PICATURI OFT., SOL. P6L 1 10,895000 3,325000 5,447500 8,772500 9,805500 4,414500
1.077 S01AE01 OFLOXACINUM FLOXAL (R) UNG. OFT. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 TUB DIN AL PREVAZUT CU APLICATOR X 3 G P6L 1 14,680000 0,000000 7,340000 7,340000 13,212000 1,468000
1.078 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 10 ML PIC. OFT., SUSPENSIE P-RF 1 10,120000 0,000000 5,060000 5,060000 9,108000 1,012000
1.079 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT., SUSPENSIE P-RF 1 5,382500 0,107500 2,691250 2,798750 4,844250 0,645750
1.080 S01BA01 DEXAMETHASONUM MAXIDEX (R) PICATURI OFT.-SUSP. 0,1% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 5,382500 3,057500 2,691250 5,748750 4,844250 3,595750
1.081 S01BA06 BETAMETHASONUM OPHTAMESONE 1 mg/ml 1 mg/ml
PIC. OFT./AURIC./NAZALE SOL. DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD, PREVAZUT CU APLICATOR PT. PICURARE DIN PEJD A 10 ML PIC. OFT., AURICULARE, NAZALE SOL. P6L 1 4,670000 0,000000 2,335000 2,335000 4,203000 0,467000
1.082 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.,SOL. 4,55 mg/1,32 mg/ml S.I.F.I. SPA ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.SOL. P-RF 1 8,160750 24,409250 4,080375 28,489625 7,344675 25,225325
1.083 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.SOL. UNIDOZA 4,55 mg/1,32 mg/ml S.I.F.I. SPA ITALIA CUTIE X 20 FLAC. UNIDOZA DIN PEJD X 0,3 ML PIC.OFT. SOL. P-RF 20 0,489645 2,171855 0,244822 2,416678 0,440680 2,220820
1.084 S01CA01 COMBINATII (CLORAMPHENICOLUM+DEXAMETHASONUM) SPERSADEX COMP PICATURI OFT.-SOL. 5mg/ml+1mg/ml LABORATOIRES THEA FRANTA CUTIE X 1 FLACON X 5 ML SOL. OFT. + PICURATOR P-RF 1 8,160750 4,799250 4,080375 8,879625 7,344675 5,615325
1.085 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) DEXATOBROM 3 mg+1 mg/ml PIC. OFT. SUSP. 3mg+1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD A 5 ML + PICURATOR P-RF 1 5,050000 0,000000 2,525000 2,525000 4,545000 0,505000
1.086 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX ( R ) PICATURI OFT.-SUSP. 3mg+1mg/ml ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR PEJD X 5 ML P-RF 1 7,770000 0,000000 3,885000 3,885000 6,993000 0,777000
1.087 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX (R) UNG. OFT. 3 mg/1 mg/g ALCON COUVREUR NV BELGIA CUTIE X 1 TUB AL, PREVAZUT CU APLICATOR PEID X 3,5 G P-RF 1 5,712525 7,357475 2,856262 10,213738 5,141272 7,928728
1.088 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML P-RF 1 28,000000 0,000000 14,000000 14,000000 25,200000 2,800000

NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (*) se iniiaz de medicul de specialitate n limita competenei i poate fi prescris n continuare de medicul de familie pe baza
scrisorii medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**1) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii i pot fi
administrate i n regim de spitalizare de zi;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (2) se prescrie numai n etapa pregtitoare pentru colonoscopie;
- Pentru medicamentele corespunztoare DCI-urilor notate cu (#) regulile de prescriere sunt stabilite prin Contractul-cadru.

Pagina 18 din 18
ANEXA 2e

SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, CU COMPLETARILE SI MODIFICARILE ULTERIOARE,
VALABILA INCEPAND CU 01 APRILIE 2017

Val. maxima suportata


Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 20% din 20% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)

1 A02BA02 RANITIDINUM RANITIDINA ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-6L 10 0,419850 0,250150 0,083970 0,586030
2 A02BA02 RANITIDINUM RANITIDIN ARENA 150mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,209925 0,025575 0,041985 0,193515
3 A02BA02 RANITIDINUM RANITIDINA 150 mg COMPR. 150mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,209925 0,026575 0,041985 0,194515
4 A02BA02 RANITIDINUM RANITIDIN COMPR. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,209925 0,025575 0,041985 0,193515
5 A02BA02 RANITIDINUM ZANTAC 150 mg COMPR. FILM. 150mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 10 COMPR. FILM. P-6L 20 0,209925 0,153575 0,041985 0,321515
6 A02BA02 RANITIDINUM RANITIDINA LPH 150 mg COMPR. FILM. 150mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,209925 0,025575 0,041985 0,193515
7 A02BA02 RANITIDINUM RANITIDINA ATB 150 MG COMPR. FILM. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 0,209925 0,025575 0,041985 0,193515
8 A02BA02 RANITIDINUM RANITIDINA LAROPHARM 150 mgCOMPR. FILM. 150mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 0,209925 0,021075 0,041985 0,189015
9 A02BA02 RANITIDINUM RANITIDINA LPH 150 mg COMPR. FILM. 150mg LABORMED PHARMA SAROMANIA CUTIE CU 3 BLISTERE DIN FOLIE PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,209925 0,026408 0,041985 0,194348
10 A02BA02 RANITIDINUM ARNETIN SOL. INJ. 50mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE X 2 ML P-RF 5 1,470596 1,157404 0,294119 2,333881
11 A02BA03 FAMOTIDINUM FAMODIN 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,209925 0,086408 0,041985 0,254348
12 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 20mg COMPR. FILM. 20mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,202333 0,000000 0,040466 0,161867
13 A02BA03 FAMOTIDINUM QUAMATEL 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,209925 0,140075 0,041985 0,308015
14 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 40 mg COMPR. FILM. 40mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,267000 0,000000 0,053400 0,213600
15 A02BA03 FAMOTIDINUM FAMODIN 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,410333 0,000000 0,082066 0,328267
16 A02BA03 FAMOTIDINUM QUAMATEL 20 mg 20mg
PULB+SOLV. PT. SOL. INJ./PERF. GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA CU PULBERE PENTRU SOLUTIE INJ./PERF. + 5 FIOLE DIN STICLA INCOLORA X 5ML SOLV. PENTRU UZ PARENTERAL S/P-RF 5 3,908000 0,000000 0,781600 3,126400
17 A02BA04 NIZATIDINUM CAPS.
NIZATIDIN VIM SPECTRUM 150 mg 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,209925 0,701575 0,041985 0,869515
18 A02BX02 SUCRALFATUM GASTROFAIT COMPR. 1g CUTIE X 5 BLIST. AL/PVC X 4 COMPR.
E.I.P.I.CO. MED S.R.L. ROMANIA P-6L 20 0,305000 0,000000 0,061000 0,244000
19 A02BX02 SUCRALFATUM VENTER COMPR. 1g KRKA D.D. SLOVENIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,320300 0,005100 0,064060 0,261340
20 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg BGP PRODUCTS B.V. OLANDA CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL. P-6L 30 0,720000 0,000000 0,144000 0,576000
21 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. X 15 CAPS. ELIB. PREL. P-6L 30 0,720000 0,000000 0,144000 0,576000
22 A03AA04 MEBEVERINUM COLOSPASMIN DRAJ. 100mg E.I.P.I.CO. MED SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 DRAJ. P-6L 20 0,360000 0,086000 0,072000 0,374000
23 A03AA05 TRIMEBUTINUM TRIMEBUTIN 100 COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,384666 0,000000 0,076933 0,307733
24 A03AA05 TRIMEBUTINUM COLPERIN 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0,384666 0,000000 0,076933 0,307733
25 A03AA05 TRIMEBUTINUM DEBRIDAT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,384666 0,208000 0,076933 0,515733
26 A03AA05 TRIMEBUTINUM DEBRIDAT 200 mg COMPR. FILM. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM.P6L 30 0,769334 0,355332 0,153866 0,970800
27 A03AA05 TRIMEBUTINUM IBUTIN (R) 300 mg COMPR. FILM. ELIB. PREL. 300mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL.P-6L 20 1,154002 0,714498 0,230800 1,637700
28 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 76,25 G GRANULE PT. 125ML SUSP. + MASURA DOZATOARE P-6L 1 6,563250 3,856750 1,312650 9,107350
29 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 152,5 G GRANULE PT. 250ML SUSP. + MASURA DOZATOARE P-6L 1 12,500000 0,000000 2,500000 10,000000
30 A03FA03 DOMPERIDONUM MOTILIUM 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 0,114812 0,341188 0,022962 0,433038
31 A03FA03 DOMPERIDONUM OROPERIDYS 10 mg 10mg
COMPR. ORODISPERSABILE PIERRE FABRE MEDICAMENT FRANTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP. P6L 30 0,114812 0,586854 0,022962 0,678704
32 A03FA03 DOMPERIDONUM DOMOTIL 10 mg 10mg
COMPR. ORODISPERSABILE ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE P6L
LABORMED PHARMA S.A. 30 0,114812 0,341188 0,022962 0,433038
33 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH 35 mg COMPR. CU ELIB. MODIF. 35mg LABORMED PHARMA SAROMANIA CUTIE X 6 BLISTERE X 10 COMPRIMATE CU ELIBERARE MODIFICATA P-6L 60 0,401333 0,000000 0,080266 0,321067
34 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA ATB 35 mg COMPR. CU ELIB. PREL. 35mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 0,401000 0,000000 0,080200 0,320800
35 C01EB15 TRIMETAZIDINUM PREDUCTAL MR 35 mg COMPR. ELIB. MODIF. 35mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. FILM. ELIB. MODIF. P-6L 60 0,401333 0,196167 0,080266 0,517234
36 C01EB15 TRIMETAZIDINUM APSTAR 35 mg COMPR. ELIB. PREL. 35mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR/AL X 60 COMPR. ELIB. PREL. P6L 60 0,401333 0,000000 0,080266 0,321067
37 C01EB15 TRIMETAZIDINUM MODUXIN MR 35 mg COMPR. ELIB. PREL. 35mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. CU ELIB. PRELUNG. P6L 30 0,401000 0,000000 0,080200 0,320800
38 C01EB15 TRIMETAZIDINUM MODUXIN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,229333 0,034000 0,045866 0,217467
39 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 20 mg COMPR. FILM. 20mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 60 0,229333 0,034167 0,045866 0,217634
40 C01EB15 TRIMETAZIDINUM PREDUCTAL 20 mg COMPR. FILM. 20mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM.P-6L 60 0,229333 0,175833 0,045866 0,359300
41 C01EB15 TRIMETAZIDINUM DILATAN 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,229333 0,034000 0,045866 0,217467
42 C01EB15 TRIMETAZIDINUM PREDUTRIM 20 mg/ml PIC. ORALE, SOL. 20mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 50 ML PIC. ORALE P6L 1 11,466657 0,863343 2,293331 10,036669
43 C04AE02 NICERGOLINUM NICERIUM (R) 15 CAPS. ELIB. MODIF. 15mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF.
P-6L 30 0,450166 0,514500 0,090033 0,874633
44 C04AE02 NICERGOLINUM NICERIUM (R) 30 UNO CAPS. ELIB. MODIF. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF.
P-6L 30 0,900333 0,000000 0,180066 0,720267
45 C04AE02 NICERGOLINUM NICERGOLINA LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,300111 0,165222 0,060022 0,405311
46 C04AE02 NICERGOLINUM GRALIN 10 mg COMPR. FILM. 10mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM. P-6L 30 0,300111 0,162555 0,060022 0,402644
47 C04AE02 NICERGOLINUM SERMION COMPR. FILM. 30mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM P-6L 30 0,900333 0,440333 0,180066 1,160600

Pagina 1 din 3
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 20% din 20% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
48 C04AE02 NICERGOLINUM NICERGOLINA LPH 30 mg COMPR. FILM. 30mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,900333 0,000000 0,180066 0,720267
49 C04AE02 NICERGOLINUM GRALIN 30 mg COMPR. FILM. 30mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM. P-6L 30 0,900333 0,000000 0,180066 0,720267
50 C04AE02 NICERGOLINUM GRALIN 5 mg COMPR. FILM. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM. P-6L 30 0,150055 0,083611 0,030011 0,203655
51 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 0,883333 0,000000 0,176666 0,706667
52 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 0,882000 0,000000 0,176400 0,705600
53 C04AX07 VINCAMINUM OXYBRAL SR 30 mg CAPS. ELIB. PREL. 30mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 CAPS. CU ELIB. PREL. P-6L 10 0,961000 0,000000 0,192200 0,768800
54 C04AX07 VINCAMINUM VINCAMINA DRAJ. 10mg BIOFARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 DRAJ. P-6L 20 0,327250 0,020750 0,065450 0,282550
55 C05CA53 DIOSMINUM (COMBINATII) ** DETRALEX ( R ) COMPR. FILM. 500mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,912666 0,000000 0,182533 0,730133
56 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90 ** TEVOCOR 1000 mg CAPS. MOI 1000 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. PRF 30 1,372333 0,000000 0,274466 1,097867
57 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90 ** OMACOR (R) CAPS. MOI 1000mg PRONOVA BIOPHARMA NORGE A.S. NORVEGIA FALC. DIN PEID X 28 CAPS. MOI P-RF 28 1,557106 0,554322 0,311421 1,800007
58 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 2,088000 19,762000 0,417600 21,432400
59 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA P-RF 1 2,088000 3,502000 0,417600 5,172400
60 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA PRF 1 2,088000 3,072000 0,417600 4,742400
61 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL A 5 G CREMA PRF 1 2,088000 4,872000 0,417600 6,542400
62 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 6,264000 1,066000 1,252800 6,077200
63 D06BB03 ACICLOVIRUM ACICLOVIR TIS 50mg/g CREMA 50mg/g TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB DIN PEJD X 15 G CREMA P-RF 1 4,700000 0,000000 0,940000 3,760000
64 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA P-RF 1 6,264000 0,696000 1,252800 5,707200
65 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 6,264000 0,696000 1,252800 5,707200
66 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA PRF 1 6,264000 1,626000 1,252800 6,637200
67 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 6,714000 0,000000 1,342800 5,371200
68 H05BA01 CALCITONINUM (SOMON) MIACALCIC (R) SOL. INJ. 50ui/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 3,600675 2,331325 0,720135 5,211865
69 M01AC01 PIROXICAMUM PIROXSAL 20 mg COMPR. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST.PVC/ AL X 10 COMPR. P-6L 20 0,136500 0,000000 0,027300 0,109200
70 M01AC01 PIROXICAMUM FLAMEXIN COMPR. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L 30 0,324000 0,643000 0,064800 0,902200
71 M01AC01 PIROXICAMUM PIROXICAM ARENA 20 MG COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,128000 0,000000 0,025600 0,102400
72 M01AC01 PIROXICAMUM PIROXICAM HELCOR 20 mg COMPR. 20mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,222000 0,000000 0,044400 0,177600
73 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 10 0,324000 1,231000 0,064800 1,490200
74 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 2 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 20 0,324000 1,230500 0,064800 1,489700
75 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 30 0,324000 1,181000 0,064800 1,440200
76 M01AC01 PIROXICAMUM FLAMEXIN (R) PULB. PT. SOL. ORALA 20mg/plic CHIESI FARMACEUTICI SPA ITALIA CUTIE X 20 PLICURI DUBLU COMPARTIMENTAT X 3 G PULB. PT. SOL. ORALA P-6L 20 0,324000 1,031000 0,064800 1,290200
77 M01AC01 PIROXICAMUM HOTEMIN SOL. INJ. 20mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 BLIST. C-PET/PE X 5 FIOLE X 1 ML SOL. INJ. P-RF 5 1,964999 0,245001 0,392999 1,817001
78 M01AC01 PIROXICAMUM PIROXICAM ATB 20 mg SUPOZ. 20 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC X 3 SUPOZ. P6L 6 0,759249 0,009084 0,151849 0,616484
79 M01AC01 PIROXICAMUM PIROXICAM ATB 20 mg SUPOZ. 20 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC X 6 SUPOZ. P6L 6 0,759249 0,009084 0,151849 0,616484
80 M01AC01 PIROXICAMUM PIROXICAM SINTOFARM 20 mg SUPOZ. 20mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L 10 0,732000 0,000000 0,146400 0,585600
81 M01AX17 NIMESULIDUM LEMESIL COMPR. 100mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,356400 0,040600 0,071280 0,325720
82 M01AX17 NIMESULIDUM NIMESULID 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,356400 0,039600 0,071280 0,324720
83 M01AX17 NIMESULIDUM NIMESULID SLAVIA COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0,356400 0,039600 0,071280 0,324720
84 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,356400 0,039600 0,071280 0,324720
85 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,356400 0,039600 0,071280 0,324720
86 M01AX17 NIMESULIDUM NIMESULID ARENA 100 mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,356400 0,039600 0,071280 0,324720
87 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 10 0,356400 0,039600 0,071280 0,324720
88 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 30 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 30 0,356400 0,039600 0,071280 0,324720
89 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 28,451089 4,108911 5,690217 26,869783
90 M05BA06 ACIDUM IBANDRONICUM * OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC.UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P-6L 1 28,451089 7,228911 5,690217 29,989783
91 M05BA06 ACIDUM IBANDRONICUM * QUODIXOR 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P-6L 1 28,451089 7,218911 5,690217 29,979783
92 M05BA06 ACIDUM IBANDRONICUM * OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM. P6L 1 28,451089 6,578911 5,690217 29,339783
93 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L 1 28,451089 7,228911 5,690217 29,989783
94 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P6L 1 28,451089 6,588911 5,690217 29,349783
95 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 28,451089 4,108911 5,690217 26,869783
96 M05BA06 ACIDUM IBANDRONICUM * OSSICA 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE P6L 1 104,030000 0,000000 20,806000 83,224000
97 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC ACCORD 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE PR/PRF 1 100,840000 0,000000 20,168000 80,672000
98 M05BA06 ACIDUM IBANDRONICUM * OSAGRAND 3 mg/3 ml SOL. INJ. 3mg/3ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ. P6L 1 104,615000 0,195000 20,923000 83,887000
99 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC FRESENIUS KABI 3 mg SOL. INJ. IN SERINGA PREUMPLUTA 3mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA CU CAPACITATEA DE 5 ML DIN POLIMER OLEFIN CICLIC SI 1 AC CONTINAND 3 ML SOL. INJ. P6L 1 104,615000 0,195000 20,923000 83,887000
100 M05BA06 ACIDUM IBANDRONICUM * BONVIVA 3mg/3ml SOL. INJ. IN SERINGA PREUMPLUTA 3mg/3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC P-6L 1 104,615000 48,285000 20,923000 131,977000
101 M05BX03 STRONTIUM RANELATUM OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 28 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF 28 5,203214 0,000000 1,040642 4,162572
102 N03AE01 CLONAZEPAMUM RIVOTRIL COMPR. 0,5mg ROCHE ROMANIA S.R.L.ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. P-RF 50 0,059456 0,082344 0,011891 0,129909
103 N03AE01 CLONAZEPAMUM CLONOTRIL 0,5 mg COMPR. 0,5mg CN UNIFARM S.A ROMANIA CUTIE X 30 COMPRIMATE PRF 30 0,059456 0,194877 0,011891 0,242442

Pagina 2 din 3
Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 20% din 20% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
104 N03AE01 CLONAZEPAMUM RIVOTRIL 2 mg COMPR. 2mg ROCHE ROMANIA S.R.L.ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-RF 30 0,225000 0,000000 0,045000 0,180000
105 N03AE01 CLONAZEPAMUM CLONOTRIL 2 mg COMPR. 2mg CN UNIFARM S.A ROMANIA CUTIE X 30 COMPRIMATE PRF 30 0,237824 0,039509 0,047564 0,229769
106 N06BX03 PIRACETAMUM PIRACETAM ARENA 400 mg CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,099824 0,265842 0,019964 0,345702
107 N06BX03 PIRACETAMUM PIRACETAM SLAVIA 400 mg COMPR. 400mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. DIN PVC/AL X 10 COMPR. P-6L 40 0,099824 0,019176 0,019964 0,099036
108 N06BX03 PIRACETAMUM PIRACETAM FARMEX 400 mg COMPR. 400mg FARMEX COMPANY SRLROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,099824 0,011176 0,019964 0,091036
109 N06BX03 PIRACETAMUM PIRACETAM MCC 400mg COMPR. 400mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,099824 0,061176 0,019964 0,141036
110 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mg COMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,099824 0,072676 0,019964 0,152536
111 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mg COMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 4 BLIST. PVC/AL X 10 COMPR. P-6L 40 0,099824 0,061676 0,019964 0,141536
112 N06BX03 PIRACETAMUM PIRACETAM LAROPHARM 400 mgCOMPR. 400mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,099824 0,212176 0,019964 0,292036
113 N06BX03 PIRACETAMUM LUCETAM (R) 1200 mg COMPR. FILM. 1200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 20 COMPR. FILM. P-6L 20 0,272500 0,000000 0,054500 0,218000
114 N06BX03 PIRACETAMUM NOOTROPIL 1200 mg COMPR. FILM. 1200mg U.C.B. PHARMA S.A. BELGIA CUTIE CU 10 BLIST. PVC/AL X 10 COMPR. FILM. P6L 100 0,299475 0,106725 0,059895 0,346305
115 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 60 COMPR.FILM. P-6L 60 0,099824 0,021842 0,019964 0,101702
116 N06BX03 PIRACETAMUM PIRACETAM HELCOR 400mg COMPR. FILM. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,099824 0,022676 0,019964 0,102536
117 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 400 mg COMPR. FILM. 400mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. FILM.P6L 20 0,099824 0,082176 0,019964 0,162036
118 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 800mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.FILM. P-6L 30 0,199650 0,021683 0,039930 0,181403
119 N06BX03 PIRACETAMUM NOOTROPIL 800 mg COMPR. FILM. 800mg U.C.B. PHARMA S.A. BELGIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. FILM.P6L 90 0,199650 0,140905 0,039930 0,300625
120 N06BX03 PIRACETAMUM PIRACETAM HELCOR 800mg COMPR. FILM. 800mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 20 0,199650 0,021350 0,039930 0,181070
121 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 800 mg COMPR. FILM. 800mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. FILM.P6L 20 0,199650 0,021350 0,039930 0,181070
122 N06BX03 PIRACETAMUM MEMOTAL1 g/5 ml SOL. INJ. 1g/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 1,862000 0,000000 0,372400 1,489600
123 R05CB15 ERDOSTEINUM ** ERDOMED 300 mg CAPS. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 10 1,633000 0,000000 0,326600 1,306400
124 R05CB15 ERDOSTEINUM ** ERDOMED 225 mg GRAN. PT. SUSP. ORALA 225mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE CU 20 PLICURI UNIDOZA DIN HARTIE AL/PE P-6L 20 1,293937 0,207563 0,258787 1,242713
125 R05CB15 ERDOSTEINUM ** ERDOMED 175 mg/5 ml PULB. PT. SUSP. ORALA 175mg/5ml CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA A 50 G PULB. PT. OBTINEREA A 100 ML SUSP. ORALA + 1 MASURA DOZATOA P-6L 1 24,439999 0,000001 4,887999 19,552001

NOT:

- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (*) se iniiaz de ctre medicul de specialitate n limita competenei i poate fi prescris n continuare de medicul de familie pe baza
scrisorii medicale emise de medicul de specialitate
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii.

Pagina 3 din 3
ANEXA 2c

SECIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREUL DE REFERIN CONFORM
DCI-urilor UTILIZATE N TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOL
DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEAST SUBLIST SE ELIBEREAZ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZ DE PRESCRIPIE MEDICAL CU REINERE N FARMACIE
VALABIL NCEPND CU 01 APRILIE 2017

Val. maxima suportata de Co-plata maxima a


sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)

1.INSUFICIENTA CARDIACA CRONICA(CLASA III SAU IV NYHA) - G 1

1 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,226000 0,226000 0,000000
2 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg MERUS LABS LUXCO II S.A.R.L. LUXEMBURGCUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,350000 0,350000 0,000000
3 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,138800 0,138800 0,000000
4 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,5 mg/2ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA S/P-RF
CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ROSU SI PORTOCALIU)X 2 ML SOL. INJ. 5 1,652000 1,652000 0,000000
5 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0,173200 0,173200 0,000000
6 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156500 0,156500 0,000000
7 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156500 0,156500 0,000000
8 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,187800 0,187800 0,125200
9 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,157000 0,157000 0,000000
10 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,187800 0,187800 0,125200
11 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,187800 0,187800 0,083200
12 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L 30 0,157666 0,157666 0,000000
13 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,260000 1,260000 0,000000
14 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,753000 0,753000 0,000000
15 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 25 mg CAPS. 25mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L 50 0,258000 0,258000 0,075400
16 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 0,258000 0,258000 0,078333
17 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,441666 0,441666 0,000000
18 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L 30 0,529999 0,529999 0,032001
19 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,222500 0,222500 0,000000
20 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 0,258000 0,258000 0,111800
21 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,215000 0,215000 0,000000
22 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,529999 0,529999 0,157001
23 C07AB02 METOPROLOLUM BLOXAN COMPR. 100mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L 30 0,077000 0,077000 0,000000
24 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,092400 0,092400 0,203933
25 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,092400 0,092400 0,204100
26 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,092400 0,092400 0,153600
27 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,092400 0,092400 0,203933
28 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,092400 0,092400 0,203933
29 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mgCOMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,092400 0,092400 0,204100
30 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,092400 0,092400 0,149933
31 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,092400 0,092400 0,198100
32 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
P-6L 30 0,092400 0,092400 0,203933
33 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 100 mg COMPR. 100mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE
P6L 30 0,092400 0,092400 0,203933
34 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,098500 0,098500 0,000000
35 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,098500 0,098500 0,000000
36 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,098666 0,098666 0,000000
37 C07AB02 METOPROLOLUM METOPROLOL ARENA 25 MG COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,098666 0,098666 0,000000
38 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0,098333 0,098333 0,000000
39 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,181999 0,181999 0,000334
40 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,181999 0,181999 0,000501
41 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,164333 0,164333 0,000000
42 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,181999 0,181999 0,000334
43 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,181999 0,181999 0,062001
44 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,172500 0,172500 0,000000

Pagina 1 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
45 C07AB02 METOPROLOLUM METOPROLOL ARENA 50 MG COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,181999 0,181999 0,000334
46 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,181999 0,181999 0,000501
47 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
P-6L 30 0,151666 0,151666 0,000000
48 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 50 mg COMPR. 50mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE
P6L 30 0,181999 0,181999 0,000334
49 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR. ELIB. MODIF. 190mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,504000 0,504000 0,000000
50 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR. ELIB. MODIF. 47,5mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,215666 0,215666 0,000000
51 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR. ELIB. MODIF. 95mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,358333 0,358333 0,000000
52 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 0,092400 0,092400 0,204100
53 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,092400 0,092400 0,203933
54 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,181333 0,181333 0,000000
55 C07AB02 METOPROLOLUM BETALOC (R) ZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,092400 0,092400 0,363600
56 C07AB02 METOPROLOLUM BETALOC (R) ZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,181999 0,181999 0,198001
57 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF.P-6L 30 0,504000 0,504000 0,000000
58 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF.P-6L 30 0,215666 0,215666 0,000000
59 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF.P-6L 30 0,358333 0,358333 0,000000
60 C07AB02 METOPROLOLUM BETALOC SOL. INJ./PERF. 5mg/5ml ASTRAZENECA AB SUEDIA CUTIE X 5 FIOLE X 5 ML SOL.INJ. I.V./PERF.S 5 4,086000 4,086000 0,000000
61 C07AB07 BISOPROLOLUM BOREZ 10 mg COMPR. FILM. 10 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,277200 0,277200 0,085800
62 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,277200 0,277200 0,808133
63 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,277200 0,277200 0,070133
64 C07AB07 BISOPROLOLUM BOREZ 2,5 mg COMPR. FILM. 2,5 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,243333 0,243333 0,000000
65 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,250800 0,250800 0,123533
66 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,209000 0,209000 0,000000
67 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,146799 0,146799 0,242534
68 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L
KRKA, D.D., NOVO MESTO SLOVENIA 30 0,146799 0,146799 0,059534
69 C07AB12 NEBIVOLOLUM ** NEBILET (R) COMPR. 5mg CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L
BERLIN CHEMIE AG MENARINI GROUP GERMANIA 28 0,274800 0,274800 0,372342
70 C07AB12 NEBIVOLOLUM ** NEBIVOLOL ACTAVIS 5 mg COMPR. 5mg ACTAVIS S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,274800 0,274800 0,088200
71 C07AB12 NEBIVOLOLUM ** X-PRESSOL 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.
P6L 30 0,274800 0,274800 0,145866
72 C07AB12 NEBIVOLOLUM ** NOLET 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC- PE- PVDC/AL X 10 COMPR.
P-6L 30 0,274800 0,274800 0,145866
73 C07AB12 NEBIVOLOLUM ** NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P-6L 28 0,274800 0,274800 0,145557
74 C07AB12 NEBIVOLOLUM ** NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,229000 0,229000 0,000000
75 C07AB12 NEBIVOLOLUM ** NEBINORM 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,229000 0,229000 0,000000
76 C07AB12 NEBIVOLOLUM ** NEBIVOLOL SANDOZ 5 mg COMPR. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,274800 0,274800 0,145557
77 C07AB12 NEBIVOLOLUM ** NEBIVOLOL TERAPIA 5mg COMPR. 5mg TERAPIA S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L 28 0,274800 0,274800 0,145557
78 C07AB12 NEBIVOLOLUM ** NEBIVOLOL TORRENT 5 mg COMPR. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L 30 0,274800 0,274800 0,145866
79 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,277333 0,277333 0,000000
80 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.P-6L 28 0,308570 0,308570 0,525715
81 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,259285 0,259285 0,000000
82 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,281000 0,281000 0,000000
83 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,308570 0,308570 0,153763
84 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,308570 0,308570 0,027430
85 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,308570 0,308570 0,076763
86 C07AG02 CARVEDILOLUM MIOCARVIL 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,308570 0,308570 0,153763
87 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,2 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,308570 0,308570 0,143430
88 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.
P-6L 28 0,342856 0,342856 0,583929
89 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR.P-6L 28 0,342856 0,342856 0,012144
90 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,342856 0,342856 0,180477
91 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,342856 0,342856 0,259144
92 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,342856 0,342856 0,181144
93 C07AG02 CARVEDILOLUM MIOCARVIL 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,342856 0,342856 0,258144
94 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,342856 0,342856 0,259644
95 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,317333 0,317333 0,000000
96 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.P-6L 28 0,216000 0,216000 0,173642
97 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,198214 0,198214 0,000000
98 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,185000 0,185000 0,000000
99 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0,216000 0,216000 0,022333

Pagina 2 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
100 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mgCOMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,216000 0,216000 0,012000
101 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,185000 0,185000 0,000000
102 C07AG02 CARVEDILOLUM MIOCARVIL 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0,216000 0,216000 0,022333
103 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,180333 0,180333 0,000000
104 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,257142 0,257142 0,000000
105 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,285714 0,285714 0,000000
106 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,180000 0,180000 0,000000
107 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,117666 0,117666 0,000000
108 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,141600 0,141600 0,000066
109 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,141600 0,141600 0,009400
110 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,118500 0,118500 0,000000
111 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,118000 0,118000 0,000000
112 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,118000 0,118000 0,000000
113 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,141600 0,141600 0,013066
114 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,118500 0,118500 0,000000
115 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,138000 0,138000 0,000000
116 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,163200 0,163200 0,067466
117 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,163200 0,163200 0,030300
118 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,138000 0,138000 0,000000
119 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,155666 0,155666 0,000000
120 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,136000 0,136000 0,000000
121 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,199500 0,199500 0,000000
122 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR.P-6L 30 0,199333 0,199333 0,000000
123 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR.P-6L 20 0,199000 0,199000 0,000000
124 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR.P-6L 20 0,199500 0,199500 0,000000
125 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0,190500 0,190500 0,000000
126 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.P-6L 28 0,228600 0,228600 0,077828
127 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,199333 0,199333 0,000000
128 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0,199400 0,199400 0,000000
129 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0,199200 0,199200 0,000000
130 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR.P-6L 20 0,199500 0,199500 0,000000
131 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,199000 0,199000 0,000000
132 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,199500 0,199500 0,000000
133 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,330500 0,330500 0,000000
134 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR.P-6L 20 0,330500 0,330500 0,000000
135 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR.P-6L 30 0,330666 0,330666 0,000000
136 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR.P-6L 20 0,330500 0,330500 0,000000
137 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.P-6L 28 0,396600 0,396600 0,112328
138 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,330666 0,330666 0,000000
139 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0,330600 0,330600 0,000000
140 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,330500 0,330500 0,000000
141 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,330500 0,330500 0,000000
142 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,330500 0,330500 0,000000
143 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,093000 0,093000 0,000000
144 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR.P-6L 20 0,094000 0,094000 0,000000
145 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.P-6L 28 0,108000 0,108000 0,036285
146 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR.P-6L 30 0,093333 0,093333 0,000000
147 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR.P-6L 20 0,093000 0,093000 0,000000
148 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,093333 0,093333 0,000000
149 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 5 mg COMPR. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,090000 0,090000 0,000000
150 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,090000 0,090000 0,000000
151 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0,093000 0,093000 0,000000
152 C09AA02 ENALAPRILUM ENAP 1,25 mg/ml SOL. INJ./PERF. 1,25mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR/PRF 5 3,204000 3,204000 0,000000
153 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,305199 0,305199 0,213134
154 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,305199 0,305199 0,231801

