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ANEXA 6

(ANEXA 2a la Ordinul CNAS nr. 1611/2018)

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 SEPTEMBRIE 2019

Contributie maxima Val. maxima suportata de Contributie maxima


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

Prescriptie
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Cod_CIM

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


Nr crt.

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)

SE ADAUGA

1,098 W66010005 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mg CAPS. GASTROREZ. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 0.336785 0.000000 0.303106 0.033679
1,099 W66011002 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mg CAPS. GASTROREZ. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 14 CAPS. GASTROREZ. P6L 14 0.604285 0.000000 0.543856 0.060429
1,100 W66017007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.247355 0.014073 0.222619 0.038809
1,101 W66018007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.290000 0.000000 0.261000 0.029000
1,102 W66016007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.123677 0.059180 0.111309 0.071548
1,103 W65996005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.050333 0.000000 0.045299 0.005034
1,104 W65997005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.193249 0.054751 0.173924 0.074076
1,105 W65998005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.341000 0.000000 0.306900 0.034100
1,106 W64585002 J01XD01 METRONIDAZOLUM METRONIDAZOL VIOSER 500 mg/100 ml SOL. PERF. 500mg/100ml VIOSER S.A. PARENTERAL SOLUTION INDUSTRY GRECIA CUTIE CU 10 FLAC. PEJD X 100 ML SOL. PERF. PRF 10 4.870000 0.394000 4.383000 0.881000
1,107 W65506004 M04AA01 ALLOPURINOLUM * ALOPURINOL AUROBINDO 100 mg COMPR. 100mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL TRANSPARENT X 30 COMPR. P6L 30 0.152791 0.021875 0.137511 0.037155
1,108 W65508004 M04AA01 ALLOPURINOLUM * ALOPURINOL AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL TRANSPARENT X 30 COMPR. P6L 30 0.411000 0.000000 0.369900 0.041100

SE MODIFICA

1 W64020007 A02BC01 OMEPRAZOLUM OMEZ 10 mg 10mg


CAPS. GASTROREZ. DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0.202933 0.431400 0.182639 0.451694
4 W52044001 A02BC01 OMEPRAZOLUM OMEPRAZOL TERAPIA 20 mg 20mg
CAPS. GASTROREZ. TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0.405867 0.414799 0.365280 0.455386
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 0.405867 0.396466 0.365280 0.437053
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 0.405867 0.373799 0.365280 0.414386
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 0.405867 0.486133 0.365280 0.526720
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 0.405867 0.353133 0.365280 0.393720
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 0.405867 0.374466 0.365280 0.415053
1,069 W42284004 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC-AL-OPA/AL X 10 CAPS. GASTROREZ P-6L 30 0.405867 0.294133 0.365280 0.334720
2 W42129001 A02BC01 OMEPRAZOLUM OMEPRAZOL-RICHTER 20 mg CAPS. GASTROREZ. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L 14 0.405867 0.316275 0.365280 0.356862
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 0.405867 0.418466 0.365280 0.459053
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 0.405867 0.326133 0.365280 0.366720
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 0.405867 0.372133 0.365280 0.412720
15 W61506002 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L 28 0.405867 0.430204 0.365280 0.470791
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 0.811735 0.005407 0.730561 0.086581
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 0.202933 0.308495 0.182639 0.328789
1,023 W65062001 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg TERAPIA S.A. ROMANIA CUTIE CU 2 BLIST. AL-PVC-PA/AL X 7 CAPS. GASTROREZ. P6L 14 0.202933 0.308495 0.182639 0.328789
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 0.405867 0.284133 0.365280 0.324720
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 0.405867 0.481275 0.365280 0.521862
1,024 W65063001 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg TERAPIA S.A. ROMANIA CUTIE CU 2 BLIST. AL-PVC-PA/AL X 7 CAPS. GASTROREZ. P6L 14 0.405867 0.481275 0.365280 0.521862
61 W07616001 B01AC05 TICLOPIDINUM 1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0.276749 1.593751 0.249074 1.621426
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 0.276749 0.447251 0.249074 0.474926
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 0.247355 0.044978 0.222619 0.069714
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 0.247355 0.025502 0.222619 0.050238
213 W42058001 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.247355 0.048645 0.222619 0.073381
214 W42659001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.247355 0.239645 0.222619 0.264381
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 0.247355 0.106145 0.222619 0.130881
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 0.247355 0.158311 0.222619 0.183047
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 0.247355 0.228645 0.222619 0.253381
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 0.247355 0.239645 0.222619 0.264381
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 0.494710 0.056290 0.445239 0.105761
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 0.494710 0.138956 0.445239 0.188427
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 0.494710 0.056956 0.445239 0.106427
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 0.494710 0.140290 0.445239 0.189761
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 0.494710 0.081956 0.445239 0.131427
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 0.123677 0.072394 0.111309 0.084762

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

Prescriptie
Cod_CIM cant. beneficiaza de (pt. asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 90%
Nr crt.

