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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 IANUARIE 2019

Contributie maxima Val. maxima suportata de Contributie maxima


a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM

cant. beneficiaza de (pt. asiguratii care beneficiaza de


Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)

1 W64020007 A02BC01 OMEPRAZOLUM OMEZ 10 mg CAPS. GASTROREZ. 10mg ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ.
DR. REDDY'S LABORATORIES P6L 30 0,259200 0,375133 0,233280 0,401053
2 W42129001 A02BC01 OMEPRAZOLUM OMEPRAZOL-RICHTER 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 0,518400 0,203742 0,466560 0,255582
3 W51990001 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 0,518400 0,305933 0,466560 0,357773
4 W52044001 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 0,518400 0,302266 0,466560 0,354106
5 W52887001 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 0,518400 0,283933 0,466560 0,335773
6 W53138001 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,213600 0,466560 0,265440
7 W55651001 A02BC01 OMEPRAZOLUM OMEPRAZOL ROMPHARM 20 mg CAPS. GASTROREZ. 20mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,259600 0,466560 0,311440
8 W56195002 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 0,320000 0,000000 0,288000 0,032000
9 W58105001 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 0,518400 0,261266 0,466560 0,313106
10 W57295005 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mgCAPS. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 0,336785 0,000000 0,303106 0,033679
11 W60470001 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 0,518400 0,373600 0,466560 0,425440
12 W60303002 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 0,396785 0,000000 0,357106 0,039679
13 W59906022 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 2 BLISTERE DIN OPA-AL-PEÎD-PE-DESICANT-PEÎD/AL A CATE 14 CAPSULE GASTROREZISTENTE P6L 28 0,396785 0,000000 0,357106 0,039679
14 W59906021 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 4 BLISTERE DIN OPA-AL-PEÎD-PE-DESICANT-PEÎD/AL A CATE 7 CAPSULE GASTROREZISTENTE P6L 28 0,396785 0,000000 0,357106 0,039679
15 W61506002 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRLROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L 28 0,518400 0,317671 0,466560 0,369511
16 W53138002 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 10 CAPS. GASTROREZ. P6L 30 0,518400 0,213600 0,466560 0,265440
17 W64021007 A02BC01 OMEPRAZOLUM OMEZ 20 mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0,518400 0,240600 0,466560 0,292440
18 W64023001 A02BC01 OMEPRAZOLUM OMEPRAZOL DR. REDDY'S 20 mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P6L 30 0,518400 0,261933 0,466560 0,313773
19 W14125001 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 0,817142 0,000000 0,735427 0,081715
20 W57296002 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mgCAPS. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 14 CAPS. GASTROREZ. P6L 14 0,604285 0,000000 0,543856 0,060429
21 W64022007 A02BC01 OMEPRAZOLUM OMEZ 40 mg CAPS. GASTROREZ. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0,681000 0,000000 0,612900 0,068100
22 W57994002 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 0,518400 0,045528 0,466560 0,097368
23 W56141001 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 15,947999 1,772001 14,353199 3,366801
24 W60679001 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 15,947999 1,772001 14,353199 3,366801
25 W42951001 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 0,259200 0,252228 0,233280 0,278148
26 W03936001 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 0,518400 0,171600 0,466560 0,223440
27 W42952001 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 0,518400 0,368742 0,466560 0,420582
28 W53686002 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 0,242000 0,000000 0,217800 0,024200
29 W08691002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,109000 0,000000 0,098100 0,010900
30 W04254002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,112874 0,041626 0,101586 0,052914
31 W52253001 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID LAROPHARM COMPR. 10mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-6L 40 0,112874 0,003376 0,101586 0,014664
32 W54362003 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 0,109500 0,000000 0,098550 0,010950
33 W52254001 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 9,480000 0,000000 8,532000 0,948000
34 W57360001 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 2,888000 0,000000 2,599200 0,288800
35 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 1,164200 0,000000 1,047780 0,116420
36 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 1,210400 0,015400 1,089360 0,136440
37 W58710002 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 2,420800 0,288300 2,178720 0,530380
38 W58363001 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 60,520058 42,149942 54,468052 48,201948
39 W62376001 A06AD11 LACTULOSUM DUPHALAC® LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,778246 3,551754 7,000421 4,329579
40 W64011001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,778246 3,551754 7,000421 4,329579
41 W64559001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% MYLAN HEALTHCARE B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,778246 3,551754 7,000421 4,329579
42 W44054002 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 11,370000 0,000000 10,233000 1,137000
43 W44054001 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 3,780000 0,000000 3,402000 0,378000
44 W05695001 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 0,505500 0,000000 0,454950 0,050550
45 W07440001 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 0,615400 0,000000 0,553860 0,061540
46 W59162002 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 0,616400 0,000000 0,554760 0,061640
47 W58461001 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 1,749679 1,613821 1,574711 1,788789

Pagina 1 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
48 W58055001 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 0,874839 0,514361 0,787355 0,601845
49 W04124001 A07EC02 MESALAZINUM ** SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0,437418 0,183682 0,393676 0,227424
50 W04126001 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0,874839 0,305261 0,787355 0,392745
51 W04126002 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 50 0,874839 0,411161 0,787355 0,498645
52 W60408001 A07EC02 MESALAZINUM ** MESALAZINA SOFARFARM 400 mg 400mg
COMPR. GASTROREZISTENTE SOFARFARM S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 0,699870 0,153796 0,629883 0,223783
53 W60409003 A07EC02 MESALAZINUM ** MESALAZINA SOFARFARM 800 mg 800mg
COMPR. GASTROREZISTENTE SOFARFARM S.R.L. ROMANIA CUTIE CU 8 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 120 1,399743 0,104840 1,259768 0,244815
54 W61355001 A07EC02 MESALAZINUM ** PENTASA 2 g GRAN. ELIB. PREL. 2g FERRING GMBH GERMANIA CUTIE CU 60 PLICURI PET/AL/PEJD X 2 G GRANULE CU ELIB. PREL. P6L 60 3,499361 3,224972 3,149424 3,574909
55 W58054001 A07EC02 MESALAZINUM ** PENTASA 1000mg SUPOZ. 1000mg FERRING GMBH GERMANIA CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI P-6L 28 6,200000 0,337500 5,580000 0,957500
56 W56484005 A07EC02 MESALAZINUM ** SALOFALK 1 g SUPOZ. 1g DR. FALK PHARMA GMBH GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L 30 6,200000 0,000000 5,580000 0,620000
57 W04125003 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 1,549995 0,740005 1,394995 0,895005
58 W04127003 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 3,100000 0,690000 2,790000 1,000000
59 W04128001 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 21,984285 0,000000 19,785856 2,198429
60 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,237666 0,000000 0,213899 0,023767
61 W07616001 B01AC05 TICLOPIDINUM 1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL
ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0,275249 1,595251 0,247724 1,622776
62 W07968001 B01AC05 TICLOPIDINUM 1) IPATON COMPR. FILM. 250mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P6L 20 0,275249 0,448751 0,247724 0,476276
63 W05001002 B02BA01 PHYTOMENADIONUM FITOMENADION TERAPIA 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 3,519999 0,000001 3,167999 0,352001
64 W10038001 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 0,310299 0,013901 0,279269 0,044931
65 W10038010 B03AA07 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES 100 mg+60 mg COMPR. FILM. 100mg+60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, AVAND CAPAC DIN PE CU COMPENSATOR X 120 COMPR. FILM. P6L 120 0,305666 0,000000 0,275099 0,030567
66 W08016001 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 0,299141 0,083859 0,269226 0,113774
67 W44026001 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 0,782666 0,000000 0,704399 0,078267
68 W54079001 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 9,610000 0,000000 8,649000 0,961000
69 W51228001 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 13,337500 1,242500 12,003750 2,576250
70 W51231001 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 13,337500 3,492500 12,003750 4,826250
71 W52797001 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 8,891666 2,048334 8,002499 2,937501
72 W42875001 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 0,269000 0,000000 0,242100 0,026900
73 W58535002 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 0,146000 0,000000 0,131400 0,014600
74 W60427001 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,5 mg/2ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA 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 1,738000 0,000000 1,564200 0,173800
75 W59968001 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 0,687533 0,035967 0,618779 0,104721
76 W59968002 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 0,687533 0,014133 0,618779 0,082887
77 W59968003 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 0,673400 0,000000 0,606060 0,067340
78 W56891002 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,346875 0,012125 0,312187 0,046813
79 W56891004 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 0,346875 0,000125 0,312187 0,034813
80 W12499003 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 0,346500 0,000000 0,311850 0,034650
81 W62345001 C01BC03 PROPAFENONUM RYTMONORM 150 mg COMPR. FILM. 150mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM. PRF 50 0,346875 0,204525 0,312187 0,239213
82 W62339001 C01BC03 PROPAFENONUM RYTMONORM 70 mg/20 ml SOL. INJ. 70mg/20ml MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. PRF 5 6,166000 0,000000 5,549400 0,616600
83 W06951001 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 0,362249 0,125751 0,326024 0,161976
84 W00311002 C01BD01 AMIODARONUM AMIODARONA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,320333 0,000000 0,288299 0,032034
85 W53954002 C01BD01 AMIODARONUM AMIODARONA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,267000 0,000000 0,240300 0,026700
86 W06951002 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. P-RF 30 0,362249 0,125751 0,326024 0,161976
87 W64483001 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,362249 0,125751 0,326024 0,161976
88 W64483002 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. PRF 30 0,362249 0,125751 0,326024 0,161976
89 W04591002 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 0,128640 0,050526 0,115776 0,063390
90 W42792002 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 0,092986 0,117514 0,083687 0,126813
91 W04587001 C01DA02 NITROGLYCERINUM NITRODERM (R) TTS 5 25mg
SIST. TERAP. TRANSDERM. NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC P-6L 10 1,641000 0,000000 1,476900 0,164100
92 W07257001 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 13,390000 0,000000 12,051000 1,339000
93 W07257002 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 13,390000 0,000000 12,051000 1,339000
94 W44053001 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 0,032666 0,000000 0,029399 0,003267
95 W53684002 C01DA08 ISOSORBIDI DINITRAS ISOSORBID DINITRAT ARENA 10 mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,041230 0,025103 0,037107 0,029226
96 W54816001 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 0,071666 0,000000 0,064499 0,007167
97 W62347001 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 0,247386 0,218614 0,222647 0,243353
98 W13871002 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 0,371079 0,623421 0,333971 0,660529
99 W53697001 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 50,511999 4,580001 45,460799 9,631201
100 W58530002 C01EA01 ALPROSTADILUM ** VASAPROSTAN 20 µg/ml PULB. PT. SOL. PERF. 20µg/ml UCB PHARMA GMBH GERMANIA PRF
CUTIE CU 15 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE, CU CAPACITATE DE 5 ML, CONTINÂND 48,2 MG PULB. PT. SOL. PERF. 15 48,985333 0,000000 44,086799 4,898534
101 W04208001 C02AB01 METHYLDOPUM DOPEGYT COMPR. 250mg UNGARIA CUTIE X 1 FLAC. X 50 COMPR.
EGIS PHARMACEUTICALS P.L.C. P-6L 50 0,583600 0,000000 0,525240 0,058360
102 W01369003 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 0,242459 0,010141 0,218213 0,034387
103 W60265001 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 0,242459 0,026941 0,218213 0,051187

Pagina 2 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
104 W43198002 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0,182000 0,000000 0,163800 0,018200
105 W62788001 C03BA11 INDAPAMIDUM INDAPAMIDA SLAVIA 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 0,330224 0,034442 0,297201 0,067465
106 W56973001 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 1,5 mg COMPR. CU ELIB. PRELUNGITA 1,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L 30 0,330224 0,038109 0,297201 0,071132
107 W61972001 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 0,330224 0,038109 0,297201 0,071132
108 W03592001 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 0,330224 0,230109 0,297201 0,263132
109 W13662001 C03BA11 INDAPAMIDUM INDAPAMID LPH 1,5 mg COMPR. ELIB. PREL. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,330224 0,037442 0,297201 0,070465
110 W52005001 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 0,330224 0,038109 0,297201 0,071132
111 W53212001 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 0,330224 0,038109 0,297201 0,071132
112 W56877001 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 0,330224 0,037442 0,297201 0,070465
113 W62164001 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 0,330224 0,037442 0,297201 0,070465
114 W13675001 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,549000 0,000000 0,494100 0,054900
115 W43065002 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 0,278333 0,000000 0,250499 0,027834
116 W52836001 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 0,330224 0,038109 0,297201 0,071132
117 W03265002 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 0,165000 0,000000 0,148500 0,016500
118 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,165000 0,000000 0,148500 0,016500
119 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,165250 0,035750 0,148725 0,052275
120 W52043001 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 0,165250 0,163750 0,148725 0,180275
121 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,165250 0,120750 0,148725 0,137275
122 W03264003 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATEP-6L 30 0,165250 0,000750 0,148725 0,017275
123 W58282001 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 1,328000 0,000000 1,195200 0,132800
124 W54824001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,793000 0,000000 0,713700 0,079300
125 W55360002 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 0,232666 0,118734 0,209399 0,142001
126 W57830002 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 0,232666 0,121667 0,209399 0,144934
127 W54823001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,465332 0,000001 0,418798 0,046535
128 W55359001 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 0,465332 0,126334 0,418798 0,172868
129 W60370001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,232666 0,001334 0,209399 0,024601
130 W08893001 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 0,232666 0,156934 0,209399 0,180201
131 W52138001 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 0,226500 0,000000 0,203850 0,022650
132 W41550001 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 0,465332 0,258168 0,418798 0,304702
133 W58726003 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 1,108833 0,001167 0,997949 0,112051
134 W07005001 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 1,108833 0,164667 0,997949 0,275551
135 W60585002 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 1,105333 0,000000 0,994799 0,110534
136 W60585001 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 1,108833 0,119167 0,997949 0,230051
137 W13574002 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 0,335041 0,277459 0,301536 0,310964
138 W53002004 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 0,335041 0,022959 0,301536 0,056464
139 W53002005 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 0,335041 0,023359 0,301536 0,056864
140 W13301002 C04AD03 PENTOXIFYLLINUM ANGIOPENT 400 mg COMPR. ELIB. PREL. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 40 0,335041 0,271209 0,301536 0,304714
141 W53506005 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 0,495600 0,000000 0,446040 0,049560
142 W53506006 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 0,479400 0,000000 0,431460 0,047940
143 W54452002 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 0,502562 0,209238 0,452305 0,259495
144 W13301001 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 0,335000 0,000000 0,301500 0,033500
145 W53123003 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 0,335041 0,000125 0,301536 0,033630
146 W13302001 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 0,502562 0,363438 0,452305 0,413695
147 W56674001 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 0,026875 0,044325 0,024187 0,047013
148 W08683002 C07AA05 PROPRANOLOLUM PROPRANOLOL 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,026875 0,059125 0,024187 0,061813
149 W12724002 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,104800 0,000000 0,094320 0,010480
150 W08684002 C07AA05 PROPRANOLOLUM PROPRANOLOL 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,104800 0,000000 0,094320 0,010480
151 W53681002 C07AA05 PROPRANOLOLUM PROPRANOLOL ARENA 40 mg COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,107500 0,000900 0,096750 0,011650
152 W41673003 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 0,215000 0,128000 0,193500 0,149500
153 W08420005 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,215000 0,129200 0,193500 0,150700
154 W62335001 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,215000 0,330500 0,193500 0,352000
155 W04263002 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,229599 0,082067 0,206639 0,105027
156 W04266001 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 0,229599 0,082401 0,206639 0,105361
157 W07222003 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,229599 0,029401 0,206639 0,052361
158 W42176001 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,229599 0,082067 0,206639 0,105027
159 W52230001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,229599 0,082067 0,206639 0,105027

Pagina 3 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
160 W53669001 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 0,229599 0,082401 0,206639 0,105361
161 W53941002 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,229599 0,025734 0,206639 0,048694
162 W57206001 C07AB02 METOPROLOLUM METOPROLOL SLAVIA 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,229599 0,073401 0,206639 0,096361
163 W59297001 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 0,215333 0,000000 0,193799 0,021534
164 W61716001 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 100 mg COMPR. 100mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,229599 0,082734 0,206639 0,105694
165 W42025001 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,057399 0,046267 0,051659 0,052007
166 W53922001 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 0,057399 0,046267 0,051659 0,052007
167 W42973003 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0,057399 0,046101 0,051659 0,051841
168 W04264002 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,114799 0,077201 0,103319 0,088681
169 W04268001 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 0,114799 0,065701 0,103319 0,077181
170 W07223003 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,114799 0,058201 0,103319 0,069681
171 W42197001 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,114799 0,077201 0,103319 0,088681
172 W52231001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,114799 0,141534 0,103319 0,153014
173 W53670001 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 0,114799 0,067201 0,103319 0,078681
174 W53940001 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 0,114799 0,077201 0,103319 0,088681
175 W57205001 C07AB02 METOPROLOLUM METOPROLOL SLAVIA 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,114799 0,075701 0,103319 0,087181
176 W61714001 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 50 mg COMPR. 50mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,114799 0,077201 0,103319 0,088681
177 W43226010 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 0,109059 0,117941 0,098153 0,128847
178 W43227010 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 0,218119 0,159547 0,196307 0,181359
179 W59569003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mgCOMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,229599 0,082067 0,206639 0,105027
180 W59568003 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 0,114799 0,076201 0,103319 0,087681
181 W04260001 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 0,229599 0,250734 0,206639 0,273694
182 W04262001 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 0,114799 0,265867 0,103319 0,277347
183 W43226004 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 0,109059 0,117941 0,098153 0,128847
184 W43227004 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 0,218119 0,159547 0,196307 0,181359
185 W00491003 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,385333 0,000000 0,346799 0,038534
186 W53950002 C07AB03 ATENOLOLUM ATENOLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,341500 0,000000 0,307350 0,034150
187 W61517001 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,371500 0,000000 0,334350 0,037150
188 W00492003 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,214666 0,000000 0,193199 0,021467
189 W53949002 C07AB03 ATENOLOLUM ATENOLOL ARENA 50 MG COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,195000 0,000000 0,175500 0,019500
190 W61516001 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,207000 0,000000 0,186300 0,020700
191 W12507001 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 0,344399 0,030243 0,309959 0,064683
192 W12507003 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 6 BLIST. PVC/AL X 14 COMPR. FILM. P6L 84 0,344399 0,352386 0,309959 0,386826
193 W64210003 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 14 COMPR. FILM. P6L 84 0,344399 0,352386 0,309959 0,386826
194 W59208001 C07AB07 BISOPROLOLUM BISOBLOCK 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,243333 0,000000 0,218999 0,024334
195 W58764001 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 0,344399 0,038267 0,309959 0,072707
196 W00625001 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,344399 0,528267 0,309959 0,562707
197 W13630003 C07AB07 BISOPROLOLUM BISOGAMMA 10 mg COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 100 0,273200 0,000000 0,245880 0,027320
198 W43154001 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 0,344399 0,020934 0,309959 0,055374
199 W58248003 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,344399 0,034267 0,309959 0,068707
200 W60359002 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,344399 0,476267 0,309959 0,510707
201 W60569004 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 0,344399 0,021267 0,309959 0,055707
202 W58765001 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 0,086099 0,169567 0,077489 0,178177
203 W60357002 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 0,086099 0,227234 0,077489 0,235844
204 W60567004 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 0,086099 0,133567 0,077489 0,142177
205 W00626001 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,172199 0,342801 0,154979 0,360021
206 W43153001 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 0,172199 0,045134 0,154979 0,062354
207 W58244003 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 0,172199 0,044134 0,154979 0,061354
208 W60358002 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,172199 0,237801 0,154979 0,255021
209 W60568004 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 0,172199 0,045134 0,154979 0,062354
210 W13629005 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 0,156100 0,000000 0,140490 0,015610
211 W59931001 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 0,248249 0,044084 0,223424 0,068909
212 W12649001 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 0,248249 0,024608 0,223424 0,049433
213 W42058001 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
EGIS PHARMACEUTICALS P.L.C. P-6L 30 0,248249 0,047751 0,223424 0,072576
214 W42659001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
LABORMED PHARMA SA P-6L 30 0,248249 0,238751 0,223424 0,263576
215 W53658001 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 0,248249 0,105251 0,223424 0,130076