Pagina 3 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
155 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,270000 0,270000 0,000000
156 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
MEDOCHEMIE ROMANIA SRL 30 0,254333 0,254333 0,000000
157 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,270000 0,270000 0,000000
158 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,305199 0,305199 0,108134
159 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,305199 0,305199 0,081229
160 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,311071 0,311071 0,000000
161 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,454800 0,454800 0,344533
162 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,454800 0,454800 0,327700
163 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,379000 0,379000 0,000000
164 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,379000 0,379000 0,000000
165 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,454800 0,454800 0,357200
166 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,454800 0,454800 0,194128
167 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 0,428500 0,428500 0,000000
168 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1,359333 1,359333 0,000000
169 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,231199 0,231199 0,033467
170 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,192666 0,192666 0,000000
171 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,193000 0,193000 0,000000
172 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,231199 0,231199 0,032015
173 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,238214 0,238214 0,000000
174 C09AA05 RAMIPRILUM PIRAMIL 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR.P-6L 28 0,285856 0,285856 0,016286
175 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,285856 0,285856 0,016144
176 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P-6L 30 0,285856 0,285856 0,016144
177 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,285856 0,285856 0,016286
178 C09AA05 RAMIPRILUM TRITACE 10 COMPR. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,285856 0,285856 0,178429
179 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mgCOMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR.P-6L 28 0,285856 0,285856 0,016286
180 C09AA05 RAMIPRILUM AMPRIGEN 10 mg COMPR. 10mg ALVOGEN IPCO S.A.R.L LUXEMBURGCUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 0,285856 0,285856 0,016144
181 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,285856 0,285856 0,016144
182 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,285856 0,285856 0,016144
183 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,285856 0,285856 0,178429
184 C09AA05 RAMIPRILUM RAMIPRIL ATB 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,238333 0,238333 0,000000
185 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 0,149642 0,149642 0,000000
186 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR.P-6L 28 0,172142 0,172142 0,000000
187 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,168333 0,168333 0,000000
188 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P-6L 30 0,172000 0,172000 0,000000
189 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,166071 0,166071 0,000000
190 C09AA05 RAMIPRILUM TRITACE(R) 2,5 COMPR. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,179199 0,179199 0,085443
191 C09AA05 RAMIPRILUM AMPRIGEN 2,5 mg COMPR. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURGCUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 0,172000 0,172000 0,000000
192 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,172000 0,172000 0,000000
193 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,172000 0,172000 0,000000
194 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,179199 0,179199 0,085443
195 C09AA05 RAMIPRILUM RAMIPRIL ATB 2,5 mg COMPR. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,149333 0,149333 0,000000
196 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,172142 0,172142 0,000000
197 C09AA05 RAMIPRILUM PIRAMIL 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR.P-6L 28 0,206400 0,206400 0,041814
198 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,206400 0,206400 0,041600
199 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P-6L 30 0,206400 0,206400 0,041600
200 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,206400 0,206400 0,032885
201 C09AA05 RAMIPRILUM TRITACE 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,206400 0,206400 0,175385
202 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR.P-6L 28 0,206400 0,206400 0,041814
203 C09AA05 RAMIPRILUM AMPRIGEN 5 mg COMPR. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURGCUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 0,206400 0,206400 0,041600
204 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,206400 0,206400 0,041600
205 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,206400 0,206400 0,041600
206 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,206400 0,206400 0,175385
207 C09AA05 RAMIPRILUM RAMIPRIL ATB 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,172000 0,172000 0,000000
208 C09CA03 VALSARTANUM ** DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,554692 0,554692 1,039236
209 C09CA03 VALSARTANUM ** AVASSAN 160 mg COMPR. FILM. 160mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,554692 0,554692 0,515665

Pagina 4 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
210 C09CA03 VALSARTANUM ** VALSARTAN TORRENT 160 mg COMPR. FILM. 160mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,462244 0,462244 0,000000
211 C09CA03 VALSARTANUM ** VALSARTAN ZENTIVA 160 mgCOMPR. FILM. 160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.P-6L 28 0,554692 0,554692 0,007093
212 C09CA03 VALSARTANUM ** VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,554692 0,554692 0,217450
213 C09CA03 VALSARTANUM ** VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,554692 0,554692 0,217450
214 C09CA03 VALSARTANUM ** DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L 28 0,495856 0,495856 2,072358
215 C09CA03 VALSARTANUM ** AVASSAN 40 mg COMPR. FILM. 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,495856 0,495856 1,083786
216 C09CA03 VALSARTANUM ** VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,413214 0,413214 0,000000
217 C09CA03 VALSARTANUM ** VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,413214 0,413214 0,000000
218 C09CA03 VALSARTANUM ** DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 0,351306 0,351306 0,843694
219 C09CA03 VALSARTANUM ** VALSARTAN TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,292755 0,292755 0,000000
220 C09CA03 VALSARTANUM ** VALSARTAN ZENTIVA 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.P-6L 28 0,351306 0,351306 0,171551
221 C09CA03 VALSARTANUM ** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,351306 0,351306 0,034408
222 C09CA03 VALSARTANUM ** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,351306 0,351306 0,034408
223 C09CA03 VALSARTANUM ** DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) P-6L 1 41,420000 41,420000 0,000000
224 C09CA06 CANDESARTANUM CILEXETIL ** TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.
P-6L 28 0,804799 0,804799 0,257701
225 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 0,804799 0,804799 0,194129
226 C09CA06 CANDESARTANUM CILEXETIL ** KARBIS 16 mg COMPR. 16mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,804799 0,804799 0,257201
227 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN TORRENT 16 mg COMPR. 16mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,700000 0,700000 0,000000
228 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,804799 0,804799 0,776986
229 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,804799 0,804799 0,061201
230 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN LABORMED 16 mg COMPR. 16mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR. P6L 28 0,804799 0,804799 0,257343
231 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,670666 0,670666 0,000000
232 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN CILEXETIL MCC 16 mgCOMPR. 16mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,804799 0,804799 0,257201
233 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN VIM SPECTRUM 16 mg COMPR. 16mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,804799 0,804799 0,061272
234 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN ATB 16 mg COMPR. 16mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,693333 0,693333 0,000000
235 C09CA06 CANDESARTANUM CILEXETIL ** KARBIS 32 mg COMPR. 32mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,723600 0,723600 0,725400
236 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN TORRENT 32 mg COMPR. 32mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,603000 0,603000 0,000000
237 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 32 mg COMPR. 32mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,723600 0,723600 1,505685
238 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,723600 0,723600 0,239400
239 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN CILEXETIL MCC 32 mgCOMPR. 32mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,723600 0,723600 0,725400
240 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN VIM SPECTRUM 32 mg COMPR. 32mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,723600 0,723600 0,239257
241 C09CA06 CANDESARTANUM CILEXETIL ** TANDESAR 8 mg COMPR. 8mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.
P-6L 28 0,531071 0,531071 0,000000
242 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 0,531071 0,531071 0,000000
243 C09CA06 CANDESARTANUM CILEXETIL ** KARBIS 8 mg COMPR. 8mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,531000 0,531000 0,000000
244 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN TORRENT 8 mg COMPR. 8mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,531000 0,531000 0,000000
245 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,588000 0,588000 0,229142
246 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,531000 0,531000 0,000000
247 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN LABORMED 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L 28 0,531071 0,531071 0,000000
248 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,490000 0,490000 0,000000
249 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN CILEXETIL MCC 8 mg COMPR. 8mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,531000 0,531000 0,000000
250 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN VIM SPECTRUM 8 mgCOMPR. 8mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,531071 0,531071 0,000000
251 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN ATB 8 mg COMPR. 8mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,531000 0,531000 0,000000

2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

1 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,226000 0,226000 0,000000
2 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg MERUS LABS LUXCO II S.A.R.L. LUXEMBURGCUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,350000 0,350000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea cardiologie, chirurgie cardiovascular i chirurgie vascular.

3. BOLNAVI CU PROCEDURI INTERVENTIONALE PERCUTANE, NUMAI DUPA IMPLANTAREA UNEI PROTEZE ENDOVASCULARE (STENT)- G3

1 B01AC04 CLOPIDOGRELUM ** PLAVIX 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 9,342333 9,342333 0,000000
2 B01AC04 CLOPIDOGRELUM ** ZYLLT COMPR. FILM. 75 mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. OPA/AL/PVC-AL X 28 COMPR. FILM. P-RF 28 0,460714 0,460714 0,000000

Pagina 5 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
3 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 COMPR. FILM. P-RF 30 0,506570 0,506570 0,074430
4 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 90 COMPR. FILM. P-RF 90 0,506570 0,506570 0,055430
5 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL MYLAN 75mg COMPR. FILM. 75mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM. P-RF 28 0,506570 0,506570 0,039144
6 B01AC04 CLOPIDOGRELUM ** TROGRAN 75 mg COMPR. FILM. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,506570 0,506570 0,600215
7 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL ACTAVIS 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,422142 0,422142 0,000000
8 B01AC04 CLOPIDOGRELUM ** TESSYRON 75 mg COMPR. FILM. 75mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM. P-RF 30 0,506570 0,506570 0,182096
9 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL DR. REDDY'S 75 mg COMPR. FILM. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 0,506570 0,506570 0,599763
10 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 30 0,506570 0,506570 0,599763
11 B01AC04 CLOPIDOGRELUM ** DEPLATT 75 mg COMPR. FILM. 75mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,506570 0,506570 0,412763
12 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 30 COMPRIMATE FILMATE P-RF 30 0,506570 0,506570 0,074430
13 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 90 COMPRIMATE FILMATE P-RF 90 0,506570 0,506570 0,055430
14 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,506570 0,506570 0,087358
15 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 0,506570 0,506570 1,141287

Tratamentul se iniiaz de ctre medicul n specialitatea cardiologie, chirurgie cardiovascular i chirurgie vascular.

4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C i D - G4

1 FARA DASABUVIRUM **1 EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 113,407142 113,407142 0,000000
2 FARA OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE(AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 1.190,124285 1.190,124285 0,000000
3 J05AB04 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )P-RF/R 140 2,333071 2,333071 0,000000
4 J05AB04 RIBAVIRINUM **1 COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 1,949464 1,949464 0,000000
5 J05AB04 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg MALTA
AUROBINDO PHARMA (MALTA) LIMITEDCUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 1,966369 1,966369 0,000000
6 J05AB04 RIBAVIRINUM **1 MODERIBA 200 mg COMPR. FILM. 200mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR. PRF 168 2,339356 2,339356 2,867489
7 J05AB04 RIBAVIRINUM **1 MODERIBA 400 mg COMPR. FILM. 400mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF 56 10,544464 10,544464 0,000000
8 J05AB04 RIBAVIRINUM **1 MODERIBA 600 mg COMPR. FILM. 600mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF 56 13,558214 13,558214 0,000000
9 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000
10 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000
11 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 3,403999 3,403999 0,959572
12 J05AF07 TENOFOVIRUM DISOPROXIL **1 VIREAD 245mg COMPR. FILM. 245mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM PR 30 32,970399 32,970399 8,027267
13 J05AF07 TENOFOVIRUM DISOPROXIL **1 COMPR. FILM.
TENOFOVIR DISOPROXIL TEVA 245 mg 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PED CU CAPAC CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. PR 30 27,475333 27,475333 0,000000
14 J05AF07 TENOFOVIRUM DISOPROXIL **1 COMPR. FILM.
TENOFOVIR DISOPROXIL TEVA 245 mg 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PED CU PERETII NGROSATI CU CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. PR 30 27,475333 27,475333 0,000000
15 J05AF07 TENOFOVIRUM DISOPROXIL **1 VIROFOB 245 mg COMPR. FILM. 245mg ALVOGEN IPCO S.AR.L. LUXEMBURGCUTIE CU 1 FLAC. PEID CU CAPAC DIN PP X 30 COMPR. FILM. PR 30 27,475333 27,475333 0,000000
16 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 41,273333 41,273333 0,000000
17 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 57,113666 57,113666 0,000000
18 J05AF10 ENTECAVIRUM **1 BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 61,447000 61,447000 0,000000
19 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOLP-RF/R 1 110,870000 110,870000 0,000000
20 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOLP-RF/R 1 163,380000 163,380000 7,000000
21 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 101,990000 101,990000 0,000000
22 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 5 SERINGI PREUMPLUTE CU 0,5 ML SOL. INJ. PR 5 92,674000 92,674000 0,000000
23 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 150,280000 150,280000 0,000000
24 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 5 SERINGI PREUMPLUTE CU 0,5 ML SOL. INJ. PR 5 136,150000 136,150000 0,000000
25 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300g/0,5ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 106,198000 106,198000 0,000000
26 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300g/0,5ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 111,208800 111,208800 8,351200
27 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480g/0,5ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 162,800000 162,800000 0,000000
28 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480g/0,8ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,8 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 163,380000 163,380000 7,460000
29 L03AB04 INTERFERONUM ALFA 2A **1 ROFERON A SOL. INJ. 9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR 1 178,400000 178,400000 0,000000
30 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 18 milioane U.I. SOL. INJ. PEN MULTIDOZA 18 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 390,310000 390,310000 0,000000
31 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 30 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 604,410000 604,410000 0,000000
32 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 100 g PULB. + SOLV. PT. SOL. INJ. 100g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 674,210000 674,210000 0,000000
33 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 100 g PULB. + SOLV. PT. SOL. INJ. 100g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 674,210000 674,210000 0,000000
34 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 120 g PULB. + SOLV. PT. SOL. INJ. 120g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 794,880000 794,880000 0,000000
35 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 120 g PULB. + SOLV. PT. SOL. INJ. 120g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 794,880000 794,880000 0,000000
36 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 150 g PULB. + SOLV. PT. SOL. INJ. 150g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 975,890000 975,890000 0,000000

Pagina 6 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
37 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 150 g PULB. + SOLV. PT. SOL. INJ. 150g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 975,890000 975,890000 0,000000
38 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 50 g PULB. + SOLV. PT. SOL. INJ. 50g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 370,000000 370,000000 0,000000
39 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 50 g PULB. + SOLV. PT. SOL. INJ. 50g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 370,000000 370,000000 0,000000
40 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 781,040000 781,040000 0,000000
41 N04BB01 AMANTADINUM ** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 0,354400 0,354400 0,000000

Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie / boli infectioase si nefrologie (doar pentru pacientii cu afectare renala consecutiva infectiei cu virusuri hepatitice)

5. HEPATITA AUTOIMUNA - G5

1 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,543200 0,543200 0,000000
2 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,234000 1,234000 0,000000
3 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLVP-RF 1 20,480000 20,480000 0,000000
4 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg PULB+SOLV. PT. SOL. INJ./PERF. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,810000 8,810000 0,000000
5 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg PULB+SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 MLS/P-RF 1 31,020000 31,020000 0,000000
6 L04AX01 AZATHIOPRINUM IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,702300 0,000000

Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie

6. CIROZA BILIARA PRIMARA, COLANGITA SCLEROZANTA PRIMITIVA, HEPATITA CRONICA SI CIROZE DE ALTE ETIOLOGII CU COLESTAZA - G6

1 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 0,946200 0,946200 0,206200
2 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 0,946200 0,946200 0,267200
3 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 0,788500 0,788500 0,000000
4 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100 2,681700 2,681700 0,000000
5 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 97,490000 97,490000 0,000000

Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie

7. CIROZA HEPATICA - G7

1 A06AD11 LACTULOSUM DUPHALAC LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 10,750000 10,750000 0,000000
2 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML P-6L 1 10,800000 10,800000 0,000000
3 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 3,590000 3,590000 0,000000
4 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA P-6L
CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP 1 17,230000 17,230000 0,000000
5 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA P-6L
CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP 1 33,340000 33,340000 0,000000
6 A06AD11 LACTULOSUM LACTULAK 660 mg/ml SOL. ORALA 660 mg/ml ROMPHARM COMPANY SRLROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L 1 6,730000 6,730000 0,000000
7 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM. P-RF 12 2,625833 2,625833 0,000000
8 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF 36 2,413333 2,413333 0,000000
9 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFA WASSERMANN SPA ITALIA P-RF
CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML 1 19,810000 19,810000 0,000000
10 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156500 0,156500 0,000000
11 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156500 0,156500 0,000000
12 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,187800 0,187800 0,125200
13 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,157000 0,157000 0,000000
14 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,187800 0,187800 0,125200
15 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,187800 0,187800 0,083200
16 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L 30 0,157666 0,157666 0,000000
17 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,260000 1,260000 0,000000
18 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,753000 0,753000 0,000000
19 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 25 mg CAPS. 25mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L 50 0,258000 0,258000 0,075400
20 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 0,258000 0,258000 0,078333

Pagina 7 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
21 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L
GEDEON RICHTER ROMANIA SA 30 0,441666 0,441666 0,000000
22 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L 30 0,529999 0,529999 0,032001
23 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,222500 0,222500 0,000000
24 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 0,258000 0,258000 0,111800
25 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,215000 0,215000 0,000000
26 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,529999 0,529999 0,157001
27 FARA DASABUVIRUM **1 EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE LTD. MAREA BRITANIE PR
CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) 56 113,407142 113,407142 0,000000
28 FARA OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE LTD. MAREA BRITANIE PR
CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE(AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) 56 1.190,124285 1.190,124285 0,000000
29 J05AB04 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )P-RF/R
MAREA BRITANIE 140 2,359642 2,359642 5,522429
30 J05AB04 RIBAVIRINUM **1 COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 2,359642 2,359642 5,438215
31 J05AB04 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 1,966369 1,966369 0,000000
32 J05AB04 RIBAVIRINUM **1 MODERIBA 200 mg COMPR. FILM. 200mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR. PRF 168 2,359642 2,359642 2,847203
33 J05AB04 RIBAVIRINUM **1 MODERIBA 400 mg COMPR. FILM. 400mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF 56 10,544464 10,544464 0,000000
34 J05AB04 RIBAVIRINUM **1 MODERIBA 600 mg COMPR. FILM. 600mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF 56 13,558214 13,558214 0,000000
35 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000
36 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000
37 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 3,403999 3,403999 0,959572
38 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 41,273333 41,273333 0,000000
39 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 57,113666 57,113666 0,000000
40 J05AF10 ENTECAVIRUM **1 BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 61,447000 61,447000 0,000000
41 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOLP-RF/R 1 110,870000 110,870000 0,000000
42 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOLP-RF/R 1 163,380000 163,380000 7,000000
43 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 101,990000 101,990000 0,000000
44 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 5 SERINGI PREUMPLUTE CU 0,5 ML SOL. INJ. PR 5 92,674000 92,674000 0,000000
45 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 150,280000 150,280000 0,000000
46 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 5 SERINGI PREUMPLUTE CU 0,5 ML SOL. INJ. PR 5 136,150000 136,150000 0,000000
47 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300g/0,5ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 106,198000 106,198000 0,000000
48 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300g/0,5ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 111,208800 111,208800 8,351200
49 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480g/0,5ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 162,800000 162,800000 0,000000
50 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480g/0,8ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,8 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 163,380000 163,380000 7,460000
51 L03AB04 INTERFERONUM ALFA 2A **1 ROFERON A SOL. INJ. 9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR 1 178,400000 178,400000 0,000000
52 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 18 milioane U.I. SOL. INJ. PEN MULTIDOZA 18 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 390,310000 390,310000 0,000000
53 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 30 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 604,410000 604,410000 0,000000
54 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 100 g PULB. + SOLV. PT. SOL. INJ. 100g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 674,210000 674,210000 0,000000
55 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 100 g PULB. + SOLV. PT. SOL. INJ. 100g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 674,210000 674,210000 0,000000
56 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 120 g PULB. + SOLV. PT. SOL. INJ. 120g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 794,880000 794,880000 0,000000
57 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 120 g PULB. + SOLV. PT. SOL. INJ. 120g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 794,880000 794,880000 0,000000
58 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 150 g PULB. + SOLV. PT. SOL. INJ. 150g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 975,890000 975,890000 0,000000
59 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 150 g PULB. + SOLV. PT. SOL. INJ. 150g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 975,890000 975,890000 0,000000
60 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 50 g PULB. + SOLV. PT. SOL. INJ. 50g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 370,000000 370,000000 0,000000
61 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 50 g PULB. + SOLV. PT. SOL. INJ. 50g MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. PR 1 370,000000 370,000000 0,000000
62 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 781,040000 781,040000 0,000000
63 N04BB01 AMANTADINUM ** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 0,354400 0,354400 0,000000

Tratamentul se ini iaz de ctre medicul in specialitatea gastroenterologie sau boli infectioase

8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10

1 A04AA01 ONDANSETRONUM ** OSETRON 4 mg COMPR. FILM. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 1,975000 1,975000 0,000000
2 A04AA01 ONDANSETRONUM ** OSETRON 8 mg COMPR. FILM. 8mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 3,345000 3,345000 0,000000
3 A04AA01 ONDANSETRONUM ** SOL. INJ.
OSETRON 8 mg SOLUTIE INJECTABILA 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 5 FIOLE X 4 ML SOL. INJ. S/P-RF 5 9,078000 9,078000 0,000000
4 A04AA01 ONDANSETRONUM ** SOL. INJ.
OSETRON 4 mg SOLUTIE INJECTABILA 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE 1 BLIST. AL/PVC X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 4,936000 4,936000 0,000000
5 A04AA01 ONDANSETRONUM ** EMESET 8 mg/4 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 4ML SOL. INJ. / PERF.S/P-RF 5 9,074000 9,074000 0,000000
6 A04AA01 ONDANSETRONUM ** EMESET 4 mg/2 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 2ML SOL. INJ/ PERF. S/P-RF 5 4,936000 4,936000 0,000000

Pagina 8 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
7 A04AA02 GRANISETRONUM ** GRANISETRON ACTAVIS 1 mg COMPR. FILM. 1mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 11,747000 11,747000 0,000000
8 A04AA02 GRANISETRONUM ** GRANEGIS 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 12,136000 12,136000 0,000000
9 A04AA02 GRANISETRONUM ** GRANORED 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 14,096400 14,096400 0,001600
10 A04AA02 GRANISETRONUM ** SETROGEN 1 mg COMPR. FILM. 1mg ALVOGEN IPCO S.A.R.L LUXEMBURGCUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. PRF 10 14,096400 14,096400 3,092600
11 A04AA02 GRANISETRONUM ** GRANISETRON ACTAVIS 2 mg COMPR. FILM. 2mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 24,501000 24,501000 0,000000
12 A04AA02 GRANISETRONUM ** GRANISETRON TEVA 1mg/1ml CONC. PT. SOL. PERF./INJ. 1mg/1ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF./INJ. S 5 14,580000 14,580000 0,000000
13 A04AA02 GRANISETRONUM ** GRANISETRON TEVA 3mg/3ml CONC. PT. SOL. PERF./INJ. 3mg/3ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3 ML CONC. PT. SOL. PERF./INJ. S 5 33,974000 33,974000 0,000000
14 A04AA02 GRANISETRONUM ** GRANISETRON KABI 1 mg/ml SOL. INJ. 1mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ. PR 5 28,870000 28,870000 0,000000
15 A04AA05 PALONOSETRONUM ** ALOXI 500mcg CAPS. MOI 500mcg HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA CUTIE X BLISTER DIN POLIAMIDA/AL/PVC X 1 CAPSULA MOALE PRF 1 288,130000 288,130000 0,000000
16 A04AA05 PALONOSETRONUM ** PALONOSETRON ACCORD 250 micrograme SOL INJ. 250micrograme ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. CARE CONTINE 5 ML SOLUTIE PALONOSETRON PRF 1 214,310000 214,310000 0,000000
17 A04AA05 PALONOSETRONUM ** FERANT 250 micrograme SOL INJ. 250micrograme MEDOCHEMIE LTD. CIPRU CUTIE CU 1 FIOLA DIN STICLA INCOLORA CARE CONTINE 5 ML SOL. INJ. PR 1 207,740000 207,740000 0,000000
18 A04AA05 PALONOSETRONUM ** ALOXI SOL. INJ. 250 mcg/5ml HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA CUTIE X 1 FLAC. DIN STICLA X 5 ML SOL. INJ. P-RF 1 249,288000 249,288000 80,432000
19 B03XA01 EPOETINUM ALFA ** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 21,785000 21,785000 0,000000
20 B03XA01 EPOETINUM ALFA ** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ.
S/P-RF/R 6 45,386666 45,386666 0,000000
21 B03XA01 EPOETINUM ALFA ** BINOCRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. P-RF/R 1 488,460000 488,460000 0,000000
22 B03XA01 EPOETINUM ALFA ** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 68,290000 68,290000 0,000000
23 B03XA01 EPOETINUM ALFA ** EPREX 40000 UI/ml SOL. INJ. IN SERINGA PREUMPLUTA 40 000UI/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. S/P-RF 1 912,804000 912,804000 99,806000
24 B03XA01 EPOETINUM ALFA ** BINOCRIT 40000 UI/1 ml SOL. INJ. IN SERINGA PREUMPLUTA 40000 UI/1 ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. P-RF/R 1 760,670000 760,670000 0,000000
25 B03XA01 EPOETINUM ALFA ** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 87,998333 87,998333 0,000000
26 B03XA01 EPOETINUM ALFA ** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 107,725000 107,725000 0,000000
27 B03XA01 EPOETINUM BETA ** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 280,040000 280,040000 0,000000
28 B03XA01 EPOETINUM BETA ** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 59,898333 59,898333 0,000000
29 B03XA01 EPOETINUM BETA ** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 999,550000 999,550000 0,000000
30 B03XA01 EPOETINUM BETA ** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 108,236666 108,236666 0,000000
31 B03XA01 EPOETINUM BETA ** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 154,340000 154,340000 0,000000
32 B03XA01 EPOETINUM ZETA ** RETACRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 228,050000 228,050000 0,000000
33 B03XA01 EPOETINUM ZETA ** RETACRIT 2000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,6ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 51,940000 51,940000 0,000000
34 B03XA01 EPOETINUM ZETA ** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. PR 1 533,260000 533,260000 0,000000
35 B03XA01 EPOETINUM ZETA ** RETACRIT 3000UI/0,9ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,9ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,9ML SOL. INJ. PR 1 73,980000 73,980000 0,000000
36 B03XA01 EPOETINUM ZETA ** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 693,880000 693,880000 0,000000
37 B03XA01 EPOETINUM ZETA ** RETACRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,4ML SOL. INJ. PR 1 98,650000 98,650000 0,000000
38 B03XA01 EPOETINUM ZETA ** RETACRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL. INJ. PR 1 123,300000 123,300000 0,000000
39 B03XA01 EPOETINUM ZETA ** RETACRIT 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 140,320000 140,320000 0,000000
40 B03XA01 EPOETINUM ZETA ** RETACRIT 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,8ML SOL. INJ. PR 1 196,010000 196,010000 0,000000
41 B03XA02 DARBEPOETINUM ALFA ** ARANESP 100mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 P-RF/R ML 4 647,495000 647,495000 0,000000
42 B03XA02 DARBEPOETINUM ALFA ** ARANESP 10mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 P-RF/R ML 4 78,342500 78,342500 0,000000
43 B03XA02 DARBEPOETINUM ALFA ** ARANESP 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X 0,3 ML P-RF/R 4 962,400000 962,400000 0,000000
44 B03XA02 DARBEPOETINUM ALFA ** ARANESP 20mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 P-RF/R ML 4 143,647500 143,647500 0,000000
45 B03XA02 DARBEPOETINUM ALFA ** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1.960,260000 1.960,260000 0,000000
46 B03XA02 DARBEPOETINUM ALFA ** ARANESP 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 P-RF/R ML 4 206,655000 206,655000 0,000000
47 B03XA02 DARBEPOETINUM ALFA ** ARANESP 40mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 P-RF/R ML 4 269,612500 269,612500 0,000000
48 B03XA02 DARBEPOETINUM ALFA ** ARANESP 500mcg/ml SOL. INJ. IN SERINGA PREUMPLUTA 500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R 1 3.219,860000 3.219,860000 0,000000
49 B03XA02 DARBEPOETINUM ALFA ** ARANESP 50mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 P-RF/R ML 4 321,740000 321,740000 0,000000
50 B03XA02 DARBEPOETINUM ALFA ** ARANESP 60mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 P-RF/R ML 4 395,560000 395,560000 0,000000
51 B03XA02 DARBEPOETINUM ALFA ** ARANESP 80mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 P-RF/R ML 4 521,557500 521,557500 0,000000
52 G03HA01 CYPROTERONUM ** ANDROCUR COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF 50 2,250800 2,250800 0,000000
53 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 10 0,832000 0,832000 0,000000
54 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 25 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 25 0,816800 0,816800 0,000000
55 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 100 0,736400 0,736400 0,000000
56 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 10 1,387000 1,387000 0,000000
57 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 25 1,327200 1,327200 0,000000
58 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 100 1,246200 1,246200 0,000000
59 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 100 1,256100 1,256100 0,000000
60 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 5 1,380000 1,380000 0,000000
61 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 10 1,425000 1,425000 0,000000