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)
227 W41912001 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.123677 0.052989 0.111309 0.065357
228 W42660001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0.123677 0.127323 0.111309 0.139691
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 0.123677 0.116823 0.111309 0.129191
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 0.123677 0.070989 0.111309 0.083357
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 0.123677 0.066323 0.111309 0.078691
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 0.123677 0.127323 0.111309 0.139691
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 0.247355 0.014073 0.222619 0.038809
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 0.123677 0.059180 0.111309 0.071548
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 0.688049 0.489284 0.619244 0.558089
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 0.688049 0.489284 0.619244 0.558089
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 0.344024 0.007642 0.309621 0.042045
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 0.344024 0.007642 0.309621 0.042045
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 0.344024 0.008118 0.309621 0.042521
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 0.096624 0.244447 0.086961 0.254110
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. FILM P-6L 28 0.096624 0.118018 0.086961 0.127681
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 0.096624 0.231709 0.086961 0.241372
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 0.096624 0.203733 0.086961 0.213396
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 0.096624 0.244376 0.086961 0.254039
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 0.096624 0.059090 0.086961 0.068753
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 0.096624 0.059376 0.086961 0.069039
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 0.193249 0.262822 0.173924 0.282147
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. FILM P-6L 28 0.193249 0.262822 0.173924 0.282147
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 0.193249 0.508536 0.173924 0.527861
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 0.193249 0.262751 0.173924 0.282076
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 0.193249 0.262465 0.173924 0.281790
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 0.193249 0.262751 0.173924 0.282076
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 0.193249 0.065322 0.173924 0.084647
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 0.193249 0.054751 0.173924 0.074076
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 0.193249 0.262751 0.173924 0.282076
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 0.289874 0.218459 0.260886 0.247447
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 0.386499 0.778858 0.347849 0.817508
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 0.386499 0.392786 0.347849 0.431436
435 W41446002 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg ROMANIA
GEDEON RICHTER ROMANIA SA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0.386499 0.192786 0.347849 0.231436
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 0.386499 0.736834 0.347849 0.775484
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 0.386499 0.741167 0.347849 0.779817
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 0.386499 0.000167 0.347849 0.038817
441 W06752001 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 0.128833 0.424167 0.115949 0.437051
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 0.128833 0.813167 0.115949 0.826051
443 W43037001 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.
MAREA BRITANIE P-6L 28 0.193249 0.676393 0.173924 0.695718
1,036 W65064001 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg TERAPIA S.A. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. P-6L 28 0.193249 0.676393 0.173924 0.695718
444 W43843001 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLISTERE DIN PA-AL-PVC/AL X 7 COMPRIMATE P-6L 28 0.386499 0.999215 0.347849 1.037865
1,037 W65065001 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg TERAPIA S.A. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. P-6L 28 0.386499 0.999215 0.347849 1.037865
1,074 W64585001 J01XD01 METRONIDAZOLUM METRONIDAZOL VIOSER 500 mg/100 ml SOL. PERF. 500mg/100ml VIOSER S.A. PARENTERAL SOLUTIONS INDUSTRY GRECIA CUTIE CU 1 FLAC. PEJD X 100 ML SOL. PERF. PRF 1 4.870000 0.580000 4.383000 1.067000
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 9.740000 0.200000 8.766000 1.174000
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 9.740000 0.000000 8.766000 0.974000
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 4.870000 0.403000 4.383000 0.890000
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 4.870000 0.403000 4.383000 0.890000
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 4.870000 0.138000 4.383000 0.625000
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 0.729675 0.161825 0.656707 0.234793
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 0.729675 0.091825 0.656707 0.164793
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 0.243224 0.132776 0.218901 0.157099
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 0.152791 0.026809 0.137511 0.042089
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 0.152791 0.024875 0.137511 0.040155
1,062 W65236001 M04AA01 ALLOPURINOLUM * MILURIT 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P6L 30 0.305583 0.001417 0.275024 0.031976
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 0.087097 0.070103 0.078387 0.078813
815 W64281004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0.087097 0.070103 0.078387 0.078813
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 0.087097 0.520069 0.078387 0.528779
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 0.087097 0.341736 0.078387 0.350446
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 0.261293 0.210107 0.235163 0.236237
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 0.261293 0.210107 0.235163 0.236237
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 0.261293 0.535007 0.235163 0.561137

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

Prescriptie
Cod_CIM cant. beneficiaza de (pt. asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 90%
Nr crt.

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)
821 W42824001 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L
MAREA BRITANIE 50 0.261293 1.157107 0.235163 1.183237
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 0.261293 0.344873 0.235163 0.371003
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 0.261293 0.683873 0.235163 0.710003
1,052 W65059001 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0.261293 1.157107 0.235163 1.183237
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 0.261293 0.194707 0.235163 0.220837
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 0.261293 0.194707 0.235163 0.220837
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 0.348392 0.280808 0.313552 0.315648
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 0.348392 0.280808 0.313552 0.315648
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 0.348392 0.908108 0.313552 0.942948
829 W42825001 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L
MAREA BRITANIE 50 0.348392 1.241008 0.313552 1.275848
831 W54334001 N03AX12 GABAPENTINUM GRIMODIN 400 mg CAPS. 400mg UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L
EGIS PHARMACEUTICALS P.L.C. 60 0.348392 0.734441 0.313552 0.769281
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 0.348392 0.833108 0.313552 0.867948
1,053 W65060001 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0.348392 1.241008 0.313552 1.275848
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 0.348392 0.259208 0.313552 0.294048
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 0.348392 0.259208 0.313552 0.294048
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 0.522588 1.773078 0.470329 1.825337
1,054 W65061001 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P6L 30 0.522588 1.773078 0.470329 1.825337

SE ELIMINA

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
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 0.686700 0.314300 0.618030 0.382970
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 0.343350 0.008316 0.309015 0.042651

Pagina 3 din 3
ANEXA 7
(ANEXA 2b la Ordinul CNAS nr. 1611/2018)
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 SEPTEMBRIE 2019

Contributie maxima a Val. maxima suportata de Val. maxima suportata de


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

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
Cod_CIM

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)