Pagina 4 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
216 W53751001 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 0,248249 0,157417 0,223424 0,182242
217 W58304001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,5 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,248249 0,227751 0,223424 0,252576
218 W63454001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,248249 0,238751 0,223424 0,263576
219 W12648002 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 0,373571 0,000000 0,336213 0,037358
220 W42059001 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 0,496499 0,054501 0,446849 0,104151
221 W42658001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,496499 0,137167 0,446849 0,186817
222 W53752001 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,496499 0,055167 0,446849 0,104817
223 W58305001 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 0,496499 0,138501 0,446849 0,188151
224 W59932001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,334333 0,000000 0,300899 0,033434
225 W63455001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,496499 0,080167 0,446849 0,129817
226 W41867002 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 0,124124 0,071947 0,111711 0,084360
227 W41912001 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
EGIS PHARMACEUTICALS P.L.C. P-6L 30 0,124124 0,052542 0,111711 0,064955
228 W42660001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
LABORMED PHARMA SA P-6L 30 0,124124 0,126876 0,111711 0,139289
229 W53663001 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 0,124124 0,116376 0,111711 0,128789
230 W53750001 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 0,124124 0,070542 0,111711 0,082955
231 W59930001 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 0,124124 0,065876 0,111711 0,078289
232 W63453001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0,124124 0,126876 0,111711 0,139289
233 W58955007 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 0,248249 0,013179 0,223424 0,038004
234 W58956007 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 0,290000 0,000000 0,261000 0,029000
235 W58954007 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 0,124124 0,058733 0,111711 0,071146
236 W41513001 C08CA01 AMLODIPINUM AMLOHEXAL 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774
237 W42020001 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 0,278399 0,029601 0,250559 0,057441
238 W52404001 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 10 mg COMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P-6L 30 0,278399 0,029601 0,250559 0,057441
239 W53430001 C08CA01 AMLODIPINUM ALMACOR 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774
240 W55742001 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 0,278399 0,030934 0,250559 0,058774
241 W57500001 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 0,278399 0,030934 0,250559 0,058774
242 W57500002 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774
243 W57802007 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,229000 0,000000 0,206100 0,022900
244 W59686002 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,278399 0,009267 0,250559 0,037107
245 W59528001 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,278399 0,197601 0,250559 0,225441
246 W60290001 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 0,278399 0,030601 0,250559 0,058441
247 W60373002 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 0,278399 0,030934 0,250559 0,058774
248 W61982001 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 0,278399 0,030601 0,250559 0,058441
249 W61982002 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 0,278399 0,030934 0,250559 0,058774
250 W41512001 C08CA01 AMLODIPINUM AMLOHEXAL 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 0,139199 0,250467 0,125279 0,264387
251 W42019001 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 0,139199 0,102801 0,125279 0,116721
252 W52403001 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 5 mg COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P-6L 30 0,139199 0,051801 0,125279 0,065721
253 W53429001 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,139199 0,104134 0,125279 0,118054
254 W55743001 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 0,139199 0,250467 0,125279 0,264387
255 W57499001 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 0,139199 0,250467 0,125279 0,264387
256 W57499002 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0,139199 0,250467 0,125279 0,264387
257 W57801007 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,139199 0,040134 0,125279 0,054054
258 W59685002 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 5 mg COMPR. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,115000 0,000000 0,103500 0,011500
259 W59527001 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,139199 0,315467 0,125279 0,329387
260 W60289001 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 0,139199 0,250801 0,125279 0,264721
261 W60372002 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 0,139199 0,147801 0,125279 0,161721
262 W61981001 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 0,139199 0,250801 0,125279 0,264721
263 W61981002 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 0,139199 0,250467 0,125279 0,264387
264 W03102002 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 0,278399 0,510934 0,250559 0,538774
265 W03104001 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X, 30 COMPR. ELIB. PREL. P-6L 30 0,139199 0,447801 0,125279 0,461721
266 W42170001 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 0,278399 0,637267 0,250559 0,665107
267 W42168001 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 0,139199 0,439134 0,125279 0,453054
268 W06813001 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 0,278399 0,637267 0,250559 0,665107
269 W53011001 C08CA02 FELODIPINUM FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,278399 0,084601 0,250559 0,112441
270 W06814001 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 0,069599 0,456734 0,062639 0,463694
271 W06815001 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 0,139199 0,438467 0,125279 0,452387

Pagina 5 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
272 W53010001 C08CA02 FELODIPINUM FELODIPIN SANDOZ 5 mg 5mg
COMPR. FILM. ELIB. PREL. HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,139199 0,265134 0,125279 0,279054
273 W57951001 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 0,139199 0,425801 0,125279 0,439721
274 W63872001 C08CA05 NIFEDIPINUM ADALAT CR 30 COMPR. ELIB. MODIF. 30mg BAYER AG GERMANIA CUTIE CU 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P6L 28 0,139199 0,425801 0,125279 0,439721
275 W04542001 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 0,092799 0,143001 0,083519 0,152281
276 W60127001 C08DA01 VERAPAMILUM VERAPAMIL ARENA 40 mg CAPS. 40mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,103999 0,017334 0,093599 0,027734
277 W57108002 C08DA01 VERAPAMILUM VERAPAMIL ARENA 80 mg CAPS. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,208000 0,002666 0,187200 0,023466
278 W62364001 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 0,624000 0,177000 0,561600 0,239400
279 W06068001 C08DA01 VERAPAMILUM CORDAMIL 40 mg COMPR. FILM. 40mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0,103999 0,012667 0,093599 0,023067
280 W06069001 C08DA01 VERAPAMILUM CORDAMIL 80 mg COMPR. FILM. 80mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0,208000 0,000000 0,187200 0,020800
281 W52127001 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 0,103999 0,154201 0,093599 0,164601
282 W62445001 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 0,103999 0,154201 0,093599 0,164601
283 W52126003 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 0,208000 0,000000 0,187200 0,020800
284 W62446002 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 0,208000 0,000000 0,187200 0,020800
285 W62446001 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 0,208000 0,000000 0,187200 0,020800
286 W59964001 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 0,793915 0,462085 0,714523 0,541477
287 W59963001 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 0,240000 0,000000 0,216000 0,024000
288 W44079001 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 0,264638 0,018862 0,238174 0,045326
289 W12201003 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L 50 0,264638 0,027762 0,238174 0,054226
290 W53585001 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 0,264638 0,018862 0,238174 0,045326
291 W41897003 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. DIN PVC/AL X 10 COMPRIMATEP-6L 60 0,264638 0,029862 0,238174 0,056326
292 W02586002 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 0,368666 0,000000 0,331799 0,036867
293 W00775001 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,071033 0,070470 0,078863
294 W06860001 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,078300 0,080200 0,070470 0,088030
295 W00774002 C09AA01 CAPTOPRILUM CAPTOPRIL LAROPHARM 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,078300 0,086700 0,070470 0,094530
296 W43029001 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 0,078300 0,046700 0,070470 0,054530
297 W06857001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,045366 0,070470 0,053196
298 W08550001 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,046033 0,070470 0,053863
299 W41981002 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,084366 0,070470 0,092196
300 W53677002 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,078300 0,046700 0,070470 0,054530
301 W53678001 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 0,145500 0,000000 0,130950 0,014550
302 W00777001 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,085733 0,140940 0,101393
303 W06862001 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156600 0,046900 0,140940 0,062560
304 W43028001 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 0,145500 0,000000 0,130950 0,014550
305 W42060001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,007400 0,140940 0,023060
306 W00776003 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,143333 0,000000 0,128999 0,014334
307 W12405001 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,156600 0,053900 0,140940 0,069560
308 W02920004 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,156600 0,053066 0,140940 0,068726
309 W02922001 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 0,156600 0,053900 0,140940 0,069560
310 W41447001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0,156600 0,043900 0,140940 0,059560
311 W51276001 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,156600 0,166257 0,140940 0,181917
312 W53672002 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,156600 0,053400 0,140940 0,069060
313 W53672003 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0,156600 0,053200 0,140940 0,068860
314 W53672004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0,156600 0,053300 0,140940 0,068960
315 W53666002 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 0,156600 0,053900 0,140940 0,069560
316 W58491002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,156600 0,052900 0,140940 0,068560
317 W62035001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,156600 0,053900 0,140940 0,069560
318 W12199001 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,313200 0,034800 0,281880 0,066120
319 W02921003 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,313200 0,035133 0,281880 0,066453
320 W02923001 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 0,313200 0,034800 0,281880 0,066120
321 W51277001 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,313200 0,222871 0,281880 0,254191
322 W53674001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313200 0,035133 0,281880 0,066453
323 W53674004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0,313200 0,035000 0,281880 0,066320
324 W56712001 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 0,313200 0,034800 0,281880 0,066120
325 W58492001 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,313200 0,034800 0,281880 0,066120
326 W62036001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,313200 0,034800 0,281880 0,066120
327 W12198001 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,078300 0,019700 0,070470 0,027530

Pagina 6 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
328 W02925001 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 0,078300 0,020200 0,070470 0,028030
329 W51275001 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHMEROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,078300 0,073128 0,070470 0,080958
330 W12811003 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 0,078300 0,019700 0,070470 0,027530
331 W53673001 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 0,078300 0,020366 0,070470 0,028196
332 W58490002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,078300 0,016700 0,070470 0,024530
333 W62034001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0,078300 0,019700 0,070470 0,027530
334 W58233001 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 3,374000 0,000000 3,036600 0,337400
335 W12794001 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,156600 0,389400 0,140940 0,405060
336 W42156001 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156600 0,408900 0,140940 0,424560
337 W42593001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,156600 0,097066 0,140940 0,112726
338 W43054001 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,111066 0,140940 0,126726
339 W53748003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,156600 0,128066 0,140940 0,143726
340 W53916002 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,279066 0,140940 0,294726
341 W54841001 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,156600 0,250185 0,140940 0,265845
342 W54843001 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 0,039150 0,286207 0,035235 0,290122
343 W12793001 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,313200 0,528466 0,281880 0,559786
344 W42088001 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,313200 0,511300 0,281880 0,542620
345 W42594001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313200 0,043800 0,281880 0,075120
346 W53747003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,313200 0,085800 0,281880 0,117120
347 W53917002 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,313200 0,541800 0,281880 0,573120
348 W54840001 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,313200 0,370371 0,281880 0,401691
349 W43055002 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 0,313200 0,138300 0,281880 0,169620
350 W53918002 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,626400 0,805600 0,563760 0,868240
351 W12795001 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,078300 0,200033 0,070470 0,207863
352 W43053001 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,124700 0,070470 0,132530
353 W53746003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,078300 0,125033 0,070470 0,132863
354 W54842001 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,078300 0,198485 0,070470 0,206315
355 W51933002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,251071 0,000000 0,225963 0,025108
356 W64367002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,251071 0,000000 0,225963 0,025108
357 W42940001 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 0,318000 0,000000 0,286200 0,031800
358 W42972001 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 0,318000 0,000000 0,286200 0,031800
359 W43524001 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,318214 0,000000 0,286392 0,031822
360 W54354001 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 0,489285 0,000000 0,440356 0,048929
361 W55273002 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 0,200714 0,000000 0,180642 0,020072
362 W60133002 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,318000 0,000000 0,286200 0,031800
363 W60133005 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,318000 0,000000 0,286200 0,031800
364 W62447001 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,489285 0,000000 0,440356 0,048929
365 W62662001 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 0,251000 0,000000 0,225900 0,025100
366 W64288002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0,200714 0,000000 0,180642 0,020072
367 W51934002 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 0,156600 0,000900 0,140940 0,016560
368 W64365002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,156600 0,000900 0,140940 0,016560
369 W42939001 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 0,156600 0,020733 0,140940 0,036393
370 W42970001 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 0,156600 0,024733 0,140940 0,040393
371 W43522001 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,156600 0,018400 0,140940 0,034060
372 W54352003 C09AA05 RAMIPRILUM TRITACE(R) 2,5 COMPR. 2,5mg ROMANIA CUTIE X 2 BLIST. X 14 COMPR.
SANOFI - AVENTIS ROMANIA S.R.L. P-6L 28 0,156600 0,122328 0,140940 0,137988
373 W60131006 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 0,156600 0,024733 0,140940 0,040393
374 W62451001 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 0,156600 0,122328 0,140940 0,137988
375 W62660001 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 0,156600 0,000400 0,140940 0,016060
376 W51932002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,181071 0,000000 0,162963 0,018108
377 W64366002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,181071 0,000000 0,162963 0,018108
378 W42237001 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 0,261333 0,000000 0,235199 0,026134
379 W42971001 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 0,260333 0,000000 0,234299 0,026034
380 W43523001 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,252142 0,000000 0,226927 0,025215
381 W54353001 C09AA05 RAMIPRILUM TRITACE® 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,313200 0,088942 0,281880 0,120262
382 W55272005 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 0,140357 0,000000 0,126321 0,014036
383 W60132003 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,261333 0,000000 0,235199 0,026134

Pagina 7 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
384 W60132008 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,261333 0,000000 0,235199 0,026134
385 W62382001 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,313200 0,088942 0,281880 0,120262
386 W62661001 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 0,181333 0,000000 0,163199 0,018134
387 W64287005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0,140357 0,000000 0,126321 0,014036
388 W05345001 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 0,104399 0,318934 0,093959 0,329374
389 W64842001 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0,104399 0,318934 0,093959 0,329374
390 W41466001 C09AA06 QUINAPRILUM ACCUPRO 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,208799 0,398867 0,187919 0,419747
391 W64840001 C09AA06 QUINAPRILUM ACCUPRO 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0,208799 0,398867 0,187919 0,419747
392 W41465001 C09AA06 QUINAPRILUM ACCUPRO 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,052199 0,150134 0,046979 0,155354
393 W64841001 C09AA06 QUINAPRILUM ACCUPRO 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0,052199 0,150134 0,046979 0,155354
394 W52069001 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 0,104399 0,296267 0,093959 0,306707
395 W61581001 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,104399 0,512386 0,093959 0,522826
396 W64284006 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,104399 0,296267 0,093959 0,306707
397 W52068001 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR. P-6L 30 0,208799 0,372534 0,187919 0,393414
398 W61582001 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,208799 0,685486 0,187919 0,706366
399 W64285006 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,208799 0,372534 0,187919 0,393414
400 W01855001 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 0,332000 0,000000 0,298800 0,033200
401 W01854001 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 0,396000 0,000000 0,356400 0,039600
402 W42590001 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 0,433500 0,000000 0,390150 0,043350
403 W52320001 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 5 mg/25mg COMPR. 5mg/25mg UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L
EGIS PHARMACEUTICALS P.L.C. 28 0,393571 0,000000 0,354213 0,039358
404 W54356001 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 5 PLUS COMPR. 5mg/25mg ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L
SANOFI - AVENTIS ROMANIA S.R.L. 28 0,444503 0,109782 0,400052 0,154233
405 W62429001 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 0,444503 0,109782 0,400052 0,154233
406 W58838001 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 0,681106 0,319894 0,612995 0,388005
407 W53261001 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 0,681106 0,496227 0,612995 0,564338
408 W53261003 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0,681106 0,496227 0,612995 0,564338
409 W58235006 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 0,545357 0,000000 0,490821 0,054536
410 W58837001 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 0,340553 0,011113 0,306497 0,045169
411 W53260001 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 0,340553 0,011113 0,306497 0,045169
412 W53260003 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0,340553 0,011113 0,306497 0,045169
413 W56259005 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 0,340553 0,201589 0,306497 0,235645
414 W58237004 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 0,340553 0,011589 0,306497 0,045645
415 W60908002 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 0,096649 0,244422 0,086984 0,254087
416 W12477002 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 0,096649 0,117993 0,086984 0,127658
417 W42158001 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 0,096649 0,231684 0,086984 0,241349
418 W08725001 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 0,096649 0,203708 0,086984 0,213373
419 W42328001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,096649 0,244351 0,086984 0,254016
420 W56959001 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 0,096649 0,059065 0,086984 0,068730
421 W58957005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,050333 0,000000 0,045299 0,005034
422 W59878005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,096649 0,059351 0,086984 0,069016
423 W60907002 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 0,193299 0,262772 0,173969 0,282102
424 W12478002 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 0,193299 0,262772 0,173969 0,282102
425 W51357002 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 0,193299 0,508486 0,173969 0,527816
426 W42159001 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 0,193299 0,262701 0,173969 0,282031
427 W08479001 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 0,193299 0,262415 0,173969 0,281745
428 W42327001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,193299 0,262701 0,173969 0,282031
429 W56960001 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 0,193299 0,065272 0,173969 0,084602
430 W58958005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,193299 0,054701 0,173969 0,074031
431 W59879005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,193299 0,262701 0,173969 0,282031
432 W41703002 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 0,289949 0,218384 0,260954 0,247379
433 W60906002 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 0,386599 0,778758 0,347939 0,817418
434 W13137001 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 0,386599 0,392686 0,347939 0,431346
435 W41446002 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 0,386599 0,192686 0,347939 0,231346
436 W41547001 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 0,386599 0,736734 0,347939 0,775394
437 W52431001 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 0,386599 0,741067 0,347939 0,779727
438 W56961001 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 0,356071 0,000000 0,320463 0,035608
439 W58959005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,341000 0,000000 0,306900 0,034100