Pagina 9 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
62 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 2,573599 2,573599 0,620401
63 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 2,144666 2,144666 0,000000
64 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRLROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 2,144666 2,144666 0,000000
65 J02AC02 ITRACONAZOLUM ITRACONAZOL ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 2,144666 2,144666 0,000000
66 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 2,144666 2,144666 0,000000
67 J02AC02 ITRACONAZOLUM ITRACONAZOL FARMEX 100 mg CAPS. 100mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. PVCA/AL X 5 CAPS. PRF 15 2,144666 2,144666 0,000000
68 J02AC03 VORICONAZOLUM ** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 95,890000 95,890000 0,000000
69 J02AC03 VORICONAZOLUM ** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM.
PRF 28 86,687142 86,687142 0,000000
70 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. PRF
REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. 28 86,687857 86,687857 0,000000
71 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. PRF
REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. 30 86,519000 86,519000 0,000000
72 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 86,687857 86,687857 0,000000
73 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg COMPR. FILM. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURGCUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 80,213571 80,213571 0,000000
74 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg COMPR. FILM. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURGCUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 80,045000 80,045000 0,000000
75 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 50 mg COMPR. FILM. 50mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 24,607857 24,607857 0,000000
76 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 50 mg COMPR. FILM. 50mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 24,439333 24,439333 0,000000
77 J02AC03 VORICONAZOLUM ** VFEND 200mg PULB. + SOLV. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE PRF
1 FLACON DIN STICLA TRANSPARENTA, CU CAPACITATEA DE 30 ML+1 PUNGA DE PERFUZIE DIN POLIPROPILENA A 50 ML+1 SERINA A 20 ML+1 ADAPTOR PT. FLACON 1 424,812000 424,812000 87,778000
78 J02AC03 VORICONAZOLUM ** VORICONAZOL SANDOZ 200 mg PULB. PT. SOL. PERF. 200 mg SANDOZ S.R.L. ROMANIA PRF
CUTIE CU 1 FLAC. DIN STICLA INCOLORA, CU CAPACIATEA DE 25 ML CARE CONTINE PULB. PT. SOL. PERF. 1 354,010000 354,010000 0,000000
79 J02AC03 VORICONAZOLUM ** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 424,812000 424,812000 88,108000
80 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg PULB. PT. SOL. PERF. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU DOP DIN CAUCIUC CLOROBUTILIC, CAPAC DIN AL SI SIGILIU ROSU DIN PLASTIC CONTINAND PULB. PT. SOL. PERF. PRF 1 354,010000 354,010000 0,000000
81 J02AC03 VORICONAZOLUM ** VORICONAZOL FRESENIUS KABI 200 mg PULB. PT. SOL. PERF. 200mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA TIP I, CU CAPACITATEA DE 25 ML, CU PULBERE PT. SOL. PERF. PRF 1 354,010000 354,010000 0,000000
82 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg PULB. PT. SOL. PERF. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA CU CAPCITATEA DE 25 ML CU PULB. PT. SOL. PERF. PRF 1 354,010000 354,010000 0,000000
83 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.266,130000 2.266,130000 0,000000
84 J02AC04 POSACONAZOLUM ** NOXAFIL 100mg CAPS. GASTROREZ. 100mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 147,492083 147,492083 0,000000
85 J02AC04 POSACONAZOLUM ** NOXAFIL 300mg CONC. PT. SOL. PERF.300mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU UN FL X 16,7ML CONC. PT SOL PERF (18MG POSACONAZOL/ML) PR 1 1.419,890000 1.419,890000 0,000000
86 J02AC04 POSACONAZOLUM ** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.660,080000 2.660,080000 0,000000
87 J02AX04 CASPOFUNGINUM ** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.396,750000 1.396,750000 0,000000
88 J02AX04 CASPOFUNGINUM ** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.801,340000 1.801,340000 0,000000
89 L01XX35 ANAGRELIDUM ** THROMBOREDUCTIN 0,5 mg CAPS. 0,5mg AOP ORPHAN PHARMACEUTICALS AG AUSTRIA CUTIE CU 1 FLAC. DIN PE X 100 CAPS. PR 100 14,483900 14,483900 0,000000
90 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 2,358400 2,358400 0,000000
91 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,828600 3,828600 0,000000
92 N02AA01 MORPHYNUM MST CONTINUS 100 mg COMPR. ELIB. MODIF. 100mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 2,910799 2,910799 0,628367
93 N02AA01 MORPHYNUM MST CONTINUS 10 mg COMPR. ELIB. MODIF. 10mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 0,626333 0,626333 0,000000
94 N02AA01 MORPHYNUM MST CONTINUS 200 mg COMPR. ELIB. MODIF. 200mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 6,769666 6,769666 0,000000
95 N02AA01 MORPHYNUM MST CONTINUS 30 mg COMPR. ELIB. MODIF. 30mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 0,925599 0,925599 0,184234
96 N02AA01 MORPHYNUM MST CONTINUS 60 mg COMPR. ELIB. MODIF. 60mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 1,944000 1,944000 0,300333
97 N02AA01 MORPHYNUM SEVREDOL 10 mg COMPR. FILM. 10mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. P-TS 60 0,751599 0,751599 0,114734
98 N02AA01 MORPHYNUM SEVREDOL 20 mg COMPR. FILM. 20mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. P-TS 60 1,219500 1,219500 0,000000
99 N02AA01 MORPHYNUM VENDAL (R) RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 2,425666 2,425666 0,000000
100 N02AA01 MORPHYNUM VENDAL (R) RETARD 30 mg COMPR. FILM. ELIB. PREL. 30mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 0,771333 0,771333 0,000000
101 N02AA01 MORPHYNUM VENDAL (R) RETARD 60 mg COMPR. FILM. ELIB. PREL. 60mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 1,620000 1,620000 0,000000
102 N02AA01 MORPHYNUM MORFINA ZENTIVA 20 mg/ml SOL. INJ. 20mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML P-TS 5 1,720000 1,720000 0,000000
103 N02AA05 OXYCODONUM OXYCONTIN 10 mg COMPR. CU ELIB. MODIF. 10 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 0,815599 0,815599 0,230234
104 N02AA05 OXYCODONUM OXYCONTIN 20 mg COMPR. CU ELIB. MODIF. 20 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 1,440199 1,440199 0,406134
105 N02AA05 OXYCODONUM OXYCONTIN 40 mg COMPR. CU ELIB. MODIF. 40 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 2,331999 2,331999 0,503334
106 N02AA05 OXYCODONUM OXYCONTIN 80 mg COMPR. CU ELIB. MODIF. 80mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 3,964399 3,964399 1,118434
107 N02AA05 OXYCODONUM RELTEBON 10 mg COMPR. CU ELIB. PREL. 10mg ACTAVIS GROUP PTC EHF. ISLANDA PR, PS
CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. 60 0,679666 0,679666 0,000000
108 N02AA05 OXYCODONUM RELTEBON 20 mg COMPR. CU ELIB. PREL. 20mg ACTAVIS GROUP PTC EHF. ISLANDA PR, PS
CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. 60 1,200166 1,200166 0,000000
109 N02AA05 OXYCODONUM CLORHIDRAT DE OXICODONA TORRENT 20 mg COMPR. CU ELIB. PREL. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL. PR, PS 60 1,200166 1,200166 0,000000
110 N02AA05 OXYCODONUM RELTEBON 40 mg COMPR. CU ELIB. PREL. 40mg ACTAVIS GROUP PTC EHF. ISLANDA PR, PS
CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. 60 1,943333 1,943333 0,000000
111 N02AA05 OXYCODONUM CLORHIDRAT DE OXICODONA TORRENT 40 mg COMPR. CU ELIB. PREL. 40mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL. PR, PS 60 1,943333 1,943333 0,000000
112 N02AA05 OXYCODONUM RELTEBON 80 mg COMPR. CU ELIB. PREL. 80mg ACTAVIS GROUP PTC EHF. ISLANDA PR, PS
CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. 60 3,303666 3,303666 0,000000
113 N02AA05 OXYCODONUM CLORHIDRAT DE OXICODONA TORRENT 80 mg COMPR. CU ELIB. PREL. 80mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL. PR, PS 60 3,304000 3,304000 0,000000
114 N02AA05 OXYCODONUM OXIDOLOR 10 mg COMPR. ELIB. PREL. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 0,679666 0,679666 0,000000
115 N02AA05 OXYCODONUM OXIDOLOR 20 mg COMPR. ELIB. PREL. 20mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 1,200166 1,200166 0,000000
116 N02AA05 OXYCODONUM OXIDOLOR 40 mg COMPR. ELIB. PREL. 40mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 1,943333 1,943333 0,000000

Pagina 10 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
117 N02AA05 OXYCODONUM OXICODONA SANDOZ 40 mg COMPR. ELIB. PREL. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 2,046000 2,046000 0,000000
118 N02AA05 OXYCODONUM OXICODONA SANDOZ 60 mg COMPR. ELIB. PREL. 60mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 7,230000 7,230000 0,000000
119 N02AA05 OXYCODONUM OXIDOLOR 80 mg COMPR. ELIB. PREL. 80mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 3,303666 3,303666 0,000000
120 N02AA05 OXYCODONUM OXICODONA SANDOZ 80 mg COMPR. ELIB. PREL. 80mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 3,546500 3,546500 0,000000
121 N02AA08 DIHYDROCODEINUM DHC CONTINUS 120 mg COMPR. ELIB. PREL. 120mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 2,159107 2,159107 0,000000
122 N02AA08 DIHYDROCODEINUM DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 0,543750 0,543750 0,000000
123 N02AA08 DIHYDROCODEINUM DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1,462142 1,462142 0,000000
124 N02AB02 PETHIDINUM MIALGIN (R) 100 mg/2 ml SOL. INJ. 50mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA X 2 ML P-TS 5 1,942000 1,942000 0,000000
125 N02AB03 FENTANYLUM ** LUNALDIN 100 micrograme COMPR. SUBLING. 100micrograme GEDEON RICHTER PLC. UNGARIA PRF
CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE 10 29,404000 29,404000 0,000000
126 N02AB03 FENTANYLUM ** LUNALDIN 200 micrograme COMPR. SUBLING. 200micrograme GEDEON RICHTER PLC. UNGARIA PRF
CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE 10 27,380000 27,380000 0,000000
127 N02AB03 FENTANYLUM ** LUNALDIN 300 micrograme COMPR. SUBLING. 300micrograme GEDEON RICHTER PLC. UNGARIA PRF
CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE 10 27,968000 27,968000 0,000000
128 N02AB03 FENTANYLUM ** LUNALDIN 400 micrograme COMPR. SUBLING. 400micrograme GEDEON RICHTER PLC. UNGARIA PRF
CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE 10 27,968000 27,968000 0,000000
129 N02AB03 FENTANYLUM ** LUNALDIN 600 micrograme COMPR. SUBLING. 600micrograme GEDEON RICHTER PLC. UNGARIA PRF
CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE 10 27,968000 27,968000 0,000000
130 N02AB03 FENTANYLUM ** LUNALDIN 800 micrograme COMPR. SUBLING. 800micrograme GEDEON RICHTER PLC. UNGARIA PRF
CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE 10 27,968000 27,968000 0,000000
131 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 100 mcg/h PLASTURE TRANSDERMIC 100mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 31,884000 31,884000 2,056000
132 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 100micrograme/h PLASTURE TRANSDERMIC 100micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA PS
CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC 5 26,570000 26,570000 0,000000
133 N02AB03 FENTANYLUM ** ALGOGESIC 100 micrograme/ora PLASTURE TRANSDERMIC 100micrograme/ora ZENTIVA K.S. REPUBLICA CEHA PS
CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC 5 31,884000 31,884000 7,800000
134 N02AB03 FENTANYLUM ** DOLFORIN 100 g/ORA PLASTURE TRANSDERMIC 100g/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMICP-TS 5 31,884000 31,884000 7,800000
135 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 25 mcg/h PLASTURE TRANSDERMIC 25mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 10,538400 10,538400 1,231600
136 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 25micrograme/h PLASTURE TRANSDERMIC 25micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA PS
CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC 5 8,782000 8,782000 0,000000
137 N02AB03 FENTANYLUM ** ALGOGESIC 25 micrograme/ora PLASTURE TRANSDERMIC 25micrograme/ora ZENTIVA K.S. REPUBLICA CEHA PS
CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC 5 10,538400 10,538400 1,813600
138 N02AB03 FENTANYLUM ** DOLFORIN 25 g/ORA PLASTURE TRANSDERMIC 25g/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMICP-TS 5 10,538400 10,538400 3,653600
139 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 50 mcg/h PLASTURE TRANSDERMIC 50mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 16,424000 16,424000 0,000000
140 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 50micrograme/h PLASTURE TRANSDERMIC 50micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA PS
CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC 5 15,444000 15,444000 0,000000
141 N02AB03 FENTANYLUM ** ALGOGESIC 50 micrograme/ora PLASTURE TRANSDERMIC 50micrograme/ora ZENTIVA K.S. REPUBLICA CEHA PS
CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC 5 18,532800 18,532800 4,927200
142 N02AB03 FENTANYLUM ** DOLFORIN 50 g/ORA PLASTURE TRANSDERMIC 50g/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMICP-TS 5 18,532800 18,532800 6,529200
143 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 75 mcg/h PLASTURE TRANSDERMIC 75mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 30,532000 30,532000 0,000000
144 N02AB03 FENTANYLUM ** ALGOGESIC 75 micrograme/ora PLASTURE TRANSDERMIC 75micrograme/ora ZENTIVA K.S. REPUBLICA CEHA PS
CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC 5 32,076000 32,076000 0,000000
145 N02AB03 FENTANYLUM ** DOLFORIN 75 g/ORA PLASTURE TRANSDERMIC 75g/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMICP-TS 5 32,076000 32,076000 0,000000
146 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,299500 0,299500 0,000000
147 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,341400 0,341400 0,057100
148 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,341400 0,341400 0,125600
149 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,341400 0,341400 0,043600
150 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,284500 0,284500 0,000000
151 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,341400 0,341400 0,057100
152 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,341400 0,341400 0,042100
153 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0,632400 0,632400 0,021266
154 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,630333 0,630333 0,000000
155 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,527000 0,527000 0,000000
156 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,528000 0,528000 0,000000
157 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,527000 0,527000 0,000000
158 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,528000 0,528000 0,000000
159 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,949599 0,949599 0,168401
160 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,904333 0,904333 0,000000
161 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,792000 0,792000 0,000000
162 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,791333 0,791333 0,000000
163 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,792000 0,792000 0,000000
164 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,791333 0,791333 0,000000
165 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,170666 1,170666 0,000000
166 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1,055000 1,055000 0,000000
167 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,055333 1,055333 0,000000
168 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1,055000 1,055000 0,000000
169 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,055333 1,055333 0,000000
170 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF 30 0,330333 0,330333 0,000000
171 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 0,949599 0,949599 0,335734

Pagina 11 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
172 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1,266000 1,266000 0,430000
173 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 0,341400 0,341400 0,056600
174 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE PRF 10 0,341400 0,341400 0,056600
175 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 5 1,675320 1,675320 0,200680
176 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 1,396100 1,396100 0,000000
177 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 1,024000 1,024000 0,000000
178 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 1,675320 1,675320 1,042680
179 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 1,158000 1,158000 0,000000
180 N07BC02 METHADONUM SINTALGON 2,5 mg COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-TS 50 0,506400 0,506400 0,000000
181 N07BC02 METHADONUM METADON BIOEEL 5 mg COMPR. 5mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 50 0,326000 0,326000 0,000000
182 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 CU SIGILIU DIN PE A 1000 ML CONC. PT. SOL. ORAL PS 1 387,080000 387,080000 0,000000
183 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII, A 1000 ML CONC. PT. SOL. ORALA PS 1 387,080000 387,080000 0,000000
184 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,181200 0,181200 0,019133
185 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,181200 0,181200 0,024000
186 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,151000 0,151000 0,000000
187 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,173500 0,173500 0,000000
188 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 0,165500 0,165500 0,000000
189 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,181200 0,181200 0,008300
190 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,173500 0,173500 0,000000
191 V03AC01 DEFEROXAMINUM ** 3) DESFERAL PULB. PT. SOL. INJ./PERF. 500mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF.S/P-RF 10 13,266000 13,266000 0,000000
192 V03AC03 DEFERASIROXUM ** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 27,555357 27,555357 0,000000
193 V03AC03 DEFERASIROXUM ** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 52,592500 52,592500 0,000000
194 V03AC03 DEFERASIROXUM ** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 95,897142 95,897142 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea oncologie sau hematologie.

9. EPILEPSIE - G11

1 N03AA02 PHENOBARBITALUM FENOBARBITAL ZENTIVA 100 mg COMPR. 100 mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,182400 0,182400 0,000000
2 N03AA02 PHENOBARBITALUM FENOBARBITAL ARENA 100mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLISTERE DIN PVC/AL A CTE 10 COMPRIMATE P-RF 30 0,187000 0,187000 0,000000
3 N03AA02 PHENOBARBITALUM FENOBARBITAL ZENTIVA 100 mg/ml SOL. INJ. 100 mg/ml ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 5 2,274000 2,274000 0,000000
4 N03AB02 PHENYTOINUM FENITOINA RICHTER 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,144000 0,144000 0,000000
5 N03AB02 PHENYTOINUM PHENHYDAN 250 mg/5 ml SOL. INJ. 250mg/5ml GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 5 ML SOL. INJ.
DESITIN ARZNEIMITTEL GMBH P-RF 5 14,054000 14,054000 0,000000
6 N03AF01 CARBAMAZEPINUM TEGRETOL (R) 200 COMPR. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 50 0,168000 0,168000 0,050200
7 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH (R) 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE P-6L/S 60 0,141833 0,141833 0,000000
8 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,141800 0,141800 0,000000
9 N03AF01 CARBAMAZEPINUM CARBAVIM COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,141800 0,141800 0,000000
10 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,141800 0,141800 0,000000
11 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,140000 0,140000 0,000000
12 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,142000 0,142000 0,000000
13 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,142000 0,142000 0,000000
14 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA SLAVIA 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,141800 0,141800 0,000000
15 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA TERAPIA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,141800 0,141800 0,000000
16 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,392200 0,392200 0,000000
17 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 400 mg COMPR. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,392000 0,392000 0,000000
18 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 150 mg COMPR. CU ELIB. PRELUNGITA 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA P6L 50 0,303800 0,303800 0,000000
19 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 300 mg COMPR. CU ELIBERARE PRELUNGITA 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,412600 0,412600 0,000000
20 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 600 mg COMPR. CU ELIBERARE PRELUNGITA 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,731600 0,731600 0,000000
21 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L 50 0,356000 0,356000 0,000000
22 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P-6L 50 0,686000 0,686000 0,000000
23 N03AF01 CARBAMAZEPINUM TEGRETOL CR 200 COMPR. FILM. ELIB. PREL. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 50 0,168000 0,168000 0,179400
24 N03AF01 CARBAMAZEPINUM TEGRETOL CR 400 COMPR. FILM. ELIB. PREL. 400mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 0,470400 0,470400 0,133600
25 N03AF01 CARBAMAZEPINUM TIMONIL SIROP SUSP. ORALA 100mg/5ml GERMANIA
DESITIN ARZNEIMITTEL GMBH CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 23,360000 23,360000 0,000000
26 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 300 mg COMPR. FILM. 300mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 0,887000 0,887000 0,000000
27 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 600 mg COMPR. FILM. 600mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 1,372200 1,372200 0,000000

Pagina 12 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
28 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 150 mg CAPS. ELIB. PREL. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 0,227760 0,227760 0,127840
29 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,189800 0,189800 0,000000
30 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,234500 0,234500 0,000000
31 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,304800 0,304800 0,000000
32 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL.
P-6L 100 0,281400 0,281400 0,067700
33 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. PP X 30 COMPR. FILM. ELIB. PREL. P-RF 30 0,365760 0,365760 0,103240
34 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,277250 0,277250 0,000000
35 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 1,924200 1,924200 0,000000
36 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCEFRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 18,430000 18,430000 0,000000
37 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCEFRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P-6L 1 18,430000 18,430000 0,000000
38 N03AX09 LAMOTRIGINUM ** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,903600 0,903600 0,028066
39 N03AX09 LAMOTRIGINUM ** PLEXXO (R) 100 mg COMPR. 100mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,849666 0,849666 0,000000
40 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 0,903600 0,903600 0,501757
41 N03AX09 LAMOTRIGINUM ** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1,768000 1,768000 0,000000
42 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 0,149285 0,149285 0,000000
43 N03AX09 LAMOTRIGINUM ** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,409999 0,409999 0,086667
44 N03AX09 LAMOTRIGINUM ** LAMOTRIN 100 mg COMPR. DISP. 100mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 0,753000 0,753000 0,000000
45 N03AX09 LAMOTRIGINUM ** LAMOTRIN 50 mg COMPR. DISP. 50mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 0,341666 0,341666 0,000000
46 N03AX09 LAMOTRIGINUM ** LAMICTAL 2 mg COMPR. DISP./MAST. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST. P-6L 30 0,009333 0,009333 0,000000
47 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. DISP./MAST. 5mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST. P-6L 30 0,026333 0,026333 0,000000
48 N03AX11 TOPIRAMATUM ** TOPRAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 0,982666 0,982666 0,000000
49 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 100 mg COMPR. FILM. 100mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 0,979833 0,979833 0,000000
50 N03AX11 TOPIRAMATUM ** LUSITRAX 100mg COMPR. FILM. 100mg ROMASTRU TRADING S.R.L.ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF 30 1,015333 1,015333 0,000000
51 N03AX11 TOPIRAMATUM ** TORLEPTA 100 mg COMPR. FILM. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 1,015333 1,015333 0,000000
52 N03AX11 TOPIRAMATUM ** TOPAMAX 100 mg COMPR. FILM. 100mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,175799 1,175799 0,335986
53 N03AX11 TOPIRAMATUM ** TOPAMAX 100 mg COMPR. FILM. 100mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 1,175799 1,175799 0,321701
54 N03AX11 TOPIRAMATUM ** TOPILEX 100 mg COMPR. FILM. 100mg AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.
LANNACHER HEILMITTEL GES.M.B.H. P6L 30 1,014333 1,014333 0,000000
55 N03AX11 TOPIRAMATUM ** TOPRAN 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 0,390333 0,390333 0,000000
56 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 25 mg COMPR. FILM. 25mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 0,390166 0,390166 0,000000
57 N03AX11 TOPIRAMATUM ** LUSITRAX 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L.ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF 30 0,391000 0,391000 0,000000
58 N03AX11 TOPIRAMATUM ** TORLEPTA 25 mg COMPR. FILM. 25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,390333 0,390333 0,000000
59 N03AX11 TOPIRAMATUM ** TOPAMAX 25 mg COMPR. FILM. 25mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,467599 0,467599 0,133472
60 N03AX11 TOPIRAMATUM ** TOPAMAX 25 mg COMPR. FILM. 25mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,467599 0,467599 0,125567
61 N03AX11 TOPIRAMATUM ** TOPILEX 25 mg COMPR. FILM. 25mg AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.
LANNACHER HEILMITTEL GES.M.B.H. P6L 30 0,389666 0,389666 0,000000
62 N03AX11 TOPIRAMATUM ** TOPRAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 0,642666 0,642666 0,000000
63 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 50 mg COMPR. FILM. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 0,626000 0,626000 0,000000
64 N03AX11 TOPIRAMATUM ** LUSITRAX 50 mg COMPR. FILM. 50mg ROMASTRU TRADING S.R.L.ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF 30 0,664000 0,664000 0,000000
65 N03AX11 TOPIRAMATUM ** TORLEPTA 50 mg COMPR. FILM. 50mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,646666 0,646666 0,000000
66 N03AX11 TOPIRAMATUM ** TOPAMAX 50 mg COMPR. FILM. 50mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,751200 0,751200 0,270585
67 N03AX11 TOPIRAMATUM ** TOPAMAX 50 mg COMPR. FILM. 50mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,751200 0,751200 0,280466
68 N03AX11 TOPIRAMATUM ** TOPILEX 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,647000 0,647000 0,000000
69 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,149200 0,149200 0,000000
70 N03AX12 GABAPENTINUM ** GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,179040 0,179040 0,015060
71 N03AX12 GABAPENTINUM ** GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,179040 0,179040 0,397460
72 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,179040 0,179040 0,228293
73 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,447800 0,447800 0,000000
74 N03AX12 GABAPENTINUM ** GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,537360 0,537360 0,218740
75 N03AX12 GABAPENTINUM ** GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS.P-6L 50 0,537360 0,537360 0,809240
76 N03AX12 GABAPENTINUM ** GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O.SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,519700 0,519700 0,000000
77 N03AX12 GABAPENTINUM ** GRIMODIN 300 mg CAPS. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,537360 0,537360 0,038140
78 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,537360 0,537360 0,359973
79 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,597600 0,597600 0,000000
80 N03AX12 GABAPENTINUM ** GABAGAMMA 400 mg CAPS. 400mg GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L
WORWAG PHARMA GMBH & CO. KG 100 0,717120 0,717120 0,475980
81 N03AX12 GABAPENTINUM ** GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS.P-6L 50 0,717120 0,717120 0,791880
82 N03AX12 GABAPENTINUM ** GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O.SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,692500 0,692500 0,000000

Pagina 13 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
83 N03AX12 GABAPENTINUM ** GRIMODIN 400 mg CAPS. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,717120 0,717120 0,312213
84 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,717120 0,717120 0,404546
85 N03AX12 GABAPENTINUM ** GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 2,180000 2,180000 0,000000
86 N03AX12 GABAPENTINUM ** GRIMODIN 600 mg COMPR. FILM. 600mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 1,867833 1,867833 0,000000
87 N03AX12 GABAPENTINUM ** GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 3,605000 3,605000 0,000000
88 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TORRENT 1000 mg COMPR. FILM. 1000 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 1,878799 1,878799 1,285867
89 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TERAPIA 1000 mg COMPR. FILM. 1000 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMP.FILM. PRF 30 1,878799 1,878799 1,635201
90 N03AX14 LEVETIRACETAMUM ** KEPPRA 1000 mg COMPR. FILM. 1000mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM.1 (BLIST. AL/PVC)P-RF 30 1,878799 1,878799 3,247534
91 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACTAVIS 1000mg COMPR. FILM. 1000mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF 30 1,864000 1,864000 0,000000
92 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TEVA 1000mg COMPR. FILM. 1000mg TEVA PHARMA OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF 30 1,878799 1,878799 0,050201
93 N03AX14 LEVETIRACETAMUM ** TRUND 1000 mg COMPR. FILM. 1000mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 60 1,784333 1,784333 0,000000
94 N03AX14 LEVETIRACETAMUM ** EPILETAM 1000 mg COMPR. FILM. 1000mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 30 1,878799 1,878799 1,635201
95 N03AX14 LEVETIRACETAMUM ** COMPR. FILM.
LEVETIRACETAM AUROBINDO 1000 mg 1000mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. PRF 30 1,878799 1,878799 0,492201
96 N03AX14 LEVETIRACETAMUM ** MYAKELL 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 1,878799 1,878799 1,635201
97 N03AX14 LEVETIRACETAMUM ** NORMEG 1000 mg COMPR. FILM. 1000mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM. PRF 30 1,565666 1,565666 0,000000
98 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TEVA 250 mg COMPR. FILM. 250 mg TEVA PHARMA OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF 30 0,472666 0,472666 0,000000
99 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TORRENT 250 mg COMPR. FILM. 250 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 0,525999 0,525999 0,204001
100 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TERAPIA 250 mgCOMPR. FILM. 250 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF 30 0,525999 0,525999 0,430334
101 N03AX14 LEVETIRACETAMUM ** KEPPRA 250 mg COMPR. FILM. 250mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF 30 0,525999 0,525999 0,897667
102 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACTAVIS 250mg COMPR. FILM. 250mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF 30 0,477666 0,477666 0,000000
103 N03AX14 LEVETIRACETAMUM ** TRUND 250 mg COMPR. FILM. 250mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 60 0,438333 0,438333 0,000000
104 N03AX14 LEVETIRACETAMUM ** EPILETAM 250 mg COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 30 0,525999 0,525999 0,430334
105 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 250 mgCOMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,525999 0,525999 0,224334
106 N03AX14 LEVETIRACETAMUM ** MYAKELL 250 mg COMPR. FILM. 250mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 0,525999 0,525999 0,430334
107 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TORRENT 500 mg COMPR. FILM. 500 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 0,673599 0,673599 0,660067
108 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TERAPIA 500 mgCOMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF 30 0,673599 0,673599 1,076067
109 N03AX14 LEVETIRACETAMUM ** KEPPRA 500 mg COMPR. FILM. 500mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF 30 0,673599 0,673599 1,882401
110 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACTAVIS 500mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF 30 0,645000 0,645000 0,000000
111 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMA OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF 30 0,561333 0,561333 0,000000
112 N03AX14 LEVETIRACETAMUM ** TRUND 500 mg COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 60 0,673599 0,673599 0,228067
113 N03AX14 LEVETIRACETAMUM ** EPILETAM 500 mg COMPR. FILM. 500mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 30 0,673599 0,673599 1,076067
114 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 500 mgCOMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,673599 0,673599 0,255067
115 N03AX14 LEVETIRACETAMUM ** MYAKELL 500 mg COMPR. FILM. 500mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 0,673599 0,673599 1,076067
116 N03AX14 LEVETIRACETAMUM ** NORMEG 500 mg COMPR. FILM. 500mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM. PRF 30 0,673599 0,673599 0,135401
117 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TORRENT 750 mg COMPR. FILM. 750 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 2,362000 2,362000 0,000000
118 N03AX14 LEVETIRACETAMUM ** MYAKELL 750 mg COMPR. FILM. 750mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 2,834400 2,834400 0,423600
119 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 1000 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 1,878799 1,878799 1,635201
120 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 250 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 250mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 0,525999 0,525999 0,362667
121 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 500 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 500mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 0,673599 0,673599 1,076067
122 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 750 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 750mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 60 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 60 2,834400 2,834400 0,042766
123 N03AX14 LEVETIRACETAMUM ** SOL. ORALA
LEVETIRACETAM ACTAVIS GROUP 100mg/ml 100 mg/ml ACTAVIS GROUP PTC EHF. ISLANDA PRF
CUTIE X 1 FLACON DIN STICLA BRUNA A 300ML PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 SERINGA PENTRU ADMINISTRARE ORALA A 10ML 1 61,270000 61,270000 0,000000
124 N03AX14 LEVETIRACETAMUM ** KEPPRA 100 mg/ml SOL. ORALA 100mg/ml UCB PHARMA SA BELGIA CUTIE X 1 FLACON X 300 ML SOL. ORALA + SERINGA PT. ADMIN. ORALA P-RF 1 73,524000 73,524000 15,986000
125 N03AX14 LEVETIRACETAMUM ** TRUND 100 mg/ml SOL. ORALA 100mg/ml GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 1 FLACON DIN STICLA BRUNA X 300ML SOLUTIE ORALA, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII DIN PP + O SERINGA DOZATAOARE (PP, PE) DE 10ML SI UN ADAPTOR PT. SERINGA PE PRF 1 61,270000 61,270000 0,000000
126 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM RATIOPHARM 100mg/ml SOL. ORALA 100mg/ml RATIOPHARM GMBH GERMANIA PRF
CUTIE CU UN FLACON DIN STICLA BRUNA A 300 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + O SERINGA PENTRU ADMINISTRARE ORALA GRADATA A 10ML 1 61,270000 61,270000 0,000000
127 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 1,794642 1,794642 2,586072
128 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 1,794642 1,794642 2,101608
129 N03AX16 PREGABALINUM ** PREGLENIX 150 mg CAPS. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,794642 1,794642 0,892500
130 N03AX16 PREGABALINUM ** PREGLENIX 150 mg CAPS. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,794642 1,794642 0,625179
131 N03AX16 PREGABALINUM ** PREGABALIN ZENTIVA 150 mg CAPS. 150mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,794464 1,794464 0,000000
132 N03AX16 PREGABALINUM ** PREGAMID 150 mg CAPS. 150mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,598333 1,598333 0,000000
133 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 1,794642 1,794642 0,611358
134 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 1,794642 1,794642 1,052500
135 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 1,794642 1,794642 0,737858
136 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,794642 1,794642 1,052500
137 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,794642 1,794642 0,737858

Pagina 14 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
138 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIECUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 1,785000 1,785000 0,000000
139 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 56 CPAS. PRF 56 1,666964 1,666964 0,000000
140 N03AX16 PREGABALINUM ** PREGABALINA DR. REDDY'S 150 mg CAPS. 150mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS.PRF 56 1,794642 1,794642 0,737858
141 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ GMBH 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 1,495535 1,495535 0,000000
142 N03AX16 PREGABALINUM ** LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 3,203142 3,203142 2,841858
143 N03AX16 PREGABALINUM ** PREGLENIX 300 mg CAPS. 300mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 3,203142 3,203142 0,934000
144 N03AX16 PREGABALINUM ** PREGLENIX 300 mg CAPS. 300mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 3,203142 3,203142 0,522393
145 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 3,203142 3,203142 0,336191
146 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 300 mg CAPS. 300mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 2,669285 2,669285 0,000000
147 N03AX16 PREGABALINUM ** PREGABALINA DR. REDDY'S 300 mg CAPS. 300mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS.PRF 56 3,203142 3,203142 0,522393
148 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 1,119856 1,119856 1,513001
149 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 1,119856 1,119856 1,294072
150 N03AX16 PREGABALINUM ** PREGLENIX 75 mg CAPS. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,119856 1,119856 0,648001
151 N03AX16 PREGABALINUM ** PREGLENIX 75 mg CAPS. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,119856 1,119856 0,505144
152 N03AX16 PREGABALINUM ** PREGABALIN ZENTIVA 75 mg CAPS. 75mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,119821 1,119821 0,000000
153 N03AX16 PREGABALINUM ** PREGAMID 75 mg CAPS. 75mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,973666 0,973666 0,000000
154 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 75 mg CAPS. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 1,119856 1,119856 0,423977
155 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 1,119856 1,119856 0,648715
156 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 1,119856 1,119856 0,505322
157 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,119856 1,119856 0,648715
158 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,119856 1,119856 0,505322
159 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 75 mgCAPS. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 1,119856 1,119856 0,115858
160 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 75 mgCAPS. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 56 CPAS. PRF 56 1,001785 1,001785 0,000000
161 N03AX16 PREGABALINUM ** PREGABALINA DR. REDDY'S 75 mg CAPS. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS.PRF 56 1,119856 1,119856 0,477644
162 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ GMBH 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,933214 0,933214 0,000000
163 N03AX17 STIRIPENTOLUM ** DIACOMIT 250mg CAPS. 250mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 12,749333 12,749333 0,000000
164 N03AX17 STIRIPENTOLUM ** DIACOMIT 500mg CAPS. 500mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 25,643166 25,643166 0,000000
165 N03AX17 STIRIPENTOLUM ** DIACOMIT 250mg PULB. PT. SUSP. ORALA 250mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 12,749333 12,749333 0,000000
166 N03AX17 STIRIPENTOLUM ** DIACOMIT 500mg PULB. PT. SUSP. ORALA 500mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 25,643166 25,643166 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea neurologie i neurologie pediatric.