SE ADAUGA

1,266 W65962005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 20 mg COMPR. GASTROREZ. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA 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
1,267 W65963005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 40 mg COMPR. GASTROREZ. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA 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
1,268 W65339001 A11CC03 ALFACALCIDOLUM ALFACALCIDOL HEATON 0,50 micrograme CAPS. MOI 0,50micrograme HEATON K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 30 CAPS. MOI PRF 30 1.194000 0.000000 0.597000 0.597000 1.074600 0.119400
1,269 W65505007 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL-PA-PVC/AL X 30 COMPR. FILM. PRF 30 1.106999 0.020667 0.553499 0.574167 0.996299 0.131367
1,270 W66019002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0.625000 0.000000 0.312500 0.312500 0.562500 0.062500
1,271 W65175002 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P6L 28 0.278399 0.418386 0.139199 0.557586 0.250559 0.446226
1,272 W62738003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 10 mg/160 mg COMPR. FILM. 10mg/160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 COMPR. FILM. P6L 28 2.347500 0.000000 1.173750 1.173750 2.112750 0.234750
1,273 W62738005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 10 mg/160 mg COMPR. FILM. 10mg/160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 56 COMPR. FILM. P6L 56 2.226428 0.000000 1.113214 1.113214 2.003785 0.222643
1,274 W62737005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/160 mg COMPR. FILM. 5mg/160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 56 COMPR. FILM. P6L 56 2.168214 0.000000 1.084107 1.084107 1.951392 0.216822
1,275 W62737003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/160 mg COMPR. FILM. 5mg/160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 COMPR. FILM. P6L 28 2.282857 0.000000 1.141428 1.141429 2.054571 0.228286
1,276 W62736005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/80 mg COMPR. FILM. 5mg/80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 56 COMPR. FILM. P6L 56 1.280000 0.946071 0.640000 1.586071 1.152000 1.074071
1,277 W62736003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/80 mg COMPR. FILM. 5mg/80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 COMPR. FILM. P6L 28 1.280000 1.066785 0.640000 1.706785 1.152000 1.194785
1,278 W54696006 C10AA05 ATORVASTATINUM ATORIS 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR.FILM. P-6L 28 0.289874 0.095483 0.144937 0.240420 0.260886 0.124471
1,279 W54697006 C10AA05 ATORVASTATINUM ATORIS 10 mg COMPR. FILM. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR.FILM. P-6L 28 0.355357 0.000000 0.177678 0.177679 0.319821 0.035536
1,280 W65411002 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** TWICOR 10 mg/10 mg COMPR. FILM. 10mg/10mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CONPR. FILM. P6L 30 2.749333 0.000000 1.374666 1.374667 2.474399 0.274934
1,281 W65412002 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** TWICOR 20 mg/10 mg COMPR. FILM. 20mg/10mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CONPR. FILM. P6L 30 3.265000 0.000000 1.632500 1.632500 2.938500 0.326500
1,282 W62934001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) ENSTILUM 50 micrograme/0,5 mg/g SPUMA CUT. 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA CUT IE CU 1 RECIPIENT PRESURIZAT DIN AL, CU UN ST RAT INT ERIOR DIN LAC POLIAMID-IMIDIC PREVAZUT CU VALVA DOZAT OARE SI SIST EM DE ACT IONARE CARE CONT INE 60 G SPUMA CUT ANAT A PRF 1 220.470000 0.000000 110.235000 110.235000 198.423000 22.047000
1,283 W65416003 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 10 mg COMPR. FILM. 10mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 2.797666 0.000000 1.398833 1.398833 2.517899 0.279767
1,284 W65416017 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 10 mg COMPR. FILM. 10mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 2.797666 0.000000 1.398833 1.398833 2.517899 0.279767
1,285 W65416031 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 10 mg COMPR. FILM. 10mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 2.797666 0.000000 1.398833 1.398833 2.517899 0.279767
1,286 W66013005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 0.513666 0.000000 0.256833 0.256833 0.462299 0.051367
1,287 W66014005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 1.081000 0.000000 0.540500 0.540500 0.972900 0.108100
1,288 W66012005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 75 mg CAPS. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 0.385166 0.000000 0.192583 0.192583 0.346649 0.038517
1,289 W61818005 R03AL06 COMBINATII (TIOTROPIUM+OLODATEROLUM) ** SPIOLTO RESPIMAT 2,5 micrograme/2,5 micrograme SOL. DE INHALAT 2,5 micrograme/2,5 micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU AMBALAJ UNIC FORMAT DIN 1 INHALATOR RESPIMAT REUTILIZABIL SI 1 CARTUS X 60 PUFURI (30 DOZE) SOL. DE INHALAT PRF 1 206.430000 0.000000 103.215000 103.215000 185.787000 20.643000
1,290 W58575005 R03BB04 TIOTROPIUM * SPIRIVA RESPIMAT 2,5 micrograme SOL. DE INHALAT 2,5micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 INHALATOR RESPIMAT RE-UTILIZABIL SI 1 CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. DE INHALAT PRF 1 138.070000 0.000000 69.035000 69.035000 124.263000 13.807000