Pagina 8 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
440 W59880005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,386599 0,552734 0,347939 0,591394
441 W06752001 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 0,128866 0,424134 0,115979 0,437021
442 W57367004 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 0,128866 0,813134 0,115979 0,826021
443 W43037001 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 0,193299 0,676343 0,173969 0,695673
444 W43843001 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 0,386599 0,999115 0,347939 1,037775
445 W43325002 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,747599 0,083067 0,672839 0,157827
446 W13251001 C10AB05 FENOFIBRATUM LIPIVIM CAPS. PULB. MICRONIZATA 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,927666 0,000000 0,834899 0,092767
447 W62360002 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 0,934499 0,126167 0,841049 0,219617
448 W62362001 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 0,934499 0,194834 0,841049 0,288284
449 W13742001 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 7,380000 0,000000 6,642000 0,738000
450 W12026001 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 8,070000 0,000000 7,263000 0,807000
451 W53912001 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 8,070000 0,000000 7,263000 0,807000
452 W44047001 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 3,695400 2,364600 3,325860 2,734140
453 W44048001 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 3,695400 2,364600 3,325860 2,734140
454 W60232003 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 1,556000 0,000000 1,400400 0,155600
455 W63442002 G03BA03 TESTOSTERONUM * UNDESTOR TESTOCAPS 40 mg CAPS. MOI 40mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI PRF 60 0,853000 0,000000 0,767700 0,085300
456 W62752001 G03BA03 TESTOSTERONUM * ANDROGEL 16,2 mg/g GEL 16,2mg/g BESINS HEALTHCARE BELGIA CUTIE CU 1 RECIPIENT MULTIDOZA DIN PP, CARE CONTINE UN REZERVOR DIN PEJD, PREVAZUT CU UN ADAPTOR LA CARE SE CONECTEAZA O POMPA DOZATOARE CU 88 G GEL PRF 1 183,182925 68,757075 164,864632 87,075368
457 W64727001 G03BA03 TESTOSTERONUM * TESTAVAN 20 mg/g GEL TRANSDERMIC 20mg/g FERRING CONTROLLED THERAPEUTICS LIMITED MAREA BRITANIE CUTIE CU 1 RECIPIENT MULTIDOZA CU POMPA DOZATOARE CARE CONTINE 85,5 G GEL TRANSDERMIC SI POATE ELIBERA 56 DOZE MASURATE PR/PRF 1 219,726994 17,833006 197,754294 39,805706
458 W59344003 G03BA03 TESTOSTERONUM * TESTIM 50 mg GEL TRANSDERMIC 50mg FERRING GMBH GERMANIA CUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMIC PR/PRF 30 5,903333 0,000000 5,312999 0,590334
459 W59232002 G03BA03 TESTOSTERONUM * NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER PHARMA AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 6 ML A 4 ML SOL. INJ. PR/PRF 1 449,819999 0,000001 404,837999 44,982001
460 W63885002 G03BA03 TESTOSTERONUM * NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 6 ML A 4 ML SOL. INJ. PR/PRF 1 449,819999 0,000001 404,837999 44,982001
461 W55402001 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 14,560000 0,000000 13,104000 1,456000
462 W62058001 G03CA03 ESTRADIOLUM * LENZETTO 1,53 mg/doza SPRAY TRANSDERMIC, SOL. 1,53mg/doza 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 28,318230 19,571770 25,486407 22,403593
463 W51724001 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 0,142987 0,713346 0,128688 0,727645
464 W51724001 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 0,142987 0,713346 0,128688 0,727645
465 W08648002 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 0,285975 0,335358 0,257377 0,363956
466 W08648002 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 0,285975 0,335358 0,257377 0,363956
467 W08649002 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 0,571950 0,100383 0,514755 0,157578
468 W08649002 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 0,571950 0,100383 0,514755 0,157578
469 W13893002 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 0,571950 0,434121 0,514755 0,491316
470 W13893002 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 0,571950 0,434121 0,514755 0,491316
471 W04237001 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 17,447499 4,122501 15,702749 5,867251
472 W08307001 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 PRF 1 8,723749 0,556251 7,851374 1,428626
473 W08310001 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 MLPRF 1 32,670000 0,000000 29,403000 3,267000
474 W05242001 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 0,095000 0,049000 0,085500 0,058500
475 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,095000 0,000000 0,085500 0,009500
476 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,095000 0,035333 0,085500 0,044833
477 W53341001 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 0,095000 0,045000 0,085500 0,054500
478 W44080001 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 3,723999 0,406001 3,351599 0,778401
479 W58639001 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 12,530000 0,000000 11,277000 1,253000
480 W58638001 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 3,723999 3,736001 3,351599 4,108401
481 W51922003 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 0,975315 3,684685 0,877783 3,782217
482 W56642001 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,438000 0,000000 0,394200 0,043800
483 W02885004 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,382000 0,000000 0,343800 0,038200
484 W00347001 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,324500 0,000000 0,292050 0,032450
485 W00346001 J01CA04 AMOXICILLINUM AMOXICILINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,355500 0,019500 0,319950 0,055050
486 W42903001 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,336000 0,000000 0,302400 0,033600
487 W00351001 J01CA04 AMOXICILLINUM AMOXICILINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,488249 0,144751 0,439424 0,193576
488 W08428003 J01CA04 AMOXICILLINUM AMOXICILINA FORTE FARMEX 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,488249 0,127751 0,439424 0,176576
489 W08428001 J01CA04 AMOXICILLINUM AMOXICILINA FORTE FARMEX 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0,459000 0,000000 0,413100 0,045900
490 W13739001 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 0,488249 0,132751 0,439424 0,181576
491 W42902001 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,488249 0,030751 0,439424 0,079576
492 W41600001 J01CA04 AMOXICILLINUM OSPAMOX 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.P-RF 12 0,875833 0,000000 0,788249 0,087584
493 W41578001 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 0,488249 0,029251 0,439424 0,078076
494 W42893001 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 2,133000 4,057000 1,919700 4,270300
495 W41580002 J01CA04 AMOXICILLINUM OSPAMOX (R) 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 5,1 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 2,133000 4,057000 1,919700 4,270300

Pagina 9 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
496 W42892002 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg/ 5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA 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 P-RF 1 4,266000 0,984000 3,839400 1,410600
497 W00388002 J01CA04 AMOXICILLINUM OSPAMOX 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 4,266000 0,914000 3,839400 1,340600
498 W41595001 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 0,315000 0,000000 0,283500 0,031500
499 W41594003 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN® 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. P-RF 12 0,481499 0,074334 0,433349 0,122484
500 W41596001 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 0,160499 0,077001 0,144449 0,093051
501 W55413001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE P-RF 1 0,213999 9,166001 0,192599 9,187401
502 W55416003 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 5,178279 0,711721 4,660451 1,229549
503 W55416002 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. P-RF 100 4,873100 0,000000 4,385790 0,487310
504 W04675002 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,323580 0,063920 0,291222 0,096278
505 W11729001 J01CF04 OXACILLINUM OXACILINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,323580 0,088420 0,291222 0,120778
506 W07274001 J01CF04 OXACILLINUM OXACILINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,647160 0,172840 0,582444 0,237556
507 W13743001 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,647160 0,028840 0,582444 0,093556
508 W12910001 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,588500 0,000000 0,529650 0,058850
509 W43092001 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,647160 0,121840 0,582444 0,186556
510 W12910003 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 0,647160 0,142840 0,582444 0,207556
511 W60469001 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 5,565099 0,244901 5,008589 0,801411
512 W60469003 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 4,830400 0,000000 4,347360 0,483040
513 W60468001 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 2,782549 2,577451 2,504294 2,855706
514 W60468003 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 2,782549 1,729151 2,504294 2,007406
515 W55354004 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 1,157278 0,573079 1,041550 0,688807
516 W00400003 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 1,012618 0,000239 0,911356 0,101501
517 W57628002 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 0,578639 0,043861 0,520775 0,101725
518 W54453002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500mg/125mg COMPR. FILM. 500mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 0,578639 0,043503 0,520775 0,101367
519 W55163002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA BRITANIE 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 P-RF 14 0,578639 0,377789 0,520775 0,435653
520 W64211008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg COMPR. FILM. 500mg/125mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 0,574285 0,000000 0,516856 0,057429
521 W55401002 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 1,012618 0,000239 0,911356 0,101501
522 W55164001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE 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 P-RF 14 1,012618 0,544524 0,911356 0,645786
523 W59497004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 875 mg/125 mg COMPR. FILM. 875mg/125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL INTRODUSE IN PUNGI DE POLIESTER/AL/POLIESTER/PE X 14 COMPR. FILM. PRF 14 1,012618 0,000239 0,911356 0,101501
524 W59497007 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 875 mg/125 mg COMPR. FILM. 875mg/125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL INTRODUSE IN PUNGI DE POLIESTER/AL/POLIESTER/PE X 21 COMPR. FILM. PRF 21 1,011904 0,000000 0,910713 0,101191
525 W64212008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM. 875mg/125mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,002857 0,000000 0,902571 0,100286
526 W62046002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 625mg SANDOZ S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 0,578639 0,711361 0,520775 0,769225
527 W00399001 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 9,029687 1,880313 8,126718 2,783282
528 W08783002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 14,100000 0,000000 12,690000 1,410000
529 W55355001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALA P-RF 1 10,113250 0,456750 9,101925 1,468075
530 W55355004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 10,113250 0,456750 9,101925 1,468075
531 W55355005 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA +LINGURITA DOZATOARE PRF 1 10,113250 0,686750 9,101925 1,698075
532 W55355006 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA +LINGURITA DOZATOARE PRF 1 20,226500 0,933500 18,203850 2,956150
533 W55342003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN ES 600mg/42,9 mg/5 ml PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CONTINÂND PULB. PENTRU 100 ML SUSPENSIE SI O LINGURITA DOZATOARE DIN POLISTIREN, MARCAT CU GRADATII PT. MASURAREA VOLUMELOR 2,5 ML SI 5,0 ML P-RF 1 37,470000 0,000000 33,723000 3,747000
534 W00402001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 312,5mg/5ml PULB. PT.SUSP. ORALA 312,5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 18,059375 1,940625 16,253437 3,746563
535 W01016005 J01DB01 CEFALEXINUM CEFALEXINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,488587 0,161413 0,439728 0,210272
536 W12083001 J01DB01 CEFALEXINUM CEFALEXINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0,488587 0,167913 0,439728 0,216772
537 W12084001 J01DB01 CEFALEXINUM CEFALEXINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,977175 0,170825 0,879457 0,268543
538 W06883003 J01DB01 CEFALEXINUM CEFALEXINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,977175 0,005825 0,879457 0,103543
539 W43520001 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,977175 0,116825 0,879457 0,214543
540 W41665001 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 1,436666 0,000000 1,292999 0,143667
541 W41666001 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 0,977175 0,105325 0,879457 0,203043
542 W44127002 J01DB01 CEFALEXINUM KEFLEX (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA P-RF
CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE 1 10,617500 0,832500 9,555750 1,894250
543 W43089001 J01DB01 CEFALEXINUM GRAN. PT. SUSP. ORALA 250mg/5ml
CEFALEXIN SANDOZ 250 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA SANDOZ SRL ROMANIA P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE 1 10,340000 0,000000 9,306000 1,034000
544 W41651001 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 10,340000 0,000000 9,306000 1,034000
545 W64364001 J01DB01 CEFALEXINUM KEFLEX® 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TEVA B.V. OLANDA PRF
CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE 1 10,617500 0,832500 9,555750 1,894250
546 W01001001 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 0,488587 1,537413 0,439728 1,586272
547 W41662001 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 0,977175 0,111825 0,879457 0,209543
548 W55436001 J01DB05 CEFADROXILUM CEFORAN 500 mg CAPS. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,977175 0,446825 0,879457 0,544543
549 W41663002 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 1,954350 0,450650 1,758915 0,646085
550 W41659001 J01DB05 CEFADROXILUM CEXYL 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA P-RF
CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE 1 5,308750 7,851250 4,777875 8,382125
551 W41660001 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 10,617500 1,402500 9,555750 2,464250

Pagina 10 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
552 W53168001 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 1,034100 0,114900 0,930690 0,218310
553 W53168002 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 1,034100 0,114900 0,930690 0,218310
554 W53169001 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 1,961000 0,000000 1,764900 0,196100
555 W53169002 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 1,961000 0,000000 1,764900 0,196100
556 W12655001 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 1,190000 0,000000 1,071000 0,119000
557 W12657001 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 1,034100 0,714900 0,930690 0,818310
558 W62257003 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 1,034100 0,114900 0,930690 0,218310
559 W12659001 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 2,068200 0,936800 1,861380 1,143620
560 W62258003 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 1,961000 0,000000 1,764900 0,196100
561 W12552001 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 12,719999 8,480001 11,447999 9,752001
562 W00985003 J01DC04 CEFACLORUM CEFACLOR ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,517050 1,138950 0,465345 1,190655
563 W56967001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250 mg CAPS. 250mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 0,517050 0,489616 0,465345 0,541321
564 W52029001 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 1,034100 0,825275 0,930690 0,928685
565 W55271001 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 1,034100 2,013900 0,930690 2,117310
566 W56966001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 500 mg CAPS. 500mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 1,034100 0,825900 0,930690 0,929310
567 W58458001 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 1,034100 1,681900 0,930690 1,785310
568 W58459001 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 1,551150 2,359850 1,396035 2,514965
569 W44130002 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 9,540000 4,390000 8,586000 5,344000
570 W56969001 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 9,540000 0,000000 8,586000 0,954000
571 W56968001 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 18,910000 0,000000 17,019000 1,891000
572 W44129002 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 19,080000 10,000000 17,172000 11,908000
573 W64369001 J01DC04 CEFACLORUM CECLOR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. PEID CONTINAND GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE DIN POLISTIREN PRF 1 19,080000 10,000000 17,172000 11,908000
574 W12210001 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 7,631999 1,908001 6,868799 2,671201
575 W51321001 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 15,263999 2,146001 13,737599 3,672401
576 W57455001 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 2,152250 0,201750 1,937025 0,416975
577 W13701001 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,799000 0,000000 3,419100 0,379900
578 W60256001 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 8,609000 1,943000 7,748100 2,803900
579 W60256003 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 8,609000 1,413000 7,748100 2,273900
580 W63368003 J01DD08 CEFIXIMUM CEFIXIMA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 8,340000 0,000000 7,506000 0,834000
581 W61965002 J01DD08 CEFIXIMUM XIFIA 100 mg/5 ml GRANULE PT. SUSP. ORALA 100mg/5ml 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 43,045000 34,275000 38,740500 38,579500
582 W05741001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,380000 0,041500 0,342000 0,079500
583 W05738001 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 0,366500 0,000000 0,329850 0,036650
584 W12479001 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 0,380000 0,004500 0,342000 0,042500
585 W53671001 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 0,380000 0,041500 0,342000 0,079500
586 W44046001 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 4,960000 0,000000 4,464000 0,496000
587 W05739001 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 4,425750 5,944250 3,983175 6,386825
588 W02983002 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,386500 0,000000 0,347850 0,038650
589 W61210001 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,438942 0,085058 0,395047 0,128953
590 W62391001 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 2,194713 0,591287 1,975241 0,810759
591 W63492001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg MYLAN PRODUCTS LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2,194713 0,591287 1,975241 0,810759
592 W14043001 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 1,097356 0,121929 0,987620 0,231665
593 W44093001 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 1,097356 0,048358 0,987620 0,158094
594 W08490001 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 1,097356 0,203358 0,987620 0,313094
595 W60253004 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 0,885714 0,000000 0,797142 0,088572
596 W62390002 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 1,097356 0,953358 0,987620 1,063094
597 W14044001 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 2,012857 0,000000 1,811571 0,201286
598 W44087001 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 2,148571 0,000000 1,933713 0,214858
599 W08491001 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 2,024285 0,000000 1,821856 0,202429
600 W54044001 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 1,947500 0,000000 1,752750 0,194750
601 W60254003 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 1,777142 0,000000 1,599427 0,177715
602 W41838002 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 2,194713 0,369572 1,975241 0,589044
603 W62389002 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 24,870376 2,799624 22,383338 5,286662
604 W44092001 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 13,500000 0,000000 12,150000 1,350000
605 W62389001 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 14,922225 5,847775 13,430002 7,339998
606 W44091001 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 29,844451 3,645549 26,860005 6,629995
607 W58393002 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 17,800000 0,000000 16,020000 1,780000

Pagina 11 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
608 W62343001 J01FA09 CLARITHROMYCINUM KLACID I.V. 500 mg PULB. PT. CONC. PT. SOL. PERF. 500mg MYLAN MEDICAL SAS FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA I, DE CAPACITATE 15 ML CONTINAND PULB. PT. CONC. PT. SOL. PERF. PRF 1 41,630000 0,000000 37,467000 4,163000
609 W07914001 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,019375 1,098562 0,141438
610 W53584001 J01MA01 OFLOXACINUM OFLOXACINA LAROPHARM 200 mg COMPR. FILM. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10COMPR. FILM.P-RF 10 1,220625 0,019375 1,098562 0,141438
611 W56957001 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,965375 1,098562 1,087438
612 W54037001 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 0,244125 3,832875 0,219712 3,857288
613 W54037002 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 0,244125 3,340875 0,219712 3,365288
614 W44077004 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 0,610312 0,109688 0,549280 0,170720
615 W01273001 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 0,610312 0,133688 0,549280 0,194720
616 W01288001 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 0,610312 0,109688 0,549280 0,170720
617 W01271002 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 0,610312 0,135688 0,549280 0,196720
618 W07862001 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 0,610312 0,146688 0,549280 0,207720
619 W54038001 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 0,610312 0,107688 0,549280 0,168720
620 W54038002 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 0,610312 0,061688 0,549280 0,122720
621 W62110003 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 0,518000 0,000000 0,466200 0,051800
622 W01274001 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 1,220625 0,026375 1,098562 0,148438
623 W44076001 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 0,969000 0,000000 0,872100 0,096900
624 W01289001 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 1,220625 0,172375 1,098562 0,294438
625 W01272001 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 1,220625 0,223375 1,098562 0,345438
626 W07863001 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 0,958000 0,000000 0,862200 0,095800
627 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,223375 1,098562 0,345438
628 W54039001 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 1,008000 0,000000 0,907200 0,100800
629 W54039002 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 0,897500 0,000000 0,807750 0,089750
630 W62111003 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 0,758000 0,000000 0,682200 0,075800
631 W42772001 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 1,083000 0,000000 0,974700 0,108300
632 W54040001 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 1,830937 2,246063 1,647843 2,429157
633 W57948001 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 2,441250 10,647321 2,197125 10,891446
634 W63880001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,441250 10,647321 2,197125 10,891446
635 W57949001 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 1,220625 8,739375 1,098562 8,861438
636 W63879001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 1,220625 8,739375 1,098562 8,861438
637 W52445001 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 1,220625 1,824375 1,098562 1,946438
638 W14009001 J01MA06 NORFLOXACINUM NORFLOXACIN LAROPHARM 400 mg COMPR. FILM. 400mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,859000 0,104000 0,773100 0,189900
639 W41800001 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,859000 0,000000 0,773100 0,085900
640 W07984001 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 0,832000 0,000000 0,748800 0,083200
641 W58303001 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 0,859000 0,068000 0,773100 0,153900
642 W62811001 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 0,859000 0,068000 0,773100 0,153900
643 W42791002 J01MB02 ACIDUM NALIDIXICUM NALIXID 500 mg CAPS. 500mg ZENTIVA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 1,066666 0,000000 0,959999 0,106667
644 W53689002 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 0,251666 0,000000 0,226499 0,025167
645 W53689002 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 0,251666 0,000000 0,226499 0,025167
646 W08257001 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 0,344700 0,038300 0,310230 0,072770
647 W63535001 J01XD01 METRONIDAZOLUM FLAGYL 250 mg (vezi P01AB01) COMPR. FILM. 250mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,344700 0,038300 0,310230 0,072770
648 W08257001 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 0,344700 0,038300 0,310230 0,072770
649 W63535001 J01XD01 METRONIDAZOLUM FLAGYL 250 mg (vezi P01AB01) COMPR. FILM. 250mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,344700 0,038300 0,310230 0,072770
650 W42139002 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 9,129166 0,000000 8,216249 0,912917
651 W42139001 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 9,434583 0,505417 8,491124 1,448876
652 W42138002 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 8,950833 0,000000 8,055749 0,895084
653 W42138001 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 9,434583 0,305417 8,491124 1,248876
654 W08927001 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 10 4,717291 0,555709 4,245561 1,027439
655 W08927002 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 4,717291 0,555709 4,245561 1,027439
656 W08927003 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 4,717291 0,290709 4,245561 0,762439
657 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 3,086613 3,653387 2,777951 3,962049
658 W43597002 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 3,086613 1,674815 2,777951 1,983477
659 W58225007 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 3,086613 0,263387 2,777951 0,572049
660 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072
661 W03156001 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 4,629920 6,990080 4,166928 7,453072
662 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.P-RF 1 4,629920 2,920080 4,166928 3,383072
663 W43598001 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 4,629920 2,030080 4,166928 2,493072