10. BOALA PARKINSON - G12

1 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,562400 0,562400 0,000000
2 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM) ** ISICOM 250 mg/25 mg COMPR. 250mg/25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 10 BLIST. PP/AL X 10 COMPR. P-6L 100 0,773600 0,773600 0,000000
3 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM) ** DUODOPA GEL INT. FARA CONCENTRATIE ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC S/P-RF 7 452,308571 452,308571 0,000000
4 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,000000
5 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** STALEVO 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 2,139000 2,139000 0,603400
6 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,000000
7 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,000000
8 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,000000
9 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,782500 1,782500 0,000000
10 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,782500 1,782500 0,000000
11 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** STALEVO 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF 100 2,139000 2,139000 0,603400
12 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** COMPR. FILM.
LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 125 mg/31,25 mg/200 mg 125mg/31,25mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,000000
13 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,782500 1,782500 0,000000
14 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,851000 1,851000 0,000000
15 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** STALEVO 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 2,207400 2,207400 0,640300
16 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** COMPR. FILM.
LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 150 mg/37,5 mg/200 mg 150mg/37,5mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,851000 1,851000 0,000000
17 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,839500 1,839500 0,000000
18 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 100 COMPR. FILM. PRF 100 1,851000 1,851000 0,000000
19 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,822800 1,822800 0,000000

Pagina 15 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
20 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 175 mg/43,75 mg/200 mg COMPR. FILM. 175mg/43,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,730800 1,730800 0,000000
21 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,994800 1,994800 0,000000
22 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
P6L 100 1,730800 1,730800 0,000000
23 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** STALEVO 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 2,207400 2,207400 0,861800
24 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,995000 1,995000 0,000000
25 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,839500 1,839500 0,000000
26 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 100 COMPR. FILM. PRF 100 1,995000 1,995000 0,000000
27 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5 mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,646200 1,646200 0,000000
28 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
P6L 100 1,646200 1,646200 0,000000
29 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** STALEVO 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 1,975440 1,975440 0,557260
30 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,646200 1,646200 0,000000
31 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,646200 1,646200 0,000000
32 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 100 COMPR. FILM. PRF 100 1,646200 1,646200 0,000000
33 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** STALEVO 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF 100 1,515120 1,515120 1,325480
34 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1,262600 1,262600 0,000000
35 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,515120 1,515120 0,006780
36 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,846300 1,846300 0,000000
37 N04BB01 AMANTADINUM ** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 0,354400 0,354400 0,000000
38 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 0,549000 0,549000 0,000000
39 N04BC04 ROPINIROLUM ** ROPINIROL TEVA 2 mg COMPR. CU ELIB. PREL. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF 30 0,916333 0,916333 0,000000
40 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 2 mg COMPR. CU ELIB. PREL. 2mg SMITHKLINE BEECHAM PLCMAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF 28 1,099285 1,099285 0,265000
41 N04BC04 ROPINIROLUM ** ROPINIROL TEVA 4 mg COMPR. CU ELIB. PREL. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF 30 1,773000 1,773000 0,000000
42 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 4 mg COMPR. CU ELIB. PREL. 4mg SMITHKLINE BEECHAM PLCMAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF 28 2,127428 2,127428 0,462929
43 N04BC04 ROPINIROLUM ** ROPINIROL TEVA 8 mg COMPR. CU ELIB. PREL. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF 30 3,044666 3,044666 0,000000
44 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 8 mg COMPR. CU ELIB. PREL. 8mg SMITHKLINE BEECHAM PLCMAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF 28 3,653570 3,653570 0,869287
45 N04BC04 ROPINIROLUM ** ROLPRYNA EP 2 mg COMPR. CU ELIBERARE PRELUNGITA 2 mg KRKA ,D.D., NOVO MESTO SLOVENIA PRF
CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. 28 0,916071 0,916071 0,000000
46 N04BC04 ROPINIROLUM ** ROLPRYNA EP 4 mg COMPR. CU ELIBERARE PRELUNGITA 4 mg KRKA ,D.D., NOVO MESTO SLOVENIA PRF
CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. 28 1,772857 1,772857 0,000000
47 N04BC04 ROPINIROLUM ** ROLPRYNA EP 8 mg COMPR. CU ELIBERARE PRELUNGITA 8 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF 28 3,044642 3,044642 0,000000
48 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 2 mg COMPR. ELIB. PREL. 2 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 0,916071 0,916071 0,000000
49 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 2 mg COMPR. ELIB. PREL. 2mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 0,916071 0,916071 0,000000
50 N04BC04 ROPINIROLUM ** NERVAMAT 2 mg COMPR. ELIB. PREL. 2mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF 28 0,916071 0,916071 0,000000
51 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 4 mg COMPR. ELIB. PREL. 4 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 1,772857 1,772857 0,000000
52 N04BC04 ROPINIROLUM ** NERVAMAT 4 mg COMPR. ELIB. PREL. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF 28 1,772857 1,772857 0,000000
53 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 4 mg COMPR. ELIB. PREL. 4mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 1,772857 1,772857 0,000000
54 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 8 mg COMPR. ELIB. PREL. 8 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 3,044642 3,044642 0,000000
55 N04BC04 ROPINIROLUM ** NERVAMAT 8 mg COMPR. ELIB. PREL. 8mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF 28 3,044642 3,044642 0,000000
56 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 8 mg COMPR. ELIB. PREL. 8mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 3,044642 3,044642 0,000000
57 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOLE ACCORD 0,088 mg COMPR. 0,088 mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 0,523333 0,523333 0,000000
58 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,088mg COMPR. 0,088mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,530000 0,530000 0,000000
59 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOLE ACCORD 0,18 mg COMPR. 0,18 mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 0,322666 0,322666 0,000000
60 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOLE ACCORD 0,18 mg COMPR. 0,18 mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 10 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 100 0,322500 0,322500 0,000000
61 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL ZENTIVA 0,18 mg COMPR. 0,18 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 0,386666 0,386666 0,000000
62 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,387000 0,387000 0,039666
63 N04BC05 PRAMIPEXOLUM ** MEDOPEXOL 0,18 mg COMPR. 0,18mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 0,387000 0,387000 0,264333
64 N04BC05 PRAMIPEXOLUM ** GLEPARK 0,18 mg COMPR. 0,18mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHACUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 0,322666 0,322666 0,000000
65 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL TORRENT 0,18 mg COMPR. 0,18mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 0,387000 0,387000 0,203666
66 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL AUROBINDO 0,18 mg COMPR. 0,18mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 0,387000 0,387000 0,136333
67 N04BC05 PRAMIPEXOLUM ** MIGLASEN 0,18 mg COMPR. 0,18mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,387000 0,387000 0,127000
68 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL AUROBINDO 0,7 mg COMPR. 0,7 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 1,889333 1,889333 0,000000
69 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL ZENTIVA 0,7 mg COMPR. 0,7 mg ZENTIVA, K.S. PRF
REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. 30 2,041680 2,041680 0,067320
70 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 2,028000 2,028000 0,000000
71 N04BC05 PRAMIPEXOLUM ** MEDOPEXOL 0,7 mg COMPR. 0,7mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,034333 2,034333 0,000000
72 N04BC05 PRAMIPEXOLUM ** GLEPARK 0,7 mg COMPR. 0,7mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 2,041680 2,041680 0,214986
73 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOLE ACCORD 0,7mg COMPR. 0,7mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 1,889333 1,889333 0,000000
74 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL TORRENT 0,7 mg COMPR. 0,7mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 2,041680 2,041680 0,396320

Pagina 16 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
75 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL STADA 0,7 mg COMPR. 0,7mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR.P-RF 30 2,027333 2,027333 0,000000
76 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOLE ACCORD 0,7mg COMPR. 0,7mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 10 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 100 1,701400 1,701400 0,000000
77 N04BC05 PRAMIPEXOLUM ** MIGLASEN 0,7 mg COMPR. 0,7mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.
P6L 30 2,041680 2,041680 0,405986
78 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 0,26 mg COMPR. ELIB. PREL. 0,26mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR.P-RF 10 0,763200 0,763200 0,755800
79 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0,636000 0,636000 0,000000
80 N04BC05 PRAMIPEXOLUM ** CALMOLAN 0,26 mg COMPR. ELIB. PREL. 0,26mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF 10 0,636000 0,636000 0,000000
81 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 0,52 mg COMPR. ELIB. PREL. 0,52mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.P-RF 30 1,679599 1,679599 0,473734
82 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,52mg COMPR. ELIB. PREL. 0,52mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 1,399666 1,399666 0,000000
83 N04BC05 PRAMIPEXOLUM ** CALMOLAN 0,52 mg COMPR. ELIB. PREL. 0,52mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 1,399666 1,399666 0,000000
84 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 1,05 mg COMPR. ELIB. PREL. 1,05mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.P-RF 30 2,550000 2,550000 1,552000
85 N04BC05 PRAMIPEXOLUM ** OPRYMEA 1,05mg COMPR. ELIB. PREL. 1,05mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 2,125000 2,125000 0,000000
86 N04BC05 PRAMIPEXOLUM ** OPRYMEA 1,57mg COMPR. ELIB. PREL. 1,57mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 5,049333 5,049333 0,000000
87 N04BC05 PRAMIPEXOLUM ** OPRYMEA 2,10mg COMPR. ELIB. PREL. 2,10mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 4,722333 4,722333 0,000000
88 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 2,1 mg COMPR. ELIB. PREL. 2,1mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.P-RF 30 5,666799 5,666799 1,598201
89 N04BC05 PRAMIPEXOLUM ** CALMOLAN 2,1 mg COMPR. ELIB. PREL. 2,1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 4,722333 4,722333 0,000000
90 N04BC05 PRAMIPEXOLUM ** OPRYMEA 2,62 mg COMPR. ELIB. PREL. 2,62mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 8,426666 8,426666 0,000000
91 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 3,15 mg COMPR. ELIB. PREL. 3,15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.P-RF 30 9,320799 9,320799 2,629201
92 N04BC05 PRAMIPEXOLUM ** OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 7,767333 7,767333 0,000000
93 N04BC09 ROTIGOTINUM ** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 7,975714 7,975714 0,000000
94 N04BC09 ROTIGOTINUM ** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 11,431428 11,431428 0,000000
95 N04BC09 ROTIGOTINUM ** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 14,614285 14,614285 0,000000
96 N04BC09 ROTIGOTINUM ** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 17,376071 17,376071 0,000000
97 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 BLIST. DIN AL/PVC X 10 COMPR. P-6L 50 0,725200 0,725200 0,000000
98 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L 100 0,701100 0,701100 0,000000
99 N04BD02 RASAGILINUM ** AZILECT 1mg COMPR. 1mg TEVA PHARMA GMBH GERMANIA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 2,882799 2,882799 4,974534
100 N04BD02 RASAGILINUM ** RASAGILINA RATIOPHARM 1 mg COMPR. 1mg TEVA B.V. OLANDA CUTIE CU BLIST AL/AL X 30 COMPR. PRF 30 2,882799 2,882799 5,978534
101 N04BD02 RASAGILINUM ** RALAGO 1 mg COMPR. 1mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,882799 2,882799 6,716867
102 N04BD02 RASAGILINUM ** RASAGILINA SANDOZ 1 mg COMPR. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 2,882799 2,882799 2,293201
103 N04BD02 RASAGILINUM ** RASAGILINA AUROBINDO 1 mg COMPR. 1mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 2,882799 2,882799 2,488867
104 N04BD02 RASAGILINUM ** RASAGILINA TORRENT 1 mg COMPR. 1mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 2,882799 2,882799 4,279201
105 N04BD02 RASAGILINUM ** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 2,882799 2,882799 6,716867
106 N04BD02 RASAGILINUM ** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU PRF
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. 30 2,882799 2,882799 6,716867
107 N04BD02 RASAGILINUM ** RASAGILINA GLENMARK 1 mg COMPR. 1mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST.OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,882799 2,882799 5,742867
108 N04BD02 RASAGILINUM ** RASAGILINA DR. REDDY'S 1 mg COMPR. 1mg ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF
DR. REDDY'S LABORATORIES 30 2,402333 2,402333 0,000000
109 N04BD02 RASAGILINUM ** HIPERAVIA 1 mg COMPR. 1mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,882799 2,882799 5,711534
110 N04BD02 RASAGILINUM ** RASIGEROLAN 1 mg COMPR. 1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. PRF 30 2,882799 2,882799 0,609867
111 N04BD02 RASAGILINUM ** RASAGILINA ZENTIVA 1 mg COMPR. 1mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. PRF 28 2,882799 2,882799 3,562915
112 N04BD02 RASAGILINUM ** RASAGILINA ZENTIVA 1 mg COMPR. 1mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,882799 2,882799 3,562867
113 N04BD02 RASAGILINUM ** AZILECT 1mg COMPR. 1mg TEVA BV OLANDA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 2,882799 2,882799 4,974534
114 N04BX02 ENTACAPONUM ** COMTAN 200mg COMPR. FILM. 200mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 100 COMPR. FILM. P-RF 100 1,922280 1,922280 0,542220
115 N04BX02 ENTACAPONUM ** ENTACAPONE TEVA COMPR. FILM. 200mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN PEID X 100 COMPR. FILM PRF 100 1,601900 1,601900 0,000000
116 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 1,779000 1,779000 0,000000
117 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PRF 60 1,689166 1,689166 0,000000
118 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 100 COMPR. FILM. PRF 100 1,601900 1,601900 0,000000
119 N04BX02 ENTACAPONUM ** ENTACAPONE TEVA COMPR. FILM. 200mg TEVA B.V. OLANDA CUTIE CU 1 FLAC. DIN PEID X 100 COMPR. FILMPRF 100 1,601900 1,601900 0,000000
120 N05AH02 CLOZAPINUM ** LEPONEX (R) 100 mg COMPR. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 1,274200 1,274200 0,000000
121 N05AH02 CLOZAPINUM ** LEPONEX (R) 25 mg COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 0,386200 0,386200 0,000000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

11. MIASTENIA GRAVIS - G13

1 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,028601
2 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,090333 0,090333 0,000000

Pagina 17 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
3 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,108399 0,108399 0,015267
4 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,025101
5 L04AX01 AZATHIOPRINUM IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,702300 0,000000
6 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,712000 0,712000 0,000000
7 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. P-6L 60 0,688833 0,688833 0,000000
8 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg MEDA AB SUEDIA CUTIE X 1 FLAC. X 20 DRAJ. S/P-RF 20 0,618500 0,618500 0,000000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

12. SCLEROZA MULTIPLA - G14

1 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,543200 0,543200 0,000000
2 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,234000 1,234000 0,000000
3 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLVP-RF 1 20,480000 20,480000 0,000000
4 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg PULB+SOLV. PT. SOL. INJ./PERF. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,810000 8,810000 0,000000
5 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg PULB+SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 MLS/P-RF 1 31,020000 31,020000 0,000000
6 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,028601
7 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,090333 0,090333 0,000000
8 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,108399 0,108399 0,015267
9 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,025101
10 L01DB07 MITOXANTRONUM ** ONKOTRONE CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY GMBHGERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. S 1 555,760000 555,760000 0,000000
11 L04AX01 AZATHIOPRINUM IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,702300 0,000000

Tratamentul se iniiaz de ctre medicul din specialitatea neurologie.

13. BOLI PSIHICE (SCHIZOFRENIE, TULBURRI SCHIZOTIPALE I DELIRANTE, TULBURRI AFECTIVE MAJORE, TULBURRI PSIHOTICE ACUTE I BOLI PSIHICE COPII, AUTISM, TULBURRI CU DEFICIT
DE ATENIE/HIPERREACTIVITATE) - G15

1 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 150 mg CAPS. ELIB. PREL. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA 50
CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L 0,227760 0,227760 0,127840
2 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA 100
CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 0,189800 0,189800 0,000000
3 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA 100
CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 0,234500 0,234500 0,000000
4 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA 100
CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 0,304800 0,304800 0,000000
5 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100 0,281400 0,281400 0,067700
6 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. PP X 30 COMPR. FILM. ELIB. PREL. P-RF 30 0,365760 0,365760 0,103240
7 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,277250 0,277250 0,000000
8 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 1,924200 1,924200 0,000000
9 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCEFRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 18,430000 18,430000 0,000000
10 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCEFRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P-6L 1 18,430000 18,430000 0,000000
11 N03AX09 LAMOTRIGINUM ** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,903600 0,903600 0,028066
12 N03AX09 LAMOTRIGINUM ** PLEXXO (R) 100 mg COMPR. 100mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,849666 0,849666 0,000000
13 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 0,903600 0,903600 0,501757
14 N03AX09 LAMOTRIGINUM ** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1,768000 1,768000 0,000000
15 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 0,149285 0,149285 0,000000
16 N03AX09 LAMOTRIGINUM ** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,409999 0,409999 0,086667
17 N03AX09 LAMOTRIGINUM ** LAMOTRIN 100 mg COMPR. DISP. 100mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 0,753000 0,753000 0,000000
18 N03AX09 LAMOTRIGINUM ** LAMOTRIN 50 mg COMPR. DISP. 50mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 0,341666 0,341666 0,000000
19 N03AX09 LAMOTRIGINUM ** LAMICTAL 2 mg COMPR. DISP./MAST. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST. P-6L 30 0,009333 0,009333 0,000000
20 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. DISP./MAST. 5mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST. P-6L 30 0,026333 0,026333 0,000000
21 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,562400 0,562400 0,000000
22 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,168000 0,168000 0,000000
23 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,267000 0,267000 0,000000
24 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATEPRF 30 0,373333 0,373333 0,000000

Pagina 18 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
25 N05AD01 HALOPERIDOLUM HALDOL COMPR. 5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,299600 0,299600 0,000000
26 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF 1 5,390000 5,390000 0,000000
27 N05AD01 HALOPERIDOLUM HALOPERIDOL - RICHTER 2mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA P-RF
CUTIE CU 1 FLAC. PICURATOR DIN STICLA BRUNA X 10 ML PICATURI ORALE, SOLUTIE 1 6,468000 6,468000 0,432000
28 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/ml SOL. INJ. 5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 5 2,206000 2,206000 0,000000
29 N05AE03 SERTINDOL ** SERDOLECT 16 mg COMPR. FILM. 16mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 14,899285 14,899285 0,000000
30 N05AE03 SERTINDOL ** SERDOLECT 4 mg COMPR. FILM. 4mg H. LUNDBECK A/S DANEMARCA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 3,767000 3,767000 0,000000
31 N05AE04 ZIPRASIDONUM ** ZYPSILA 40 mg CAPS. 40mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.P-RF 60 2,787333 2,787333 0,000000
32 N05AE04 ZIPRASIDONUM ** ZYPSILA 60 mg CAPS. 60mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.P-RF 60 4,212166 4,212166 0,000000
33 N05AE04 ZIPRASIDONUM ** ZYPSILA 80 mg CAPS. 80mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.P-RF 60 4,330833 4,330833 0,000000
34 N05AF01 FLUPENTIXOLUM ** FLUANXOL DEPOT SOL. INJ. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 7,118000 7,118000 0,000000
35 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. DIN PEJD X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDER P-RF 50 0,358800 0,358800 0,000000
36 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL 25 mg COMPR. FILM. 25mg H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. DIN PEJD X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDER P-RF 50 0,568000 0,568000 0,000000
37 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL 20 mg/ml PIC. ORALE-SOL. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. + CAPAC SECURIZAT PT. COPII X 20 ML P-RF 1 29,290000 29,290000 0,000000
38 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL (R) DEPOT SOL. INJ. 200mg/ml H. LUNDBECK A/S CUTIE X 10 FIOLE X 1 ML
DANEMARCA P-RF 10 12,456000 12,456000 0,000000
39 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL ACUPHASE (R) SOL. INJ. 50mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 5 FIOLE X 1 ML P-RF 5 9,058000 9,058000 0,000000
40 N05AH02 CLOZAPINUM ** LEPONEX (R) 100 mg COMPR. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 1,274200 1,274200 0,000000
41 N05AH02 CLOZAPINUM ** LEPONEX (R) 25 mg COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 0,386200 0,386200 0,000000
42 N05AH03 OLANZAPINUM ** ZALASTA 10mg COMPR. 10mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)P-RF 28 0,671428 0,671428 0,000000
43 N05AH03 OLANZAPINUM ** OLAZAX 10 mg COMPR. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. P-RF 28 0,671570 0,671570 0,070215
44 N05AH03 OLANZAPINUM ** ZALASTA 5mg COMPR. 5mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)P-RF 28 0,440357 0,440357 0,000000
45 N05AH03 OLANZAPINUM ** OLAZAX 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU BLIST. AL/AL X 28 COMPR. P-RF
REPUBLICA CEHA 28 0,446400 0,446400 0,107885
46 N05AH03 OLANZAPINUM ** ZYPREXA 10 mg COMPR. FILM. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 0,671570 0,671570 6,514858
47 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,671570 0,671570 2,413430
48 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,671570 0,671570 2,413763
49 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,563000 0,563000 0,000000
50 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,671428 0,671428 0,000000
51 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,671428 0,671428 0,000000
52 N05AH03 OLANZAPINUM ** LAPOZAN 15 mg COMPR. FILM. 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 2,440713 2,440713 4,871787
53 N05AH03 OLANZAPINUM ** EGOLANZA 15 mg COMPR. FILM. 15mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 2,440713 2,440713 5,162501
54 N05AH03 OLANZAPINUM ** EGOLANZA 20 mg COMPR. FILM. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 2,764285 2,764285 6,115000
55 N05AH03 OLANZAPINUM ** ZYPREXA 5 mg COMPR. FILM. 5mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 0,446400 0,446400 3,342885
56 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,446400 0,446400 0,846100
57 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,446400 0,446400 2,016600
58 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,372000 0,372000 0,000000
59 N05AH03 OLANZAPINUM ** BLOONIS 5 mg COMPR. FILM. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,443928 0,443928 0,000000
60 N05AH03 OLANZAPINUM ** BLOONIS 5 mg COMPR. FILM. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,443928 0,443928 0,000000
61 N05AH03 OLANZAPINUM ** ZALASTA 10mg COMPR. ORODISPERSABILE 10mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 0,586071 0,586071 0,000000
62 N05AH03 OLANZAPINUM ** OLANZAPINE TEVA 10mg COMPR. ORODISPERSABILE 10mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP. P-RF 30 0,671570 0,671570 0,062430
63 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,671570 0,671570 4,084501
64 N05AH03 OLANZAPINUM ** OLAZAX DISPERZI 10 mg COMPR. ORODISPERSABILE 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,671570 0,671570 0,358430
65 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. ORODISPERSABILE 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 0,671570 0,671570 2,412430
66 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. ORODISPERSABILE 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 50 COMPR. ORODISPERSABILE P-RF 50 0,671570 0,671570 2,252630
67 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. ORODISPERSABILE 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,671428 0,671428 0,000000
68 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 10 mg COMPR. ORODISPERSABILE 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,559642 0,559642 0,000000
69 N05AH03 OLANZAPINUM ** IRROPIA 10 mg COMPR. ORODISPERSABILE 10mg ROMASTRU TRADING S.R.L.ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 0,671570 0,671570 0,361287
70 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 10 mg COMPR. ORODISPERSABILE 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,671570 0,671570 3,776644
71 N05AH03 OLANZAPINUM ** WRANELON 10 mg COMPR. ORODISPERSABILE 10mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 0,671570 0,671570 0,362001
72 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 10 mg COMPR. ORODISPERSABILE 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0,671428 0,671428 0,000000
73 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. ORODISPERSABILE 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,671428 0,671428 0,000000
74 N05AH03 OLANZAPINUM ** ZALASTA 15mg COMPR. ORODISPERSABILE 15mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 2,033928 2,033928 0,000000
75 N05AH03 OLANZAPINUM ** OLANZAPINE TEVA 15mg COMPR. ORODISPERSABILE 15mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP. P-RF 30 2,440713 2,440713 0,586953
76 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,440713 2,440713 3,426787
77 N05AH03 OLANZAPINUM ** OLAZAX DISPERZI 15 mg COMPR. ORODISPERSABILE 15mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,440713 2,440713 3,426787
78 N05AH03 OLANZAPINUM ** LAPOZAN 15 mg COMPR. ORODISPERSABILE 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 2,440713 2,440713 3,426287
79 N05AH03 OLANZAPINUM ** BLOONIS 15 mg COMPR. ORODISPERSABILE 15mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,440713 2,440713 0,000001

Pagina 19 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
80 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 15 mg COMPR. ORODISPERSABILE 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,435000 2,435000 0,000000
81 N05AH03 OLANZAPINUM ** IRROPIA 15 mg COMPR. ORODISPERSABILE 15mg ROMASTRU TRADING S.R.L.ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 2,440713 2,440713 0,129644
82 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 15 mg COMPR. ORODISPERSABILE 15mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,440713 2,440713 3,426787
83 N05AH03 OLANZAPINUM ** WRANELON 15 mg COMPR. ORODISPERSABILE 15mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 2,440713 2,440713 2,030358
84 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 2,440713 2,440713 0,000001
85 N05AH03 OLANZAPINUM ** BLOONIS 15 mg COMPR. ORODISPERSABILE 15mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,440713 2,440713 0,000001
86 N05AH03 OLANZAPINUM ** ZALASTA 20mg COMPR. ORODISPERSABILE 20mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 2,303571 2,303571 0,000000
87 N05AH03 OLANZAPINUM ** OLANZAPINE TEVA 20mg COMPR. ORODISPERSABILE 20mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP. P-RF 30 2,304000 2,304000 0,000000
88 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 20 mg COMPR. ORODISPERSABILE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,764285 2,764285 6,577857
89 N05AH03 OLANZAPINUM ** OLAZAX DISPERZI 20 mg COMPR. ORODISPERSABILE 20mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,764285 2,764285 3,458215
90 N05AH03 OLANZAPINUM ** BLOONIS 20 mg COMPR. ORODISPERSABILE 20mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,764285 2,764285 0,000357
91 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 20 mg COMPR. ORODISPERSABILE 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,749642 2,749642 0,000000
92 N05AH03 OLANZAPINUM ** IRROPIA 20 mg COMPR. ORODISPERSABILE 20mg ROMASTRU TRADING S.R.L.ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 2,764285 2,764285 3,457143
93 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 20 mg COMPR. ORODISPERSABILE 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,764285 2,764285 3,245000
94 N05AH03 OLANZAPINUM ** WRANELON 20 mg COMPR. ORODISPERSABILE 20mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 2,764285 2,764285 2,111786
95 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 20 mg COMPR. ORODISPERSABILE 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 2,749642 2,749642 0,000000
96 N05AH03 OLANZAPINUM ** BLOONIS 20 mg COMPR. ORODISPERSABILE 20mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,764285 2,764285 0,000357
97 N05AH03 OLANZAPINUM ** ZALASTA 5mg COMPR. ORODISPERSABILE 5mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 0,440357 0,440357 0,000000
98 N05AH03 OLANZAPINUM ** OLANZAPINE TEVA 5mg COMPR. ORODISPERSABILE 5mg TEVA PHARMA BV OLANDA CUTIE X 30 COMPR. FILM. (BLIST. OPA-AL-PVC/AL) P-RF 30 0,443666 0,443666 0,000000
99 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 5 mg COMPR. ORODISPERSABILE 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,446400 0,446400 2,060742
100 N05AH03 OLANZAPINUM ** OLAZAX DISPERZI 5 mg COMPR. ORODISPERSABILE 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,446400 0,446400 0,107885
101 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. ORODISPERSABILE 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 0,446400 0,446400 0,845933
102 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. ORODISPERSABILE 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 50 COMPR. ORODISPERSABILE P-RF 50 0,446400 0,446400 0,845800
103 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 5 mg COMPR. ORODISPERSABILE 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,446400 0,446400 0,015742
104 N05AH03 OLANZAPINUM ** IRROPIA 5 mg COMPR. ORODISPERSABILE 5mg ROMASTRU TRADING S.R.L.ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 0,446400 0,446400 0,107885
105 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 5 mg COMPR. ORODISPERSABILE 5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,446400 0,446400 1,598600
106 N05AH03 OLANZAPINUM ** WRANELON 5 mg COMPR. ORODISPERSABILE 5mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (2X14) COMPR. ORODISPERSABILE PRF 28 0,446400 0,446400 0,107885
107 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 5 mg COMPR. ORODISPERSABILE 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0,440357 0,440357 0,000000
108 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 7,5 mg COMPR. ORODISPERSABILE 7,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 3,313571 3,313571 0,000000
109 N05AH03 OLANZAPINUM ** ZYPADHERA 210mg 210mg
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 210MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 650,040000 650,040000 0,000000
110 N05AH03 OLANZAPINUM ** ZYPADHERA 300mg 300mg
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 300MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 916,710000 916,710000 0,000000
111 N05AH03 OLANZAPINUM ** ZYPADHERA 405mg 405mg
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 405MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 1.223,460000 1.223,460000 0,000000
112 N05AH03 OLANZAPINUM ** ZYPREXA 10 mg PULB. PT. SOL. INJ. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. X 10 MG PULB.PT.SOL.INJ. P-RF 1 20,710000 20,710000 0,000000
113 N05AH04 QUETIAPINUM ** NETIAPIN 150 mg COMPR. CU ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1,441399 1,441399 0,601267
114 N05AH04 QUETIAPINUM ** NETIAPIN 200 mg COMPR. CU ELIB. PREL. 200mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1,633333 1,633333 0,000000
115 N05AH04 QUETIAPINUM ** NETIAPIN 300 mg COMPR. CU ELIB. PREL. 300mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1,982599 1,982599 0,159734
116 N05AH04 QUETIAPINUM ** NETIAPIN 400 mg COMPR. CU ELIB. PREL. 400mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 2,461200 2,461200 0,141466
117 N05AH04 QUETIAPINUM ** NETIAPIN 50 mg COMPR. CU ELIB. PREL. 50mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 0,466333 0,466333 0,000000
118 N05AH04 QUETIAPINUM ** SEROQUEL XR 150 mg COMPR. ELIB. PREL. 150mg ASTRAZENECA UK LIMITEDMAREA BRITANIE CUTIE CU 6 BLIST. PVC-PCTFE/AL X 10 COMPR. ELIB. PREL. P-RF 60 1,441399 1,441399 1,644934
119 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 150 mg COMPR. ELIB. PREL. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,201166 1,201166 0,000000
120 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 200 mg COMPR. ELIB. PREL. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,416166 1,416166 0,000000
121 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 300 mg COMPR. ELIB. PREL. 300mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,652166 1,652166 0,000000
122 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 400 mg COMPR. ELIB. PREL. 400mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 2,051000 2,051000 0,000000
123 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 50 mg COMPR. ELIB. PREL. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,559599 0,559599 0,036901
124 N05AH04 QUETIAPINUM ** KETILEPT 100 mg COMPR. FILM. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF 60 0,426799 0,426799 0,538701
125 N05AH04 QUETIAPINUM ** KVENTIAX 100 mg COMPR. FILM. 100mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 0,355666 0,355666 0,000000
126 N05AH04 QUETIAPINUM ** QUETROP 100 mg COMPR. FILM. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 60 0,426799 0,426799 1,033701
127 N05AH04 QUETIAPINUM ** Q MIND 100 mg COMPR. FILM. 100mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 0,426799 0,426799 0,418201
128 N05AH04 QUETIAPINUM ** KETILEPT 200 mg COMPR. FILM. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM.
P-RF 60 0,602799 0,602799 0,347367
129 N05AH04 QUETIAPINUM ** KVENTIAX 200 mg COMPR. FILM. 200mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 0,502333 0,502333 0,000000
130 N05AH04 QUETIAPINUM ** QUETROP 200 mg COMPR. FILM. 200mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 60 0,602799 0,602799 1,275034
131 N05AH04 QUETIAPINUM ** Q MIND 200 mg COMPR. FILM. 200mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 0,602799 0,602799 0,813367
132 N05AH04 QUETIAPINUM ** KETILEPT 300 mg COMPR. FILM. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM.
P-RF 60 1,256799 1,256799 0,352867
133 N05AH04 QUETIAPINUM ** KVENTIAX 300 mg COMPR. FILM. 300mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,047333 1,047333 0,000000
134 N05AH04 QUETIAPINUM ** QUETROP 300 mg COMPR. FILM. 300mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 60 1,256799 1,256799 1,445534