SE MODIFICA

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 0.541156 0.137415 0.270578 0.407993 0.487040 0.191531
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 1.082313 0.011258 0.541156 0.552415 0.974081 0.119490
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 0.541156 0.770986 0.270578 1.041564 0.487040 0.825102
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 0.541156 0.435986 0.270578 0.706564 0.487040 0.490102
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 1.082313 0.636972 0.541156 1.178129 0.974081 0.745204
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 1.082313 0.361972 0.541156 0.903129 0.974081 0.470204
29 W56303002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZISTENTE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 0.541156 0.435986 0.270578 0.706564 0.487040 0.490102
30 W56304002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg COMPR. GASTROREZISTENTE 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 1.082313 0.361972 0.541156 0.903129 0.974081 0.470204
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 0.597000 0.023400 0.298500 0.321900 0.537300 0.083100
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 0.597000 0.209333 0.298500 0.507833 0.537300 0.269033
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 1.194000 0.000000 0.597000 0.597000 1.074600 0.119400
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 10.417333 1.642667 5.208666 6.851334 9.375599 2.684401
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 10.417333 1.642667 5.208666 6.851334 9.375599 2.684401
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 5.208666 1.492334 2.604333 4.096667 4.687799 2.013201
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 5.208666 1.492334 2.604333 4.096667 4.687799 2.013201
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 10.417333 1.738667 5.208666 6.947334 9.375599 2.780401
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 10.417333 1.738667 5.208666 6.947334 9.375599 2.780401
1,093 W63590012 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI (20 mg)/0,2 ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI(20mg)/0,2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (STICLA TIP I) ASAMBLATE CU DOP DIN CAUCIUC (CLOROBUTILIC SAU BROMOBUTILIC) SI AC DE INJECTIE PR/PRF 10 5.208666 1.492334 2.604333 4.096667 4.687799 2.013201
1,094 W63591012 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI (40 mg)/0,4 ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI(40mg)/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (STICLA TIP I) ASAMBLATE CU DOP DIN CAUCIUC (CLOROBUTILIC SAU BROMOBUTILIC) SI AC DE INJECTIE PR/PRF 10 10.417333 1.738667 5.208666 6.947334 9.375599 2.780401
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 6.944887 2.004113 3.472443 5.476557 6.250398 2.698602
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 10.417333 2.968667 5.208666 8.177334 9.375599 4.010401
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 13.889774 2.981226 6.944887 9.926113 12.500796 4.370204
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 29.763805 24.994195 14.881902 39.876098 26.787424 27.970576
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 59.527616 57.863384 29.763808 87.627192 53.574854 63.816146
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 1.106999 0.058358 0.553499 0.611858 0.996299 0.169058
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 1.106999 0.020667 0.553499 0.574167 0.996299 0.131367
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 1.106999 0.020667 0.553499 0.574167 0.996299 0.131367
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 1.106999 0.540858 0.553499 1.094358 0.996299 0.651558
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 0.553499 0.181301 0.276749 0.458051 0.498149 0.236651
100 W53412001 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 0.553499 0.181101 0.276749 0.457851 0.498149 0.236451
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 1.079678 0.306036 0.539839 0.845875 0.971710 0.414004
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 1.079678 0.807643 0.539839 1.347482 0.971710 0.915611
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 1.079678 0.307107 0.539839 0.846946 0.971710 0.415075

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Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
Cod_CIM

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
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 1.079678 0.307107 0.539839 0.846946 0.971710 0.415075
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 1.079678 0.307107 0.539839 0.846946 0.971710 0.415075
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 1.079678 0.307107 0.539839 0.846946 0.971710 0.415075
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 1.079678 0.437643 0.539839 0.977482 0.971710 0.545611
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 1.079678 1.625679 0.539839 2.165518 0.971710 1.733647
1,194 W65679001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. PRF 56 1.079678 1.625679 0.539839 2.165518 0.971710 1.733647
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 1.619517 0.267804 0.809758 1.077563 1.457565 0.429756
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 1.619517 0.128340 0.809758 0.938099 1.457565 0.290292
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 1.619517 0.128340 0.809758 0.938099 1.457565 0.290292
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 1.619517 0.311018 0.809758 1.120777 1.457565 0.472970
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 1.619517 0.128340 0.809758 0.938099 1.457565 0.290292
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 1.619517 0.150661 0.809758 0.960420 1.457565 0.312613
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 1.619517 0.993518 0.809758 1.803277 1.457565 1.155470
1,195 W65680001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. P6L 56 1.619517 0.993518 0.809758 1.803277 1.457565 1.155470
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 0.091466 0.156600 0.248066 0.281880 0.122786
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 0.091466 0.156600 0.248066 0.281880 0.122786
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 0.079266 0.313200 0.392466 0.563760 0.141906
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 0.079266 0.313200 0.392466 0.563760 0.141906
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 1.376099 0.217829 0.688049 0.905879 1.238489 0.355439
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 0.344024 2.224190 0.172012 2.396202 0.309621 2.258593
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 0.344024 1.319547 0.172012 1.491559 0.309621 1.353950
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 0.344024 0.086690 0.172012 0.258702 0.309621 0.121093
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 0.344024 0.086690 0.172012 0.258702 0.309621 0.121093
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 0.688049 0.506951 0.344024 0.850976 0.619244 0.575756
231 W55631001 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) P-6L 1 4.128299 20.751701 2.064149 22.815851 3.715469 21.164531
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 0.681428 0.000000 0.340714 0.340714 0.613285 0.068143
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 0.688049 0.517665 0.344024 0.861690 0.619244 0.586470
1,132 W60637006 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM. P-6L 30 0.688049 0.541284 0.344024 0.885309 0.619244 0.610089
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 1.376099 0.224615 0.688049 0.912665 1.238489 0.362225
1,134 W60638007 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM. P-6L 30 1.376099 0.259567 0.688049 0.947617 1.238489 0.397177
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 1.376099 0.054258 0.688049 0.742308 1.238489 0.191868
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 0.688049 0.172665 0.344024 0.516690 0.619244 0.241470
278 W05785002 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 1.376099 0.071758 0.688049 0.759808 1.238489 0.209368
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 0.772999 0.243429 0.386499 0.629929 0.695699 0.320729
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 0.289874 0.607459 0.144937 0.752396 0.260886 0.636447
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 0.289874 0.075792 0.144937 0.220729 0.260886 0.104780
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 0.289874 0.075792 0.144937 0.220729 0.260886 0.104780
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 0.289874 0.104459 0.144937 0.249396 0.260886 0.133447
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 0.289874 0.061792 0.144937 0.206729 0.260886 0.090780
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 0.289874 0.001792 0.144937 0.146729 0.260886 0.030780
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 0.289874 0.607459 0.144937 0.752396 0.260886 0.636447
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 0.579749 0.592917 0.289874 0.882792 0.521774 0.650892
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 0.579749 0.000251 0.289874 0.290126 0.521774 0.058226
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 0.579749 0.592917 0.289874 0.882792 0.521774 0.650892
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 1.159499 0.169072 0.579749 0.748822 1.043549 0.285022
1,102 W64879006 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1.159499 0.169072 0.579749 0.748822 1.043549 0.285022
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 0.579749 2.746679 0.289874 3.036554 0.521774 2.804654
1,182 W62399024 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30X1 COMPR. FILM. P6L 30 0.579749 0.033584 0.289874 0.323459 0.521774 0.091559
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 0.579749 0.065917 0.289874 0.355792 0.521774 0.123892
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 0.579749 0.211584 0.289874 0.501459 0.521774 0.269559
412 W59899004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. 28 0.579749 0.066322 0.289874 0.356197 0.521774 0.124297
413 W59899017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. 28 0.579749 0.066322 0.289874 0.356197 0.521774 0.124297
416 W61054001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA P6L
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. 30 0.579749 0.312917 0.289874 0.602792 0.521774 0.370892
1,138 W65079001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 0.579749 2.746679 0.289874 3.036554 0.521774 2.804654
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 0.579749 0.077584 0.289874 0.367459 0.521774 0.135559
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 0.579749 1.617917 0.289874 1.907792 0.521774 1.675892
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 1.159499 3.705501 0.579749 4.285251 1.043549 3.821451
1,183 W62400024 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30X1 COMPR. FILM. P6L 30 1.159499 0.018501 0.579749 0.598251 1.043549 0.134451
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 1.159499 0.000143 0.579749 0.579893 1.043549 0.116093
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 1.159499 0.000143 0.579749 0.579893 1.043549 0.116093
1,139 W65078001 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 1.159499 3.705501 0.579749 4.285251 1.043549 3.821451
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 1.159499 2.171167 0.579749 2.750917 1.043549 2.287117
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 2.318999 0.000643 1.159499 1.160143 2.087099 0.232543
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 2.318999 0.000643 1.159499 1.160143 2.087099 0.232543
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 2.318999 0.312001 1.159499 1.471501 2.087099 0.543901
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 2.318999 0.461667 1.159499 1.621167 2.087099 0.693567
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 0.289874 2.346197 0.144937 2.491134 0.260886 2.375185
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 0.289874 0.039459 0.144937 0.184396 0.260886 0.068447
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 0.289874 0.494459 0.144937 0.639396 0.260886 0.523447
446 W59898004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. 28 0.289874 0.039054 0.144937 0.183991 0.260886 0.068042
447 W59898017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. 28 0.289874 0.039054 0.144937 0.183991 0.260886 0.068042
450 W61053001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA P6L
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. 30 0.289874 0.521792 0.144937 0.666729 0.260886 0.550780
1,140 W65077001 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 0.289874 2.346197 0.144937 2.491134 0.260886 2.375185