Pagina 12 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
664 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072
665 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 2,900080 4,166928 3,363072
666 W52334001 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 4,629920 2,900080 4,166928 3,363072
667 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072
668 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4,629920 2,900080 4,166928 3,363072
669 W57430001 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 4,629920 2,900080 4,166928 3,363072
670 W58226001 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 4,629920 1,670080 4,166928 2,133072
671 W60221003 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 4,629920 2,920080 4,166928 3,383072
672 W60221001 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 4,629920 2,920080 4,166928 3,383072
673 W43599002 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 6,145714 0,000000 5,531142 0,614572
674 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,543306 1,383836 1,388975 1,538167
675 W03157001 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 1,543306 2,960979 1,388975 3,115310
676 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.P-RF 7 1,543306 1,383836 1,388975 1,538167
677 W43596001 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 1,543306 0,528122 1,388975 0,682453
678 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,543306 1,382408 1,388975 1,536739
679 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,543306 0,976694 1,388975 1,131025
680 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,543306 1,383836 1,388975 1,538167
681 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,543306 0,182408 1,388975 0,336739
682 W58322002 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PEÎD, DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CE CONTINE PULB. PENTRU 35 ML SUSP. ORALA SI O SERINGA DIN PP DE 5 ML CU MARCAJ LA FIECARE 0,2 ML PRF 1 10,803148 20,026852 9,722833 21,107167
683 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,846337 0,257663 0,761703 0,342297
684 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,846337 0,323163 0,761703 0,407797
685 W56038001 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 0,846337 0,281663 0,761703 0,366297
686 W53676001 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 1,692675 0,435325 1,523407 0,604593
687 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,846337 0,090663 0,761703 0,175297
688 W06667003 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 0,755000 0,000000 0,679500 0,075500
689 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,846337 0,095163 0,761703 0,179797
690 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,846337 0,095163 0,761703 0,179797
691 W06668003 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 1,692675 1,211325 1,523407 1,380593
692 W00058001 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 49,248000 0,000000 44,323200 4,924800
693 W42120001 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 0,072337 0,016163 0,065103 0,023397
694 W53947002 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MG CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,072337 0,005329 0,065103 0,012563
695 W53948002 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,144674 0,047826 0,130206 0,062294
696 W03600001 M01AB01 INDOMETACINUM INDOMETACIN ATB 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 0,270900 0,474100 0,243810 0,501190
697 W03609001 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,270900 0,453100 0,243810 0,480190
698 W12694002 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0,270900 0,450100 0,243810 0,477190
699 W44020001 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 0,434022 2,145478 0,390619 2,188881
700 W63730001 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P6L 20 0,434022 2,145478 0,390619 2,188881
701 W53220001 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 0,217011 0,369655 0,195309 0,391357
702 W02472002 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 20 0,289348 0,083652 0,260413 0,112587
703 W13296001 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 0,173000 0,000000 0,155700 0,017300
704 W51307003 M01AB05 DICLOFENACUM REFEN RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P6L 20 0,289348 0,080652 0,260413 0,109587
705 W51307002 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 0,289348 0,080652 0,260413 0,109587
706 W02459003 M01AB05 DICLOFENACUM DICLOFENAC 50 mg 50mg
COMPR. FILM. GASTROREZ. TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,123500 0,000000 0,111150 0,012350
707 W60292001 M01AB05 DICLOFENACUM DICLOFENAC HELCOR 50 mg 50mg
COMPR. FILM. GASTROREZ. A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,123500 0,000000 0,111150 0,012350
708 W54364001 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 0,072337 0,135663 0,065103 0,142897
709 W54363004 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 0,123333 0,000000 0,110999 0,012334
710 W55024001 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 0,888000 0,000000 0,799200 0,088800
711 W14114001 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0,541800 0,056533 0,487620 0,110713
712 W12288001 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,541800 0,056200 0,487620 0,110380
713 W02480002 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 0,541800 0,060200 0,487620 0,114380
714 W60401001 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 0,067725 0,568941 0,060952 0,575714
715 W60401002 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 0,067725 0,564275 0,060952 0,571048
716 W56142001 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 0,096449 0,272051 0,086804 0,281696
717 W44108003 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 0,096449 0,456551 0,086804 0,466196
718 W44107001 M01AB15 KETOROLACUM TROMETHAMIN KETANOV SOL. INJ. 30mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML P-RF 10 1,927800 0,776200 1,735020 0,968980
719 W56143003 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 1,927800 0,214200 1,735020 0,406980

Pagina 13 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
720 W61916001 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 1,927800 0,214200 1,735020 0,406980
721 W61916002 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 1,927800 0,214200 1,735020 0,406980
722 W57635001 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 0,144674 0,359326 0,130206 0,373794
723 W61427001 M01AB16 ACECLOFENACUM AFLAMIL 100 mg PULB. PT.SUSP. ORALA 100mg GEDEON RICHTER ROMANIA S.A. ROMANIA P6L 20 0,144674
CUTIE CU 20 PLICURI UNIDOZA DIN MATERIAL COMPLEX DIN HARTIE DE TIP OPALINA LAMINATA PE UN STRAT DE ALUMINIU (20 ΜM) SI FILM DIN PEJD 1,264326 0,130206 1,278794
724 W56784001 M01AC02 TENOXICAMUM TENOXICAM ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,341100 0,429400 0,306990 0,463510
725 W12900001 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 0,341100 0,351900 0,306990 0,386010
726 W12899001 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) 20mg
LIOF. + SOLV. PT. SOL. INJ. ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF 1 2,068000 3,862000 1,861200 4,068800
727 W04103001 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 0,341100 0,241900 0,306990 0,276010
728 W04103002 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 0,341100 0,242900 0,306990 0,277010
729 W43917001 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 0,341100 0,037900 0,306990 0,072010
730 W53657001 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 0,341100 0,037900 0,306990 0,072010
731 W60286002 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 0,341100 0,027900 0,306990 0,062010
732 W42654003 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0,341100 0,037900 0,306990 0,072010
733 W04104002 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 0,170550 0,299450 0,153495 0,316505
734 W04104001 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 0,170550 0,298450 0,153495 0,315505
735 W43916001 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 0,170550 0,135450 0,153495 0,152505
736 W53656001 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 0,170550 0,135450 0,153495 0,152505
737 W53827001 M01AC06 MELOXICAMUM MELOXICAM LAROPHARM 7,5 mg COMPR. 7,5mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. P-6L 20 0,170550 0,134450 0,153495 0,151505
738 W42653003 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 0,170550 0,134450 0,153495 0,151505
739 W61229001 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 3 2,063333 0,000000 1,856999 0,206334
740 W61229002 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 5 2,068000 0,000000 1,861200 0,206800
741 W60600001 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 2,068000 0,000000 1,861200 0,206800
742 W08929002 M01AC06 MELOXICAMUM MOVALIS 15mg/1,5ml SOL. INJ. 15mg/1,5ml BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1,5 ML SIL. INJ. P-RF 5 2,068000 0,000000 1,861200 0,206800
743 W41449001 M01AC06 MELOXICAMUM MELOXICAM 15 mg SUPOZ. 15mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 1,007500 0,712500 0,906750 0,813250
744 W42896001 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 0,741712 0,149788 0,667540 0,223960
745 W54212001 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 0,678000 0,000000 0,610200 0,067800
746 W03880001 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 0,741712 0,079788 0,667540 0,153960
747 W12622001 M01AE03 KETOPROFENUM PROFENID (R) 100 mg COMPR. FILM. 100mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM. P-6L 30 0,440666 0,000000 0,396599 0,044067
748 W43110001 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 0,295000 0,000000 0,265500 0,029500
749 W63532001 M01AE03 KETOPROFENUM PROFENID 100 mg COMPR. FILM. 100mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM. P6L 30 0,440666 0,000000 0,396599 0,044067
750 W43111001 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 0,247237 0,128763 0,222513 0,153487
751 W60385001 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 1,198000 0,000000 1,078200 0,119800
752 W60385002 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 1,196000 0,000000 1,076400 0,119600
753 W03881002 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 1,023000 0,000000 0,920700 0,102300
754 W54214001 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 1,198000 0,904000 1,078200 1,023800
755 W14020001 M01AE03 KETOPROFENUM KETOMAG SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L 10 0,712999 0,000001 0,641699 0,071301
756 W00242001 M04AA01 ALLOPURINOLUM * MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 0,165110 0,014490 0,148599 0,031001
757 W00242003 M04AA01 ALLOPURINOLUM * MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 COMPR. P6L 60 0,165110 0,012556 0,148599 0,029067
758 W00243001 M04AA01 ALLOPURINOLUM * MILURIT 300 mg COMPR. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 0,457666 0,000000 0,411899 0,045767
759 W01429002 M04AC01 COLCHICINUM COLCHICINA COMPR. 1mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-RF 40 0,157250 0,000000 0,141525 0,015725
760 W12691002 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,278186 0,037814 0,250367 0,065633
761 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,278186 0,213314 0,250367 0,241133
762 W60291001 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 0,278186 0,126814 0,250367 0,154633
763 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,278186 0,141814 0,250367 0,169633
764 W42957001 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,278186 0,126314 0,250367 0,154133
765 W58072001 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 0,556374 0,132292 0,500736 0,187930
766 W60236002 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 0,556374 0,107292 0,500736 0,162930
767 W61448003 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 0,556333 0,000000 0,500699 0,055634
768 W63391001 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 0,556374 0,113626 0,500736 0,169264
769 W63391003 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 0,556374 0,113626 0,500736 0,169264
770 W58893002 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 0,834562 0,028438 0,751105 0,111895
771 W60237002 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 0,834562 0,118104 0,751105 0,201561
772 W61449001 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 0,834000 0,000000 0,750600 0,083400
773 W61449003 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 0,833666 0,000000 0,750299 0,083367
774 W61449011 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 0,834000 0,000000 0,750600 0,083400
775 W61449013 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 0,833666 0,000000 0,750299 0,083367

Pagina 14 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
776 W63389001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL.P-RF 10 0,834562 0,029438 0,751105 0,112895
777 W63389002 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PP/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 0,834562 0,029438 0,751105 0,112895
778 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.
LANNACHER HEILMITTEL GES.M.B.H. PRF 30 1,112749 0,000251 1,001474 0,111526
779 W61450003 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 1,076000 0,000000 0,968400 0,107600
780 W43360001 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 0,834562 0,472771 0,751105 0,556228
781 W43361001 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 1,112749 0,613584 1,001474 0,724859
782 W64091001 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 5 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 5 2,221904 0,566096 1,999713 0,788287
783 W64091002 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 100 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 100 2,221904 0,209696 1,999713 0,431887
784 W64091003 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 2 TAVITE DIN PVC CU 10 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 10 2,221904 0,568096 1,999713 0,790287
785 W05961001 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 1,976000 0,000000 1,778400 0,197600
786 W05966001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 1,076000 0,000000 0,968400 0,107600
787 W05967001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 2,221904 0,640096 1,999713 0,862287
788 W05969001 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 1,218000 0,000000 1,096200 0,121800
789 W59300001 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 9,878333 6,416667 8,890499 7,404501
790 W59299001 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 4,939166 3,575834 4,445249 4,069751
791 W56161005 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 9,878333 0,000000 8,890499 0,987834
792 W59112004 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 6,791666 0,000000 6,112499 0,679167
793 W56160005 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 4,939166 0,699167 4,445249 1,193084
794 W51397003 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 0,149350 0,068850 0,134415 0,083785
795 W00796003 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH (R) 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE P6L 60 0,149166 0,000000 0,134249 0,014917
796 W00806001 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,149200 0,000000 0,134280 0,014920
797 W00797001 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,149350 0,000150 0,134415 0,015085
798 W00798002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,149350 0,000150 0,134415 0,015085
799 W62172002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA TERAPIA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,149200 0,000000 0,134280 0,014920
800 W62477001 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA FARMEX 200 mg COMPR. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,146500 0,000000 0,131850 0,014650
801 W62477002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA FARMEX 200 mg COMPR. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,148000 0,000000 0,133200 0,014800
802 W00807001 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,298700 0,114500 0,268830 0,144370
803 W53816001 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 0,298700 0,114300 0,268830 0,144170
804 W58631001 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 150 mg 150mg
COMPR. CU ELIB. PRELUNGITA DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA P6L 50 0,112012 0,207788 0,100810 0,218990
805 W58632001 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 300 mg 300mg
COMPR. CU ELIBERARE PRELUNGITA DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,224025 0,210575 0,201622 0,232978
806 W58633001 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 600 mg 600mg
COMPR. CU ELIBERARE PRELUNGITA DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,448050 0,322350 0,403245 0,367155
807 W12426001 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 0,224025 0,121175 0,201622 0,143578
808 W63239001 N03AF01 CARBAMAZEPINUM NEUROTOP RETARD 300 mg COMPR. ELIB. PREL. 300mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P6L 50 0,224025 0,121175 0,201622 0,143578
809 W12428001 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 0,448050 0,252150 0,403245 0,296955
810 W63238001 N03AF01 CARBAMAZEPINUM NEUROTOP RETARD 600 mg COMPR. ELIB. PREL. 600mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P6L 50 0,448050 0,252150 0,403245 0,296955
811 W51395001 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 0,149350 0,216450 0,134415 0,231385
812 W51394001 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 0,298700 0,337633 0,268830 0,367503
813 W00825001 N03AF01 CARBAMAZEPINUM TIMONIL SIROP SUSP. ORALA 100mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 24,590000 0,000000 22,131000 2,459000
814 W56688004 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 0,129784 0,027416 0,116805 0,040395
815 W64281004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L
AUROBINDO PHARMA ROMANIA S.R.L. 50 0,129784 0,027416 0,116805 0,040395
816 W54332002 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 0,129784 0,477382 0,116805 0,490361
817 W60025001 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 0,129784 0,299049 0,116805 0,312028
818 W56689004 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 0,389355 0,082045 0,350419 0,120981
819 W64282004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,389355 0,082045 0,350419 0,120981
820 W41589005 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 0,389355 0,406945 0,350419 0,445881
821 W42824001 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 0,389355 1,029045 0,350419 1,067981
822 W43540001 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 0,389355 0,066645 0,350419 0,105581
823 W54333001 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 0,389355 0,216811 0,350419 0,255747
824 W60026001 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 0,389355 0,555811 0,350419 0,594747
825 W64360001 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,389355 0,066645 0,350419 0,105581
826 W56690004 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 0,519141 0,110059 0,467226 0,161974
827 W64283004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,519141 0,110059 0,467226 0,161974
828 W41590005 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 0,519141 0,737359 0,467226 0,789274
829 W42825001 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 0,519141 1,070259 0,467226 1,122174
830 W43541001 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 0,519141 0,088459 0,467226 0,140374
831 W54334001 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 0,519141 0,563692 0,467226 0,615607

Pagina 15 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
832 W60027001 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 0,519141 0,662359 0,467226 0,714274
833 W64361001 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,519141 0,088459 0,467226 0,140374
834 W42826001 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 0,778712 1,516954 0,700840 1,594826
835 W52419001 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 0,126843 0,049657 0,114158 0,062342
836 W60383001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,253687 0,027313 0,228318 0,052682
837 W60384001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATEPRF 30 0,393000 0,000000 0,353700 0,039300
838 W56620001 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 5,073750 0,616250 4,566375 1,123625
839 W61980001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg/ml PIC. ORALE, SOL. 2mg/ml ARENA GROUP S.A. ROMANIA PRF
CUTIE CU 1 FLAC. DIN STICLA BRUNA CARE CONTINE 10 ML PICATURI ORALE, SOL., PREVAZUT CU PICURATOR DIN PEJD 1 5,073750 2,156250 4,566375 2,663625
840 W03427002 N05AD01 HALOPERIDOLUM HALOPERIDOL - RICHTER 2mg/ml PIC. 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 5,073750 2,186250 4,566375 2,693625
841 W61141001 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 50 mg/ml SOL. INJ. 50mg/ml GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 5 8,902000 0,000000 8,011800 0,890200
842 W54845001 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 0,770765 1,553235 0,693688 1,630312
843 W02443001 N05BA01 DIAZEPAMUM DIAZEPAM RICHTER 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,108500 0,000000 0,097650 0,010850
844 W12717001 N05BA01 DIAZEPAMUM DIAZEPAM COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 0,146000 0,000000 0,131400 0,014600
845 W52908001 N05BA01 DIAZEPAMUM DIAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,113500 0,000000 0,102150 0,011350
846 W60414001 N05BA01 DIAZEPAMUM DIAZEPAM 5 mg/ml SOL. INJ. 10mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 2,514000 0,000000 2,262600 0,251400
847 W10514001 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 PRF 5 5,452000 0,000000 4,906800 0,545200
848 W10515001 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 PRF 5 4,770000 0,000000 4,293000 0,477000
849 W60895002 N05BA03 MEDAZEPAMUM * MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLISTERE PVC/AL X 10 COMPRIMATEP-RF 20 0,134000 0,000000 0,120600 0,013400
850 W60895003 N05BA03 MEDAZEPAMUM * MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 5 BLISTERE PVC/AL X 10 COMPRIMATEP-RF 50 0,122600 0,000000 0,110340 0,012260
851 W12943002 N05BA03 MEDAZEPAMUM * MEDAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 20 COMPR. P-RF 20 0,138812 0,027688 0,124930 0,041570
852 W53797001 N05BA03 MEDAZEPAMUM * MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,135000 0,000000 0,121500 0,013500
853 W53797002 N05BA03 MEDAZEPAMUM * MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,134666 0,000000 0,121199 0,013467
854 W41692001 N05BA06 LORAZEPAMUM * ANXIAR (R) 1 mg COMPR. 1 mg ROMANIA
GEDEON RICHTER ROMANIA SA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0,111050 0,034950 0,099945 0,046055
855 W06824001 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 1,5 mg COMPR. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,041643 0,074857 0,037478 0,079022
856 W06824003 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 0,041643 0,075023 0,037478 0,079188
857 W06826001 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,083287 0,030213 0,074958 0,038542
858 W55412001 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 0,083287 0,030713 0,074958 0,039042
859 W06826003 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 0,083287 0,030379 0,074958 0,038708
860 W00252001 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 0,069406 0,128927 0,062465 0,135868
861 W08624001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,25 mg COMPR. 0,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,069406 0,062094 0,062465 0,069035
862 W08624003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,25 mg COMPR. 0,25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,069406 0,061927 0,062465 0,068868
863 W41469001 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 0,069406 0,062594 0,062465 0,069535
864 W07122001 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 0,069406 0,061927 0,062465 0,068868
865 W59969001 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 0,069406 0,061594 0,062465 0,068535
866 W59969002 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 0,069406 0,062094 0,062465 0,069035
867 W59969003 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 0,069406 0,061927 0,062465 0,068868
868 W00253001 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 0,138812 0,162521 0,124930 0,176403
869 W08625003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,5 mg COMPR. 0,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,138812 0,070854 0,124930 0,084736
870 W08625001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,5 mg COMPR. 0,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,138812 0,070688 0,124930 0,084570
871 W07123001 N05BA12 ALPRAZOLAMUM * FRONTIN 0,5 mg COMPR. 0,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,138812 0,070854 0,124930 0,084736
872 W42783001 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 0,138812 0,071188 0,124930 0,085070
873 W59972001 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 0,138812 0,071188 0,124930 0,085070
874 W59972002 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 0,138812 0,070688 0,124930 0,084570
875 W59972003 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 0,138812 0,070854 0,124930 0,084736
876 W00254001 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 0,277625 0,138375 0,249862 0,166138
877 W08626003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,277333 0,000000 0,249599 0,027734
878 W08626001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,277500 0,000000 0,249750 0,027750
879 W41470001 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 0,277625 0,000375 0,249862 0,028138
880 W07126001 N05BA12 ALPRAZOLAMUM * FRONTIN 1mg COMPR. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,277625 0,000375 0,249862 0,028138
881 W59973001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0,277000 0,000000 0,249300 0,027700
882 W59973002 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,277625 0,000375 0,249862 0,028138
883 W59973003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,277625 0,000375 0,249862 0,028138
884 W12245003 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH® 2,5 mg COMPR. 2.5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,058950 0,016050 0,053055 0,021945
885 W59781001 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 0,117900 0,013100 0,106110 0,024890
886 W12246003 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH® 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,085666 0,000000 0,077099 0,008567
887 W43099001 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 0,382000 0,000000 0,343800 0,038200