Pagina 20 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
135 N05AH04 QUETIAPINUM ** Q MIND 300 mg COMPR. FILM. 300mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,256799 1,256799 0,489701
136 N05AH04 QUETIAPINUM ** SEROQUEL XR 200 mg COMPR. FILM. ELIB. PREL. 200mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 1,699399 1,699399 2,415934
137 N05AH04 QUETIAPINUM ** SEROQUEL XR 300 mg COMPR. FILM. ELIB. PREL. 300mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 1,982599 1,982599 4,164567
138 N05AH04 QUETIAPINUM ** SEROQUEL XR 400 mg COMPR. FILM. ELIB. PREL. 400mg ASTRAZENECA UK LIMITEDMAREA BRITANIE CUTIE X 6 BLIST. PVC-PCTFE/AL X 10 COMPR. CU ELIB. PREL. P-RF 60 2,461200 2,461200 5,400300
139 N05AH04 QUETIAPINUM ** SEROQUEL XR 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE DIN AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 0,559599 0,559599 0,544734
140 N05AL01 SULPIRIDUM EGLONYL (R) 50 mg CAPS. 50mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. X 15 CAPS. P-RF 30 0,274333 0,274333 0,000000
141 N05AL01 SULPIRIDUM EGLONYL 50 mg CAPS. 50mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE CU 1 BLIST. PVC/AL X 30 CAPS. PRF 30 0,274333 0,274333 0,000000
142 N05AL01 SULPIRIDUM EGLONYL (R) 200 mg COMPR. 200mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 1 BLIST. X 12 COMPR. P-RF 12 0,698333 0,698333 0,000000
143 N05AL05 AMISULPRIDUM ** AMISULPRIDA LPH 200 mg COMPR. 200mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 30 1,522000 1,522000 0,000000
144 N05AL05 AMISULPRIDUM ** MIDORA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 1,522000 1,522000 0,000000
145 N05AL05 AMISULPRIDUM ** SOLIAN 200 mg COMPR. DIVIZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 1,826400 1,826400 0,437266
146 N05AL05 AMISULPRIDUM ** SOLIAN 400 mg COMPR. FILM. 400mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 3,672000 3,672000 0,000000
147 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,303833 0,303833 0,000000
148 N05AX08 RISPERIDONUM ** SPRING 1 mg COMPR. FILM. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,364599 0,364599 0,150401
149 N05AX08 RISPERIDONUM ** RISPEN 1 COMPR. FILM. 1mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,359600 0,359600 0,000000
150 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 1 mg COMPR. FILM. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,364599 0,364599 0,018901
151 N05AX08 RISPERIDONUM ** RONYDAL 1 mg COMPR. FILM. 1mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,364599 0,364599 0,050901
152 N05AX08 RISPERIDONUM ** RISPEN 2 COMPR. FILM. 2 mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,309000 0,309000 0,000000
153 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 2 mg COMPR. FILM. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,309000 0,309000 0,222333
154 N05AX08 RISPERIDONUM ** RISON 2 mg COMPR. FILM. 2mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,257500 0,257500 0,000000
155 N05AX08 RISPERIDONUM ** SPRING 2 mg COMPR. FILM. 2mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,309000 0,309000 0,564000
156 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 2 mg COMPR. FILM. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,309000 0,309000 0,530000
157 N05AX08 RISPERIDONUM ** RONYDAL 2 mg COMPR. FILM. 2mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,309000 0,309000 0,614333
158 N05AX08 RISPERIDONUM ** TORENDO 3 mg COMPR. FILM. 3mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,507600 0,507600 0,687733
159 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 3 mg COMPR. FILM. 3mg ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
TEVA PHARMACEUTICALS S.R.L. P-RF 60 0,507600 0,507600 0,270066
160 N05AX08 RISPERIDONUM ** RISON 3 mg COMPR. FILM. 3mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,423000 0,423000 0,000000
161 N05AX08 RISPERIDONUM ** SPRING 3 mg COMPR. FILM. 3mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,507600 0,507600 0,874066
162 N05AX08 RISPERIDONUM ** RISPEN 3 COMPR. FILM. 3mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,507600 0,507600 0,000000
163 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 3 mg COMPR. FILM. 3mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,507600 0,507600 0,851400
164 N05AX08 RISPERIDONUM ** RONYDAL 3 mg COMPR. FILM. 3mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,507500 0,507500 0,000000
165 N05AX08 RISPERIDONUM ** RISPEN 4 COMPR. FILM. 4 mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,309000 0,309000 0,000000
166 N05AX08 RISPERIDONUM ** TORENDO 4 mg COMPR. FILM. 4mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,309000 0,309000 1,334333
167 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 4 mg COMPR. FILM. 4mg ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
TEVA PHARMACEUTICALS S.R.L. P-RF 60 0,309000 0,309000 0,795833
168 N05AX08 RISPERIDONUM ** RISON 4 mg COMPR. FILM. 4mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,257500 0,257500 0,000000
169 N05AX08 RISPERIDONUM ** SPRING 4 mg COMPR. FILM. 4mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,309000 0,309000 1,579666
170 N05AX08 RISPERIDONUM ** RISPERIDONA MEDOCHEMIE 4 mg COMPR. FILM. 4mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. PRF 20 0,309000 0,309000 1,503500
171 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 4 mg COMPR. FILM. 4mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,309000 0,309000 1,416000
172 N05AX08 RISPERIDONUM ** RONYDAL 4 mg COMPR. FILM. 4mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,309000 0,309000 1,608833
173 N05AX08 RISPERIDONUM ** TORENDO Q-TAB 1 mg COMPR. ORODISPERSABILE 1mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 0,364599 0,364599 0,062067
174 N05AX08 RISPERIDONUM ** ESSENS OD 1 mg COMPR. ORODISPERSABILE 1mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 0,364599 0,364599 0,070067
175 N05AX08 RISPERIDONUM ** TORENDO Q-TAB 2 mg COMPR. ORODISPERSABILE 2mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 0,309000 0,309000 0,597000
176 N05AX08 RISPERIDONUM ** ESSENS OD 2 mg COMPR. ORODISPERSABILE 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 0,309000 0,309000 0,619666
177 N05AX08 RISPERIDONUM ** ESSENS OD 3 mg COMPR. ORODISPERSABILE 3mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 0,507600 0,507600 0,929733
178 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 25mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 374,930000 374,930000 0,000000
179 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 37,5 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 37,5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 530,080000 530,080000 0,000000
180 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 50 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 635,690000 635,690000 0,000000
181 N05AX08 RISPERIDONUM ** RISPOLEPT SOL. ORALA 1mg/ml JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 30 ML SOL. ORALA + 1 PIPETA P-RF 1 17,330000 17,330000 0,000000
182 N05AX12 ARIPIPRAZOLUM ** ABILIFY 10mg COMPR. 10mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR. P-RF 28 3,330856 3,330856 8,151644
183 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 10mg COMPR. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 3,330856 3,330856 0,492810
184 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL GLENMARK 10 mg COMPR. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA PRF
CUTIE CU 1 BLSIT. OPA-AL-PVC/AL X 28 COMPR. 28 3,330856 3,330856 4,132715
185 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 3,330856 3,330856 1,012477
186 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 3,330856 3,330856 2,180810
187 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL SANDOZ 10 mgCOMPR. 10mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. ALU/ALU X 28 COMPR. PRF 28 3,330856 3,330856 4,132715
188 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR.PRF 28 2,775714 2,775714 0,000000
189 N05AX12 ARIPIPRAZOLUM ** ARICOGAN 10 mg COMPR. 10mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 3,330856 3,330856 0,492810

Pagina 21 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
190 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 10 mg COMPR. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. PRF 28 3,330357 3,330357 0,000000
191 N05AX12 ARIPIPRAZOLUM ** RESTIGULIN 10 mg COMPR. 10mg ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. PRF
GEDEON RICHTER ROMANIA S.A. 28 3,330856 3,330856 1,358072
192 N05AX12 ARIPIPRAZOLUM ** EXPLEMED 10 mg COMPR. 10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 14 COMPR.
PRF 28 3,330856 3,330856 2,295929
193 N05AX12 ARIPIPRAZOLUM ** ZYKALOR 10 mg COMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 3,330856 3,330856 4,132810
194 N05AX12 ARIPIPRAZOLUM ** LEMILVO 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 3,330856 3,330856 3,635144
195 N05AX12 ARIPIPRAZOLUM ** ABILIFY 15mg COMPR. 15mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR. P-RF 28 4,996285 4,996285 6,486215
196 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 15mg COMPR. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 4,996285 4,996285 0,643715
197 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL GLENMARK 15 mg COMPR. 15mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA PRF
CUTIE CU 1 BLSIT. OPA-AL-PVC/AL X 28 COMPR. 28 4,996285 4,996285 2,467286
198 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 15 mg COMPR. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 4,343333 4,343333 0,000000
199 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL AUROBINDO 15 mg COMPR. 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 4,996285 4,996285 0,745048
200 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL SANDOZ 15 mgCOMPR. 15mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. ALU/ALU X 28 COMPR. PRF 28 4,996285 4,996285 2,467286
201 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 15 mg COMPR. 15mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR.PRF 28 4,163571 4,163571 0,000000
202 N05AX12 ARIPIPRAZOLUM ** ZYKALOR 15 mg COMPR. 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 4,996285 4,996285 2,467381
203 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 15 mg COMPR. 15mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. PRF 28 4,996071 4,996071 0,000000
204 N05AX12 ARIPIPRAZOLUM ** RESTIGULIN 15 mg COMPR. 15mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. PRF 28 4,996285 4,996285 1,910857
205 N05AX12 ARIPIPRAZOLUM ** ARICOGAN 15 mg COMPR. 15mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 4,996285 4,996285 0,270381
206 N05AX12 ARIPIPRAZOLUM ** EXPLEMED 15 mg COMPR. 15mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. PRF 28 4,996285 4,996285 1,565143
207 N05AX12 ARIPIPRAZOLUM ** LEMILVO 15 mg COMPR. 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 4,878333 4,878333 0,000000
208 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 20 mg COMPR. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 11,686666 11,686666 0,000000
209 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 30 mg COMPR. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 11,686666 11,686666 0,000000
210 N05AX12 ARIPIPRAZOLUM ** ASTORET 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA PRF
CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE 28 3,330856 3,330856 4,132715
211 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 10 mg COMPR. ORODISPERSABILE 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. ORODISPERSABILE PRF 28 3,330357 3,330357 0,000000
212 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TORRENT 10 mg COMPR. ORODISPERSABILE 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE PRF 28 3,330856 3,330856 3,143786
213 N05AX12 ARIPIPRAZOLUM ** LEMILVO 10 mg COMPR. ORODISPERSABILE 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE ORODISPERSABILE PRF 30 3,330856 3,330856 3,635144
214 N05AX12 ARIPIPRAZOLUM ** ASTORET 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA PRF
CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE 28 4,996285 4,996285 2,467286
215 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 15 mg COMPR. ORODISPERSABILE 15mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. ORODISPERSABILE PRF 28 4,996071 4,996071 0,000000
216 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TORRENT 15 mg COMPR. ORODISPERSABILE 15mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE PRF 28 4,996285 4,996285 1,958000
217 N05AX12 ARIPIPRAZOLUM ** LEMILVO 15 mg COMPR. ORODISPERSABILE 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE ORODISPERSABILE PRF 30 4,878333 4,878333 0,000000
218 N05AX12 ARIPIPRAZOLUM ** ABILIFY MAINTENA 400mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 400mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE CU UN FL.X 400 MG PULB., UN FL. DE 2 ML CU SOLV., O SERINGA LUER-LOCK DE 3 ML CU AC HIPODERMIC SECURIZAT, O SERINGA JETABILA DE 3 ML CU VRF LUER-LOCK, UN ADAPTOR PENTRU FLACON, UN AC HIPODERMIC SECURIZAT SI UN AC HIPODERMIC SECURIZAT PT OBEZI PRF 1 1.163,560000 1.163,560000 0,000000
219 N05AX12 ARIPIPRAZOLUM ** ABILIFY 7,5mg/ml SOL. INJ. 7,5mg/ml OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1FLAC. X 1,3ML SOL.INJ P-RF 1 19,950000 19,950000 0,000000
220 N05AX12 ARIPIPRAZOLUM ** ABILIFY 1mg/ml SOL. ORALA 1mg/ml OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1 FLACON PET CU SISTEM DE INCHIDERE DIN PROPILENA SECURIZAT PENTRU COPII X 150ML + 1 MASURA DOZATOARE + 1 PICURATOR CALIBRAT DIN PROPILENA-POLIETILENA DE JOASA DENSITAT P-RF 1 121,050000 121,050000 0,000000
221 N05AX13 PALIPERIDONUM ** INVEGA 3mg COMPR. ELIB. PREL. 3mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL) P-RF 30 15,777333 15,777333 0,000000
222 N05AX13 PALIPERIDONUM ** INVEGA 6mg COMPR. ELIB. PREL. 6mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIEX 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL) P-RF 30 16,040000 16,040000 0,000000
223 N05AX13 PALIPERIDONUM ** INVEGA 9mg COMPR. ELIB. PREL. 9mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL) P-RF 30 17,477333 17,477333 0,000000
224 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 100mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1.463,340000 1.463,340000 0,000000
225 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 150mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 2.055,980000 2.055,980000 0,000000
226 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 944,130000 944,130000 0,000000
227 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 75mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1.202,120000 1.202,120000 0,000000
228 N06AB04 CITALOPRAMUM ** LINISAN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 0,246000 0,246000 0,000000
229 N06AB04 CITALOPRAMUM ** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 1,368000 1,368000 0,000000
230 N06AB10 ESCITALOPRAMUM ** DEPRESINAL 10 mg COMPR. FILM. 10 mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 0,778666 0,778666 0,000000
231 N06AB10 ESCITALOPRAMUM ** CIPRALEX 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 0,918000 0,918000 0,346285
232 N06AB10 ESCITALOPRAMUM ** ESCITIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,848928 0,848928 0,000000
233 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM-TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 0,776000 0,776000 0,000000
234 N06AB10 ESCITALOPRAMUM ** LENUXIN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,848928 0,848928 0,000000
235 N06AB10 ESCITALOPRAMUM ** ESLOREX 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,780666 0,780666 0,000000
236 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0,780357 0,780357 0,000000
237 N06AB10 ESCITALOPRAMUM ** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. PRF 14 0,848571 0,848571 0,000000
238 N06AB10 ESCITALOPRAMUM ** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,848928 0,000000
239 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0,778214 0,778214 0,000000
240 N06AB10 ESCITALOPRAMUM ** ELICEA 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,780666 0,780666 0,000000
241 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,778214 0,778214 0,000000
242 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 0,765000 0,765000 0,000000
243 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,848928 0,000000
244 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM-TEVA 15 mg COMPR. FILM. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 1,018713 1,018713 0,111620

Pagina 22 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
245 N06AB10 ESCITALOPRAMUM ** ELICEA 15 mg COMPR. FILM. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,018713 1,018713 0,350287
246 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM-TEVA 20 mg COMPR. FILM. 20mg ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
TEVA PHARMACEUTICALS S.R.L. P-RF 30 1,370000 1,370000 0,000000
247 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 1,642800 1,642800 0,625771
248 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 1,399642 1,399642 0,000000
249 N06AB10 ESCITALOPRAMUM ** ELICEA 20 mg COMPR. FILM. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,406000 1,406000 0,000000
250 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 10 mg 10mg
COMPR. ORODISPERSABILE KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 0,780357 0,780357 0,000000
251 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 10 mg 10mg
COMPR. ORODISPERSABILE KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 0,780357 0,780357 0,000000
252 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE PRF 30 0,918000 0,918000 0,015666
253 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 15 mg 15mg
COMPR. ORODISPERSABILE KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 1,018713 1,018713 0,350572
254 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 15 mg 15mg
COMPR. ORODISPERSABILE KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 1,018713 1,018713 0,332358
255 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 20 mg 20mg
COMPR. ORODISPERSABILE KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 1,576785 1,576785 0,000000
256 N06AB10 ESCITALOPRAMUM ** ELICEA Q-TAB 20 mg 20mg
COMPR. ORODISPERSABILE KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 1,576785 1,576785 0,000000
257 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 20 mg COMPR. ORODISPERSABILE 20mg ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE
TEVA PHARMACEUTICALS S.R.L. PRF 30 1,369000 1,369000 0,000000
258 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPAITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 1,264000 1,264000 0,000000
259 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPAITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 60 1,094833 1,094833 0,000000
260 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPAITALIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 60 1,094833 1,094833 0,000000
261 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPAITALIA CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF 20 1,264000 1,264000 0,000000
262 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ANGELINI FRANCESCO SPAITALIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-RF 30 0,644666 0,644666 0,000000
263 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ANGELINI FRANCESCO SPAITALIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. ELIB. PREL. P-RF 30 0,644666 0,644666 0,000000
264 N06AX14 TIANEPTINUM ** LYXIT 12,5 mg COMPR. FILM. 12,5 mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 0,460333 0,460333 0,000000
265 N06AX14 TIANEPTINUM ** LYXIT 12,5 mg COMPR. FILM. 12,5 mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 0,445222 0,445222 0,000000
266 N06AX14 TIANEPTINUM ** NOBIXAL 12,5 mg COMPR. FILM. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF 30 0,460333 0,460333 0,000000
267 N06AX14 TIANEPTINUM ** NOBIXAL 12,5 mg COMPR. FILM. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. PRF 30 0,460333 0,460333 0,000000
268 N06AX14 TIANEPTINUM ** COAXIL (R) DRAJ. 12,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 0,534266 0,534266 0,173400
269 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,665599 0,665599 1,347258
270 N06AX16 VENLAFAXINUM ** ELIFY EP 150 mg CAPS. ELIB. PREL. 150 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF 30 0,665599 0,665599 0,332734
271 N06AX16 VENLAFAXINUM ** IVRYX 150mg CAPS. ELIB. PREL. 150 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,665599 0,665599 0,195115
272 N06AX16 VENLAFAXINUM ** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,665599 0,665599 0,642972
273 N06AX16 VENLAFAXINUM ** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,554666 0,554666 0,000000
274 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,665599 0,665599 0,190829
275 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,665599 0,665599 0,643067
276 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 0,665599 0,665599 0,643067
277 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,665599 0,665599 0,643067
278 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,665599 0,665599 0,002734
279 N06AX16 VENLAFAXINUM ** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,596333 0,596333 0,000000
280 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,715599 0,715599 0,116067
281 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,391200 0,391200 0,927014
282 N06AX16 VENLAFAXINUM ** ELIFY EP 75 mg CAPS. ELIB. PREL. 75 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 0,391200 0,391200 0,358133
283 N06AX16 VENLAFAXINUM ** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,391200 0,391200 0,000228
284 N06AX16 VENLAFAXINUM ** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 0,391200 0,391200 0,493800
285 N06AX16 VENLAFAXINUM ** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,326000 0,326000 0,000000
286 N06AX16 VENLAFAXINUM ** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,391200 0,391200 0,271466
287 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 75 mg CAPS. ELIB. PREL. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,391200 0,391200 0,265228
288 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,391200 0,391200 0,488133
289 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 0,391200 0,391200 0,494133
290 N06AX16 VENLAFAXINUM ** VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,391200 0,391200 0,494133
291 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,391200 0,391200 0,000800
292 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 37,5 mg COMPR. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,715599 0,715599 0,116067
293 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,847333 0,847333 0,000000
294 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 75 mg COMPR. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,391200 0,391200 0,488133
295 N06AX16 VENLAFAXINUM ** ARGOFAN 150 SR COMPR. ELIB. PREL. 150mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,665000 0,665000 0,000000
296 N06AX16 VENLAFAXINUM ** ARGOFAN 75 SR COMPR. ELIB. PREL. 75mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,391000 0,391000 0,000000
297 N06AX21 DULOXETINUM ** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 1,286799 1,286799 1,653201
298 N06AX21 DULOXETINUM ** DULSEVIA 30 mg CAPS. GASTROREZ. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 1,200000 1,200000 0,000000
299 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 1,286799 1,286799 0,651772

Pagina 23 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
300 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1,286799 1,286799 0,651772
301 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 30 mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 1,286799 1,286799 0,256415
302 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 30 mg CAPS. GASTROREZ. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,286799 1,286799 0,624867
303 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,179642 1,179642 0,000000
304 N06AX21 DULOXETINUM ** DULOXETINA TEVA 30 mg CAPS. GASTROREZ. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,072333 1,072333 0,000000
305 N06AX21 DULOXETINUM ** DULOXGAMMA 30 mg CAPS. GASTROREZ. 30mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,286799 1,286799 0,724986
306 N06AX21 DULOXETINUM ** DULOXGAMMA 30 mg CAPS. GASTROREZ. 30mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1,286799 1,286799 0,724986
307 N06AX21 DULOXETINUM ** DULASOLAN 30 mg CAPS. GASTROREZ. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 1,157666 1,157666 0,000000
308 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1,286799 1,286799 0,539986
309 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 1,286799 1,286799 0,539986
310 N06AX21 DULOXETINUM ** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 2,539200 2,539200 2,023657
311 N06AX21 DULOXETINUM ** DULSEVIA 60 mg CAPS. GASTROREZ. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 2,500000 2,500000 0,000000
312 N06AX21 DULOXETINUM ** ZATINEX 60 mg CAPS. GASTROREZ. 60mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 2,539200 2,539200 0,505442
313 N06AX21 DULOXETINUM ** ZATINEX 60 mg CAPS. GASTROREZ. 60mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 2,539200 2,539200 0,505442
314 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 60 mg CAPS. GASTROREZ. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 2,539200 2,539200 0,505442
315 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 60 mg CAPS. GASTROREZ. 60mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 2,406071 2,406071 0,000000
316 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 60 mg CAPS. GASTROREZ. 60mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 2,539200 2,539200 0,379133
317 N06AX21 DULOXETINUM ** DULOXETINA TEVA 60 mg CAPS. GASTROREZ. 60mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 2,116000 2,116000 0,000000
318 N06AX21 DULOXETINUM ** DULOXGAMMA 60 mg CAPS. GASTROREZ. 60mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 2,539200 2,539200 0,532942
319 N06AX21 DULOXETINUM ** DULOXGAMMA 60 mg CAPS. GASTROREZ. 60mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 2,539200 2,539200 0,532942
320 N06AX21 DULOXETINUM ** DULASOLAN 60 mg CAPS. GASTROREZ. 60mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 2,240333 2,240333 0,000000
321 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. GASTROREZ. PRF 30 2,380333 2,380333 0,000000
322 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 2,380333 2,380333 0,000000
323 N06BA09 ATOMOXETINUM ** STRATTERA 10 mg CAPS. 10mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 13,407142 13,407142 0,000000
324 N06BA09 ATOMOXETINUM ** STRATTERA 18 mg CAPS. 18mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 13,491428 13,491428 0,000000
325 N06BA09 ATOMOXETINUM ** STRATTERA 25 mg CAPS. 25mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 12,654285 12,654285 0,000000
326 N06BA09 ATOMOXETINUM ** STRATTERA 40 mg CAPS. 40mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 12,654285 12,654285 0,000000
327 N06BA09 ATOMOXETINUM ** STRATTERA 60 mg CAPS. 60mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 12,654285 12,654285 0,000000
328 N06BA09 ATOMOXETINUM ** STRATTERA 80 mg CAPS. 80mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PCTFE-PE-PVC/AL X 7 CAPS. P-RF/R 28 15,916785 15,916785 0,000000
329 N06BA09 ATOMOXETINUM ** STRATTERA 4 mg/ml SOL. ORALA 4mg/ml ELI LILLY HOLDINGS LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA DE CULOARE BRUNA CU 100 ML SOL. ORALA+1 DISPOZITIV CARE CONTINE O SERINGA PT. ADMINISTRARE ORALA DE 10 ML GRADATA PT. FIECARE MILILITRU SI UN ADAPTOR PT. STICLA DIN PEJD PRF 1 202,470000 202,470000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea psihiatrie i psihiatrie pediatric/neuropsihiatrie infantil.

14. DEMENE (DEGENERATIVE, VASCULARE, MIXTE) - G 16

1 N06DA02 DONEPEZILUM ** YASNAL 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU, BLIST., DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 1,251428 1,251428 0,000000
2 N06DA02 DONEPEZILUM ** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,256570 1,256570 0,896763
3 N06DA02 DONEPEZILUM ** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 1,256570 1,256570 0,896763
4 N06DA02 DONEPEZILUM ** TUADIN 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,237666 1,237666 0,000000
5 N06DA02 DONEPEZILUM ** DONECEPT 10 MG COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,047142 1,047142 0,000000
6 N06DA02 DONEPEZILUM ** COGNEZIL 10 mg COMPR. FILM. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF 28 1,256570 1,256570 0,477001
7 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,256570 1,256570 0,862001
8 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 1,256570 1,256570 0,755230
9 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 1,256570 1,256570 0,755037
10 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,256570 1,256570 0,755096
11 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 1,256570 1,256570 0,650981
12 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 1,256570 1,256570 0,651030
13 N06DA02 DONEPEZILUM ** DONEPEZIL TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 1,256570 1,256570 0,564096
14 N06DA02 DONEPEZILUM ** XALINAT 10 mg COMPR. FILM. 10mg GALENICA S.A. GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 1,256570 1,256570 1,059858
15 N06DA02 DONEPEZILUM ** YASNAL 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 0,985000 0,985000 0,000000
16 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,158856 1,158856 0,383810
17 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 1,158856 1,158856 0,383810
18 N06DA02 DONEPEZILUM ** TUADIN 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,158856 1,158856 0,347144
19 N06DA02 DONEPEZILUM ** DONECEPT 5 MG COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 0,965714 0,965714 0,000000

Pagina 24 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
20 N06DA02 DONEPEZILUM ** COGNEZIL 5 mg COMPR. FILM. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF 28 1,158856 1,158856 0,127215
21 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,158856 1,158856 0,371144
22 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 1,158856 1,158856 0,293744
23 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 1,158856 1,158856 0,294179
24 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,158856 1,158856 0,293810
25 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 1,158856 1,158856 0,218797
26 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 1,158856 1,158856 0,218944
27 N06DA02 DONEPEZILUM ** DONEPEZIL TORRENT 5 mg COMPR. FILM. 5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 1,158856 1,158856 0,100477
28 N06DA02 DONEPEZILUM ** XALINAT 5 mg COMPR. FILM. 5mg GALENICA S.A. GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 1,158856 1,158856 0,553286
29 N06DA02 DONEPEZILUM ** YASNAL 10 mg COMPR. ORODISPERSABILE 10 mg KRKA D.D. SLOVENIA CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL TIP "PEEL-OPEN" A CATE 28 COMPR. ORODISP. PRF 28 1,251428 1,251428 0,000000
30 N06DA02 DONEPEZILUM ** DONEPEZIL TEVA 10 mg COMPR. ORODISPERSABILE 10mg ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.
TEVA PHARMACEUTICALS S.R.L. P-RF 28 1,187142 1,187142 0,000000
31 N06DA02 DONEPEZILUM ** DONEPEZIL STADA HEMOFARM 10 mg
COMPR. ORODISPERSABILE 10mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,256570 1,256570 2,433430
32 N06DA02 DONEPEZILUM ** DARIZOL 10 mg COMPR. ORODISPERSABILE 10mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE PRF 28 1,256428 1,256428 0,000000
33 N06DA02 DONEPEZILUM ** ARICEPT EVESS COMPR. ORODISPERSABILE 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. ORODISPERSABILE PRF 28 1,256570 1,256570 4,127001
34 N06DA02 DONEPEZILUM ** YASNAL 5 mg COMPR. ORODISPERSABILE 5 mg KRKA D.D. SLOVENIA CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL "PEEL-OPEN" A CATE 28 COMPR. ORODISP. PRF 28 1,158856 1,158856 0,023286
35 N06DA02 DONEPEZILUM ** DONEPEZIL TEVA 5 mg COMPR. ORODISPERSABILE 5mg ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.
TEVA PHARMACEUTICALS S.R.L. P-RF 28 1,158856 1,158856 0,028286
36 N06DA02 DONEPEZILUM ** DONEPEZIL STADA HEMOFARM 5 mgCOMPR. ORODISPERSABILE 5mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,158856 1,158856 1,506144
37 N06DA02 DONEPEZILUM ** DARIZOL 5 mg COMPR. ORODISPERSABILE 5mg NEOLA PHARMA S.R.L. ROMANIA PRF
CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE 28 1,158856 1,158856 0,498286
38 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA TORRENT 1,5 mg CAPS. 1,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS.P-RF/R 56 1,178570 1,178570 0,114108
39 N06DA03 RIVASTIGMINUM ** RIDAXIN 1,5 mg CAPS. 1,5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 1,178570 1,178570 0,005715
40 N06DA03 RIVASTIGMINUM ** NIMVASTID 1.5mg CAPS. 1.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE P-RF/R 28 0,982142 0,982142 0,000000
41 N06DA03 RIVASTIGMINUM ** NIMVASTID 3mg CAPS. 3mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE P-RF/R 28 1,174285 1,174285 0,000000
42 N06DA03 RIVASTIGMINUM ** RIVASTIGMINE SANDOZ 3mg CAPS. 3mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST.PVC/AL X 56 CAPS. P-RF/R 56 1,409142 1,409142 0,983358
43 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA TORRENT 3 mg CAPS. 3mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS.P-RF/R 56 1,409142 1,409142 0,554429
44 N06DA03 RIVASTIGMINUM ** RIDAXIN 3 mg CAPS. 3mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 1,409107 1,409107 0,000000
45 N06DA03 RIVASTIGMINUM ** RIDAXIN 4,5 mg CAPS. 4,5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 2,080285 2,080285 0,156857
46 N06DA03 RIVASTIGMINUM ** RIDAXIN 6 mg CAPS. 6mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 2,724428 2,724428 0,128250
47 N06DA03 RIVASTIGMINUM ** NIMVASTID 1.5 mg COMPR. ORODISPERSABILE 1.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 0,982142 0,982142 0,000000
48 N06DA03 RIVASTIGMINUM ** NIMVASTID 3mg COMPR. ORODISPERSABILE 3mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 1,174285 1,174285 0,000000
49 N06DA03 RIVASTIGMINUM ** NIMVASTID 4.5 mg COMPR. ORODISPERSABILE 4.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 1,733571 1,733571 0,000000
50 N06DA03 RIVASTIGMINUM ** NIMVASTID 6mg COMPR. ORODISPERSABILE 6mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 2,270357 2,270357 0,000000
51 N06DA03 RIVASTIGMINUM ** EXELON 13,3mg/24h PLASTURE TRANSDERMIC 13,3/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 11,130666 11,130666 0,000000
52 N06DA03 RIVASTIGMINUM ** EXELON 4,6mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 3,568800 3,568800 4,503200
53 N06DA03 RIVASTIGMINUM ** EVERTAS 4,6 mg/24 h PLASTURE TRANSDERMIC 4,6mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 2,974000 2,974000 0,000000
54 N06DA03 RIVASTIGMINUM ** EXELON 9,5mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 6,295999 6,295999 1,776001
55 N06DA03 RIVASTIGMINUM ** EVERTAS 9,5 mg/24 h PLASTURE TRANSDERMIC 9,5mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 5,246666 5,246666 0,000000
56 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA DR. REDDY'S 4,6 mg/24 ore PLASTURI TRANSDERMICI 4,6mg/24ore DR. REDDY'S LABORATORIES ROMANIA PRF
CUTIE CU 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HRTIE/POLIETILENTEREFTALAT/AL/POLIACRILONITRIL CU CU SISTEM DE NCHIDERE SECURIZAT PENTRU COPII, A CTE 1 PLASTURE TRANSDERMIC PROTEJ. DE O FOLIE DIN FILM DIN TEREFTALAT DE POLIETILENA SILICONATA 30 3,568800 3,568800 1,677866
57 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA DR. REDDY'S 9,5 mg/24 ore PLASTURI TRANSDERMICI 9,5mg/24ore DR. REDDY'S LABORATORIES ROMANIA PRF
CUTIE CU 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HRTIE/POLIETILENTEREFTALAT/AL/POLIACRILONITRIL CU CU SISTEM DE NCHIDERE SECURIZAT PENTRU COPII, A CTE 1 PLASTURE TRANSDERMIC PROTEJ. DE O FOLIE DIN FILM DIN TEREFTALAT DE POLIETILENA SILICONATA 30 5,246666 5,246666 0,000000
58 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA TEVA 2 mg/ml SOL. ORALA 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA P-RF/R
CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPACIT. 125ML X 120ML SOLUTIE ORALA, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII, CU O SERINGA DOZATOARE GRADATA DIN PP SI UN ADAPTOR DIN PE 1 301,210000 301,210000 0,000000
59 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA SANDOZ 2mg/ml SOL. ORALA 2mg/ml SANDOZ GMBH AUSTRIA CUTIE CU FLAC. DIN STICLA BRUNA A 120 ML SOL.ORALA + SERINGA DOZATOARE PR 1 251,020000 251,020000 0,000000
60 N06DA04 GALANTAMINUM ** GALSYA 16 mg CAPS. ELIB. PREL. 16mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,815666 1,815666 0,000000
61 N06DA04 GALANTAMINUM ** GALANTAMINA ZENTIVA 16 mg CAPS. ELIB. PREL. 16mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 1,513571 1,513571 0,000000
62 N06DA04 GALANTAMINUM ** GALSYA 24 mg CAPS. ELIB. PREL. 24mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,815666 1,815666 0,000000
63 N06DA04 GALANTAMINUM ** GALANTAMINA ZENTIVA 24 mg CAPS. ELIB. PREL. 24mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 1,513571 1,513571 0,000000
64 N06DA04 GALANTAMINUM ** GALSYA 8 mg CAPS. ELIB. PREL. 8mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,815666 1,815666 0,000000
65 N06DA04 GALANTAMINUM ** GALANTAMINA ZENTIVA 8 mgCAPS. ELIB. PREL. 8mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 1,513571 1,513571 0,000000
66 N06DA04 GALANTAMINUM ** REMINYL (R) 4 mg/ml SOL. ORALA 4mg/ml JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 1 FLACON X 100 ML + 1 PIPETA DOZATOARE P-RF 1 124,860000 124,860000 0,000000
67 N06DX01 MEMANTINUM ** MEMANTINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBH GERMANIA CUTIE CU BLISTERE DIN FOLIE PVC/PVDC-AL X 56 COMPRIMATE FILMATE PR 56 0,650714 0,650714 0,000000
68 N06DX01 MEMANTINUM ** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R 56 0,650785 0,650785 1,572250
69 N06DX01 MEMANTINUM ** MEMANTINA TORRENT 10 mgCOMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,009572
70 N06DX01 MEMANTINUM ** NEMDATINE 10mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 0,647857 0,647857 0,000000
71 N06DX01 MEMANTINUM ** MEMANTINA DR. REDDY'S 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,570892 0,570892 0,000000
72 N06DX01 MEMANTINUM ** MIRVEDOL 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,650535 0,650535 0,000000
73 N06DX01 MEMANTINUM ** MEMANTINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,542321 0,542321 0,000000
74 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,034393