Pagina 2 din 4
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
Cod_CIM

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
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 0.289874 0.790840 0.144937 0.935777 0.260886 0.819828
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 3.474250 0.627750 1.737125 2.364875 3.126825 0.975175
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 3.474250 1.022083 1.737125 2.759208 3.126825 1.369508
1,184 W65535004 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** CO-ROSWERA 10 mg/10 mg COMPR. FILM. 10mg/10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 3.474250 0.627750 1.737125 2.364875 3.126825 0.975175
1,185 W65537004 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** CO-ROSWERA 20 mg/10 mg COMPR. FILM. 20mg/10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 3.474250 1.022083 1.737125 2.759208 3.126825 1.369508
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 55.138750 0.021250 27.569375 27.590625 49.624875 5.535125
471 W56194001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) DAIVOBET 50 micrograme/0,5mg/g UNGUENT 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL/EPOXID-FENOL X 15 G UNGUENT P-RF 1 55.138750 0.021250 27.569375 27.590625 49.624875 5.535125
573 W57773001 G04BD07 TOLTERODINUM ** # UROFLOW 1 COMPR. FILM. 1mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0.377100 0.468614 0.188550 0.657164 0.339390 0.506324
574 W57774001 G04BD07 TOLTERODINUM ** # UROFLOW 2 COMPR. FILM. 2mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0.754200 0.122585 0.377100 0.499685 0.678780 0.198005
575 W56677002 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 10 mg COMPR. FILM. 10 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 3.016800 0.369533 1.508400 1.877933 2.715120 0.671213
576 W43104001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 10 mg COMPR. FILM. 10mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 3.016800 1.364533 1.508400 2.872933 2.715120 1.666213
577 W62757002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 3.016800 0.369200 1.508400 1.877600 2.715120 0.670880
578 W63709008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 3.016800 0.512200 1.508400 2.020600 2.715120 0.813880
579 W63709010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 3.016800 0.335200 1.508400 1.843600 2.715120 0.636880
580 W63709013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 3.016800 0.161644 1.508400 1.670044 2.715120 0.463324
581 W63709001 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 3.016800 0.512200 1.508400 2.020600 2.715120 0.813880
582 W63709003 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 3.016800 0.335200 1.508400 1.843600 2.715120 0.636880
583 W63709006 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 3.016800 0.161644 1.508400 1.670044 2.715120 0.463324
584 W56676002 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 5 mg COMPR. FILM. 5 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 1.508400 0.574266 0.754200 1.328466 1.357560 0.725106
585 W43105001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 5 mg COMPR. FILM. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 1.508400 1.867266 0.754200 2.621466 1.357560 2.018106
586 W62756002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 1.508400 1.535266 0.754200 2.289466 1.357560 1.686106
587 W63708008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 1.508400 1.771600 0.754200 2.525800 1.357560 1.922440
588 W63708010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 1.508400 1.506600 0.754200 2.260800 1.357560 1.657440
589 W63708013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 1.508400 1.350488 0.754200 2.104688 1.357560 1.501328
590 W63708001 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 1.508400 1.771600 0.754200 2.525800 1.357560 1.922440
591 W63708003 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 1.508400 1.506600 0.754200 2.260800 1.357560 1.657440
592 W63708006 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 1.508400 1.350488 0.754200 2.104688 1.357560 1.501328
593 W62488001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 1 mg/ml SUSP. ORALA 1mg/ml ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA BRUNA DIN PET CARE CONTINE 150 ML SUSP. ORALA P6L 1 45.251999 138.088001 22.625999 160.714001 40.726799 142.613201
594 W43786001 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.565650 0.822016 0.282825 1.104841 0.509085 0.878581
595 W43789001 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 1.131300 1.105366 0.565650 1.671016 1.018170 1.218496
707 W06864001 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 0.486449 0.407551 0.243224 0.650776 0.437804 0.456196
708 W60403002 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN TROMETAMOL SANDOZ 25mg COMPR. FILM. 25mg SANDOZ S.R.L. ROMANIA CUTIE BLIST. DIN PVC-PVDC/AL X 20 COMPRIMATE FILMATE P6L 20 0.486449 0.110051 0.243224 0.353276 0.437804 0.158696
746 W62612001 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. PRF 28 0.631375 0.977553 0.315687 1.293241 0.568237 1.040691
747 W62612002 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 28X1 COMPR. FILM. PRF 28 0.631375 0.977553 0.315687 1.293241 0.568237 1.040691
1,211 W63613010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.306470 1.130137 0.653235 1.783372 1.175823 1.260784
1,212 W63613008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1.306470 1.398530 0.653235 2.051765 1.175823 1.529177
1,213 W63613003 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 1.306470 1.130137 0.653235 1.783372 1.175823 1.260784