Pagina 16 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
888 W64484001 N05CF01 ZOPICLONUM * IMOVANE 7,5 mg COMPR. FILM. 7,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. PRF 20 0,382000 0,000000 0,343800 0,038200
889 W13133001 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 0,236000 0,000000 0,212400 0,023600
890 W13133002 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 0,235000 0,000000 0,211500 0,023500
891 W53913001 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 0,236000 0,000000 0,212400 0,023600
892 W54358001 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 0,236000 0,128000 0,212400 0,151600
893 W54358002 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 0,236000 0,127500 0,212400 0,151100
894 W54358003 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 0,236000 0,127500 0,212400 0,151100
895 W62440001 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 0,236000 0,128000 0,212400 0,151600
896 W62440002 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 0,236000 0,127500 0,212400 0,151100
897 W62440003 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 0,236000 0,127500 0,212400 0,151100
898 W01358001 N06AA04 CLOMIPRAMINUM * ANAFRANIL (R) 10 mg DRAJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,153166 0,104500 0,137849 0,119817
899 W01359001 N06AA04 CLOMIPRAMINUM * ANAFRANIL (R) 25 mg DRAJ. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,382916 0,102417 0,344624 0,140709
900 W52017001 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 0,327800 0,000000 0,295020 0,032780
901 W02865001 N06AA12 DOXEPINUM * DOXEPIN 25 mg DRAJ. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,382916 0,417417 0,344624 0,455709
902 W60729001 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,241108 0,490892 0,216997 0,515003
903 W60729002 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,241108 0,444992 0,216997 0,469103
904 W13241001 N06AB03 FLUOXETINUM * FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 CAPS. P-RF 14 0,482217 0,364925 0,433995 0,413147
905 W13241002 N06AB03 FLUOXETINUM * FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS. P-RF 28 0,482217 0,347783 0,433995 0,396005
906 W08497001 N06AB03 FLUOXETINUM * MAGRILAN 20 mg CAPS. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 0,444666 0,000000 0,400199 0,044467
907 W60730001 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,482217 0,361783 0,433995 0,410005
908 W60730002 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,482217 0,263483 0,433995 0,311705
909 W10228001 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 0,482217 0,902425 0,433995 0,950647
910 W43706001 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 0,482217 0,958116 0,433995 1,006338
911 W41796001 N06AB05 PAROXETINUM * ARKETIS COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-RF 30 0,482217 0,065449 0,433995 0,113671
912 W57051001 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 0,482217 0,167449 0,433995 0,215671
913 W04913003 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 0,482217 0,423783 0,433995 0,472005
914 W43958002 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 0,482217 0,065449 0,433995 0,113671
915 W64362002 N06AB05 PAROXETINUM * PAXETIN 20 mg COMPR. FILM. 20mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. OPA-AL-PVC/PVC-AL-OPA X 10 COMPR. FILM. PRF 30 0,482217 0,065449 0,433995 0,113671
916 W44097001 N06AB06 SERTRALINUM * SERLIFT 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 0,964434 0,385923 0,867990 0,482367
917 W12874001 N06AB06 SERTRALINUM * ASENTRA (R) COMPR. FILM. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 0,964434 0,169137 0,867990 0,265581
918 W52511006 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 0,758214 0,000000 0,682392 0,075822
919 W55563001 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 0,964434 0,385566 0,867990 0,482010
920 W59051001 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 0,951333 0,000000 0,856199 0,095134
921 W59303002 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 0,964434 0,385566 0,867990 0,482010
922 W60444001 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 0,964434 0,385899 0,867990 0,482343
923 W61376006 N06AB06 SERTRALINUM * SERTRALINA AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,392333 0,000000 0,353099 0,039234
924 W63954004 N06AB06 SERTRALINUM * SERTRALINA ACCORD 100 mg COMPR. FILM. 100mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,740666 0,000000 0,666599 0,074067
925 W44096001 N06AB06 SERTRALINUM * SERLIFT 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 0,482217 0,280640 0,433995 0,328862
926 W12873001 N06AB06 SERTRALINUM * ASENTRA (R) COMPR. FILM. 50mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 0,461785 0,000000 0,415606 0,046179
927 W52510006 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 0,373571 0,000000 0,336213 0,037358
928 W55562001 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 0,482217 0,303497 0,433995 0,351719
929 W59050001 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 0,475666 0,000000 0,428099 0,047567
930 W59302001 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 0,482217 0,079783 0,433995 0,128005
931 W60443001 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 0,482217 0,256449 0,433995 0,304671
932 W61375006 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 0,386333 0,000000 0,347699 0,038634
933 W63953004 N06AB06 SERTRALINUM * SERTRALINA ACCORD 50 mg COMPR. FILM. 50mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,365666 0,000000 0,329099 0,036567
934 W55564001 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 11,573215 42,766785 10,415893 43,924107
935 W62371001 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 0,482217 0,654116 0,433995 0,702338
936 W64560001 N06AB08 FLUVOXAMINUM * FEVARIN 100 COMPR. FILM. 100mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 2 BLIST. PVC/PVDC X 15 COMPR. FILM. PRF 30 0,482217 0,654116 0,433995 0,702338
937 W62372001 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 0,241108 0,346892 0,216997 0,371003
938 W64561001 N06AB08 FLUVOXAMINUM * FEVARIN 50 COMPR. FILM. 50mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 2 BLIST. PVC/PVDC X 15 COMPR. FILM. PRF 30 0,241108 0,346892 0,216997 0,371003
939 W12823003 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 0,509166 1,417500 0,458249 1,468417
940 W60361001 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 0,254583 0,641750 0,229124 0,667209
941 W42062001 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 0,507333 0,000000 0,456599 0,050734
942 W44013002 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 0,509166 0,351500 0,458249 0,402417
943 W56832001 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 0,507000 0,000000 0,456300 0,050700

Pagina 17 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
944 W60362001 N06AX11 MIRTAZAPINUM * MIRTAZAPIN ARENA 30 mg COMPR. FILM. 30mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.
PRF 30 0,502333 0,000000 0,452099 0,050234
945 W64105002 N06AX11 MIRTAZAPINUM * VALDREN 30 mg COMPR. FILM. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU 3 BLIST. ALBE OPACE PVC/PVDC/AL X 10 COMPR. FILM.PRF 30 0,509166 0,045167 0,458249 0,096084
946 W64363002 N06AX11 MIRTAZAPINUM * PHARMATAZ 30 mg COMPR. FILM. 30mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 0,509166 0,351500 0,458249 0,402417
947 W60363001 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 0,763749 1,472917 0,687374 1,549292
948 W53476002 N06AX11 MIRTAZAPINUM * ZULIN 30 mg 30mg
COMPR. ORODISPERSABILE ANTIBIOTICE S.A. ROMANIA CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE P-RF 30 0,509166 0,001834 0,458249 0,052751
949 W63233003 N06AX11 MIRTAZAPINUM * REMERON SOLTAB 30 mg 30mg
COMPR. ORODISPERSABILE MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC-PA-POLIESTER PERFORATE PT. ELIB. UNEI UNITATI DOZATE X 6 COMPR. ORODISPERSABILE PRF 30 0,509166 1,417500 0,458249 1,468417
950 W56742002 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 0,882838 1,038947 0,794554 1,127231
951 W58756003 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 0,882838 0,168495 0,794554 0,256779
952 W64861002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,882838 1,038947 0,794554 1,127231
953 W52122001 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 0,882838 0,495376 0,794554 0,583660
954 W52962005 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 0,584000 0,000000 0,525600 0,058400
955 W54057002 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 0,882838 0,018947 0,794554 0,107231
956 W55396001 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 0,882838 0,495495 0,794554 0,583779
957 W61609006 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 0,703666 0,000000 0,633299 0,070367
958 W53268003 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 0,220709 0,407291 0,198638 0,429362
959 W55395001 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 0,220709 0,654957 0,198638 0,677028
960 W56741002 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 0,441419 0,665366 0,397277 0,709508
961 W58755003 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 0,441419 0,209247 0,397277 0,253389
962 W64860002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,441419 0,665366 0,397277 0,709508
963 W52123001 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 0,441419 0,490723 0,397277 0,534865
964 W52961005 N06AX16 VENLAFAXINUM ** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,343000 0,000000 0,308700 0,034300
965 W53269003 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 0,441419 0,256581 0,397277 0,300723
966 W54056002 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 0,441419 0,250366 0,397277 0,294508
967 W55397001 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 0,441419 0,484581 0,397277 0,528723
968 W61608006 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 0,413000 0,000000 0,371700 0,041300
969 W55398001 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 0,220709 0,654957 0,198638 0,677028
970 W55399001 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 0,294279 0,597721 0,264851 0,627149
971 W55400001 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 0,441419 0,484581 0,397277 0,528723
972 W52959001 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 0,700666 0,000000 0,630599 0,070067
973 W52958001 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 0,412000 0,000000 0,370800 0,041200
974 W52868001 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 0,731500 0,018000 0,658350 0,091150
975 W52868002 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. P-6L 60 0,725500 0,000000 0,652950 0,072550
976 W42888001 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 0,689400 0,320600 0,620460 0,389540
977 W10714001 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0,689400 0,280600 0,620460 0,349540
978 W42888001 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 0,689400 0,320600 0,620460 0,389540
979 W10714001 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0,689400 0,280600 0,620460 0,349540
980 W53579001 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 3,280000 0,000000 2,952000 0,328000
981 W00225003 P02CA03 ALBENDAZOLUM ESKAZOLE COMPR. 400mg GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 12 BLIST. PVC-PVDC/AL X 1 COMPR. P-RF 12 6,527500 0,000000 5,874750 0,652750
982 W13994001 P02CA03 ALBENDAZOLUM DUADOR 200 mg COMPR. FILM. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. X 2 COMPR. FILM. P-RF 2 3,280000 0,210000 2,952000 0,538000
983 W62163001 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 3,280000 0,210000 2,952000 0,538000
984 W55736001 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 3,280000 0,220000 2,952000 0,548000
985 W00228001 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 4,155750 2,104250 3,740175 2,519825
986 W60595001 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 4,070000 0,000000 3,663000 0,407000
987 W55331001 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 3,730000 0,000000 3,357000 0,373000
988 W55330001 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 1,344990 0,305010 1,210491 0,439509
989 W12650001 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 1,649700 6,550300 1,484730 6,715270
990 W10597001 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 8,248500 2,641500 7,423650 3,466350
991 W51508001 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 7,440000 0,000000 6,696000 0,744000
992 W41683001 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 1 107,370000 0,000000 96,633000 10,737000
993 W43881001 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 28,070000 0,000000 25,263000 2,807000
994 W43881003 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 72,707500 5,522500 65,436750 12,793250
995 W00680001 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 36,353750 5,416250 32,718375 9,051625
996 W43882002 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 72,707500 8,772500 65,436750 16,043250
997 W03767001 R03BB01 IPRATROPII BROMIDUM * IPRAVENT INHALER 20mcg/doza SUSP. INHAL. PRESURIZATA 20mcg/doza CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLACON AL PRESURIZAT X 200 DOZE SUSP.DE INHALAT PRESURIZATA P-6L 1 13,760000 0,000000 12,384000 1,376000
998 W05494001 R03CC02 SALBUTAMOLUM SALBUTAMOL MCC 4 mg COMPR. 4mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,381500 0,000000 0,343350 0,038150
999 W44064001 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 3,220000 0,000000 2,898000 0,322000

Pagina 18 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT

Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.

UT/ Pret de compensare 100% beneficiaza de compensare 90%


tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
1.000 W42239001 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 0,776000 0,000000 0,698400 0,077600
1.001 W07705001 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 0,256250 0,000000 0,230625 0,025625
1.002 W05848001 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 0,381250 0,000000 0,343125 0,038125
1.003 W57245001 R03DX05 OMALIZUMABUM ** XOLAIR 150 mg SOL INJ. 150mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOLUTIE INJECTABILAPR/PRF 1 1.595,980000 0,000000 1.436,382000 159,598000
1.004 W57244001 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 1 810,030000 36,120000 729,027000 117,123000
1.005 W01411002 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,193125 0,017541 0,173812 0,036854
1.006 W01409002 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,193125 0,022475 0,173812 0,041788
1.007 W01407004 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 0,174000 0,000000 0,156600 0,017400
1.008 W54406001 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 0,193125 0,006375 0,173812 0,025688
1.009 W01189001 R06AB04 CHLORPHENAMINUM CLORFENIRAMIN COMPR. 4mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,126500 0,000000 0,113850 0,012650
1.010 W42728001 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 0,698850 0,456650 0,628965 0,526535
1.011 W43156001 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 0,698850 0,456150 0,628965 0,526035
1.012 W59369003 R06AE07 CETIRIZINUM ZYRTEC 10 mg/ml PICATURI ORALE, SOL. 10mg/ml UCB PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA + PICURATOR DIN PEJD X 20 ML PIC. ORALE, SOL. P6L 1 13,280000 0,000000 11,952000 1,328000
1.013 W11534001 R06AX17 KETOTIFENUM H - KETOTIFEN COMPR. 1mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,188000 0,004000 0,169200 0,022800
1.014 W11987002 R06AX17 KETOTIFENUM KETOTIFEN COMPR. 1mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,188000 0,000000 0,169200 0,018800
1.015 W52907001 R06AX17 KETOTIFENUM KETOTIFEN LAROPHARM 1 mg COMPR. 1mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,188000 0,000000 0,169200 0,018800
1.016 W58781002 R06AX17 KETOTIFENUM KETOTIFEN LPH 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR P6L 30 0,181333 0,000000 0,163199 0,018134
1.017 W03905001 R06AX17 KETOTIFENUM KETOF 1 mg/5 ml SIROP 1mg/5ml HEXAL AG GERMANIA CUTIE X 1 FLACON X 100 ML SIROP + MASURA DOZATOARE P-6L 1 12,480000 0,000000 11,232000 1,248000
1.018 W55653001 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 10,140000 0,000000 9,126000 1,014000
1.019 W58663002 S01BC03 DICLOFENACUM VOLTAREN OPHTHA CD PICATURI OFT.-SOL. 0,1% LABORATOIRES THEA FRANTA PRF
CUTIE X 1 FLAC. PEJD X 5 ML PICATURI OFT.-SOL. + PICURATOR PEJD + CAPAC CU INEL DE SIGURANTA 1 12,479999 2,340001 11,231999 3,588001
1.020 W60088001 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL 1,3 mg/g+2,5 mg/g GEL OFT. 1,3mg/g+2,5mg/g THEA FARMA S.P.A. ITALIA CUTIE CU 1 FLAC. DIN PEJD +PICURATOR DIN PE X 5 G GEL OFT. PRF 1 15,775000 38,445000 14,197500 40,022500
1.021 W59770001 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 14,680000 0,000000 13,212000 1,468000
1.022 W59771001 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 15,775000 1,095000 14,197500 2,672500

NOTĂ:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se iniţiază de către medicul de specialitate în limita competenţei şi poate fi prescris în continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (1) se efectuează pentru pacienţii cu intoleranţă la acidum acetylsalicylicum.

Pagina 19 din 19
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 IANUARIE 2019

Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie


maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
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 W56172001 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 0,640714 0,000000 0,320357 0,320357 0,576642 0,064072
2 W56920002 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 0,249285 0,000000 0,124642 0,124643 0,224356 0,024929
3 W54403001 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 0,348214 0,000000 0,174107 0,174107 0,313392 0,034822
4 W54684002 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 0,288000 0,000000 0,144000 0,144000 0,259200 0,028800
5 W60432003 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 0,348333 0,000000 0,174166 0,174167 0,313499 0,034834
6 W60623001 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 0,348214 0,000000 0,174107 0,174107 0,313392 0,034822
7 W60745001 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 0,348333 0,000000 0,174166 0,174167 0,313499 0,034834
8 W61230005 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 0,224000 0,000000 0,112000 0,112000 0,201600 0,022400
9 W61932062 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 0,358333 0,000000 0,179166 0,179167 0,322499 0,035834
10 W56919002 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 0,453928 0,000000 0,226964 0,226964 0,408535 0,045393
11 W54404002 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 0,640714 0,000000 0,320357 0,320357 0,576642 0,064072
12 W54685002 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 0,607000 0,000000 0,303500 0,303500 0,546300 0,060700
13 W57634001 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 0,641000 0,000000 0,320500 0,320500 0,576900 0,064100
14 W57634003 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 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
15 W59855003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL ATB 40 mg COMPR. GASTROREZ. 40mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ. P6L 30 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
16 W60746001 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 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
17 W61231005 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 0,408333 0,000000 0,204166 0,204167 0,367499 0,040834
18 W61933054 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 0,627666 0,000000 0,313833 0,313833 0,564899 0,062767
19 W61651001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL SUN 40 mg PULB. PT. SOL. INJ. 40mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA CU DOP DIN CAUCIUC SI CAPSA DIN AL, CU PULB. PT. SOL. INJ. PRF 1 9,280000 0,000000 4,640000 4,640000 8,352000 0,928000
20 W61931001 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 13,420000 0,000000 6,710000 6,710000 12,078000 1,342000
21 W55421004 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 0,678571 0,000000 0,339285 0,339286 0,610713 0,067858
22 W56890010 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 0,457142 0,000000 0,228571 0,228571 0,411427 0,045715
23 W55422004 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 1,093571 0,000000 0,546785 0,546786 0,984213 0,109358
24 W56889010 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 0,913928 0,000000 0,456964 0,456964 0,822535 0,091393
25 W06755002 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 0,691199 0,620943 0,345599 0,966543 0,622079 0,690063
26 W56303013 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZ. 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ. P6L 14 0,691199 0,285943 0,345599 0,631543 0,622079 0,355063
27 W06756002 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 1,382399 0,336886 0,691199 1,028086 1,244159 0,475126
28 W56304013 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ. P6L 14 1,382399 0,061886 0,691199 0,753086 1,244159 0,200126
29 W56303002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg 20mg
COMPR. GASTROREZISTENTE TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 0,691199 0,285943 0,345599 0,631543 0,622079 0,355063
30 W56304002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg 40mg
COMPR. GASTROREZISTENTE TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 1,382399 0,061886 0,691199 0,753086 1,244159 0,200126
31 W53101001 A02BC05 ESOMEPRAZOLUM NEXIUM 10 mg 10mg
GRAN. GASTROREZ. PT. SUSP.ORALA ASTRAZENECA AB SUEDIA CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA P-6L 28 2,627857 0,000000 1,313928 1,313929 2,365071 0,262786
32 W62392007 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 0,337175 0,714825 0,168587 0,883413 0,303457 0,748543
33 W62392006 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 0,337175 0,609610 0,168587 0,778198 0,303457 0,643328
34 W04674001 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 0,844000 0,000000 0,422000 0,422000 0,759600 0,084400
35 W05444001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE CU UN BLISTER DIN PVC-PE-PVDC/ALUMINIUM A 12 COMPRIMATE FILMATE P-RF 12 2,516111 0,221389 1,258055 1,479445 2,264499 0,473001
36 W05444002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE CU 3 BLISTERE DIN PVC-PE-PVDC/ALUMINIUM A CATE 12 COMPRIMATE FILMATE P-RF 36 2,516111 0,000000 1,258055 1,258056 2,264499 0,251612
37 W63734001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 12 COMPR. FILM. PRF 12 2,516111 0,221389 1,258055 1,479445 2,264499 0,473001
38 W63734002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL A CATE 12 COMPR. FILM. PRF 36 2,516111 0,000000 1,258055 1,258056 2,264499 0,251612
39 W63735001 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFASIGMA S.P.A. ITALIA CUTIE CU UN FLACON DIN STICLA BRUNA CONTINÂND GRANULE PENTRU 60 ML SUSPENSIE ORALA, ÎNSOTIT DE O MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML. PRF 1 15,096681 5,563319 7,548340 13,111660 13,587012 7,072988
40 W08631001 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 3,688500 0,000000 1,844250 1,844250 3,319650 0,368850
41 W61505003 A07EA06 BUDESONIDUM ** # CORTIMENT 9mg COMPR. ELIB. PREL. 9mg FERRING GMBH GERMANIA CUTIE CU BLIST. DIN PA-AL/PVC-AL X 30 COMPRIMATE ELIBERARE PRELUNGITA PRF 30 11,791755 3,142245 5,895877 9,038123 10,612579 4,321421
42 W58169003 A07EA06 BUDESONIDUM ** # BUDENOFALK UNO 9 mg GRANULE GASTROREZ. 9mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 30 PLICURI PET/AL/PEJD CU GRANULE GASTROREZ. PRF 30 11,791755 0,726245 5,895877 6,622123 10,612579 1,905421
43 W54445001 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 1 319,940000 0,000000 159,970000 159,970000 287,946000 31,994000
44 W41577002 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 1,431875 0,691625 0,715937 1,407563 1,288687 0,834813
45 W63750001 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg BIOPROJET PHARMAFRANTA CUTIE CU 2 BLIST. X 10 CAPS. PRF 20 1,431875 0,691625 0,715937 1,407563 1,288687 0,834813
46 W41575002 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. ORALA 10mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 16 PLICURI X 1 G P-RF 16 1,431875 0,288750 0,715937 1,004688 1,288687 0,431938
47 W60148002 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. ORALA 30mg LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 3 G P-RF 16 1,431875 0,000000 0,715937 0,715938 1,288687 0,143188
48 W63749002 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. ORALA 30mg BIOPROJET PHARMAFRANTA CUTIE CU 16 PLICURI DIN HÂRTIE/AL/PE X 3 G PULB. ORALA PRF 16 1,431875 0,000000 0,715937 0,715938 1,288687 0,143188
49 W63610002 A08AB01 ORLISTATUM **1 XENICAL 120mg CAPS. 120mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC)PRF 84 1,748809 0,000000 0,874404 0,874405 1,573928 0,174881
50 W00231001 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 0,553666 0,066734 0,276833 0,343567 0,498299 0,122101
51 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,553666 0,252667 0,276833 0,529500 0,498299 0,308034
52 W44042001 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 P-RF 30 1,107333 0,000000 0,553666 0,553667 0,996599 0,110734
53 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 1,107333 0,086667 0,553666 0,640334 0,996599 0,197401
54 W52168003 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOCTACID 600 HR COMPR. FILM. 600mg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 100 COMPR. FILM. P-6L 100 1,941383 0,264717 0,970691 1,235409 1,747244 0,458856
55 W52168001 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 1,941383 0,426283 0,970691 1,396975 1,747244 0,620422
56 W60364001 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOSSEN 600 mg COMPR. FILM. 600mg AAA - PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 30 1,676666 0,000000 0,838333 0,838333 1,508999 0,167667