Pagina 25 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
75 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,034393
76 N06DX01 MEMANTINUM ** MEMANTINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,005286
77 N06DX01 MEMANTINUM ** MARIXINO 10mg COMPR. FILM. 10mg CONSILIENT HEALTH LTD. IRLANDA CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE PR 56 0,619821 0,619821 0,000000
78 N06DX01 MEMANTINUM ** COGNOMEM 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,034393
79 N06DX01 MEMANTINUM ** MEMANTINA LANNACHER HEILMITTEL 10 mg COMPR. FILM. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 70 COMPR. FILM. PR 70 0,628428 0,628428 0,000000
80 N06DX01 MEMANTINUM ** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 0,650785 0,650785 0,032965
81 N06DX01 MEMANTINUM ** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 0,650785 0,650785 0,032965
82 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 14 COMPR. FILM. PR 14 0,648571 0,648571 0,000000
83 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 0,647857 0,647857 0,000000
84 N06DX01 MEMANTINUM ** MEMANTINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBH GERMANIA CUTIE X BLISTERE DIN FOLIE PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 1,644428 1,644428 0,100572
85 N06DX01 MEMANTINUM ** MEMANTINA TORRENT 20 mgCOMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. PR 56 1,644428 1,644428 0,373786
86 N06DX01 MEMANTINUM ** NEMDATINE 20mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 1,552500 1,552500 0,000000
87 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PR 28 1,644428 1,644428 0,449500
88 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. PR 28 1,644428 1,644428 0,449500
89 N06DX01 MEMANTINUM ** MEMANTINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR 28 1,491071 1,491071 0,000000
90 N06DX01 MEMANTINUM ** COGNOMEM 20 mg COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 1,644285 1,644285 0,000000
91 N06DX01 MEMANTINUM ** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 1,644428 1,644428 0,419857
92 N06DX01 MEMANTINUM ** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 1,644428 1,644428 0,419857
93 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 14 COMPR. FILM. PRF 14 1,540714 1,540714 0,000000
94 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PRF 28 1,491071 1,491071 0,000000
95 N06DX01 MEMANTINUM ** MEMANTINA TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. ORODISPERSABILE PR 56 0,650785 0,650785 0,034393
96 N06DX01 MEMANTINUM ** MEMANTINA TEVA 20 mg COMPR. ORODISPERSABILE 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 28X1 COMPR. ORODISPERSABILE PR 28 1,370357 1,370357 0,000000
97 N06DX01 MEMANTINUM ** EBIXA 5mg/doza PICATURI ORALE - SOL. 5mg/doza H LUNDBECK A/S DANEMARCA CUTIE X 1 FLACON DIN STICLA BRUNA CU POMPA DOZATOARE X 50 ML SOLUTIE P-RF/R 1 115,980000 115,980000 25,020000
98 N06DX01 MEMANTINUM ** MEMANTINA TEVA 10 mg/ml SOL. ORALA 10 mg/ml ROMANIA CUTIE CU 1 FLAC. DIN STICLA + SERINGA DOZATOARE A 50 ML SOL. ORALA
TEVA PHARMACEUTICALS S.R.L. PR 1 96,650000 96,650000 0,000000
99 N06DX01 MEMANTINUM ** MEMANTINA TORRENT 10 mg/ml SOL. ORALA 10mg/ml TORRENT PHARMA SRL ROMANIA CUTIE CU 1 FLAC. A 100 ML SOL. SOL. ORALA SI O POMPA DOZATOARE PR 1 183,300000 183,300000 0,000000

Tratamentul se initiaza de catre medicul in specialitatea psihiatrie, neurologie sau geriatrie

15. COLAGENOZE MAJORE (LUPUS ERITEMATOS SISTEMIC, SCLERODERMIE, POLI/DERMATOMIOZITA, VASCULITE SISTEMICE) - G 17

1 H02AB04 METHYLPREDNISOLONUM 5) MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,543200 0,543200 0,000000
2 H02AB04 METHYLPREDNISOLONUM 5) MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,234000 1,234000 0,000000
3 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBHGERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,542400 0,542400 0,000000
4 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 15,890000 15,890000 0,000000
5 L04AX01 AZATHIOPRINUM IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,702300 0,000000
6 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 0,542833 0,542833 0,000000
7 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL 200 mg COMPR. FILM. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM. P-6L 60 0,542833 0,542833 0,000000

Tratamentul se initiaza si se monitorizeaza de catre medicul in specialitatea reumatologie, nefrologie si boli infectioase.

16. POLIARTRITA REUMATOID, ARTROPATIA PSORIAZIC, PSORIAZIS CRONIC SEVER I ARTRITA JUVENIL - G 18

1 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0,584200 0,584200 0,000000
2 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L.ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L 50 0,585200 0,585200 0,000000
3 H02AB01 BETAMETHASONUM DIPROPHOS SUSP. INJ. I.M. 7mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 5,366000 5,366000 0,000000
4 H02AB04 METHYLPREDNISOLONUM 5) MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,543200 0,543200 0,000000
5 H02AB04 METHYLPREDNISOLONUM 5) MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,234000 1,234000 0,000000
6 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 61,880000 61,880000 0,000000
7 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 118,008000 118,008000 9,082000
8 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 46,730000 46,730000 0,000000
9 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 79,700000 79,700000 0,000000
10 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 98,340000 98,340000 0,000000
11 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 56,076000 56,076000 13,944000

Pagina 26 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
12 L01BA01 METHOTREXATUM METOJECT 50mg/ml 50mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA GERMANIA
MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 110,680000 110,680000 0,000000
13 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATEGERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.30ML SOLUTIA INJECTABILA PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,880000 74,880000 0,000000
14 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDA SANDOZ 10 mg COMPR. FILM. 10 mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP CU DESICANT X 30 COMPR. FILM. PR 30 1,899666 1,899666 0,000000
15 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE WINTHROP 10mg COMPR. FILM. 10mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 1,899666 1,899666 0,000000
16 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDA SANDOZ 20 mg COMPR. FILM. 20 mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP DESICANT X 30 COMPR. FILM. PR 30 3,149333 3,149333 0,000000
17 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE WINTHROP 20mg COMPR. FILM. 20mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 3,608333 3,608333 0,000000
18 L04AA13 LEFLUNOMIDUM ** LEFLON 20 mg COMPR. FILM. 20mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR 30 3,608333 3,608333 0,000000
19 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 2,358400 2,358400 0,000000
20 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,828600 3,828600 0,000000
21 L04AX01 AZATHIOPRINUM IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,702300 0,000000
22 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 2,474500 2,474500 0,000000
23 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,195600 0,195600 0,385400
24 M01AB05 DICLOFENACUM DICLOTARD 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 0,354500 0,354500 0,000000
25 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 0,163000 0,163000 0,000000
26 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 0,425400 0,425400 0,119600
27 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,354500 0,354500 0,000000
28 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,140400 0,140400 0,040100
29 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,117000 0,117000 0,000000
30 M01AB05 DICLOFENACUM DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,117000 0,117000 0,000000
31 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 0,140400 0,140400 0,102600
32 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 0,197666 0,197666 0,000000
33 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 0,117000 0,117000 0,000000
34 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 0,117000 0,117000 0,000000
35 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 MLP-RF 5 1,010400 1,010400 0,671600
36 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 1,010400 1,010400 0,083600
37 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 1,010400 1,010400 0,083600
38 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF.P-RF 5 0,842000 0,842000 0,000000
39 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0,570000 0,570000 0,000000
40 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 0,684000 0,684000 0,194000
41 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,570000 0,570000 0,000000
42 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0,572000 0,572000 0,000000
43 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 3 SUPOZITOARE P6L 6 0,606666 0,606666 0,000000
44 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 5 SUPOZITOARE P6L 10 0,601000 0,601000 0,000000
45 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 0,960000 0,960000 0,000000
46 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 0,542833 0,542833 0,000000
47 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL 200 mg COMPR. FILM. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM. P-6L 60 0,542833 0,542833 0,000000

Tratamentul se iniiaz de ctre medicul din specialitatea reumatologie, nefrologie, medicin intern, pediatrie, reabilitare medical i dermatovenerologie.

17. SPONDILITA ANKILOZANTA - G 19

1 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0,584200 0,584200 0,000000
2 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L.ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L 50 0,585200 0,585200 0,000000
3 H02AB01 BETAMETHASONUM DIPROPHOS SUSP. INJ. I.M. 7mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 5,366000 5,366000 0,000000
4 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 2,474500 2,474500 0,000000
5 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,195600 0,195600 0,385400
6 M01AB05 DICLOFENACUM DICLOTARD 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 0,354500 0,354500 0,000000
7 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 0,163000 0,163000 0,000000
8 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 0,425400 0,425400 0,119600
9 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,354500 0,354500 0,000000
10 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,140400 0,140400 0,040100
11 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,117000 0,117000 0,000000

Pagina 27 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
12 M01AB05 DICLOFENACUM DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,117000 0,117000 0,000000
13 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 0,140400 0,140400 0,102600
14 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 0,197666 0,197666 0,000000
15 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 0,117000 0,117000 0,000000
16 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 0,117000 0,117000 0,000000
17 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 MLP-RF 5 1,010400 1,010400 0,671600
18 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 1,010400 1,010400 0,083600
19 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 1,010400 1,010400 0,083600
20 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF.P-RF 5 0,842000 0,842000 0,000000
21 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0,570000 0,570000 0,000000
22 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 0,684000 0,684000 0,194000
23 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,570000 0,570000 0,000000
24 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0,572000 0,572000 0,000000
25 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 3 SUPOZITOARE P6L 6 0,606666 0,606666 0,000000
26 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 5 SUPOZITOARE P6L 10 0,601000 0,601000 0,000000
27 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 0,960000 0,960000 0,000000

Tratamentul se iniiaz de ctre medicul din specialitatea reumatologie sau reabilitare medical.

18. BOLI ENDOCRINE (GU ENDEMIC, INSUFICIEN SUPRARENAL CRONIC, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELAR, TUMORI NEUROENDOCRINE I OSTEOPORO
SEVER) - G 22

1 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 10,795000 10,795000 0,000000
2 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 9,912500 9,912500 0,000000
3 H01AX01 PEGVISOMANTUM **1 SOMAVERT 10 mg PULB. + SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE X 30 FLAC. CU PULB., INSOTITE DE 30 FLAC. X 8 ML SOLV. PT. RECONSTITUIRE P-RF/R 30 270,534666 270,534666 0,000000
4 H01AX01 PEGVISOMANTUM **1 SOMAVERT 20 mg PULB. + SOLV. PT. SOL. INJ. 20mg PFIZER LIMITED MAREA BRITANIE CUTIE X 30 FLAC. CU LIOF., INSOTITE DE 30 FLAC. A 8 ML SOLV. PT. RECONSTITUIRE P-RF/R 30 539,183333 539,183333 0,000000
5 H01BA02 DESMOPRESSINUM DESMOPRESINA TEVA 0,2mg COMPR. 0,2mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL- PVC/AL X 30 COMPR.P-RF 30 2,499333 2,499333 0,000000
6 H01BA02 DESMOPRESSINUM MINIRIN 0,2 mg COMPR. 0,2mg FERRING GMBH GERMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF 30 2,999199 2,999199 0,846134
7 H01BA02 DESMOPRESSINUM MINIRIN MELT 120 mcg LIOF. ORAL 120mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST. AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 30 6,047000 6,047000 0,000000
8 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 1 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 10 3,337000 3,337000 0,000000
9 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 30 3,169333 3,169333 0,000000
10 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 20 mg PULB. + SOLV. PT. SUSP. INJ. (I.M.) CU ELIB. PRELU 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE PR 1 2.919,710000 2.919,710000 0,000000
11 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 10 mg PULB.+SOLV. PT. SOL. INJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 1.495,280000 1.495,280000 0,000000
12 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 20 mg PULB.+SOLV. PT. SOL. INJ. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 2.919,710000 2.919,710000 0,000000
13 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 30 mg PULB.+SOLV. PT. SOL. INJ. 30mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 4.251,210000 4.251,210000 0,000000
14 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 10 mg PULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE PR 1 1.519,360000 1.519,360000 0,000000
15 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 30 mg PULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG. 30mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULB. + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE PR 1 4.344,140000 4.344,140000 0,000000
16 H01CB02 OCTREOTIDUM **1 SANDOSTATIN 0,1 mg/ml SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR 5 8,830000 8,830000 0,000000
17 H01CB03 LANREOTIDUM **1 SOMATULINE PR 30 mg LIOF. PT. SOL. INJ. + SOLV. 30mg IPSEN PHARMA FRANTA S
CUTIE X 1 FLACON LIOF. + 1 FIOLA X 2 ML SOLV. + 1 SERINGA X 3 ML + 2 ACE 1 1.611,250000 1.611,250000 0,000000
18 H01CB03 LANREOTIDUM **1 SOMATULINE AUTOGEL 120 mg SOL. INJ. IN SERINGA PREUMPLUTA 120mg IPSEN PHARMA FRANTA PR
CUTIE CU 1 SERINGA PREUMPLUTA PE TEREFTALAT/AL/PE LAMINATA X 0,5 ML PREVAZUTA CU SIST. DE SIGURANTA AUTOMAT SI 1 AC DIN OTEL (1,2MMX20MM), TEACA DIN PLASTIC PT. AC (PEID) SI 1 OPRITOR PT. PISTON (BROMOBUTIL CAUCIUC) 1 4.667,070000 4.667,070000 0,000000
19 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,3 mg SOL INJ. 0,3mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,3 MGPR 30 223,166333 223,166333 0,000000
20 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,6 mg SOL INJ. 0,6mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,6 MGPR 30 262,131666 262,131666 0,000000
21 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,9 mg SOL INJ. 0,9mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,9 MGPR 30 295,473666 295,473666 0,000000
22 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 0,403000 0,403000 0,000000
23 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,028601
24 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,090333 0,090333 0,000000
25 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,108399 0,108399 0,015267
26 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,025101
27 H02AB09 HYDROCORTISONUM HYDROCORTISONE SUCCINAT SODICLIOF. + SOLV. PT. SOL. INJ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA S/P-RF
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML 1 3,910000 3,910000 0,000000
28 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV. PR/PRF 1 11,910000 11,910000 0,000000
29 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 4,692000 4,692000 2,398000
30 H02AB09 HYDROCORTISONUM HIDROCORTIZON ZENTIVA 19.6mg/5mlSOL. INJ. 19,6mg/5ml ZENTIVA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 1 ML SOL. A + 5 FIOLE DIN STICLA BRUNA CU CAPACITATEA DE 5ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 4 ML SOL. B S/P-RF 5 4,426000 4,426000 0,000000
31 H03AA01 LEVOTHYROXINUM EUTHYROX 100mcg COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 0,121400 0,121400 0,000000
Pagina 28 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
32 H03AA01 LEVOTHYROXINUM EUTHYROX 100g COMPR. 100g MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,121400 0,121400 0,000000
33 H03AA01 LEVOTHYROXINUM EUTHYROX 200mcg COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 0,250500 0,250500 0,000000
34 H03AA01 LEVOTHYROXINUM EUTHYROX 200g COMPR. 200g MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-6L 100 0,250500 0,250500 0,000000
35 H03AA01 LEVOTHYROXINUM EUTHYROX 25mcg COMPR. 25mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 0,085800 0,085800 0,000000
36 H03AA01 LEVOTHYROXINUM EUTHYROX 25g COMPR. 25g MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,085800 0,085800 0,000000
37 H03AA01 LEVOTHYROXINUM EUTHYROX 50mcg COMPR. 50mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 0,085800 0,085800 0,000000
38 H03AA01 LEVOTHYROXINUM EUTHYROX 50g COMPR. 50g MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,085800 0,085800 0,000000
39 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF 100 0,127300 0,127300 0,000000
40 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 0,127300 0,127300 0,000000
41 H05AA02 TERIPARATIDUM ** FORSTEO 20g/80l SOL. INJ. 20g/80l ELI LILLY NEDERLAND BV OLANDA P-RF
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 CG/80CL) 1 1.417,480000 1.417,480000 0,000000
42 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 0,549000 0,549000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea endocrinologie sau oncologie.

Pagina 29 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
19. BOALA WILSON - G23

1 M01CC01 PENICILLAMINUM ** 4) CUPRIPEN 250mg CAPS. 250mg CN UNIFARM S.A. ROMANIA FLACON X 30 CAPSULE PRF 30 1,375666 1,375666 0,000000

Tratamentul se iniiaz de ctre medicul din specialitatea endocrinologie, neurologie sau neurologie pediatric.

20. BOALA CRONICA DE RINICHI - faza predializa - G 25

1 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA ** VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 31,080000 31,080000 0,000000
2 B03XA01 EPOETINUM ALFA ** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 21,785000 21,785000 0,000000
3 B03XA01 EPOETINUM ALFA ** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 45,386666 45,386666 0,000000
4 B03XA01 EPOETINUM ALFA ** BINOCRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. P-RF/R 1 488,460000 488,460000 0,000000
5 B03XA01 EPOETINUM ALFA ** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 68,290000 68,290000 0,000000
6 B03XA01 EPOETINUM ALFA ** EPREX 40000 UI/ml SOL. INJ. IN SERINGA PREUMPLUTA 40 000UI/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. S/P-RF 1 912,804000 912,804000 99,806000
7 B03XA01 EPOETINUM ALFA ** BINOCRIT 40000 UI/1 ml SOL. INJ. IN SERINGA PREUMPLUTA 40000 UI/1 ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. P-RF/R 1 760,670000 760,670000 0,000000
8 B03XA01 EPOETINUM ALFA ** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 87,998333 87,998333 0,000000
9 B03XA01 EPOETINUM ALFA ** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 107,725000 107,725000 0,000000
10 B03XA01 EPOETINUM BETA ** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 280,040000 280,040000 0,000000
11 B03XA01 EPOETINUM BETA ** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 59,898333 59,898333 0,000000
12 B03XA01 EPOETINUM BETA ** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 999,550000 999,550000 0,000000
13 B03XA01 EPOETINUM BETA ** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 108,236666 108,236666 0,000000
14 B03XA01 EPOETINUM BETA ** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 154,340000 154,340000 0,000000
15 B03XA01 EPOETINUM ZETA ** RETACRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 228,050000 228,050000 0,000000
16 B03XA01 EPOETINUM ZETA ** RETACRIT 2000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,6ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 51,940000 51,940000 0,000000
17 B03XA01 EPOETINUM ZETA ** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. PR 1 533,260000 533,260000 0,000000
18 B03XA01 EPOETINUM ZETA ** RETACRIT 3000UI/0,9ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,9ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,9ML SOL. INJ. PR 1 73,980000 73,980000 0,000000
19 B03XA01 EPOETINUM ZETA ** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 693,880000 693,880000 0,000000
20 B03XA01 EPOETINUM ZETA ** RETACRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,4ML SOL. INJ. PR 1 98,650000 98,650000 0,000000
21 B03XA01 EPOETINUM ZETA ** RETACRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL. INJ. PR 1 123,300000 123,300000 0,000000
22 B03XA01 EPOETINUM ZETA ** RETACRIT 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 140,320000 140,320000 0,000000
23 B03XA01 EPOETINUM ZETA ** RETACRIT 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,8ML SOL. INJ. PR 1 196,010000 196,010000 0,000000
24 B03XA02 DARBEPOETINUM ALFA ** ARANESP 100mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 P-RF/R ML 4 647,495000 647,495000 0,000000
25 B03XA02 DARBEPOETINUM ALFA ** ARANESP 10mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 P-RF/R ML 4 78,342500 78,342500 0,000000
26 B03XA02 DARBEPOETINUM ALFA ** ARANESP 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X 0,3 ML P-RF/R 4 962,400000 962,400000 0,000000
27 B03XA02 DARBEPOETINUM ALFA ** ARANESP 20mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 P-RF/R ML 4 143,647500 143,647500 0,000000
28 B03XA02 DARBEPOETINUM ALFA ** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1.960,260000 1.960,260000 0,000000
29 B03XA02 DARBEPOETINUM ALFA ** ARANESP 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 P-RF/R ML 4 206,655000 206,655000 0,000000
30 B03XA02 DARBEPOETINUM ALFA ** ARANESP 40mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 P-RF/R ML 4 269,612500 269,612500 0,000000
31 B03XA02 DARBEPOETINUM ALFA ** ARANESP 500mcg/ml SOL. INJ. IN SERINGA PREUMPLUTA 500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R 1 3.219,860000 3.219,860000 0,000000
32 B03XA02 DARBEPOETINUM ALFA ** ARANESP 50mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 P-RF/R ML 4 321,740000 321,740000 0,000000
33 B03XA02 DARBEPOETINUM ALFA ** ARANESP 60mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 P-RF/R ML 4 395,560000 395,560000 0,000000
34 B03XA02 DARBEPOETINUM ALFA ** ARANESP 80mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 P-RF/R ML 4 521,557500 521,557500 0,000000
35 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 100mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 778,610000 778,610000 0,000000
36 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 1.132,460000 1.132,460000 0,000000
37 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 264,720000 264,720000 0,000000
38 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 50 mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 50 mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 424,740000 424,740000 0,000000
39 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 75mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 75mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 601,690000 601,690000 0,000000
40 C09CA04 IRBESARTANUM ** IRBESARTAN AUROBINDO 150 mgCOMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,359199 0,359199 0,009372
41 C09CA04 IRBESARTANUM ** IRBESARTAN AUROBINDO 300 mgCOMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,516071 0,516071 0,000000
42 C09CA04 IRBESARTANUM ** IRBESARTAN GALENICA 150 mg COMPR. FILM. 150 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 0,359199 0,359199 0,009372
43 C09CA04 IRBESARTANUM ** IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,359199 0,359199 0,424372
44 C09CA04 IRBESARTANUM ** IRBESARTAN SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,359199 0,359199 0,257586
45 C09CA04 IRBESARTANUM ** IRPRESTAN 150 mg COMPR. FILM. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 0,299333 0,299333 0,000000
46 C09CA04 IRBESARTANUM ** IFIRMASTA 150 mg COMPR. FILM. 150mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,359199 0,359199 0,178301

Pagina 30 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
47 C09CA04 IRBESARTANUM ** IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,359199 0,359199 0,238301
48 C09CA04 IRBESARTANUM ** IRBESARTAN ZENTIVA 150mgCOMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 0,359199 0,359199 0,208301
49 C09CA04 IRBESARTANUM ** IRBESARTAN HF 150 mg COMPR. FILM. 150mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,359199 0,359199 0,400801
50 C09CA04 IRBESARTANUM ** APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,359199 0,359199 0,846515
51 C09CA04 IRBESARTANUM ** ATOKKEN 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,359199 0,359199 0,424372
52 C09CA04 IRBESARTANUM ** IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,359199 0,359199 0,238301
53 C09CA04 IRBESARTANUM ** IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,619285 0,619285 0,192857
54 C09CA04 IRBESARTANUM ** IRBESARTAN GALENICA 300 mg COMPR. FILM. 300 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 0,576785 0,576785 0,000000
55 C09CA04 IRBESARTANUM ** IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,619285 0,619285 0,192857
56 C09CA04 IRBESARTANUM ** IRBESARTAN TERAPIA 300 mg COMPR. FILM. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,619285 0,619285 0,456072
57 C09CA04 IRBESARTANUM ** IRBESARTAN SANDOZ 300 mg COMPR. FILM. 300mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0,619285 0,619285 0,183215
58 C09CA04 IRBESARTANUM ** IFIRMASTA 300mg COMPR. FILM. 300mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,619285 0,619285 0,244286
59 C09CA04 IRBESARTANUM ** IRBESARTAN ZENTIVA 300mgCOMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)
P-6L 28 0,619285 0,619285 0,267857
60 C09CA04 IRBESARTANUM ** IRBESARTAN HF 300 mg COMPR. FILM. 300mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,619285 0,619285 0,416715
61 C09CA04 IRBESARTANUM ** APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,619285 0,619285 0,981429
62 C09CA04 IRBESARTANUM ** ATOKKEN 300 mg COMPR. FILM. 300mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,619285 0,619285 0,456072
63 C09CA04 IRBESARTANUM ** ATOKKEN 75 mg COMPR. FILM. 75mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,856428 0,856428 0,000000
64 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,028601
65 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,090333 0,090333 0,000000
66 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,108399 0,108399 0,015267
67 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,025101
68 H05BX02 PARICALCITOLUM ** ZEMPLAR 1g CAPS. MOI 1g ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI P-RF 28 10,363571 10,363571 0,000000
69 H05BX02 PARICALCITOLUM ** ZEMPLAR 2g CAPS. MOI 2g ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. P-RF 28 17,300357 17,300357 0,000000
70 H05BX02 PARICALCITOLUM ** ZEMPLAR SOL. INJ. 5 g/ml ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 47,686000 47,686000 0,000000
71 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBHGERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,542400 0,542400 0,000000
72 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 2,358400 2,358400 0,000000
73 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,828600 3,828600 0,000000
74 L04AX01 AZATHIOPRINUM IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,702300 0,000000
75 V06DDN1 COMBINATII (AMINOACIZI) ** KETOSTERIL COMPR. FILM. FARA CONCENTRATIE FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE X 5 BLIST. DIN PVC/AL X 20 COMPR. FILM.
P-RF 100 2,272200 2,272200 0,000000

Tratamentul se initiaza de catre medicul in specialitatea nefrologie.