1,214 W63613001 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 1.306470 1.398530 0.653235 2.051765 1.175823 1.529177
1,227 W62880005 N03AX16 PREGABALINUM ** # PREGABALINA DR. REDDY'S 150 mg CAPS. 150mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1.567767 1.099554 0.783883 1.883438 1.410990 1.256331
1,230 W62572011 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.567767 1.099554 0.783883 1.883438 1.410990 1.256331
1,231 W62572008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1.567767 1.430804 0.783883 2.214688 1.410990 1.587581
1,232 W62572003 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 1.567767 1.099554 0.783883 1.883438 1.410990 1.256331
1,233 W62572001 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 1.567767 1.430804 0.783883 2.214688 1.410990 1.587581
1,234 W63615010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 2.612944 1.772948 1.306472 3.079420 2.351649 2.034243
1,235 W63615008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2.612944 2.095627 1.306472 3.402099 2.351649 2.356922
1,236 W63615003 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 2.612944 1.772948 1.306472 3.079420 2.351649 2.034243
1,237 W63615001 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 2.612944 2.095627 1.306472 3.402099 2.351649 2.356922
1,244 W62883005 N03AX16 PREGABALINUM ** # PREGABALINA DR. REDDY'S 300 mg CAPS. 300mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 3.135534 0.788394 1.567767 2.356161 2.821980 1.101948
839 W41743001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 0.783883 0.307545 0.391941 0.699487 0.705494 0.385934
840 W41743002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 0.783883 0.271117 0.391941 0.663059 0.705494 0.349506
1,246 W62571003 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 0.783883 0.927902 0.391941 1.319844 0.705494 1.006291
1,247 W62571001 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 0.783883 1.079688 0.391941 1.471630 0.705494 1.158077
1,260 W62878005 N03AX16 PREGABALINUM ** # PREGABALINA DR. REDDY'S 75 mg CAPS. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0.783883 0.898438 0.391941 1.290380 0.705494 0.976827
1,263 W62571011 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.783883 0.927902 0.391941 1.319844 0.705494 1.006291
1,264 W62571008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0.783883 1.079688 0.391941 1.471630 0.705494 1.158077
841 W64906002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0.783883 0.271117 0.391941 0.663059 0.705494 0.349506
842 W64906001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0.783883 0.307545 0.391941 0.699487 0.705494 0.385934
1,249 W62278006 N03AX16 PREGABALINUM ** # PREGAMID 75 mg CAPS. 75mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0.783883 0.132783 0.391941 0.524725 0.705494 0.211172
1,265 W64181001 N03AX16 PREGABALINUM ** # SIRANALEN 20 mg/ml SOL. ORALA 20mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 FLAC. PEID CONTINAND 473 ML SOL. ORALA, O SERINGA PT. ADMINISTRARE ORALA, UN ADAPTOR DIN PLASTIC ALB CARE SE ATASEAZA LA FLAC. PRIN IMPINGERE PRF 1 98.873861 44.906139 49.436930 94.343070 88.986474 54.793526
843 W60055001 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL ZENTIVA 0,18 mg COMPR. 0,18 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 0.187665 0.219668 0.093832 0.313501 0.168898 0.238435
844 W53525002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0.187665 0.261668 0.093832 0.355501 0.168898 0.280435
845 W54712001 N04BC05 PRAMIPEXOLUM * MEDOPEXOL 0,18 mg COMPR. 0,18mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 0.187665 0.379001 0.093832 0.472834 0.168898 0.397768
846 W55286001 N04BC05 PRAMIPEXOLUM * GLEPARK 0,18 mg COMPR. 0,18mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 0.187665 0.138001 0.093832 0.231834 0.168898 0.156768
847 W60054001 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL ZENTIVA 0,7 mg COMPR. 0,7 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 0.729810 1.417523 0.364905 1.782428 0.656829 1.490504
848 W53527002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0.729810 1.303190 0.364905 1.668095 0.656829 1.376171
849 W54713001 N04BC05 PRAMIPEXOLUM * MEDOPEXOL 0,7 mg COMPR. 0,7mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 0.729810 1.405856 0.364905 1.770761 0.656829 1.478837
850 W55288001 N04BC05 PRAMIPEXOLUM * GLEPARK 0,7 mg COMPR. 0,7mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 0.729810 1.241856 0.364905 1.606761 0.656829 1.314837
851 W54798001 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,26 mg COMPR. ELIB. PREL. 0,26mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 10 0.271072 1.255928 0.135536 1.391464 0.243964 1.283036
852 W60244001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0.271072 0.398594 0.135536 0.534130 0.243964 0.425702
853 W60802001 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,26 mg COMPR. ELIB. PREL. 0,26mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF 10 0.271072 0.398928 0.135536 0.534464 0.243964 0.426036
854 W54799002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,52 mg COMPR. ELIB. PREL. 0,52mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 0.542145 1.649855 0.271072 1.920928 0.487930 1.704070
855 W60240001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,52mg COMPR. ELIB. PREL. 0,52mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0.542145 0.932188 0.271072 1.203261 0.487930 0.986403
856 W60803002 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,52 mg COMPR. ELIB. PREL. 0,52mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 0.542145 0.932188 0.271072 1.203261 0.487930 0.986403