Pagina 1 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
57 W64296002 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # ACID TIOCTIC ROMPHARM 600 mg/24 mlSOL INJ. 600mg/24ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 25 ML X 24 ML SOL. INJ. PR/PRF 5 16,462000 0,000000 8,231000 8,231000 14,815800 1,646200
58 W53289002 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 16,462000 8,462000 8,231000 16,693000 14,815800 10,108200
59 W52808004 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 12,060000 0,000000 6,030000 6,030000 10,854000 1,206000
60 W64849001 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000UI/0,2ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA PR/PRF 10 12,060000 0,000000 6,030000 6,030000 10,854000 1,206000
61 W62441002 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI anti-Xa/0,2ml SOL. INJ. 2000UI anti-Xa/0,2ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 10 6,030000 0,671000 3,015000 3,686000 5,427000 1,274000
62 W63590002 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI (20 mg)/0,2 ml SOL. INJ. 2000UI(20mg)/0,2ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 10 6,030000 0,671000 3,015000 3,686000 5,427000 1,274000
63 W62442002 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI anti-Xa/0,4ml SOL. INJ. 4000UI anti-Xa/0,4ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 10 12,060000 0,096000 6,030000 6,126000 10,854000 1,302000
64 W63591002 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI (40 mg)/0,4 ml SOL. INJ. 4000UI(40mg)/0,4ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 10 12,060000 0,096000 6,030000 6,126000 10,854000 1,302000
65 W63592002 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI (60 mg)/0,6 ml SOL. INJ. 6000UI(60mg)/0,6ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 10 15,626000 0,000000 7,813000 7,813000 14,063400 1,562600
66 W62443002 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI anti-Xa/0,6ml SOL. INJ. 6000UIanti-Xa/0,6ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 10 15,626000 0,000000 7,813000 7,813000 14,063400 1,562600
67 W62444002 B01AB05 ENOXAPARINUM ** # CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 6 20,621666 0,000000 10,310833 10,310833 18,559499 2,062167
68 W63593002 B01AB05 ENOXAPARINUM ** # CLEXANE 8000 UI (80 mg)/0,8 ml SOL. INJ. 8000UI(80mg)/0,8ml SANOFI ROMANIA S.R.L. ROMANIA 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. PR/PRF 6 20,621666 0,000000 10,310833 10,310833 18,559499 2,062167
69 W61293001 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 8,039997 0,909003 4,019998 4,929002 7,235997 1,713003
70 W61291001 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 12,060000 1,326000 6,030000 7,356000 10,854000 2,532000
71 W61292001 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 16,079995 0,791005 8,039997 8,831003 14,471995 2,399005
72 W59473001 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA 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 PR/PRF 10 34,457138 20,300862 17,228569 37,529431 31,011424 23,746576
73 W59475001 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE 20000 UI anti-Xa/ml LEO PHARMA A/S DANEMARCA 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 PR/PRF 10 68,914283 48,476717 34,457141 82,933859 62,022854 55,368146
74 W59472003 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA 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 PR/PRF 10 6,030000 6,823000 3,015000 9,838000 5,427000 7,426000
75 W59472004 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA 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 PR/PRF 10 7,752855 2,020145 3,876427 5,896573 6,977569 2,795431
76 W59474001 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA 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 PR/PRF 2 8,614283 29,945717 4,307141 34,252859 7,752854 30,807146
77 W59474002 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA 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 PR/PRF 2 24,120000 28,445000 12,060000 40,505000 21,708000 30,857000
78 W59474003 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA 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 PR/PRF 2 31,011427 31,303573 15,505713 46,809287 27,910284 34,404716
79 W05757002 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 2,078000 0,074200 1,039000 1,113200 1,870200 0,282000
80 W05757003 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 2,078000 0,000000 1,039000 1,039000 1,870200 0,207800
81 W60955001 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 1,732400 0,000000 0,866200 0,866200 1,559160 0,173240
82 W63737001 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVDC-PVC/AL-PVDC A CATE 25 CAPS. MOI P6L 50 2,078000 0,074200 1,039000 1,113200 1,870200 0,282000
83 W63737002 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P6L 60 2,078000 0,000000 1,039000 1,039000 1,870200 0,207800
84 W60954001 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 6,605000 0,000000 3,302500 3,302500 5,944500 0,660500
85 W05758001 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 7,425500 0,820500 3,712750 4,533250 6,682950 1,563050
86 W63736001 B01AB11 SULODEXIDUM ** VESSEL DUE F SOL. INJ. 600ULS/2ml ALFASIGMA S.P.A. ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML PRF 10 7,425500 0,820500 3,712750 4,533250 6,682950 1,563050
87 W54317002 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 0,611666 0,000000 0,305833 0,305833 0,550499 0,061167
88 W54317003 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 0,592000 0,000000 0,296000 0,296000 0,532800 0,059200
89 W54973001 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 1,100998 0,064359 0,550499 0,614858 0,990898 0,174459
90 W55445003 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 0,725333 0,000000 0,362666 0,362667 0,652799 0,072534
91 W55972003 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 1,100998 0,026668 0,550499 0,577167 0,990898 0,136768
92 W56912006 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 1,100998 0,026668 0,550499 0,577167 0,990898 0,136768
93 W57177005 B01AC04 CLOPIDOGRELUM ** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,604642 0,000000 0,302321 0,302321 0,544177 0,060465
94 W57992002 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 0,968000 0,000000 0,484000 0,484000 0,871200 0,096800
95 W54317007 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 30 COMPRIMATE FILMATE P-RF 30 0,611666 0,000000 0,305833 0,305833 0,550499 0,061167
96 W54317009 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 90 COMPRIMATE FILMATE P-RF 90 0,592000 0,000000 0,296000 0,296000 0,532800 0,059200
97 W59687002 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 0,625000 0,000000 0,312500 0,312500 0,562500 0,062500
98 W61520001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 1,100998 0,546859 0,550499 1,097358 0,990898 0,656959
99 W58717002 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 0,550499 0,184301 0,275249 0,459551 0,495449 0,239351
100 W53412001 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 0,550499 0,184101 0,275249 0,459351 0,495449 0,239151
101 W52943002 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. (AL/AL) X 10 CAPS. (30X1 BLISTER PERFORAT UNIDOZA ) P-RF 30 5,718666 0,067000 2,859333 2,926333 5,146799 0,638867
102 W52943003 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 6 BLIST. (AL/AL) X 10 CAPS. (60X1 BLISTER PERFORAT UNIDOZA ) P-RF 60 5,696333 0,000000 2,848166 2,848167 5,126699 0,569634
103 W60379002 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. P-RF 10 11,420000 0,623000 5,710000 6,333000 10,278000 1,765000
104 W60379003 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. P-RF 30 11,420000 0,000000 5,710000 5,710000 10,278000 1,142000
105 W63896002 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. PRF 10 11,420000 0,623000 5,710000 6,333000 10,278000 1,765000
106 W63896003 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. PRF 30 11,420000 0,000000 5,710000 5,710000 10,278000 1,142000
107 W57283004 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 5,619000 0,000000 2,809500 2,809500 5,057100 0,561900
108 W57283003 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 5,619000 0,000000 2,809500 2,809500 5,057100 0,561900
109 W61204003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 2,5mg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 2,5mg/0,5ml IRLANDA
ASPEN PHARMA TRADING LIMITED P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA 10 19,705000 0,000000 9,852500 9,852500 17,734500 1,970500
110 W61202003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 7,5mg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 7,5mg/0,6ml IRLANDA
ASPEN PHARMA TRADING LIMITED P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE 10 51,805875 7,630125 25,902937 33,533063 46,625287 12,810713
111 W51230001 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 32,734000 0,000000 16,367000 16,367000 29,460600 3,273400
112 W63258002 C01EB17 IVABRADINUM ** IVABRADINE ZENTIVA 5 mg COMPR. FILM. 5 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 0,233876 0,575919 0,809795 1,036654 0,349060
113 W42777003 C01EB17 IVABRADINUM ** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 1,151838 0,735483 0,575919 1,311402 1,036654 0,850667
114 W62962004 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 1,151838 0,234947 0,575919 0,810866 1,036654 0,350131
115 W62962014 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 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 1,151838 0,234947 0,575919 0,810866 1,036654 0,350131
116 W63479001 C01EB17 IVABRADINUM ** RAENOM 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 0,234947 0,575919 0,810866 1,036654 0,350131
117 W63443003 C01EB17 IVABRADINUM ** FELOCORD 5 mg COMPR. FILM. 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 1,553519 0,575919 2,129438 1,036654 1,668703
118 W63904002 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 1,139054 0,575919 1,714973 1,036654 1,254238
119 W63775001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. PRF 56 1,151838 1,553519 0,575919 2,129438 1,036654 1,668703

Pagina 2 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
120 W42779003 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 1,727758 0,159563 0,863879 1,023442 1,554982 0,332339
121 W62963004 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 1,727758 0,020099 0,863879 0,883978 1,554982 0,192875
122 W62963014 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 1,727758 0,020099 0,863879 0,883978 1,554982 0,192875
123 W63259002 C01EB17 IVABRADINUM ** IVABRADINE ZENTIVA 7,5 mg COMPR. FILM. 7,5mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,585892 0,000000 0,792946 0,792946 1,427302 0,158590
124 W63480001 C01EB17 IVABRADINUM ** RAENOM 7,5 mg COMPR. FILM. 7,5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,727758 0,202777 0,863879 1,066656 1,554982 0,375553
125 W63444003 C01EB17 IVABRADINUM ** FELOCORD 7,5 mg COMPR. FILM. 7,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,727758 0,885277 0,863879 1,749156 1,554982 1,058053
126 W63905001 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 7,5 mg COMPR. FILM. 7,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,727758 0,772420 0,863879 1,636299 1,554982 0,945196
127 W63776001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. P6L 56 1,727758 0,885277 0,863879 1,749156 1,554982 1,058053
128 W62327003 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 0,969839 0,166946 0,484919 0,651866 0,872855 0,263930
129 W62333003 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 1,371428 0,000000 0,685714 0,685714 1,234285 0,137143
130 W05447001 C02AC06 RILMENIDINUM TENAXUM COMPR. 1mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 1,056000 0,000000 0,528000 0,528000 0,950400 0,105600
131 W42324004 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 2,144749 1,272251 1,072374 2,344626 1,930274 1,486726
132 W42325004 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 3,441333 0,000000 1,720666 1,720667 3,097199 0,344134
133 W04501004 C07AB12 NEBIVOLOLUM NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,672857 0,000000 0,336428 0,336429 0,605571 0,067286
134 W52443005 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 0,382666 0,000000 0,191333 0,191333 0,344399 0,038267
135 W53839001 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 0,442333 0,000000 0,221166 0,221167 0,398099 0,044234
136 W55035003 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 0,199666 0,000000 0,099833 0,099833 0,179699 0,019967
137 W58211001 C07AB12 NEBIVOLOLUM NEBIVOLOL TORRENT 5 mg COMPR. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L 30 0,442333 0,000000 0,221166 0,221167 0,398099 0,044234
138 W64198003 C07AB12 NEBIVOLOLUM NEBIVOLOL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. P6L 30 0,438666 0,000000 0,219333 0,219333 0,394799 0,043867
139 W64800005 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVDC/AL X 10 COMPR. P6L 30 0,382666 0,000000 0,191333 0,191333 0,344399 0,038267
140 W57345001 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 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
141 W57345002 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 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
142 W57345003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,575333 0,000333 0,287666 0,288000 0,517799 0,057867
143 W57344001 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 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
144 W57344002 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 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
145 W57344003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,575333 0,009667 0,287666 0,297334 0,517799 0,067201
146 W62093003 C07FX05 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 4,056919 0,004152 2,028459 2,032612 3,651227 0,409844
147 W62095003 C07FX05 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 4,056919 0,004152 2,028459 2,032612 3,651227 0,409844
148 W62094003 C07FX05 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 4,056919 0,004152 2,028459 2,032612 3,651227 0,409844
149 W62096003 C07FX05 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 4,044464 0,000000 2,022232 2,022232 3,640017 0,404447
150 W03916002 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 0,278399 0,418386 0,139199 0,557586 0,250559 0,446226
151 W03916001 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 0,278399 0,417315 0,139199 0,556515 0,250559 0,445155
152 W12827004 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 0,278399 0,394767 0,139199 0,533967 0,250559 0,422607
153 W55999006 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 0,278399 0,173601 0,139199 0,312801 0,250559 0,201441
154 W43062014 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 0,556799 0,505534 0,278399 0,783934 0,501119 0,561214
155 W56001006 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 0,556799 0,158601 0,278399 0,437001 0,501119 0,214281
156 W54042001 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 0,313200 0,628800 0,156600 0,785400 0,281880 0,660120
157 W54042002 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313200 0,628800 0,156600 0,785400 0,281880 0,660120
158 W54194003 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 0,313200 0,091466 0,156600 0,248066 0,281880 0,122786
159 W55290004 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 0,313200 0,102800 0,156600 0,259400 0,281880 0,134120
160 W61726001 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 0,313200 0,227466 0,156600 0,384066 0,281880 0,258786
161 W54043001 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 0,626400 1,162933 0,313200 1,476133 0,563760 1,225573
162 W54043002 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,626400 1,162933 0,313200 1,476133 0,563760 1,225573
163 W55291004 C09AA04 PERINDOPRILUM PRINDEX 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU BLIST. AL/AL X 30 COMPR.
REPUBLICA CEHA P-6L 30 0,626400 0,030933 0,313200 0,344133 0,563760 0,093573
164 W58117004 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 0,626400 0,078933 0,313200 0,392133 0,563760 0,141573
165 W61727001 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 0,626400 0,174266 0,313200 0,487466 0,563760 0,236906
166 W42663001 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 0,782999 0,290001 0,391499 0,681501 0,704699 0,368301
167 W59480001 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 0,782999 0,005334 0,391499 0,396834 0,704699 0,083634
168 W42664001 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 0,391499 0,519501 0,195749 0,715251 0,352349 0,558651
169 W59479001 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 0,391499 0,285834 0,195749 0,481584 0,352349 0,324984
170 W62353001 C09AA10 TRANDOLAPRILUM GOPTEN® 0,5 mg CAPS. 0,5mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0,078300 0,286200 0,039150 0,325350 0,070470 0,294030
171 W62355001 C09AA10 TRANDOLAPRILUM GOPTEN® 2 mg CAPS. 2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,313200 0,327514 0,156600 0,484114 0,281880 0,358834
172 W62357001 C09AA10 TRANDOLAPRILUM GOPTEN® 4 mg CAPS. 4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,626400 0,577171 0,313200 0,890371 0,563760 0,639811
173 W13178003 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 0,313200 1,169300 0,156600 1,325900 0,281880 1,200620
174 W13177003 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 0,078300 0,690628 0,039150 0,729778 0,070470 0,698458
175 W56887001 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 0,589000 0,000000 0,294500 0,294500 0,530100 0,058900
176 W52394004 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 0,387666 0,000000 0,193833 0,193833 0,348899 0,038767
177 W57158001 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 0,589000 0,000000 0,294500 0,294500 0,530100 0,058900
178 W56888001 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 0,798666 0,000000 0,399333 0,399333 0,718799 0,079867
179 W52393004 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 0,662666 0,000000 0,331333 0,331333 0,596399 0,066267
180 W57157001 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 0,837333 0,000000 0,418666 0,418667 0,753599 0,083734
181 W56278004 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 0,889006 0,162327 0,444503 0,606830 0,800105 0,251228
182 W54255004 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 0,889006 0,264994 0,444503 0,709497 0,800105 0,353895