21. GLAUCOM - G 26

1 S01EC03 DORZOLAMIDUM DORZOPT 20 mg/ml PIC. OFT., SOL


20mg/ml ROMPHARM COMPANY SRLROMANIA CUTIE X 1 FLAC. PEJD X 5 ML PIC. OFT., SOL P-RF 1 14,530000 14,530000 0,000000
2 S01EC03 DORZOLAMIDUM DORZOLAMIDA ARENA 20 mg/ml PIC. OFT., SOL.
20mg/ml ARENA GROUP S.A. ROMANIA P6L
CUTIE CU 1 FLAC. ALB, OPAC DIN PE DE DENSITATE MEDIE, CU CAPACITATEA DE 10 ML, PREVAZUT CU PICURATOR SIGILAT SI UN CAPAC ASAMBLATE DIN 2 PIESE, CU 5 ML PIC. OFT., SOL. 1 14,530000 14,530000 0,000000
3 S01EC03 DORZOLAMIDUM TRUSOPT 20 mg/ml PIC. OFT., SOL.
20mg/ml SANTEN OY FINLANDA P6L
CUTIE CU 1 FLAC. DE TIP OCUMETER PLUS ALCATUIT DINTR-UN FLAC. TRANSLUCID DIN PED,CU CAPACITATEA DE 8 ML,CU PICURATOR DIN PED,NCHIS CU UN CAPAC ALCATUIT DIN 2 COMPONENTE SI PREVAZUT CU BANDA DE SIGURANTA, CA PARTE A ETICHETEI PROD.X5 ML SOL.OFT. 1 17,436000 17,436000 4,904000
4 S01EC04 BRINZOLAMIDUM AZOPT 10mg/ml PICATURI OFT.-SUSP. 10mg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON, PEJD X 5 ML P-6L 1 44,870000 44,870000 0,000000
5 S01ED01 TIMOLOLUM TIMOLOL ROMPHARM 0,25% PIC. OFT., SOL. 2,5mg/ml ROMPHARM COMPANY SRLROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL. P-6L 1 3,110000 3,110000 0,000000
6 S01ED01 TIMOLOLUM TIMOLOL ROMPHARM 0,5% PIC. OFT.,SOL. 5mg/ml ROMPHARM COMPANY SRLROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL. P-6L 1 4,980000 4,980000 0,000000
7 S01ED01 TIMOLOLUM TIMOLOL 0,25% PICATURI OFT.-SOL. 0,25% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON PEID, PREVAZUT CU PICURATOR X 5 ML P-6L 1 3,130000 3,130000 0,000000
8 S01ED01 TIMOLOLUM TIMOLOL 0,5% PICATURI OFT.-SOL. 0,5% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON CU PICURATOR X 5 ML P-6L 1 5,300000 5,300000 0,000000
9 S01ED02 BETAXOLOLUM BETAX PIC. OFT.-SOL. 5mg/ml ROMPHARM SRL ROMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L 1 5,320000 5,320000 0,000000
10 S01ED02 BETAXOLOLUM BETOPTIC PIC.OFTALMICE,SOL. 5mg/ml ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD PREV. CU PICURATOR X 5 ML PIC.OFTALMICE, SOL. P-6L 1 6,384000 6,384000 6,436000
11 S01ED02 BETAXOLOLUM BETOPTIC - S PICATURI OFT.-SUSP. 0,25% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 15,330000 15,330000 0,000000
12 S01ED05 CARTEOLOLUM FORTINOL EP 2% PIC. OFTALMICE CU ELIB. PREL. 20mg/ml GERMANIA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFTALMICE CU ELIB. PREL.
DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH P-6L 1 10,890000 10,890000 0,000000
13 S01ED51 COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM) ** AZARGA PIC. OFT. SUSP. 10mg/ml+5mg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 5 ML SUSP. OFT. P-RF 1 58,030000 58,030000 0,000000
14 S01ED51 COMBINATII (BIMATOPROSTUM + TIMOLOLUM)GANFORT PIC. OFT.,SOL. 300mcg/ml+5mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC.OFT.SOL.P-RF 1 69,360000 69,360000 0,000000
15 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) SIFIOPT 20 mg/5 mg/ml PIC. OFT., SOL. 20mg/5mg/ml OFTAFARMA ROMNIA S.R.L. ROMANIA CUTIE CU 1 FLAC. PE ALB, OPAC +PICURATOR PEID A 5 ML PIC. OFT. SOL. PRF 1 26,430000 26,430000 0,000000
16 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT 20 mg/l + 5 mg/ml PIC. OFT.-SOL. 20mg/ml+5mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLACON DE TIP OCUMETER PLUS X 5 ML PIC. OFT., SOL. P6L 1 31,716000 31,716000 4,204000
17 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM)GLAUTAN PLUS 50 micrograme/ml + 5 mg/ml PIC. OFT., SOL 50 micrograme/ml + 5 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA P6L
CUTIE X 1 FLACON DIN PEJD CU PICURATOR DIN PEJD INCHIS CU CAPAC DIN PEID X 2.5ML PICATURI OFTALMICE- 1 29,000000 29,000000 0,000000
18 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM)ARUCOM 50 micrograme/ml + 5 mg/ml PIC. OFT., SOL. 50micrograme/ml+5mg/ml GERMANIA CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL.
DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH P6L 1 28,980000 28,980000 0,000000
19 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM)XALCOM (R) SOL. OFT. 50mcg/ml+5mg/mlPFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML P-6L 1 34,776000 34,776000 8,394000
20 S01ED51 COMBINATII (TRAVOPROSTUM+TIMOLOLUM) DUOTRAV 40mcg/ml + 5mg/ml PIC. OFT.-SOL. 40mcg/ml + 5mg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE P-RF 1 62,810000 62,810000 0,000000

Pagina 31 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
21 S01EE01 LATANOPROSTUM SIFITAN 50 micrograme/ml PIC. OFT., SOL 50micrograme/ml NTC S.R.L. ITALIA P6L
CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL. 1 25,150000 25,150000 0,000000
22 S01EE01 LATANOPROSTUM ARULATAN 50 micrograme/ml PIC. OFT., SOL. 50micrograme/ml DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE CU 1 FLAC. PEJD CU DOP PICURATOR PEID X 2,5 ML PIC. OFT., SOL. P-6L 1 25,150000 25,150000 0,000000
23 S01EE01 LATANOPROSTUM MONOPOST 50 micrograme/ml PIC. OFT., SOL., IN RECIPIENT UNIDOZA 50micrograme/ml LABORATOIRES THEA FRANTA CUTIE CU 30 (6X5) RECIPIENTE UNIDOZA DIN PEID AMBALATE CATE 5 IN 6 PLICURI LAMINATE DIN PE-AL-COPOLIMER A CATE 0,2 MILILITRI PIC. OFT., SOL. P6L 30 1,874000 1,874000 0,000000
24 S01EE01 LATANOPROSTUM GLAUTAN 0,05 mg/ml PIC. OFT.,SOL. 0,05mg/ml ROMPHARM COMPANY SRLROMANIA CUTIE CU 1 FLAC. PEJD CU CAPACITATEA DE 5 ML+PICURATOR DIN PEJD, CU CAPAC DE SIGURANTA DIN PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 25,150000 25,150000 0,000000
25 S01EE01 LATANOPROSTUM XALATAN (R) PICATURI OFT.-SOL. 50mcg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PICURATOR PE X 2,5 ML P-6L 1 30,180000 30,180000 7,260000
26 S01EE03 BIMATOPROSTUM BIMAGAN 0,3 mg/ml PIC. OFT., SOL 0,3 mg/ml ROMPHARM COMPANY SRLROMANIA CUTIE X 1 FLACON ALB DIN PEJD CU PICURATOR DIN PEJD SI CAPAC CU INEL DE SIGURANTA DIN PEID X 3ML PICATURI OFTALMICE , SOLUTIE PRF 1 42,800000 42,800000 0,000000
27 S01EE03 BIMATOPROSTUM BIMAGAN 0,1 mg/ml PIC. OFT., SOL. 0,1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN FLACON DIN PEJD CU PICURATOR DIN PEJD SI CAPAC VERDE- ALBASTRUI DIN PED A 3 ML PICATURI OFTALMICE, SOLUTIE PRF 1 50,970000 50,970000 0,000000
28 S01EE03 BIMATOPROSTUM LUMIGAN 0,1mg/ml PIC. OFT.,SOL. 0,1mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFT. SOL.
P-RF 1 61,164000 61,164000 13,296000
29 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30mcg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 4ML PICATURI OFTALMICE, SOLUTIE PRF 1 87,630000 87,630000 0,000000
30 S01EE04 TRAVOPROSTUM BONDULC 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. TRANSLUCID DIN PP CU CAPACITATEA DE 5 ML, PREVAZUT CU DOP PICURATOR TRANSPARENT DIN PEJD SI CAPAC DIN PEID A 2,5 ML PIC. OFT., SOL. P6L 1 33,440000 33,440000 0,000000
31 S01EE04 TRAVOPROSTUM TRAVOPROST ZENTIVA 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. TRANSLUCID DIN PP CU CAPACITATEA DE 5 ML, CU PICURATOR TRANSPARENT DIN PEJD A 2 ,5 ML PIC. OFT. SOL. P6L 1 36,290000 36,290000 0,000000
32 S01EE04 TRAVOPROSTUM TRAVATAN 40mcg/ml PICATURI OFT.SOL. 40mcg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML P-6L 1 40,128000 40,128000 15,712000

Tratamentul se iniiaz de ctre medicul n specialitatea oftalmologie.

22. PEMFIGUS - G 27

1 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 10 0,832000 0,832000 0,000000
2 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 25 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 25 0,816800 0,816800 0,000000
3 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 100 0,736400 0,736400 0,000000
4 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 10 1,387000 1,387000 0,000000
5 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 25 1,327200 1,327200 0,000000
6 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/mlSOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 100 1,246200 1,246200 0,000000
7 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 100 1,256100 1,256100 0,000000
8 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 5 1,380000 1,380000 0,000000
9 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 10 1,425000 1,425000 0,000000
10 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,543200 0,543200 0,000000
11 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,234000 1,234000 0,000000
12 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLVP-RF 1 20,480000 20,480000 0,000000
13 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg PULB+SOLV. PT. SOL. INJ./PERF. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,810000 8,810000 0,000000
14 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg PULB+SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 MLS/P-RF 1 31,020000 31,020000 0,000000
15 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,028601
16 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,090333 0,090333 0,000000
17 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,108399 0,108399 0,015267
18 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,108399 0,108399 0,025101
19 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBHGERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,542400 0,542400 0,000000
20 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 15,890000 15,890000 0,000000
21 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 2,358400 2,358400 0,000000
22 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,828600 3,828600 0,000000
23 L04AX01 AZATHIOPRINUM IMURAN COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 0,702300 0,702300 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea dermatologie.

23. BOALA GAUCHER - G 29

1 A16AB02 IMIGLUCERASUM **1 CEREZYME 400U PULB. PT.CONC. PT.SOL. PERF. 400U GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. PR 1 6.149,520000 6.149,520000 0,000000
2 A16AB10 VELAGLUCERASE ALFA **1 VPRIV 400 unitati PULB. PT. SOL. PERF. 400unitati Shire Pharmaceuticals Ireland Limited IRLANDA 5 FLAC. DIN STICLA X 400 UNITATI PULBERE PT. SOL. PERF. PR 5 6.417,332000 6.417,332000 0,000000

Dup precizarea diagnosticului de ctre laboratoarele de specialitate, tratamentul se iniiaz de ctre medicul din specialitatea gastroenterologie, hematologie, neurologie, neurologie pediatric i pediatrie.

Pagina 32 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
24. BOLI VENERICE (SIFILIS, GONOREE, INFECTIA CU CHLAMIDIA) - G 3

1 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,416000 0,416000 0,000000
2 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,363000 0,363000 0,000000
3 J01AA02 DOXYCYCLINUM DOXICICLINA SANDOZ 100 mg CAPS. 100mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,361000 0,361000 0,000000
4 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 CAPS. P-RF 20 0,155000 0,155000 0,000000
5 J01AA07 TETRACYCLINUM TETRACICLINA ATB 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 0,186000 0,186000 0,150000
6 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 1000000UIPULB. PT. SOL. INJ. 1 000 000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. 100 P-RF/S 4,141700 4,141700 0,000000
7 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 1000000UIPULB. PT. SOL. INJ. 1 000 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. 1 P-RF 4,850000 4,850000 0,000000
8 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. 1 P-RF 4,840000 4,840000 0,000000
9 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. 100 P-RF/S 4,141700 4,141700 0,000000
10 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 400 000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. 100 P-RF/S 2,848000 2,848000 0,000000
11 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 400 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. 1 P-RF 3,270000 3,270000 0,000000
12 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. 12 P-RF 0,299166 0,299166 0,000000
13 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. 12 P-RF 0,527500 0,527500 0,000000
14 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. 12 P-RF 0,225833 0,225833 0,000000
15 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA 1 P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE 8,920000 8,920000 0,000000
16 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. P-RF
1 5,590000 5,590000 0,000000
17 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M.
100 S/P-RF 4,662700 4,662700 0,000000
18 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 2,237000 2,237000 0,000000
19 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,609000 3,609000 0,000000
20 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATEPRF 5 10,020000 10,020000 0,000000
21 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF 10 9,516000 9,516000 0,000000
22 J01DD08 CEFIXIMUM XIFIA 100 mg/5 ml GRANULE PT. SUSP. ORALA 100mg/5ml INN-FARM D.O.O. SLOVENIA PRF 1
CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPCITATEA DE 150 ML CARE CONTINE 53 G GRAN. PT. SUSP. ORALA+1 MASURA DOZATOARE DIN PP PT. MASURAREA VOLUMULUI DE SOLVENT GRADATA LA 66 ML+1 SERINGA DOZATOARE DIN PLASTIC A 5 ML, GRADATA DE LA 0,5 ML PANA LA 5 ML 74,620000 74,620000 0,000000
23 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,367500 0,367500 0,000000
24 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,422000 0,422000 0,000000
25 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,441000 0,441000 0,056500
26 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 3,291666 3,291666 0,000000
27 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,949999 3,949999 1,116667
28 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg PLIVA LJUBLJANA D.O.O.SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM.P-RF 6 4,146666 4,146666 0,000000
29 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 6 COMPR. FILM. P-RF 6 3,291666 3,291666 0,000000
30 J01FA10 AZITHROMYCINUM AZIBIOT 250 mg COMPR. FILM. 250mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR.FILM. PRF 6 3,291666 3,291666 0,000000
31 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg PLIVA LJUBLJANA D.O.O.SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM.P-RF 3 4,875999 4,875999 3,707334
32 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 COMPR. FILM. P-RF 3 4,063333 4,063333 0,000000
33 J01FA10 AZITHROMYCINUM AZIBIOT 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM.P-RF 3 4,875999 4,875999 0,440667
34 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 4,875999 4,875999 0,700667
35 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF 3 4,875999 4,875999 0,700667
36 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM.P-RF 3 4,875999 4,875999 0,700667
37 J01FA10 AZITHROMYCINUM AZATRIL 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF 3 4,875999 4,875999 0,254001
38 J01FA10 AZITHROMYCINUM AZITROMICINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF 3 4,875999 4,875999 0,700667
39 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 15,426666 15,426666 0,000000
40 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA P-RF 1
CUTIE X 1 FLACON DIN PE CU PULBERE PENTRU 15ML SUSPENSIE ORALA RECONSTITUITA + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENTRU ADMINISTRAREA ORALA + O LINGURITA DOZATOARE 14,470000 14,470000 0,000000
41 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA 19,340000 19,340000 0,000000
42 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (800 MG) SUSP. ORALA 19,290000 19,290000 0,000000
43 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 17,364000 17,364000 4,896000
44 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 39,680000 39,680000 0,000000
45 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 60,360000 60,360000 0,000000
46 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 3,871000 3,871000 0,000000
47 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 3,404000 3,404000 0,000000
48 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,683000 0,683000 0,000000
49 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,707000 0,707000 0,000000
50 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,683000 0,683000 0,000000
51 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,709000 0,709000 0,000000
52 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,720000 0,720000 0,000000
53 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,681000 0,681000 0,000000

Pagina 33 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
54 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,638000 0,638000 0,000000
55 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,700000 0,700000 0,000000
56 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1,012800 1,012800 0,170200
57 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,920000 0,920000 0,000000
58 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,012800 1,012800 0,309200
59 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,012800 1,012800 0,358200
60 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,911000 0,911000 0,000000
61 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,012800 1,012800 0,358200
62 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,957000 0,957000 0,000000
63 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,852000 0,852000 0,000000
64 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,844000 0,844000 0,000000
65 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1,031000 1,031000 0,000000
66 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,237200 1,237200 2,633800
67 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 750 mg COMPR. FILM. 750mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 1,200000 1,200000 0,000000
68 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 12,554285 12,554285 0,000000
69 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 1,012800 1,012800 8,540533
70 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF.100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 2,833800 2,833800 0,000000
71 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF.100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 3,400560 3,400560 0,073440
72 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF.100mg/10ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA PREVAZUTE CU INEL DE RUPERE X 10 ML S/P-RF 5 3,400560 3,400560 0,085440
73 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 100ML S 10 8,815000 8,815000 0,000000
74 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 16,023000 16,023000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea dermatologie i obstetric-ginecologie (pentru gonoree i infecia cu Chlamidia).

IMUNOSUPRESOARE SELECTIVE - G31


25. BOALA CRONICA INFLAMATORIE INTESTINALA - G31a

1 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.823,720000 1.823,720000 0,000000
2 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.567,590000 1.567,590000 0,000000
3 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.520,356666 1.520,356666 0,000000
4 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.593,040000 1.593,040000 0,000000
5 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg ABBVIE LTD. MAREA BRITANIE PR
2 CUTII A CATE 1 FLACON ( 0,8 ML SOLUTIE STERILA)+ O SERINGA STERILA+ UN AC STERIL+UN ADAPTOR STERIL PENTRU FLACON + 2 TAMPOANE CU ALCOOL 2 1.956,550000 1.956,550000 0,000000
6 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 1.956,550000 1.956,550000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea gastro-enterologie i medicin intern.

Pagina 34 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
26. POLIARTITRITA REUMATOIDA - G31b

1 L01XC02 RITUXIMABUM **1 MABTHERA 100 mg CONC. PT. SOL. PERF.10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 1.032,520000 1.032,520000 0,000000
2 L01XC02 RITUXIMABUM **1 MABTHERA 500 mg CONC. PT. SOL. PERF.10mg/ml ROCHE REGISTRATION LTD. S
MAREA BRITANIE CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) 1 5.088,050000 5.088,050000 0,000000
3 L01XC02 RITUXIMABUM **1 MABTHERA 1400 mg SOL INJ. 120mg/ml ROCHE REGISTRATION LTD. PR
MAREA BRITANIE CUTIE X 1 FLACON (1400 MG RITUXIMAB /11,7 ML 1 7.154,720000 7.154,720000 0,000000
4 L04AA24 ABATACEPTUM **1 ORENCIA PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA S 1 1.434,080000 1.434,080000 0,000000
5 L04AA24 ABATACEPTUM **1 ORENCIA SOL INJ. IN SERINGA PRE-UMPLUTA 125mg/ml BRISTOL-MYERS SQUIBB MAREA BRITANIE PR
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA CU AC CU GARDA X 125 MG/ML SOL INJ. 4 983,055000 983,055000 0,000000
6 L04AA24 ABATACEPTUM **1 ORENCIA 125 mg 125mg
SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE 4 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE PR 4 983,055000 983,055000 0,000000
7 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 496,610000 496,610000 0,000000
8 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 496,277500 496,277500 0,000000
9 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
10 L04AB01 ETANERCEPTUM **1 ENBREL 50mg 50mg
SOL. INJ. IN STILOU INJECTOR PREUMPLUT PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
11 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.823,720000 1.823,720000 0,000000
12 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.567,590000 1.567,590000 0,000000
13 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.520,356666 1.520,356666 0,000000
14 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.593,040000 1.593,040000 0,000000
15 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 1.956,550000 1.956,550000 0,000000
16 L04AB05 CERTOLIZUMAB PEGOL **1 CIMZIA SOL. INJ. IN SERINGA PREUMPLUTA 200 mg UCB PHARMA SA BELGIA P-RF/R
CUTIE X 2 SERINGI PREUMPLUTE DIN STICLA CU PISTON A 1 ML + 2 TAMPOANE CU ALCOOL 2 1.859,470000 1.859,470000 0,000000
17 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.988,470000 3.988,470000 0,000000
18 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5MLPR 1 3.988,470000 3.988,470000 0,000000
19 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF.20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. S 1 648,750000 648,750000 0,000000
20 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF.20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF.S 1 2.908,050000 2.908,050000 0,000000
21 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF.20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF.S 1 1.508,960000 1.508,960000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie, medicin intern, nefrologie (pentru pacienii cu afectare renal) i reabilitarea medical.

27. ARTROPATIA PSORIAZICA - G31c

1 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 496,610000 496,610000 0,000000
2 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 496,277500 496,277500 0,000000
3 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
4 L04AB01 ETANERCEPTUM **1 ENBREL 50mg 50mg
SOL. INJ. IN STILOU INJECTOR PREUMPLUT PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
5 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.823,720000 1.823,720000 0,000000
6 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.567,590000 1.567,590000 0,000000
7 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.520,356666 1.520,356666 0,000000
8 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.593,040000 1.593,040000 0,000000
9 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 1.956,550000 1.956,550000 0,000000
10 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.988,470000 3.988,470000 0,000000
11 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5MLPR 1 3.988,470000 3.988,470000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie i reabilitare medical.

28. SPONDILITA ANKILOZANTA - G 31d

1 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 496,610000 496,610000 0,000000
2 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 496,277500 496,277500 0,000000
3 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
4 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
5 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.823,720000 1.823,720000 0,000000

Pagina 35 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
6 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.567,590000 1.567,590000 0,000000
7 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.520,356666 1.520,356666 0,000000
8 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.593,040000 1.593,040000 0,000000
9 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 1.956,550000 1.956,550000 0,000000
10 L04AB05 CERTOLIZUMAB PEGOL **1 CIMZIA SOL. INJ. IN SERINGA PREUMPLUTA 200 mg UCB PHARMA SA BELGIA P-RF/R
CUTIE X 2 SERINGI PREUMPLUTE DIN STICLA CU PISTON A 1 ML + 2 TAMPOANE CU ALCOOL 2 1.859,470000 1.859,470000 0,000000
11 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.988,470000 3.988,470000 0,000000
12 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5MLPR 1 3.988,470000 3.988,470000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie, medicin intern i reabilitare medical.

Pagina 36 din 37
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)

29. ARTRITA JUVENILA - G 31e

1 L04AA24 ABATACEPTUM **1 ORENCIA PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA S 1 1.434,080000 1.434,080000 0,000000
2 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 496,610000 496,610000 0,000000
3 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 496,277500 496,277500 0,000000
4 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
5 L04AB01 ETANERCEPTUM **1 ENBREL 50mg 50mg
SOL. INJ. IN STILOU INJECTOR PREUMPLUT PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
6 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg ABBVIE LTD. MAREA BRITANIE 2 CUTII A CATE 1 FLACON ( 0,8 ML SOLUTIE STERILA)+ O SERINGA STERILA+ UN AC STERIL+UN ADAPTOR STERIL PENTRU FLACON + 2 TAMPOANE CU ALCOOL PR 2 1.956,550000 1.956,550000 0,000000
7 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 1.956,550000 1.956,550000 0,000000
8 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.988,470000 3.988,470000 0,000000
9 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5MLPR 1 3.988,470000 3.988,470000 0,000000
10 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF.20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. S 1 648,750000 648,750000 0,000000
11 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF.20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF.S 1 2.908,050000 2.908,050000 0,000000
12 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF.20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF.S 1 1.508,960000 1.508,960000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie, pediatrie i reabilitare medical.

30. PSORIAZIS CRONIC SEVER - G 31f

1 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 496,610000 496,610000 0,000000
2 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 496,277500 496,277500 0,000000
3 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
4 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
5 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.823,720000 1.823,720000 0,000000
6 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.567,590000 1.567,590000 0,000000
7 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITEDMAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 3 1.520,356666 1.520,356666 0,000000
8 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.PR 1 1.593,040000 1.593,040000 0,000000
9 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg ABBVIE LTD. MAREA BRITANIE PR
2 CUTII A CATE 1 FLACON ( 0,8 ML SOLUTIE STERILA)+ O SERINGA STERILA+ UN AC STERIL+UN ADAPTOR STERIL PENTRU FLACON + 2 TAMPOANE CU ALCOOL 2 1.956,550000 1.956,550000 0,000000
10 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 1.956,550000 1.956,550000 0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea dermatologie.

NOTA:
- Pentru medicamentele corespunztoare acestei seciuni iniierea tratamentului se face de ctre medicul de specialitate, altul dect medicul de familie, excepie fcnd medicamentele din G1 - Insuficien cardiac
cronic (clasa III sau IV Nyha) poziiile 2, 3, 4, 5, 6, 7 i 9, (conf. HG 720/2008, cu modificarile si completarile ulterioare) pentru care iniierea tratamentului poate fi efectuat i de ctre medicul de familie;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**1) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii i pot fi administrate i n regim
de spitalizare de zi;
- Medicamentul corespunztor DCI-ului notat cu (3) se livreaz mpreun cu solventul;
- Medicamentele corespunztoare DCI-urilor notate cu (4) se import cu avizul Ageniei Naionale a Medicamentului i a Dispozitivelor Medicale;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (5) se utilizeaz numai pentru cazurile fr rspuns terapeutic la prednisonum;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu () se efectueaz n baza contractelor cost-volum-rezultat ncheiate;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu ( ) se efectueaz n baza contractelor cost-volum ncheiate.

Pagina 37 din 37
ANEXA 2d

SECIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREUL DE REFERIN - CONFORM DCI-URILOR, ALTELE DECT CELE DIN
SUBLISTELE A, B, SUBLISTA C SECIUNEA C1 I SUBLISTA D, CORESPUNZTOARE MEDICAMENTELOR, DE CARE BENEFICIAZ COPIII PN LA 18 ANI, TINERII DE LA
18 LA 26 DE ANI DAC SUNT ELEVI, UCENICI SAU STUDENI, DAC NU REALIZEAZ VENITURI, PRECUM I GRAVIDE I LEHUZE, N TRATAMENTUL AMBULATORIU,
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE
VALABIL NCEPND CU 01 APRILIE 201

Val. maxima suportata de Co-plata maxima a


sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
cod Tara det. amba referinta / UT compensare 100% din din pretul de
Nr. crt ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)

1 A03AD02 DROTAVERINUM NO - SPA 40 mg/2 ml SOL. INJ. 40mg/2ml CHINOIN PRIVATE CO. LTD.UNGARIACUTIE X 25 FIOLE X 2ML SOL. INJ. P-RF 25 1,016800 1,016800 0,000000
2 A03BA01 ATROPINUM SULFAT DE ATROPINA TAKEDA 1 mg/ml SOL. INJ. 1mg/ml TAKEDA GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. S 5 1,606000 1,606000 0,000000
3 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,375000 0,375000 0,000000
4 A03DA02 COMBINATII ALGIFEN COMPRIMATE COMPR. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,375000 0,375000 0,000000
5 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 5 ML SOL. INJ.P-RF 5 2,540000 2,540000 0,000000
6 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA PRF
CUTIE CU 5 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI 2 INELE COLORATE PE GTUL FIOLEI (GALBEN SI ALB), A CTE 5 ML SOL. INJ. 5 2,540000 2,540000 0,000000
7 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA PRF
CUTIE CU 10 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI 2 INELE COLORATE PE GTUL FIOLEI (GALBEN SI ALB), A CTE 5 ML SOL. INJ. 10 2,539000 2,539000 0,000000
8 A05BAN3 COMBINATII ASPATOFORT (R) SOL. INJ. FARA CONCENTRATIE TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 10 ML P-RF 10 3,253000 3,253000 0,000000
9 A06AD65 COMBINATII ENDOFALK PULB. PT. SOL. ORALA FARA CONCENTRATIE DR. FALK PHARMA GMBH GERMANIA CUTIE X 6 PLICURI DE HARTIE/AL/PEJD X 55,318 G PULB. PT. SOL. ORALA P-RF 6 5,656666 5,656666 0,000000
10 A06AD65 COMBINATII FORTRANS PULB. PT. SOL. ORALA FARA CONCENTRATIE IPSEN PHARMA FRANTA CUTIE CU 4 PLICURI DIN HARTIE-AL-PE X 73,69 G PULB. PT. SOL. ORALA P-RF 4 6,787999 6,787999 3,127001
11 A07AX03 NIFUROXAZIDUM ERCEFURYL (R) 200 mg CAPS. 200mg SANOFI-SYNTHELABO OTCFRANTA CUTIE X 2 BLIST. X 14 CAPS. P-RF 28 0,422500 0,422500 0,000000
12 A11CA01 RETINOLUM CAPS.
VITAMINA A FORTE BIOFARM 50000 UI MOI 50000ui BIOFARM SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. MOIP6L 30 0,190666 0,190666 0,000000
13 A11CA01 RETINOLUM VITAMINA A BIOFARM 20mg/ml PIC. ORALE, SOL. 20mg/ml BIOFARM SA ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-6L 1 3,070000 3,070000 0,000000
14 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 20 CAPS. MOI. P6L 100 0,691000 0,691000 0,000000
15 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,286000 0,286000 0,000000
16 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE CU 2 BLIST. AL/PVC X 15 COMPR.P6L 30 0,286000 0,286000 0,000000
17 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 500 COMPR. 500UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,231666 0,231666 0,000000
18 A11CC05 COLECALCIFEROLUM VITAMINA D3 BIOFARM 18000UI/mlPIC. ORALE, SOL. 0,45mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLACON X 10 ML PIC. ORALE, SOL. P-6L 1 5,240000 5,240000 0,000000
19 A11CC05 COLECALCIFEROLUM VIGANTOL OIL PIC. ORALE, SOL. 0,5mg/ml MERCK KGAA GERMANIA P-6L
CUTIE X 1 FLACON DIN STICLA X 10 ML PIC. ORALE SOLUTIE, PREVAZUT CU PICURATOR 1 6,010000 6,010000 0,000000
20 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 1000 COMPR. 1000 UI/0,55 mg MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,277000 0,277000 0,000000
21 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 500 COMPR. 500 UI/0,55 mg MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,222333 0,222333 0,000000
22 A11DA01 THIAMINUM VITAMINA B1 ZENTIVA 100 mg/2 mlSOL. INJ. 100mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,448000 1,448000 0,000000
23 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ.P-6L 50 0,596000 0,596000 0,000000
24 A11DAN1 BENFOTIAMINUM NEUROSSEN 300 mg COMPR. FILM. 300mg AAA-PHARMA GMBHGERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 2,566333 2,566333 0,000000
25 A11DBN1 COMBINATII MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 50 0,972600 0,972600 0,000000
26 A11DBN1 COMBINATII NEUROMULTIVIT COMPR. FILM. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. P-6L 20 0,553680 0,553680 0,025820
27 A11DBN1 COMBINATII NEUROMULTIVIT COMPR. FILM. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVC/AL X 20 COMPR. FILM. P-6L 100 0,461400 0,461400 0,000000
28 A11DBN1 COMBINATII MILGAMMA (R) 100+100mg DRAJ. 100mg+100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 DRAJ.P-6L 60 1,555333 1,555333 0,000000
29 A11DBN1 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 0,972600 0,972600 0,000000
30 A11DBN1 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 0,972600 0,972600 0,000000
31 A11DBN1 COMBINATII NEUROSSEN INJEKT SOL. INJ. FARA CONCENTRATIE AAA-PHARMA GMBHGERMANIA PRF
CUTIE X 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML SOL. INJ. 10 3,713000 3,713000 0,000000
32 A11DBN1 COMBINATII MILGAMMA (R) NA SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 1 ML P-RF 5 3,842000 3,842000 0,000000
33 A11GA01 ACIDUM ASCORBICUM ACID ASCORBIC ARENA 750 mg SOL INJ. 750mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ.PRF 5 2,046000 2,046000 0,000000
34 A11GA01 ACIDUM ASCORBICUM VITAMEDI-C 750 mg/5ml SOL INJ. 750mg/5ml GERMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ.PR
PASCOE PHARMAZEUTISCHE PRAPARATE GMBH 5 2,455200 2,455200 2,796800
35 A11GA01 ACIDUM ASCORBICUM VITAMINA C ARENA 750 mg SOL. INJ. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ. P-RF 5 2,455200 2,455200 2,796800
36 A11HA02 PYRIDOXINUM VITAMINA B6 250 mg COMPR. 250 mg ARENA GROUP SA ROMANIA CUTIE X 1 FLACON DIN PE X 20 COMPR.P-6L 20 0,472500 0,472500 0,000000
37 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 0,472500 0,472500 0,000000
38 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg/5 mlSOL. INJ. 250mg/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 2,144000 2,144000 0,000000
39 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 50 mg/2ml SOL. INJ. 50mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,448000 1,448000 0,000000
40 A11HA03 TOCOFEROLUM VITAMINA E 400 mg CAPS. MOI 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 12 CAPS. MOI P-6L 24 0,404583 0,404583 0,000000
41 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU 94mg/ml SOL. INJ. 94mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FIOLE DIN PEJD X 10 ML SOL. INJ. P-RF 20 0,875000 0,875000 0,000000
42 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU ZENTIVA 95 mg/ml SOL. INJ. 95mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE X 10 ML SOL. INJ. P-RF 5 1,050000 1,050000 2,254000
43 A16AA01 LEVOCARNITINUM CARNIL (R) SOL. ORALA 100mg/ml GRECIA
ANFARM HELLAS S.A. PHARMACEUTICALS P-6L
CUTIE X 10 FLACOANE DIN STICLA BRUNA, ACOPERITE CU UN CAPAC DIN AL. X 10 ML 10 1,599000 1,599000 0,000000