Pagina 3 din 4
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
Cod_CIM

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
857 W54800002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 1,05 mg COMPR. ELIB. PREL. 1,05mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 1.094715 3.076285 0.547357 3.623643 0.985243 3.185757
858 W60241001 N04BC05 PRAMIPEXOLUM * OPRYMEA 1,05mg COMPR. ELIB. PREL. 1,05mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 1.094715 0.888618 0.547357 1.435976 0.985243 0.998090
859 W60243001 N04BC05 PRAMIPEXOLUM * OPRYMEA 2,10mg COMPR. ELIB. PREL. 2,10mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 2.189431 1.576902 1.094715 2.671618 1.970487 1.795846
860 W54801002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 2,1 mg COMPR. ELIB. PREL. 2,1mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 2.189431 5.359902 1.094715 6.454618 1.970487 5.578846
861 W60805002 N04BC05 PRAMIPEXOLUM * CALMOLAN 2,1 mg COMPR. ELIB. PREL. 2,1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 2.189431 1.729902 1.094715 2.824618 1.970487 1.948846
862 W54802002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 3,15 mg COMPR. ELIB. PREL. 3,15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 3.284147 4.896186 1.642073 6.538260 2.955732 5.224601
863 W62151001 N04BC05 PRAMIPEXOLUM * OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 3.284147 4.896519 1.642073 6.538593 2.955732 5.224934
864 W10479001 N04BC08 PIRIBEDILUM ** PRONORAN 50 mg DRAJ. ELIB. PREL. 50mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL. P-RF 30 0.651616 0.333384 0.325808 0.659192 0.586454 0.398546
874 W55813002 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0.615357 0.000000 0.307678 0.307679 0.553821 0.061536
895 W43297002 N06AX21 DULOXETINUM ** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 0.622922 1.156720 0.311461 1.468181 0.560629 1.219013
896 W61820005 N06AX21 DULOXETINUM ** DULSEVIA 30 mg CAPS. GASTROREZ. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 0.622922 0.471078 0.311461 0.782539 0.560629 0.533371
897 W61959001 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.598863 0.311461 0.910324 0.560629 0.661156
898 W61959002 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.598863 0.311461 0.910324 0.560629 0.661156
899 W62006001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 30 mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.719220 0.311461 1.030681 0.560629 0.781513
900 W62305004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 30 mg CAPS. GASTROREZ. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 0.622922 0.577078 0.311461 0.888539 0.560629 0.639371
901 W62054001 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.619578 0.311461 0.931039 0.560629 0.681871
902 W62274004 N06AX21 DULOXETINUM ** DULASOLAN 30 mg CAPS. GASTROREZ. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 0.622922 0.481411 0.311461 0.792872 0.560629 0.543704
903 W62301003 N06AX21 DULOXETINUM ** DULOXETINA STADA 30 mg CAPS. GASTROREZ. 30mg STADA M&D SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 1.350292 0.311461 1.661753 0.560629 1.412585
904 W62808002 N06AX21 DULOXETINUM ** DULOXETINA SANDOZ 30 mg CAPS. GASTROREZ. 30mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.421006 0.311461 0.732467 0.560629 0.483299
905 W62801002 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.534220 0.311461 0.845681 0.560629 0.596513
906 W62801012 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.534220 0.311461 0.845681 0.560629 0.596513
907 W63955004 N06AX21 DULOXETINUM ** DOZZEX 30 mg CAPS. GASTROREZ. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0.622922 0.629578 0.311461 0.941039 0.560629 0.691871
908 W63230001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 45 mg CAPS. GASTROREZ. 45mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 0.934383 1.397759 0.467191 1.864951 0.840944 1.491198
909 W43298001 N06AX21 DULOXETINUM ** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 1.245844 1.464156 0.622922 2.087078 1.121259 1.588741
916 W62306004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 60 mg CAPS. GASTROREZ. 60mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1.245844 0.006822 0.622922 0.629744 1.121259 0.131407
918 W62803003 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. GASTROREZ. PRF 30 1.245844 0.549822 0.622922 1.172744 1.121259 0.674407
919 W62803013 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1.245844 0.549822 0.622922 1.172744 1.121259 0.674407
921 W63956004 N06AX21 DULOXETINUM ** DOZZEX 60 mg CAPS. GASTROREZ. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1.245844 0.053441 0.622922 0.676363 1.121259 0.178026
1,006 W58575001 R03BB04 TIOTROPIUM * SPIRIVA RESPIMAT 2,5 micrograme SOL. DE INHALAT 2,5micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 AMBALAJ UNIC CU UN INHALATOR RESPIMAT SI UN CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. PT. INHALAT PRF 1 138.070000 0.000000 69.035000 69.035000 124.263000 13.807000
1,076 W55648001 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT., SUSPENSIE P-RF 1 5.730000 0.030000 2.865000 2.895000 5.157000 0.603000
1,078 W02427001 S01BA01 DEXAMETHASONUM MAXIDEX (R) PICATURI OFT.-SUSP. 0,1% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 5.730000 0.000000 2.865000 2.865000 5.157000 0.573000
1,079 W63597001 S01BA01 DEXAMETHASONUM MAXIDEX 1 mg/ml PICATURI OFT.-SUSP. 1 mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 5.730000 0.000000 2.865000 2.865000 5.157000 0.573000