Pagina 3 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
183 W63520001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 10 mg/2,5 mg COMPR. FILM. 10mg/2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. X 30 COMPR. FILM. P6L 30 0,889006 0,313994 0,444503 0,758497 0,800105 0,402895
184 W52783004 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 0,889006 0,183994 0,444503 0,628497 0,800105 0,272895
185 W60020001 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 0,357333 0,000000 0,178666 0,178667 0,321599 0,035734
186 W52784004 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 0,889006 0,184327 0,444503 0,628830 0,800105 0,273228
187 W60021001 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 0,628000 0,000000 0,314000 0,314000 0,565200 0,062800
188 W43136001 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 0,565333 0,000000 0,282666 0,282667 0,508799 0,056534
189 W64843001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE COMPR. FILM. 10mg/12,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,565333 0,000000 0,282666 0,282667 0,508799 0,056534
190 W43137001 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 0,889006 0,129327 0,444503 0,573830 0,800105 0,218228
191 W64844001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE FORTE COMPR. FILM. 20mg/12,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,889006 0,129327 0,444503 0,573830 0,800105 0,218228
192 W53990002 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 3,083000 0,000000 1,541500 1,541500 2,774700 0,308300
193 W58750001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 4 mg/ 10 mg COMPR. 4mg/10 mg GEDEON RICHTER ROMÂNIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,754649 0,011684 0,377324 0,389009 0,679184 0,087149
194 W57913007 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 0,738666 0,000000 0,369333 0,369333 0,664799 0,073867
195 W64004001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 4 mg/10 mg COMPR. 4mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,743666 0,000000 0,371833 0,371833 0,669299 0,074367
196 W57912007 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 0,485132 0,100534 0,242566 0,343100 0,436618 0,149048
197 W58748001 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 0,485132 0,129201 0,242566 0,371767 0,436618 0,177715
198 W64003001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 4 mg/5 mg COMPR. 4mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,485132 0,169868 0,242566 0,412434 0,436618 0,218382
199 W57915007 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 0,970264 0,145736 0,485132 0,630868 0,873237 0,242763
200 W58751001 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 0,970264 0,181736 0,485132 0,666868 0,873237 0,278763
201 W64006001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 8 mg/10 mg COMPR. 8mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,970264 0,138736 0,485132 0,623868 0,873237 0,235763
202 W57914007 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 0,700746 0,197587 0,350373 0,547960 0,630671 0,267662
203 W58749001 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 0,700746 0,242254 0,350373 0,592627 0,630671 0,312329
204 W64005001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 8 mg/5 mg COMPR. 8mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,700746 0,172920 0,350373 0,523293 0,630671 0,242995
205 W62329002 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 1,949642 0,213929 0,974821 1,188750 1,754677 0,408894
206 W62331002 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 1,949642 0,637143 0,974821 1,611964 1,754677 0,832108
207 W62349001 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 1,735714 0,000000 0,867857 0,867857 1,562142 0,173572
208 W60513005 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 0,977000 0,000000 0,488500 0,488500 0,879300 0,097700
209 W60512005 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 0,775029 0,141637 0,387514 0,529152 0,697526 0,219140
210 W60515005 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 1,318666 0,000000 0,659333 0,659333 1,186799 0,131867
211 W60514005 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 1,145976 0,057024 0,572988 0,630012 1,031378 0,171622
212 W61004001 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 1,558948 0,544385 0,779474 1,323859 1,403053 0,700280
213 W61003001 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 1,154865 0,746801 0,577432 1,324234 1,039378 0,862288
214 W61002001 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 1,183556 0,322110 0,591778 0,913888 1,065200 0,440466
215 W61001001 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 0,779473 0,597193 0,389736 0,986930 0,701525 0,675141
216 W56930003 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 1,362213 0,231715 0,681106 0,912822 1,225991 0,367937
217 W57790002 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 1,127500 0,000000 0,563750 0,563750 1,014750 0,112750
218 W57676003 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 0,486938 0,000000 0,243469 0,243469 0,438244 0,048694
219 W58146002 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 0,591428 0,000000 0,295714 0,295714 0,532285 0,059143
220 W58950003 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,750714 0,000000 0,375357 0,375357 0,675642 0,075072
221 W58950013 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,750714 0,000000 0,375357 0,375357 0,675642 0,075072
222 W56929003 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L 28 0,340553 2,227661 0,170276 2,397938 0,306497 2,261717
223 W57789002 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 0,340553 1,323018 0,170276 1,493295 0,306497 1,357074
224 W58948003 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,340553 0,090161 0,170276 0,260438 0,306497 0,124217
225 W58948013 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,340553 0,090161 0,170276 0,260438 0,306497 0,124217
226 W56931003 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 0,681106 0,513894 0,340553 0,854447 0,612995 0,582005
227 W57675003 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 0,308367 0,000000 0,154183 0,154184 0,277530 0,030837
228 W58145002 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 0,550714 0,000000 0,275357 0,275357 0,495642 0,055072
229 W58949003 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,402142 0,000000 0,201071 0,201071 0,361927 0,040215
230 W58949013 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,402142 0,000000 0,201071 0,201071 0,361927 0,040215
231 W55631001 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 4,086639 20,793361 2,043319 22,836681 3,677975 21,202025
232 W59429005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,388571 0,000000 0,194285 0,194286 0,349713 0,038858
233 W59430005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,543571 0,000000 0,271785 0,271786 0,489213 0,054358
234 W54081003 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 0,681106 0,144251 0,340553 0,484804 0,612995 0,212362
235 W55941002 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 0,566428 0,000000 0,283214 0,283214 0,509785 0,056643
236 W59580002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,596071 0,000000 0,298035 0,298036 0,536463 0,059608
237 W60637002 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,681106 0,524608 0,340553 0,865161 0,612995 0,592719
238 W63000003 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 0,629642 0,000000 0,314821 0,314821 0,566677 0,062965
239 W63001003 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 0,855714 0,000000 0,427857 0,427857 0,770142 0,085572
240 W54082003 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 1,132500 0,000000 0,566250 0,566250 1,019250 0,113250
241 W55942002 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 0,855714 0,000000 0,427857 0,427857 0,770142 0,085572
242 W59581002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,932857 0,000000 0,466428 0,466429 0,839571 0,093286
243 W60638002 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 1,362213 0,238501 0,681106 0,919608 1,225991 0,374723
244 W55622005 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 1,118571 0,000000 0,559285 0,559286 1,006713 0,111858
245 W54889004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P-6L 28 0,532142 0,000000 0,266071 0,266071 0,478927 0,053215

Pagina 4 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
246 W55592003 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 0,769000 0,000000 0,384500 0,384500 0,692100 0,076900
247 W58808002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,362213 0,068144 0,681106 0,749251 1,225991 0,204366
248 W58874004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,784333 0,000000 0,392166 0,392167 0,705899 0,078434
249 W59606002 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 1,118571 0,000000 0,559285 0,559286 1,006713 0,111858
250 W60125003 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 0,706666 0,000000 0,353333 0,353333 0,635999 0,070667
251 W61496002 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 1,118666 0,000000 0,559333 0,559333 1,006799 0,111867
252 W61638001 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 0,912500 0,000000 0,456250 0,456250 0,821250 0,091250
253 W62724001 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 0,730333 0,000000 0,365166 0,365167 0,657299 0,073034
254 W58252021 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN MYLAN 16 mg COMPR. 16mg GENERICS (UK) LTD.MAREA BRITANIE CUTIE CU BLISTERE DIN PVC/AL X 30 COMPRIMATE P6L 30 0,864333 0,000000 0,432166 0,432167 0,777899 0,086434
255 W55593003 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 1,379333 0,000000 0,689666 0,689667 1,241399 0,137934
256 W58806001 C09CA06 CANDESARTANUM CILEXETIL ATACAND 32 mg COMPR. 32mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,848928 0,000000 0,924464 0,924464 1,664035 0,184893
257 W58875004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,993666 0,000000 0,496833 0,496833 0,894299 0,099367
258 W61497002 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 1,526000 0,000000 0,763000 0,763000 1,373400 0,152600
259 W61640001 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 1,014285 0,000000 0,507142 0,507143 0,912856 0,101429
260 W64539008 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 32 mg COMPR. 32mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P6L 28 1,472500 0,000000 0,736250 0,736250 1,325250 0,147250
261 W55621005 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 8 mg COMPR. 8mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 0,558928 0,000000 0,279464 0,279464 0,503035 0,055893
262 W54885004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P-6L 28 0,381428 0,000000 0,190714 0,190714 0,343285 0,038143
263 W55591003 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 0,557333 0,000000 0,278666 0,278667 0,501599 0,055734
264 W58807002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,681106 0,179608 0,340553 0,520161 0,612995 0,247719
265 W58873004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,551666 0,000000 0,275833 0,275833 0,496499 0,055167
266 W59607002 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 0,558571 0,000000 0,279285 0,279286 0,502713 0,055858
267 W60124003 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 0,516333 0,000000 0,258166 0,258167 0,464699 0,051634
268 W61495004 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 0,559333 0,000000 0,279666 0,279667 0,503399 0,055934
269 W61636001 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 0,558928 0,000000 0,279464 0,279464 0,503035 0,055893
270 W62723001 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 0,558666 0,000000 0,279333 0,279333 0,502799 0,055867
271 W58251021 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN MYLAN 8 mg COMPR. 8mg GENERICS (UK) LTD.MAREA BRITANIE CUTIE CU BLISTERE DIN PVC/AL X 30 COMPRIMATE P6L 30 0,476666 0,000000 0,238333 0,238333 0,428999 0,047667
272 W56746002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 40mg COMPR. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,553571 0,000000 0,276785 0,276786 0,498213 0,055358
273 W55585002 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 0,605357 0,000000 0,302678 0,302679 0,544821 0,060536
274 W55534001 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 0,621000 0,000000 0,310500 0,310500 0,558900 0,062100
275 W58256003 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 0,490333 0,000000 0,245166 0,245167 0,441299 0,049034
276 W59495002 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 0,681106 0,023001 0,340553 0,363554 0,612995 0,091112
277 W56747002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 80mg COMPR. 80 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,747857 0,000000 0,373928 0,373929 0,673071 0,074786
278 W05785002 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 1,362213 0,085644 0,681106 0,766751 1,225991 0,221866
279 W55586002 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 0,840714 0,000000 0,420357 0,420357 0,756642 0,084072
280 W55535001 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 0,788333 0,000000 0,394166 0,394167 0,709499 0,078834
281 W58257003 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 0,750333 0,000000 0,375166 0,375167 0,675299 0,075034
282 W59401002 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 1,028571 0,000000 0,514285 0,514286 0,925713 0,102858
283 W59496002 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 0,918571 0,000000 0,459285 0,459286 0,826713 0,091858
284 W57129003 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 0,624642 0,000000 0,312321 0,312321 0,562177 0,062465
285 W57130003 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 0,793928 0,000000 0,396964 0,396964 0,714535 0,079393
286 W56252005 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 0,651071 0,000000 0,325535 0,325536 0,585963 0,065108
287 W43460003 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 0,479285 0,000000 0,239642 0,239643 0,431356 0,047929
288 W57669001 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 0,699824 0,499818 0,349912 0,849730 0,629841 0,569801
289 W57668001 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 0,699824 0,301604 0,349912 0,651516 0,629841 0,371587
290 W07646001 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 0,699824 0,509461 0,349912 0,859373 0,629841 0,579444
291 W07647001 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 0,699824 0,827676 0,349912 1,177588 0,629841 0,897659
292 W59584002 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 0,643214 0,000000 0,321607 0,321607 0,578892 0,064322
293 W59585002 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 0,699824 0,325890 0,349912 0,675802 0,629841 0,395873
294 W60639002 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 0,699824 0,509461 0,349912 0,859373 0,629841 0,579444
295 W61154002 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 0,699824 0,111961 0,349912 0,461873 0,629841 0,181944
296 W61154011 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 0,699824 0,111961 0,349912 0,461873 0,629841 0,181944
297 W60640002 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 0,699824 0,827676 0,349912 1,177588 0,629841 0,897659
298 W61158002 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 0,699824 0,213747 0,349912 0,563659 0,629841 0,283730
299 W61158011 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 0,699824 0,213747 0,349912 0,563659 0,629841 0,283730
300 W60641002 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 0,699824 0,829461 0,349912 1,179373 0,629841 0,899444
301 W61159002 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 0,699824 0,180176 0,349912 0,530088 0,629841 0,250159
302 W61159011 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 0,699824 0,180176 0,349912 0,530088 0,629841 0,250159
303 W57991006 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 0,675178 0,000000 0,337589 0,337589 0,607660 0,067518
304 W58871004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 16mg/12,5mg COMPR. 16mg/12,5mgZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,699824 0,074176 0,349912 0,424088 0,629841 0,144159
305 W57535004 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 0,463333 0,000000 0,231666 0,231667 0,416999 0,046334
306 W57535013 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 0,463333 0,000000 0,231666 0,231667 0,416999 0,046334
307 W58870004 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 0,464666 0,000000 0,232333 0,232333 0,418199 0,046467
308 W59718002 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 0,699824 0,424818 0,349912 0,774730 0,629841 0,494801

Pagina 5 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
309 W59819005 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 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
310 W59820005 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 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
311 W59719001 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 0,699824 0,450176 0,349912 0,800088 0,629841 0,520159
312 W12033002 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 0,699824 0,936247 0,349912 1,286159 0,629841 1,006230
313 W53178002 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 0,699824 1,013390 0,349912 1,363302 0,629841 1,083373
314 W59921007 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 30 COMPR. P6L 30 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
315 W59921008 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/PVC/PVDC X 30 COMPR. P6L 30 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
316 W60206003 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 0,699824 0,027509 0,349912 0,377421 0,629841 0,097492
317 W60248003 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 0,699824 0,418176 0,349912 0,768088 0,629841 0,488159
318 W60207003 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 0,699824 0,304176 0,349912 0,654088 0,629841 0,374159
319 W60249003 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 0,699824 0,419842 0,349912 0,769754 0,629841 0,489825
320 W51851005 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 2,586428 0,608214 1,293214 1,901428 2,327785 0,866857
321 W64723005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 2,586428 0,608214 1,293214 1,901428 2,327785 0,866857
322 W51852005 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 2,510356 0,493394 1,255178 1,748572 2,259320 0,744430
323 W64722005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 2,510356 0,493394 1,255178 1,748572 2,259320 0,744430
324 W51853005 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 1,293214 1,900714 0,646607 2,547321 1,163892 2,030036
325 W64721005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 1,293214 1,900714 0,646607 2,547321 1,163892 2,030036
326 W53445002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 20 mg/5 mg COMPR. FILM. 20mg/5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 1,293214 0,508928 0,646607 1,155535 1,163892 0,638250
327 W57427002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM 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 1,293214 2,146428 0,646607 2,793035 1,163892 2,275750
328 W64084002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 20 mg/5 mg COMPR. FILM. 20mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 1,042500 0,646607 1,689107 1,163892 1,171822
329 W64151010 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 28X1 COMPR. FILM. P6L 28 1,293214 0,952143 0,646607 1,598750 1,163892 1,081465
330 W64151011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 30X1 COMPR. FILM. P6L 30 1,293214 0,877119 0,646607 1,523726 1,163892 1,006441
331 W64151002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 0,952143 0,646607 1,598750 1,163892 1,081465
332 W64245001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 1,042500 0,646607 1,689107 1,163892 1,171822
333 W64151003 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,293214 0,877119 0,646607 1,523726 1,163892 1,006441
334 W64245006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 1,042500 0,646607 1,689107 1,163892 1,171822
335 W64426002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 20 mg/5 mg COMPR. FILM. 20mg/5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 2,146428 0,646607 2,793035 1,163892 2,275750
336 W53447002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/10 mg COMPR. FILM. 40mg/10mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 2,386428 0,000000 1,193214 1,193214 2,147785 0,238643
337 W57425002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM 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 2,586428 1,183929 1,293214 2,477143 2,327785 1,442572
338 W64086002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 40 mg/10 mg COMPR. FILM. 40mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,560000 0,000000 1,280000 1,280000 2,304000 0,256000
339 W64153010 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 28X1 COMPR. FILM. P6L 28 2,555000 0,000000 1,277500 1,277500 2,299500 0,255500
340 W64153011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 30X1 COMPR. FILM. P6L 30 2,555333 0,000000 1,277666 1,277667 2,299799 0,255534
341 W64153002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,555000 0,000000 1,277500 1,277500 2,299500 0,255500
342 W64247001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,560000 0,000000 1,280000 1,280000 2,304000 0,256000
343 W64153003 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 2,555333 0,000000 1,277666 1,277667 2,299799 0,255534
344 W64247006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,560000 0,000000 1,280000 1,280000 2,304000 0,256000
345 W64428002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/10 mg COMPR. FILM. 40mg/10mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,586428 1,183929 1,293214 2,477143 2,327785 1,442572
346 W53446002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/5 mg COMPR. FILM. 40mg/5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 2,288214 0,000000 1,144107 1,144107 2,059392 0,228822
347 W57426002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM 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 2,327785 1,111857 1,163892 2,275750 2,095006 1,344636
348 W64085002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 40 mg/5 mg COMPR. FILM. 40mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,007929 1,163892 1,171822 2,095006 0,240708
349 W64152010 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 28X1 COMPR. FILM. P6L 28 2,327785 0,044715 1,163892 1,208608 2,095006 0,277494
350 W64152011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 30X1 COMPR. FILM. P6L 30 2,327785 0,044881 1,163892 1,208774 2,095006 0,277660
351 W64152002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,044715 1,163892 1,208608 2,095006 0,277494
352 W64246001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,007929 1,163892 1,171822 2,095006 0,240708
353 W64152003 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 2,327785 0,044881 1,163892 1,208774 2,095006 0,277660
354 W64246006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,007929 1,163892 1,171822 2,095006 0,240708
355 W64427002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/5 mg COMPR. FILM. 40mg/5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 1,111857 1,163892 2,275750 2,095006 1,344636
356 W57234002 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 3,140249 0,346536 1,570124 1,916661 2,826224 0,660561
357 W64768002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,148854 0,337931 1,574427 1,912358 2,833968 0,652817
358 W57236002 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 3,355336 0,193235 1,677668 1,870903 3,019802 0,528769
359 W64769002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/25 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,355336 0,193235 1,677668 1,870903 3,019802 0,528769
360 W57233002 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 3,054216 0,057569 1,527108 1,584677 2,748794 0,362991
361 W64770002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,062818 0,048967 1,531409 1,580376 2,756536 0,355249
362 W57235002 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 3,112500 0,000000 1,556250 1,556250 2,801250 0,311250
363 W64771002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,112500 0,000000 1,556250 1,556250 2,801250 0,311250
364 W51412001 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 0,773199 0,243229 0,386599 0,629829 0,695879 0,320549
365 W12893001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 0,289949 0,607384 0,144974 0,752359 0,260954 0,636379
366 W54696007 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 0,289949 0,075717 0,144974 0,220692 0,260954 0,104712
367 W55516003 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 0,289949 0,454384 0,144974 0,599359 0,260954 0,483379
368 W59346005 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 0,234333 0,000000 0,117166 0,117167 0,210899 0,023434
369 W59408001 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 0,289949 0,104384 0,144974 0,249359 0,260954 0,133379
370 W57297016 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 0,289949 0,061717 0,144974 0,206692 0,260954 0,090712
371 W61225003 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 0,136000 0,000000 0,068000 0,068000 0,122400 0,013600