Pagina 1 din 5
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
cod Tara det. amba referinta / UT compensare 100% din din pretul de
Nr. crt ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
44 A16AXN1 DIVERSE ACTOVEGIN 200 mg DRAJ. 200mg TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P6L 50 2,901600 2,901600 0,000000
45 A16AXN1 DIVERSE ACTOVEGIN 200 mg/5 ml SOL. INJ. 200mg/5ml TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE X 5 ML SOL. INJ. PR 5 21,744000 21,744000 0,000000
46 B02BX01 ETAMSYLATUM ETAMSILAT ZENTIVA 250mgSOL. INJ. 250mg/2ml ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. P-RF 5 1,396000 1,396000 0,000000
47 B02BX02 CARBAZOCHROMI SALICYLASADRENOSTAZIN SOL. INJ. 0,3mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 5 ML P-RF 5 2,638000 2,638000 0,000000
48 B03AA03 FERROSI GLUCONAS ASCOFER COMPR. FARA CONCENTRATIE ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 20 COMPR. P-6L 20 0,400500 0,400500 0,000000
49 B03AD02 COMBINATII FERRETAB (R) CAPS. ELIB. PREL. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. AL/PVC X 20 CAPS. ELIB. PREL. P-6L 100 0,286000 0,286000 0,000000
50 B03AD02 COMBINATII FERRETAB (R) CAPS. ELIB. PREL. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 30 0,343200 0,343200 0,019800
51 B03AD03 COMBINATII TARDYFERON FOL (R) DRAJ. ELIB. PREL. FARA CONCENTRATIE LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L 30 0,463333 0,463333 0,000000
52 B03AD04 COMBINATII MALTOFER FOL COMPR. MAST. FARA CONCENTRATIE VIFOR FRANCE S.A.FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MAST. P-6L 30 0,617333 0,617333 0,000000
53 B03AE01 COMBINATII FERRO - FOLGAMMA (R) CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. MOI P-RF 50 0,497000 0,497000 0,000000
54 B03AE10 COMBINATII TOT'HEMA SOL. ORALA FARA CONCENTRATIE FRANTA CUTIE X 20 FIOLE X 10 ML
LABORATOIRE INNOTECH INTERNATIONAL P-6L 20 0,886500 0,886500 0,000000
55 B03BA01 CYANOCOBALAMINUM VITAMINA B12 ZENTIVA 50g/ml SOL. INJ. 50g/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. P-RF 5 1,448000 1,448000 0,000000
56 C01EA01 ALPROSTADILUM ** ALPROSTADIL "REMEDIA" 500 g CONC. PT. SOL. PERF. 500g FARMACEUTICA REMEDIA S.A. ROMANIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF. S 5 332,144000 332,144000 0,000000
57 C01EA01 ALPROSTADILUM ** ALPROSTADIL "REMEDIA" 500 g CONC. PT. SOL. PERF. 500g ROMANIA
FARMACEUTICA REMEDIA DISTRIBUTION&LOGISTICS S.R.L. PR 5 332,144000
CUTIE CU 5 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE DE CULOARE GALBENA, A CTE 1 ML CONCENTRAT PENTRU SOL. PERF. 332,144000 0,000000
58 C05AA01 COMBINATII HEMORZON SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOFORMATE PVC X 3 SUPOZ. P-6L 6 1,210000 1,210000 0,000000
59 C05AA01 COMBINATII HEMORZON UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-6L 1 12,960000 12,960000 0,000000
60 C05AA08 COMBINATII ULTRAPROCT SUPOZITOARE SUPOZ. FARA CONCENTRATIE BAYER PHARMA AGGERMANIA CUTIE X 2 FOLII AL/PE X 5 SUPOZ. P-RF 10 1,342000 1,342000 0,000000
61 C05AA08 COMBINATII ULTRAPROCT UNGUENT RECTAL UNGUENT RECTAL FARA CONCENTRATIE BAYER PHARMA AGGERMANIA CUTIE X 1 TUB AL X 30 G + 1 CANULA PEJD P-RF 1 32,060000 32,060000 0,000000
62 C05AD01 COMBINATII DOXIPROCT UNGUENT RECTAL FARA CONCENTRATIE OM PHARMA S.A. PORTUGALIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT RECTAL + CANULA APLICATOAREP-6L 1 21,660000 21,660000 0,000000
63 C05BX01 CALCII DOBESILAS DOXILEK CAPS. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC. X 10 CAPS. P-6L 30 0,742000 0,742000 0,000000
64 C05CA54 TROXERUTINUM (COMBINATII)GINKOR FORT CAPS. FARA CONCENTRATIE IPSEN PHARMA FRANTA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,890000 0,890000 0,000000
65 C07NAN1 COMBINATII DISTONOCALM (R) COMPR. FILM. FARA CONCENTRATIE ZENTIVA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,245666 0,245666 0,000000
66 C08CA06 NIMODIPINUM NIMOTOP 30 mg COMPR. FILM. 30mg BAYER PHARMA AGGERMANIA CUTIE CU 10 BLIST. AL/PP X 10 COMPR. FILM. P-RF 100 0,713400 0,713400 0,000000
67 C08CA06 NIMODIPINUM NIMOTOP SOL. PERF. 10mg/50ml BAYER PHARMA AGGERMANIA S 5 29,144000
CUTIE X 5 CUTII X 1 FLACON DIN STICLA DE CULOARE BRUNA X 50 ML + 1 PERFUZOR DIN POLIETILENA 29,144000 0,000000
68 D01AC05 ISOCONAZOLUM TRAVOGEN CREMA 10mg/1g BAYER PHARMA AGGERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA PRF 1 17,470000 17,470000 0,000000
69 D01AC05 ISOCONAZOLUM TRAVOGEN 10mg/g CREMA 10mg/g BAYER PHARMA AGGERMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA PRF 1 11,630000 11,630000 0,000000
70 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA 2% TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB PEJD X 15 G P-RF 1 3,470000 3,470000 0,000000
71 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA CREMA 20mg/g SC HYPERION SA ROMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA P-RF 1 4,640000 4,640000 0,000000
72 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA CREMA 20mg/g SC HYPERION SA ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 3,470000 3,470000 0,000000
73 D01AC08 KETOCONAZOLUM NIZORAL 20 mg/g CREMA 20mg/g JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 4,164000 4,164000 1,186000
74 D05AXN1 COMBINATII ASORIAN SOL. CUT. FARA CONCENTRATIE BIOFARM SA ROMANIA CUTIE X 1 FLACON X 100 ML P-RF 1 10,550000 10,550000 0,000000
75 D07AC04 FLUOCINOLONI ACETONIDUM FLUOCINOLON ACETONID 0,025% UNGUENT 0,025% LAROPHARM SRL ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 7,670000 7,670000 0,000000
76 D07CB01 COMBINATII NIDOFLOR CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 10,370000 10,370000 0,000000
77 D07CC02 COMBINATII FLUOCINOLON N ATB 0,25 mg/5 mg/g UNGUENT 0,25mg/5mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 18 G UNG. PRF 1 8,510000 8,510000 0,000000
78 D07XB02 COMBINATII TRIAMCINOLON S CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 9,340000 9,340000 0,000000
79 D07XC01 COMBINATII DIPROSALIC SOL. CUT. FARA CONCENTRATIE MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR P-RF 1 6,270000 6,270000 0,000000
80 D07XC01 COMBINATII DIPROSALIC UNGUENT FARA CONCENTRATIE MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENTP-RF 1 3,420000 3,420000 0,000000
81 D07XC01 COMBINATII (BETAMETHASONUM+ACIDUM SALICYLICUM) SAL-EKARZIN 0,50 mg/30 mg pe gram UNGUENT 0,50mg/30mg pe gram ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB AL X 15 G UNGUENT P-RF 1 7,260000 7,260000 0,000000
82 D07XC04 COMBINATII TRAVOCORT CREMA 10mg/1mg/1g BAYER PHARMA AGGERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 26,150000 26,150000 0,000000
83 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 100 ML SOL. CUT. P-RF 1 21,790000 21,790000 0,000000
84 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 30 ML SOL. CUT. P-RF 1 8,400000 8,400000 0,000000
85 D10AF52 COMBINATII ZINERYT PULB. + SOLV. SOL. CUT. 40mg/12mg/ml ASTELLAS PHARMA EUROPE BV OLANDA P-RF 1 27,380000
CUTIE X 1 FLAC. DIN PEID PULB. PT. SOL. CUTANATA + APLICATOR DIN PP CU SOLV. PT 30 ML SOL. CUTANATA 27,380000 0,000000
86 D11AH02 PIMECROLIMUS ELIDEL 1% (10mg/g) CREMA 10mg/g MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 TUB AL X 30 G CREMA P-RF 1 124,050000 124,050000 0,000000
87 G01AF01 METRONIDAZOLUM FLAGYL OVULE 500mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST. X 5 OVULE P-RF 10 0,884000 0,884000 0,000000
88 G01AX12 CICLOPIROXUM DAFNEGIN OVULE 100mg POLICHEM SA LUXEMBURG P-6L 6 6,000000
CUTIE X 1 FOLIE. TERMOSUDATA DIN PVC/PE X 6 OVULE + 6 APLICATOARE DIN PE 6,000000 0,000000
89 G01BDN1 COMBINATII TERGYNAN COMPR. VAG. FARA CONCENTRATIE LAB. BOUCHARA-RECORDATI FRANTA CUTIE X 1 FOLIE HARTIE/PE/AL/PE X 10 COMPR. VAG. P-RF 10 2,613000 2,613000 0,000000
90 G03AC06 MEDROXYPROGESTERONUM SAYANA 104 mg 104mg
SUSP. INJ. IN SERINGA PREUMPLUTA PFIZER EUROPE MA EEIG MAREA BRITANIE PRF 1 81,370000
CUTIE CU O SERINGA PREUMPLUTA DE UNICA FOLOSINTA CU AC DE DIMENSIUNEA 26G, 3/8, DIN STICLA INCOLORA, CU CAPAC SI PISTON DIN CAUCIUC BROMOBUTILIC, CARE CONTINE 0,65 ML SUSPENSIE INJECTABILA 81,370000 0,000000
91 G03DB04 NOMEGESTROLUM LUTENYL (R) COMPR. 5mg LAB. THERAMEX MONACO CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P6L 10 1,943000 1,943000 0,000000
92 G03GA01 GONADOTROPHINUM CHORIONICUM PREGNYL 5000 5000ui/ml
LIOF. + SOLV. PT. SOL. INJ. NV ORGANON OLANDA S/P-RF 1 15,180000
CUTIE CU 1 FIOLA CU CAPACITATEA DE 2 ML, DIN STICLA INCOLORA, CU PUNCT DE RUPERE, TIP OPC, CONTINND PULB. PT. SOL. INJ. SI 1 FIOLA CU CAPACITATEA DE 1 ML, DIN STICLA INCOLORA, CU PUNCT DE RUPERE, TIP OPC, CONTINND SOLV. PT. SOL. INJ. 15,180000 0,000000
93 G03GA02 MENOTROPINUM MENOPUR FARA CONCENTRATIE FERRING GMBH
LIOF. + SOLV. PT. SOL. INJ. GERMANIA S/P-RF 10 78,451000
CUTIE X 10 FLAC. DIN STICLA INCOLORA CU LIOF. + 10 FIOLE X 1 ML SOLV. PT. SOL. INJ. 78,451000 0,000000
94 G03GA02 MENOTROPINUM MERIOFERT 150 UI PULB+SOLV. PT. SOL. INJ. 150UI LABORATOIRES GENEVRIER SA FRANTA PR 10 151,619000
CUTIE CU 10 SETURI CARE CONTIN: FLACOANE CU PULB. PT. SOL. INJ. SI FIOLE CU SOLVENT PT. SOL. INJ. 151,619000 0,000000
95 G03GA02 MENOTROPINUM MERIOFERT 75 UI PULB+SOLV. PT. SOL. INJ. 75UI LABORATOIRES GENEVRIER SA FRANTA PR 10 79,352000
CUTIE CU 10 SETURI CARE CONTIN: FLACOANE CU PULB. PT. SOL. INJ. SI FIOLE CU SOLVENT PT. SOL. INJ. 79,352000 0,000000

Pagina 2 din 5
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
cod Tara det. amba referinta / UT compensare 100% din din pretul de
Nr. crt ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
96 G04BCN1 COMBINATII URALYT-U GRANULE FARA CONCENTRATIE MADAUS GMBH GERMANIA CUTIE X 1 FLAC. PP X 280 G GRANULE + 1 LINGURITA DOZATOARE + 1 CALENDAR DE CONTROL + HARTIE INDICATO P-6L 1 59,060000 59,060000 0,000000
97 H03AA03 COMBINATII NOVOTHYRAL (R) 100 COMPR. 100mcg+20mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 0,300300 0,300300 0,000000
98 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 1 23,076840 23,076840 3,103160
99 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 10 22,818000 22,818000 0,000000
100 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 50 19,939200 19,939200 0,000000
101 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S 100 19,230700 19,230700 0,000000
102 J01EB05 SULFAFURAZOLUM SULFAFURAZOL ARENA 500 mg COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,655500 0,655500 0,000000
103 J01GB03 GENTAMICINUM GENTAMICINA EIPICO 40 mg/ml SOL INJ. 40mg/ml E.I.P.I.CO MED S.R.L. ROMANIA CUTIE CU 3 FLAC. DIN STICLA TIP I INCOLORA CU CAPACITATEA DE 2,5 ML, CONTINAND 2 ML SOL. INJ. PRF 3 0,686666 0,686666 0,000000
104 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 40mg/ml KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 0,740000 0,740000 0,000000
105 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 50 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF/S 50 0,823999 0,823999 0,036601
106 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 0,823999 0,823999 0,170001
107 J01XB01 COLISTINUM COLISTINA ATB 1.000.000 UIPULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, NCHISE CU DOP DIN CAUCIUC HALOBUTILIC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC FLIP-OFF DIN POLIPROPILENA, CONTINND PULB. PENTRU SOL. INJ./PERF. S 10 21,974000 21,974000 0,000000
108 J02AC03 VORICONAZOLUM ** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 95,890000 95,890000 0,000000
109 J02AC03 VORICONAZOLUM ** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 86,687142 86,687142 0,000000
110 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 86,687857 86,687857 0,000000
111 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 86,519000 86,519000 0,000000
112 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 86,687857 86,687857 0,000000
113 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg COMPR. FILM. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 80,213571 80,213571 0,000000
114 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg COMPR. FILM. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 80,045000 80,045000 0,000000
115 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 50 mg COMPR. FILM. 50mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 24,607857 24,607857 0,000000
116 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 50 mg COMPR. FILM. 50mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 24,439333 24,439333 0,000000
117 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 2.266,130000 2.266,130000 0,000000
118 M01AA01 PHENYLBUTAZONUM FENILBUTAZONA 250 mg SUPOZ. 250mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 1,089000 1,089000 0,000000
119 M01AB55 COMBINATII TRATUL PLUS CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,546000 0,546000 0,000000
120 M01AB55 COMBINATII TRATUL PLUS CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 50 0,517800 0,517800 0,000000
121 M01AB55 COMBINATII NEODOLPASSE 0,30 mg+0,12 mg/ml SOL. PERF. 0,30mg+0,12mg/ml FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 250 ML SOL. PERF. PR 10 22,722000 22,722000 0,000000
122 M01AB55 COMBINATII (DICLOFENACUM+OMEPRAZOLUM) DICLOPRAM 75 mg/20 mg CAPS. ELIB. MODIF. 75mg/20mg REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. ELIB. MODIFICATA
PHARMASWISS CESKA REPUBLIKA S.R.O. P6L 30 2,095000 2,095000 0,000000
123 M01AB55 COMBINATII (DICLOFENACUM+OMEPRAZOLUM) DICLOPRAM 75 mg/20 mg CAPS. ELIB. MODIF. 75mg/20mg REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 CAPS. ELIB. MODIFICATA
PHARMASWISS CESKA REPUBLIKA S.R.O. P6L 60 1,989666 1,989666 0,000000
124 M01AB55 COMBINATII (PARACETAMOLUM+DICLOFENACUM) ACECLOFEN SUPOZ. 500mg+50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL/PE X 3 SUPOZ. P-6L 6 1,036666 1,036666 0,000000
125 M01AB55 DICLOFENACUM+MISOPROSTOLUM ARTHROTEC 75 COMPR. GASTROREZ. 75mg+0,200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL X 10 COMPR. GASTROREZ. P-6L 20 1,482500 1,482500 0,000000
126 M01AE01 IBUPROFENUM PADUDEN (R) SR 300 mg CAPS. ELIB. PREL. 300mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-6L 10 1,453000 1,453000 0,000000
127 M01AE01 IBUPROFENUM BRUFEN RETARD 800 mg COMPR. ELIB. PREL. 800mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. CU ELIB. PREL. P6L 30 0,628000 0,628000 0,000000
128 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 0,195000 0,195000 0,000000
129 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P6L 30 0,234000 0,234000 0,065333
130 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,234000 0,234000 0,065333
131 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 600 COMPR. FILM. 600mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 0,380000 0,380000 0,000000
132 M01AE01 IBUPROFENUM FASPIC 600 GRAN. PT. SOL. ORALA 600mg ZAMBON S.P.A. ITALIA CUTIE X 30 PLICURI UNIDOZA X 3 G GRAN. PT. SOL. ORALA P-6L 30 0,456000 0,456000 0,429333
133 M01AE01 IBUPROFENUM BRUFEN 600 mg GRANULE EFF. 600mg BGP PRODUCTS AB SUEDIA CUTIE CU 20 PLICURI DIN FOLII LAMINATE DIN HARTIE/PE/AL/PE, TERMOSUDATE, CE CONTIN GRANULE EFF. P6L 20 0,456000 0,456000 0,088500
134 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CU CAPAC DIN PP SI O SERINGA DOZATOARE (GRADATA) DIN PEJD PRF 1 6,920000 6,920000 0,000000
135 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CU CAPAC DIN PE SI O SERINGA DOZATOARE (GRADATA) DIN PEJD PRF 1 6,920000 6,920000 0,000000
136 M01AE01 IBUPROFENUM BRUFEN 20 mg/ml SUSP. ORALA 20mg/ml BGP PRODUCTS AB SUEDIA CUTIE CU 1 FLAC. DIN PET DE CULOARE BRUNA CU CAPAC DIN AL SI SIGILIU DIN PEJD + SERINGA DOZATOARE DIN PP DE 5 ML, A 100 ML SUSP. ORALA P6L 1 8,304000 8,304000 2,326000
137 M01AE02 NAPROXENUM REUXEN 250 mg COMPR. 250mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,751000 0,751000 0,000000
138 M01AE02 NAPROXENUM REUXEN 500 mg COMPR. 500mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 1,196500 1,196500 0,000000
139 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L 10 1,055000 1,055000 0,000000
140 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P6L 20 0,902000 0,902000 0,000000
141 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L 10 1,511400 1,511400 0,075600
142 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P6L 20 1,259500 1,259500 0,000000
143 M01AG01 ACIDUM MEFENAMICUM VIDAN COMPR. FILM. 500mg VIANEX SA GRECIA CUTIE X 3 BLIST. AL/PVC X 8 COMPR. FILM. P-6L 24 0,432083 0,432083 0,000000
144 M01AH04 PARECOXIBUM DYNASTAT 40mg PULB. PT. SOL. INJ. 40mg PFIZER LIMITED MAREA BRITANIE CUTIE X 10 FLAC. X 40 MG PULB. PT. SOL. INJ. S/P-RF 10 30,123000 30,123000 0,000000
145 M03BB03 CHLORZOXAZONUM CLORZOXAZON 250 mg COMPR. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,229500 0,229500 0,000000
146 M03BB03 CHLORZOXAZONUM CLORZOXAZONA ARENA 250 mg COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,213666 0,213666 0,000000
147 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0,504000 0,504000 0,000000

Pagina 3 din 5
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
cod Tara det. amba referinta / UT compensare 100% din din pretul de
Nr. crt ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
148 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 20 0,509000 0,509000 0,000000
149 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,252666 0,252666 0,000000
150 M09AX01 ACIDUM HIALURONICUM HYALGAN (R) SOL. INJ. 20mg/2ml CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 2 ML P-RF 1 127,790000 127,790000 0,000000
151 N02AA59 COMBINATII ( PARACETAMOLUM + CODEINUM) ULTRACOD 500 mg/30 mg COMPR. 500 mg/30 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 0,793200 0,793200 0,333466
152 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) PARADOREN 500mg/30mg COMPR. 500mg+30mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,661000 0,661000 0,000000
153 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) PARADOREN 500mg/60mg COMPR. 500mg+60mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 1,028500 1,028500 0,000000
154 N02AA59 COMBINATII (IBUPROFENUM+CODEINUM)BRUFEN PLUS 400 mg/30 mg COMPR. FILM. 400mg/30mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. AL/PVDC-PVC/PVDC X 30 COMPR. FILM. PRF 30 1,021000 1,021000 0,000000
155 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN (R) 500 mg COMPR. 500mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,384600 0,384600 0,043900
156 N02BB02 METAMIZOLUM NATRIUM ALINDOR COMPR. 500mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,384600 0,384600 0,043900
157 N02BB02 METAMIZOLUM NATRIUM SINTOCALMIN COMPR. 500mg SINTOFARM SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.P-RF 20 0,342000 0,342000 0,000000
158 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN COMPR. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,384600 0,384600 0,038900
159 N02BB02 METAMIZOLUM NATRIUM METAMIZOL FARMACOM 500 mg COMPR. 500mg FARMACOM SA ROMANIA CUTIE X 2 BLIST., PVC/AL X 10 COMPR. P-RF 20 0,326000 0,326000 0,000000
160 N02BB02 METAMIZOLUM NATRIUM ALGIOTOP COMPR. 500mg SANTA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.P-RF 20 0,343500 0,343500 0,000000
161 N02BB02 METAMIZOLUM NATRIUM ALGOBLOCK COMPR. 500mg BIOFARM S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,320500 0,320500 0,000000
162 N02BB02 METAMIZOLUM NATRIUM ALGOZONE 500mg COMPR. 500mg LABORMED PHARMA S.A. ROMANIA CUTIE X 2 BLIST.PVC-PVDC/AL A CATE 10 COMPR. P-RF 20 0,353000 0,353000 0,000000
163 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg COMPR. 500mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 20 COMPR. PRF 20 0,371500 0,371500 0,000000
164 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg/ml PIC. ORALE, SOL. 500mg/ml TORRENT PHARMA S.R.L. ROMANIA P6L CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 100 ML PIC. ORALE, SOL. 1 28,460000 28,460000 0,000000
165 N02BB02 METAMIZOLUM NATRIUM LOCAMIN 500 mg/ml 500mg/ml
PIC. ORALE, SOL. STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD SI CAPAC DIN PEID/PP SECURIZAT PT. COPII X 50 ML PIC. ORALE,SOL. P6L 1 29,800000 29,800000 0,000000
166 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN (R) 1 g/2 ml SOL. INJ. 1g/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ.P-RF 5 1,226000 1,226000 0,000000
167 N02BB02 METAMIZOLUM NATRIUM SINTOCALMIN 300 mg SUPOZ. 300mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. PVC/PE X 3 SUPOZ. P-RF 6 1,261666 1,261666 0,000000
168 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN 300 mg SUPOZ. 300mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE, OPACE DIN PVC X 6 SUPOZ. PRF 12 1,253333 1,253333 0,000000
169 N05CD08 MIDAZOLAMUM DORMICUM (R) COMPR. FILM. 7,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. FILM. P-RF 10 0,578000 0,578000 0,000000
170 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 1 mg/ml SOL. INJ. 1mg/ml CHIESI PHARMACEUTICALS GMBHAUSTRIA CUTIE X 10 FIOLE X 5 ML SOL. INJ. S/P-RF 10 1,770000 1,770000 0,000000
171 N05CD13 CINOLAZEPAMUM GERODORM (R) COMPR. 40mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF 30 0,797000 0,797000 0,000000
172 N06BA04 METHYLFENIDATUM ** CONCERTA 18 mg COMPR. FILM. ELIB. PREL. 18mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 2,966666 2,966666 0,000000
173 N06BA04 METHYLFENIDATUM ** CONCERTA 36 mg COMPR. FILM. ELIB. PREL. 36mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 4,681333 4,681333 0,000000
174 N06BA04 METHYLFENIDATUM ** CONCERTA 54 mg COMPR. FILM. ELIB. PREL. 54mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 6,082000 6,082000 0,000000
175 N06BX02 PYRITINOLUM PIRITINOL ARENA 100 mg DRAJ. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. X 10 DRAJ. P-6L 30 0,450000 0,450000 0,000000
176 N06BX02 PYRITINOLUM ENCEPHABOL 100 mg DRAJ. 100mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 0,540000 0,540000 0,129600
177 N06BX02 PYRITINOLUM ENCEPHABOL 200 mg DRAJ. 200mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 1,259200 1,259200 0,000000
178 N06BX02 PYRITINOLUM ENCEPHABOL 80,5 mg/5 ml SUSP. ORALA 80,5mg/5ml MERCK KGAA GERMANIA P6L
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 200 ML + 1 LINGURITA DOZATOARE DIN PP ALBA, CU GRADATII LA 1,25 ML, 2,5 ML, 5 ML 1 42,110000 42,110000 0,000000
179 N07CA02 CINNARIZINUM CINARIZINA ARENA 25 mg CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. P-6L 40 0,085500 0,085500 0,000000
180 N07CA02 CINNARIZINUM STUGERON 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. P-6L 40 0,093600 0,093600 0,088900
181 N07CA02 CINNARIZINUM CINARIZIN 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 3 BLIST. X 20 COMPR. P-6L 60 0,078000 0,078000 0,000000
182 P01AX08 TENONITROZOLUM ATRICAN 250 mg CAPS. MOI GASTROREZ. 250mg LAB. INNOTECH INT.FRANTA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. MOI GASTROREZ. P-RF 8 1,445000 1,445000 0,000000
183 R01AD07 TIXOCORTOLUM PIVALONE 0,9mg/pulverizare 0,9mg/pulverizare
SPRAY NAZAL SUSPENSIE PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLACON X 10 ML + POMPA DOZATOARE + APLICATOR NAZAL P-RF 1 10,880000 10,880000 0,000000
184 R01ADN1 COMBINATII (BETAMETHASONUM+TETRYZOLINUM) BIORINIL SPRAY NAZ.,SUSP. 0,5 mg/1 mg/ ml THEA FARMA SPA ITALIA CUTIE X 1 FLACON X 10 ML SPRAY NAZAL, SUSP. PREVAZUT CU NEBULIZATOR P-RF 1 26,840000 26,840000 0,000000
185 R01BA52 COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE) AERINAZE (vezi R06AX27) 2,5mg/120mg COMPR. FILM. ELIB. MODIF. 2,5mg/120mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 10 COMPR.FILM.ELIB.MODIF. ( BLIST.PCTFE/PVC/AL) P-RF 10 2,179000 2,179000 0,000000
186 R01BA52 CLARINASE 5 mg/120 mg
COMBINATII (LORATADINUM+PSEUDOEFEDRINUM) 5mg/120mg COMPR. ELIB. MODIF. BAYER S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 COMPR. ELIB. MODIF. P-6L 7 1,372857 1,372857 0,000000
187 EPHEDRINI HYDROCHLORIDUM EFEDRINA ARENA
R03CA02 COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,324666 0,324666 0,000000
188 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA ZENTIVA 50 mg/ mlSOL. INJ. 50mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S 5 1,538000 1,538000 0,000000
189 R05CB01 ACETYLCYSTEINUM ACC INJECT 300mg/3ml 300mg/3ml SOL. INJ./ SOL. PT. INHALAT PRIN NEBULIZATOR HEXAL AG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. S/P-RF 5 1,566000 1,566000 0,000000
190 R05CB01 ACETYLCYSTEINUM FLUIMUCIL 2% PEDIATRIC SOL. ORALA 2% ZAMBON S.P.A. ITALIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SOL. ORALA + MASURA DOZATOARE (5 SI 10 ML) P-RF 1 13,620000 13,620000 0,000000
191 R05CB01 ACETYLCYSTEINUM FLUIMUCIL 300mg/3ml SOL.INJ./INHAL.NEBULIZ./INSTILATIE ENDOTRAHEOBRON. ZAMBON S.P.A. ITALIA CUTIE X 5 FIOLE DIN STICLA X 3 ML SOL.INJ/SOL.PT.INHALAT PRIN NEBULIZATOR/SOL.PT.INSTILATIE ENDOTRAH S/P-RF 5 1,710000 1,710000 0,000000
192 R05CB03 CARBOCISTEINUM RHINATHIOL 100mg/5ml pentru copii SIROP 100 mg/5 ml SANOFI-AVENTIS OTC FRANTA CUTIE X 1 FLACON DIN STICLA INCOLORA X 125 ML SIROP + LINGURITA DOZATOARE P-RF 1 7,428000 7,428000 2,092000
193 R05CB03 CARBOCISTEINUM HUMEX EXPECTORANT PENTRU COPII SIROP 100mg/5ml LAB. URGO FRANTA CUTIE X 1 FLACON X 125ML SIROP + MASURA DOZATOARE A 5 ML P-RF 1 6,190000 6,190000 0,000000
194 R05CB03 CARBOCISTEINUM FLUIDOL 100mg/5ml SOL. ORALA 100mg/5ml TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PVC X 100 ML SIROP + LINGURITA DUBLA GRADATA LA 2,5 SI 5 ML P-RF 1 4,160000 4,160000 0,000000
195 R06AD02 PROMETHAZINUM ROMERGAN SIROP 5mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 ML SIROP + MASURA DOZATOARE P-RF 1 2,910000 2,910000 0,000000
196 R06AE05 MECLOZINUM EMETOSTOP COMPR. 30mg SPECIFAR SA GRECIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,373000 0,373000 0,000000
197 R06AX02 CYPROHEPTADINUM PERITOL COMPR. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIACUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,168500 0,168500 0,000000
198 R06AX02 CYPROHEPTADINUM CIPROHEPTADINA ARENA 4 mg COMPR. 4mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,169333 0,169333 0,000000
199 R06AX13 LORATADINUM CLARITINE SIROP 1mg/ml BAYER S.R.L. ROMANIA CUTIE X 1 FLACON X 120 ML + LINGURITA DOZATOARE
P-6L 1 12,756000 12,756000 3,594000

Pagina 4 din 5
Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
cod Tara det. amba referinta / UT compensare 100% din din pretul de
Nr. crt ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
200 R06AX13 LORATADINUM LORATADINA BIOFARM 5mg/5ml 5mg/5ml SIROP BIOFARM S.A. ROMANIA P-RF
CUTIE CU UN FLACON DIN STICLA BRUNA X 100ML SIROP SI O MASURA DOZATOARE DIN PE, PREVAZUTA CU GRADATII DE LA 2,5 LA 20ML 1 7,350000 7,350000 0,000000
201 R06AX13 LORATADINUM LORATADINA LEK 5mg/5ml SUSP. ORALA 5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA P-6L
CUTIE X 1 FLACON DIN STICLA BRUNA X 120 ML SUSP. ORALA + LINGURITA DOZATOARE 1 10,630000 10,630000 0,000000
202 R06AX13 LORATADINUM LORATADINA LEK 5mg/5ml SUSP. ORALA 5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA P6L
CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC CU FILET DIN PEID X 120 ML SUSP. ORALA + LINGURITA DOZATOARE 1 10,630000 10,630000 0,000000
203 S01AA01 CHLORAMPHENICOLUM SIFICETINA 4mg/ml S.I.F.I. SPA
PULB. + SOLV. PT. SOL. OFT. ITALIA P-RF
CUTIE X 1 FLAC. STICLA BRUNA X 5 ML SOLV. + O PUNGA X UN REZERVOR CU PULB. + UN PICURATOR 1 20,030000 20,030000 0,000000
204 S01AA13 ACIDUM FUSIDICUM FUCITHALMIC 10mg/g GEL OFT. 10mg/g AMDIPHARM LIMITEDIRLANDA CUTIE X 1 TUB AL CU CANULA APLICATOARE X 5 G GEL OFTALMIC P-6L 1 13,980000 13,980000 0,000000
205 S01AA24 KANAMYCINUM KANAMICINA SULFAT 1% UNG. OFT. 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL X 6 G P-RF 1 6,640000 6,640000 0,000000
206 S01AA30 COMBINATII COLBIOCIN FARA CONCENTRATIE S.I.F.I. SPA
PULB. + SOLV. PT. SOL. OFT. ITALIA CUTIE X 1 FLACON X 5 ML SOLV. + PLIC REZERVOR PULBERE + DISP. PICURARE P-RF 1 33,280000 33,280000 0,000000
207 S01BA07 FLUOROMETHOLONUM FLUMETOL S PICATURI OFT.SUSP. 2mg/ml THEA FARMA SPA ITALIA CUTIE X 1 FLACON PEJD X 10ML PIC. OFT. SUSP. P-RF 1 33,220000 33,220000 0,000000
208 S01BC01 INDOMETACINUM INDOCOLLYRE (R) 0,1% PICATURI OFT.-SOL. 0,1% LAB. CHAUVIN FRANTA CUTIE X 1 FLACON PICURATOR DIN POLIETILENA X 5 ML P-6L 1 14,500000 14,500000 0,000000
209 S02CA05 COMBINATII OTIS-T FARA CONCENTRATIE TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PE X 10 ML PIC. AURICULARE, SOL.
PICATURI AURICULARE-SOL. P-RF 1 4,212000 4,212000 0,948000
210 S02CA05 COMBINATII SOL. AURICULARA FARA CONCENTRATIE BIOFARM SA
SOLUTIE AURICULARA CU CLORAMFENICOL SI FLUOCINOLON ROMANIA P-RF
CUTIE X 1 FLAC DIN STICLA BRUNA+APLICATOR TIP PIPETA X 10 ML SOL. AURICULARA 1 3,510000 3,510000 0,000000

Nota:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii.;
Medicamentele din aceast sublist corespund DCI-urilor din nomenclatorul de produse, altele dect cele din sublistele A, B, sublista C seciunea C1 i sublista D. Pentru categoriile de asigurai menionate
n aceast sublist, medicamentele corespunztoare denumirilor comune internaionale din sublista A, sublista B, seciunea C1 a sublistei C i sublista D se vor acorda n regim de compensare de 100% la
pre de referin, indiferent de indicaia pentru care sunt prevzute n aceste subliste.

Pagina 5 din 5

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