Pagina 6 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
372 W62152005 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 0,289949 0,001717 0,144974 0,146692 0,260954 0,030712
373 W64099007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,136000 0,000000 0,068000 0,068000 0,122400 0,013600
374 W64877001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,289949 0,607384 0,144974 0,752359 0,260954 0,636379
375 W12894001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 0,579899 0,592767 0,289949 0,882717 0,521909 0,650757
376 W54697007 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
377 W55517003 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 0,579899 0,386767 0,289949 0,676717 0,521909 0,444757
378 W59347005 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 0,281333 0,000000 0,140666 0,140667 0,253199 0,028134
379 W59409001 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 0,537666 0,000000 0,268833 0,268833 0,483899 0,053767
380 W57298016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 20 mg COMPR. FILM. 20mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,322000 0,000000 0,161000 0,161000 0,289800 0,032200
381 W61226003 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 0,281000 0,000000 0,140500 0,140500 0,252900 0,028100
382 W62153005 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 0,430333 0,000000 0,215166 0,215167 0,387299 0,043034
383 W64100007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,265666 0,000000 0,132833 0,132833 0,239099 0,026567
384 W64878001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,579899 0,592767 0,289949 0,882717 0,521909 0,650757
385 W57506007 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 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
386 W12895001 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. P-6L 14 1,159799 0,168772 0,579899 0,748672 1,043819 0,284752
387 W54698004 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 1,086428 0,000000 0,543214 0,543214 0,977785 0,108643
388 W54698007 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 0,681000 0,000000 0,340500 0,340500 0,612900 0,068100
389 W55518003 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 1,123666 0,000000 0,561833 0,561833 1,011299 0,112367
390 W59348005 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 1,109000 0,000000 0,554500 0,554500 0,998100 0,110900
391 W59410001 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 0,908000 0,000000 0,454000 0,454000 0,817200 0,090800
392 W57299016 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 0,644666 0,000000 0,322333 0,322333 0,580199 0,064467
393 W61227003 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 0,483333 0,000000 0,241666 0,241667 0,434999 0,048334
394 W62154005 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 0,667333 0,000000 0,333666 0,333667 0,600599 0,066734
395 W64101007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,559333 0,000000 0,279666 0,279667 0,503399 0,055934
396 W61227016 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,483333 0,000000 0,241666 0,241667 0,434999 0,048334
397 W57507007 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 1,054333 0,000000 0,527166 0,527167 0,948899 0,105434
398 W12897001 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. P-6L 14 1,101428 0,000000 0,550714 0,550714 0,991285 0,110143
399 W55519003 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 1,111333 0,000000 0,555666 0,555667 1,000199 0,111134
400 W57508007 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 1,071333 0,000000 0,535666 0,535667 0,964199 0,107134
401 W59349005 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 1,111333 0,000000 0,555666 0,555667 1,000199 0,111134
402 W59411001 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 1,111000 0,000000 0,555500 0,555500 0,999900 0,111100
403 W57300016 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 1,093333 0,000000 0,546666 0,546667 0,983999 0,109334
404 W61228003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,775666 0,000000 0,387833 0,387833 0,698099 0,077567
405 W62155005 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 1,111333 0,000000 0,555666 0,555667 1,000199 0,111134
406 W61228013 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,775666 0,000000 0,387833 0,387833 0,698099 0,077567
407 W57308006 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 0,408666 0,000000 0,204333 0,204333 0,367799 0,040867
408 W13864001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 0,579899 2,746529 0,289949 3,036479 0,521909 2,804519
409 W55327002 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 0,579899 0,077434 0,289949 0,367384 0,521909 0,135424
410 W57059005 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 0,579899 0,065767 0,289949 0,355717 0,521909 0,123757
411 W55990002 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 0,579899 0,211434 0,289949 0,501384 0,521909 0,269424
412 W59899004 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 0,579899 0,727958 0,289949 1,017908 0,521909 0,785948
413 W59899017 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 0,579899 0,727958 0,289949 1,017908 0,521909 0,785948
414 W59657004 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 0,406333 0,000000 0,203166 0,203167 0,365699 0,040634
415 W60392003 C10AA07 ROSUVASTATINUM ROVASTAMED 10mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,377500 0,000000 0,188750 0,188750 0,339750 0,037750
416 W61054001 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 0,579899 0,312767 0,289949 0,602717 0,521909 0,370757
417 W62399023 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,579899 0,016434 0,289949 0,306384 0,521909 0,074424
418 W62948004 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTD T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-POLIAMIDA/AL/PEJD DESICANT/PEID X 30 COMPR. FILM. P6L 30 0,308666 0,000000 0,154333 0,154333 0,277799 0,030867
419 W62948019 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTD. T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-OPA/AL/PVC X 30 COMPR. FILM. P6L 30 0,308666 0,000000 0,154333 0,154333 0,277799 0,030867
420 W64682002 C10AA07 ROSUVASTATINUM ROSI 10 mg COMPR. FILM. 10mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,579899 1,617767 0,289949 1,907717 0,521909 1,675757
421 W57309006 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 0,810333 0,000000 0,405166 0,405167 0,729299 0,081034
422 W13865001 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 1,159799 3,705201 0,579899 4,285101 1,043819 3,821181
423 W55328002 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 0,920333 0,000000 0,460166 0,460167 0,828299 0,092034
424 W57061005 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 0,955666 0,000000 0,477833 0,477833 0,860099 0,095567
425 W59900004 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 1,159799 0,719486 0,579899 1,299386 1,043819 0,835466
426 W59900017 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 1,159799 0,719486 0,579899 1,299386 1,043819 0,835466
427 W59658004 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 0,808000 0,000000 0,404000 0,404000 0,727200 0,080800
428 W60393003 C10AA07 ROSUVASTATINUM ROVASTAMED 20mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,152142 0,000000 0,576071 0,576071 1,036927 0,115215
429 W61055001 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 1,055000 0,000000 0,527500 0,527500 0,949500 0,105500
430 W62400023 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,159799 0,052867 0,579899 0,632767 1,043819 0,168847
431 W62949004 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 20 mg COMPR. FILM. 20mg GENERICS (UK) LTD T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-POLIAMIDA/AL/PEJD DESICANT/PEID X 30 COMPR. FILM. P6L 30 0,618000 0,000000 0,309000 0,309000 0,556200 0,061800
432 W62949019 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 20 mg COMPR. FILM. 20mg GENERICS (UK) LTD. T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-OPA/AL/PVC X 30 COMPR. FILM. P6L 30 0,618000 0,000000 0,309000 0,309000 0,556200 0,061800
433 W64684002 C10AA07 ROSUVASTATINUM ROSI 20 mg COMPR. FILM. 20mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,159799 2,170867 0,579899 2,750767 1,043819 2,286847
434 W55329002 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 1,351000 0,000000 0,675500 0,675500 1,215900 0,135100

Pagina 7 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
435 W57063005 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 1,157000 0,000000 0,578500 0,578500 1,041300 0,115700
436 W55992002 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 1,154000 0,000000 0,577000 0,577000 1,038600 0,115400
437 W59901017 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 2,319598 0,612902 1,159799 1,772701 2,087638 0,844862
438 W59901004 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 2,319598 0,612902 1,159799 1,772701 2,087638 0,844862
439 W59659004 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 1,214666 0,000000 0,607333 0,607333 1,093199 0,121467
440 W60394003 C10AA07 ROSUVASTATINUM ROVASTAMED 40mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,727500 0,000000 0,863750 0,863750 1,554750 0,172750
441 W61056001 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 2,319598 0,311402 1,159799 1,471201 2,087638 0,543362
442 W64686002 C10AA07 ROSUVASTATINUM ROSI 40 mg COMPR. FILM. 40mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 2,319598 0,461068 1,159799 1,620867 2,087638 0,693028
443 W43678001 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 0,289949 2,346122 0,144974 2,491097 0,260954 2,375117
444 W57058005 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 0,289949 0,039384 0,144974 0,184359 0,260954 0,068379
445 W55989002 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 0,289949 0,494384 0,144974 0,639359 0,260954 0,523379
446 W59898004 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 0,289949 1,610051 0,144974 1,755026 0,260954 1,639046
447 W59898017 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 0,289949 1,610051 0,144974 1,755026 0,260954 1,639046
448 W59656004 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 0,203333 0,000000 0,101666 0,101667 0,182999 0,020334
449 W60391003 C10AA07 ROSUVASTATINUM ROVASTAMED 5mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,289949 0,790765 0,144974 0,935740 0,260954 0,819760
450 W61053001 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 0,289949 0,521717 0,144974 0,666692 0,260954 0,550712
451 W62947004 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 5 mg COMPR. FILM. 5mg GENERICS (UK) LTD T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-POLIAMIDA/AL/PEJD DESICANT/PEID X 30 COMPR. FILM. P6L 30 0,154666 0,000000 0,077333 0,077333 0,139199 0,015467
452 W62947019 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 5 mg COMPR. FILM. 5mg GENERICS (UK) LTD. T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-OPA/AL/PVC X 30 COMPR. FILM. P6L 30 0,154666 0,000000 0,077333 0,077333 0,139199 0,015467
453 W53771001 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 0,403500 0,000000 0,201750 0,201750 0,363150 0,040350
454 W51918006 C10AX09 EZETIMIBUM EZETROL (R) COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 28 3,032333 1,306238 1,516166 2,822405 2,729099 1,609472
455 W60949001 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 3,032333 0,787333 1,516166 2,303500 2,729099 1,090567
456 W63969006 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR.
PRF 30 3,032333 0,000000 1,516166 1,516167 2,729099 0,303234
457 W63969016 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL-PVC/ACLAR X 30 COMPR. PRF 30 3,032333 0,000000 1,516166 1,516167 2,729099 0,303234
458 W61288003 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 4,102000 0,000000 2,051000 2,051000 3,691800 0,410200
459 W61295003 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 4,200583 0,295750 2,100291 2,396042 3,780524 0,715809
460 W43316001 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 0,732666 0,076667 0,366333 0,443000 0,659399 0,149934
461 W56680001 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 0,709666 0,000000 0,354833 0,354833 0,638699 0,070967
462 W43315001 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 0,732666 0,069000 0,366333 0,435333 0,659399 0,142267
463 W56679001 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 0,577666 0,000000 0,288833 0,288833 0,519899 0,057767
464 W56682001 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 0,732666 0,487667 0,366333 0,854000 0,659399 0,560934
465 W56681001 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 0,732666 0,213334 0,366333 0,579667 0,659399 0,286601
466 W05806001 D01BA02 TERBINAFINUM LAMISIL (R) COMPR. 250mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. X 14 COMPR. P-RF 14 1,093660 0,630625 0,546830 1,177455 0,984294 0,739991
467 W43931014 D01BA02 TERBINAFINUM TERBINAFINE 250 mg COMPR. 250mg ACTAVIS GROUP HFISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 28 0,750000 0,000000 0,375000 0,375000 0,675000 0,075000
468 W53418001 D01BA02 TERBINAFINUM TERBINAFINA SLAVIA 250mg COMPR. 250mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR. P-RF 14 1,093660 0,327054 0,546830 0,873884 0,984294 0,436420
469 W61192002 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 1,093660 0,114554 0,546830 0,661384 0,984294 0,223920
470 W58498001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * DAIVOBET 50 micrograme/0,5 mg/g 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 55,160000 0,000000 27,580000 27,580000 49,644000 5,516000
471 W56194001 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 55,160000 0,000000 27,580000 27,580000 49,644000 5,516000
472 W53799002 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 1,639666 0,000000 0,819833 0,819833 1,475699 0,163967
473 W59985001 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 11,290000 0,000000 5,645000 5,645000 10,161000 1,129000
474 W59986001 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 11,317499 0,082501 5,658749 5,741251 10,185749 1,214251
475 W54309001 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA CUTIE X 500 G CREMA PRF 1 105,740000 0,000000 52,870000 52,870000 95,166000 10,574000
476 W56789001 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 16,774285 65,725715 8,387142 74,112858 15,096856 67,403144
477 W43172001 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE P-RF 1 39,140000 0,000000 19,570000 19,570000 35,226000 3,914000
478 W63433001 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml LEO PHARMA A/S DANEMARCA CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE P-RF 1 39,140000 0,000000 19,570000 19,570000 35,226000 3,914000
479 W07761001 D06BB10 IMIQUIMODUM * ALDARA 5% CREMA 5% MEDA AB SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA P-RF 12 22,525833 0,000000 11,262916 11,262917 20,273249 2,252584
480 W63158001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID 1 mg/g CREMA 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN AL CU 30 G CREMA PRF 1 12,302500 0,227500 6,151250 6,378750 11,072250 1,457750
481 W63159001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID LIPOCREAM 1mg/g CREMA 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN AL X 30 G CREMA PRF 1 12,302500 0,197500 6,151250 6,348750 11,072250 1,427750
482 W63157001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID CRELO 1 mg/g EMULSIE CUT. 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN PEJD DE CULOARE ALBA OPAC, PREVAZUT CU APLICATOR PT. PICURARE DIN PEJD INCOLORA X 30 G EMULSIE CUTANATA PRF 1 12,302500 0,457500 6,151250 6,608750 11,072250 1,687750
483 W63160001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID 1 mg/ml SOL. CUT. 1mg/ml LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN PEJD, PREVAZUT CU APLICATOR PENTRU PICURARE DIN PEJD X 30 ML SOL. CUTANATA PRF 1 11,710000 0,000000 5,855000 5,855000 10,539000 1,171000
484 W57223001 D07AC13 MOMETASONUM ELOCOM CREMA 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3,710000 2,020000 1,855000 3,875000 3,339000 2,391000
485 W59624001 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 3,710000 0,000000 1,855000 1,855000 3,339000 0,371000
486 W57222001 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3,710000 2,020000 1,855000 3,875000 3,339000 2,391000
487 W59623001 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 3,710000 0,000000 1,855000 1,855000 3,339000 0,371000
488 W61468004 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 22,476000 2,904000 11,238000 14,142000 20,228400 5,151600
489 W63875004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 22,476000 2,904000 11,238000 14,142000 20,228400 5,151600
490 W61468005 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 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000
491 W63875005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G CREMA PRF 1 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000
492 W61466002 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 34,970000 0,000000 17,485000 17,485000 31,473000 3,497000
493 W63873002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA PRF 1 34,970000 0,000000 17,485000 17,485000 31,473000 3,497000
494 W61467004 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 22,476000 3,654000 11,238000 14,892000 20,228400 5,901600
495 W63874004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G UNGUENT PRF 1 22,476000 3,654000 11,238000 14,892000 20,228400 5,901600
496 W61467005 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 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000
497 W63874005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G UNGUENT PRF 1 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000

Pagina 8 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de 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
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.

Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
498 W13497001 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 10,600000 0,000000 5,300000 5,300000 9,540000 1,060000
499 W13088001 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 10,600000 0,000000 5,300000 5,300000 9,540000 1,060000
500 W55012001 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 6,320000 6,810000 3,160000 9,970000 5,688000 7,442000
501 W63648001 D07AD01 CLOBETASOLUM * CLOBETAZOL ATB 0,5 mg/g CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 25 G CREMA PRF 1 6,320000 2,110000 3,160000 5,270000 5,688000 2,742000
502 W12704002 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 5,690000 0,000000 2,845000 2,845000 5,121000 0,569000
503 W55013001 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 6,320000 3,400000 3,160000 6,560000 5,688000 4,032000
504 W61823001 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 6,320000 0,000000 3,160000 3,160000 5,688000 0,632000
505 W60525001 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 22,160000 0,000000 11,080000 11,080000 19,944000 2,216000
506 W59984001 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 16,930000 5,870000 8,465000 14,335000 15,237000 7,563000
507 W59984002 D07CC01 COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg pe gram LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL X 20 G CREMA PRF 1 22,573333 7,056667 11,286666 18,343334 20,315999 9,314001
508 W56787001 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 P6L 1 39,560000 0,000000 19,780000 19,780000 35,604000 3,956000
509 W61504001 D10AX03 ACIDUM AZELAICUM SKINOREN CREMA 200mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 32,020000 0,000000 16,010000 16,010000 28,818000 3,202000
510 W63891001 D10AX03 ACIDUM AZELAICUM SKINOREN 200 mg/g CREMA 200mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 32,020000 0,000000 16,010000 16,010000 28,818000 3,202000
511 W61503002 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 40,025000 11,005000 20,012500 31,017500 36,022500 15,007500
512 W64050003 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g BAYER AG GERMANIA CUTIE CU 1 TUB AL X 50 G GEL PRF 1 40,025000 11,005000 20,012500 31,017500 36,022500 15,007500
513 W03829001 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 1,127583 0,545417 0,563791 1,109209 1,014824 0,658176
514 W57698001 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 1,123666 0,000000 0,561833 0,561833 1,011299 0,112367
515 W57699001 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 2,255166 0,007834 1,127583 1,135417 2,029649 0,233351
516 W51716002 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 2,160333 1,230500 1,080166 2,310667 1,944299 1,446534
517 W64599001 G01AA51 COMBINATII POLYGYNAX VIRGO CAPS. MOI VAG. FARA FRANTA CUTIE CU 1 BLIST. PVC/PVDC TRANSPARENT/AL X 6 CAPS. VAG. MOI
LABORATOIRE INNOTECH INTERNATIONAL PRF 6 2,160333 0,314667 1,080166 1,394834 1,944299 0,530701
518 W01949002 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 2,160333 0,541333 1,080166 1,621500 1,944299 0,757367
519 W51914001 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 36,490000 0,000000 18,245000 18,245000 32,841000 3,649000
520 W03126002 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 27,980000 0,000000 13,990000 13,990000 25,182000 2,798000
521 W03125002 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 15,860000 0,000000 7,930000 7,930000 14,274000 1,586000
522 W03123004 G01AF12 FENTICONAZOLUM LOMEXIN CREMA VAGINALA CREMA VAG. 2% RECORDATI SPA ITALIA CUTIE X 1 TUB AL + APLICATOR X 78 G CREMA P-RF 1 37,900000 0,000000 18,950000 18,950000 34,110000 3,790000
523 W54844001 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 4,661769 31,128231 2,330884 33,459116 4,195592 31,594408
524 W52516001 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 1,622678 0,016322 0,811339 0,827661 1,460410 0,178590
525 W63731001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON CREMA VAG. 40mg/g+200mg/g ALFASIGMA S.P.A. ITALIA CUTIE CU 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN PP PRF 1 9,736069 4,173931 4,868034 9,041966 8,762462 5,147538
526 W63733001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON OVULE 500mg/100mg ALFASIGMA S.P.A. ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULEPRF 10 1,622678 2,375322 0,811339 3,186661 1,460410 2,537590
527 W61909001 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 1,622678 0,000179 0,811339 0,811518 1,460410 0,162447
528 W61909002 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 1,622678 0,000179 0,811339 0,811518 1,460410 0,162447
529 W61909003 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 1,622142 0,000000 0,811071 0,811071 1,459927 0,162215
530 W61909004 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 1,622142 0,000000 0,811071 0,811071 1,459927 0,162215
531 W63732001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE ALFASIGMA S.P.A. ITALIA P-RF
CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE 5 1,622191 3,135809 0,811095 3,946905 1,459971 3,298029
532 W58814001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore 20micrograme/24ore
SISTEM CU CEDARE INTRAUTERINA BAYER OY FINLANDA P-RF
CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR 1 474,300000 0,000000 237,150000 237,150000 426,870000 47,430000
533 W64655001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore 20micrograme/24ore
SISTEM CU CEDARE INTRAUTERINA BAYER AG GERMANIA PRF
CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR 1 474,300000 0,000000 237,150000 237,150000 426,870000 47,430000
534 W00716002 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 5,797750 5,387250 2,898875 8,286125 5,217975 5,967025
535 W00716001 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 5,797750 4,642250 2,898875 7,541125 5,217975 5,222025
536 W63310001 G03CA04 ESTRIOLUM * OVESTIN 0,5 mg OVULE 0,5 mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 3 BLIST. PVC/PE X 5 OVULE PRF 15 1,464000 0,000000 0,732000 0,732000 1,317600 0,146400
537 W12902001 G03CX01 TIBOLONUM ** LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 1,653571 0,000000 0,826785 0,826786 1,488213 0,165358
538 W63437001 G03CX01 TIBOLONUM ** LIVIAL 2,5 mg COMPR. 2,5mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 28 COMPR. PRF