SE ELIMINA

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 5.639160 7.213840 2.819580 10.033420 5.075244 7.777756
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 7.250347 9.277653 3.625173 12.902827 6.525312 10.002688
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 8.055940 30.504060 4.027970 34.532030 7.250346 31.309654
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 22.556640 30.008360 11.278320 41.286680 20.300976 32.264024
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 29.001394 33.313606 14.500697 47.814303 26.101254 36.213746
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
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
881 W59846001 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 1.014285 0.000000 0.507142 0.507143 0.912856 0.101429
913 W62007001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 60 mg CAPS. GASTROREZ. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 1.248118 1.352953 0.624059 1.977012 1.123306 1.477765
1,077 W55648002 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 10 ML PIC. OFT., SUSPENSIE P-RF 1 10.650000 0.000000 5.325000 5.325000 9.585000 1.065000

Pagina 4 din 4
ANEXA 8
(ANEXA 2c la Ordinul CNAS nr. 1611/2018)
SECŢIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ CONFORM
DCI-urilor UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI
DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE
VALABILĂ ÎNCEPÂND CU 01 SEPTEMBRIE 2019

Val. maxima suportata de Contributie maxima


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

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

TARA amba referinta / UT compensare 100% din din pretul de


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)

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

SE ADAUGA

241 W66017007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.261428 0.261428 0.000000
242 W66018007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.290000 0.290000 0.000000
243 W66016007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.182857 0.182857 0.000000

SE ELIMINA

225 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 0.457713 0.457713 0.100858

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

SE ADAUGA

14 W65505007 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL-PA-PVC/AL X 30 COMPR. FILM. PRF 30 0.710400 0.710400 0.417266
15 W66019002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0.625000 0.625000 0.000000

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

SE MODIFICA

77 W64676001 J05AP09 DASABUVIRUM **1 β EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE ) PR 56 18.082321 18.082321 0.000000
1 W61485001 J05AP09 DASABUVIRUM **1 β EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 18.082321 18.082321 0.000000
78 W64675001 J05AP53 OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 β VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPR. FIECARE ) PR 56 194.662321 194.662321 0.000000
2 W61486001 J05AP53 OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 β VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE(AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 194.662321 194.662321 0.000000
43 W62156001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN POLIETILENA DE INALTA DENSITATE (PEID) PREVAZUTE CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2,177.205000 2,177.205000 0.000000
44 W64756001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2,177.205000 2,177.205000 0.000000
45 W62930001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 1,150.273214 1,150.273214 0.000000
46 W64591001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME OLANDA CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 1,150.273214 1,150.273214 0.000000

7. CIROZA HEPATICA - G7

SE MODIFICA

94 W64676001 J05AP09 DASABUVIRUM **1 β EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE ) PR 56 18.082321 18.082321 0.000000
27 W61485001 J05AP09 DASABUVIRUM **1 β EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 18.082321 18.082321 0.000000
95 W64675001 J05AP53 OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 β VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPR. FIECARE ) PR 56 194.662321 194.662321 0.000000
28 W61486001 J05AP53 OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 β VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE(AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 194.662321 194.662321 0.000000
61 W62156001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN POLIETILENA DE INALTA DENSITATE (PEID) PREVAZUTE CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2,177.205000 2,177.205000 0.000000
62 W64756001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2,177.205000 2,177.205000 0.000000
63 W62930001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 1,150.273214 1,150.273214 0.000000
64 W64591001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME OLANDA CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 1,150.273214 1,150.273214 0.000000

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

SE ADAUGA

Pagina 1 din 4
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

TARA amba referinta / UT compensare 100% din din pretul de


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
244 W65379001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA SANDOZ 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (TIP I) CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 969.350000 969.350000 0.000000
245 W65380001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA SANDOZ 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (TIP I) CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1,243.530000 1,243.530000 0.000000

SE MODIFICA

123 W64540001 L01XX35 ANAGRELIDUM ** ANAGRELIDA TERAPIA 0,5 mg CAPS. 0,5mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9.346800 9.346800 0.000000

9. EPILEPSIE - G11

SE ADAUGA

180 W66007002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. FILM. PRF 30 2.311200 2.311200 0.185800
181 W66006002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0.843199 0.843199 0.134801
182 W66013005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 0.513666 0.513666 0.000000
183 W66014005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 1.081000 1.081000 0.000000
184 W66012005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 75 mg CAPS. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 0.385166 0.385166 0.000000

10. BOALA PARKINSON - G12

SE ADAUGA

97 W65198006 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 2 mg COMPR. CU ELIB. PREL. 2mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL-HÂRTIE X 28 COMPR. CU ELIB. PREL. P-RF 28 1.158428 1.158428 0.215143
98 W65199003 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 4 mg COMPR. CU ELIB. PREL. 4mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL-HÂRTIE X 28 COMPR. CU ELIB. PREL. P-RF 28 2.240570 2.240570 0.289072
99 W65200003 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 8 mg COMPR. CU ELIB. PREL. 8mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL-HÂRTIE X 28 COMPR. CU ELIB. PREL. PRF 28 3.847713 3.847713 0.716572
100 W65895001 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 2 mg COMPR. ELIB. PREL. 2mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 0.965357 0.965357 0.000000
101 W65896001 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 4 mg COMPR. ELIB. PREL. 4mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 1.867142 1.867142 0.000000
102 W65897001 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 8 mg COMPR. ELIB. PREL. 8mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 3.206428 3.206428 0.000000

SE ELIMINA

94 W65198002 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 2 mg COMPR. CU ELIB. PREL. 2mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. CU ELIB. PREL. P-RF 28 1.158428 1.158428 0.215143
95 W65199001 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 4 mg COMPR. CU ELIB. PREL. 4mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. CU ELIB. PREL. P-RF 28 2.240570 2.240570 0.289072
96 W65200001 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 8 mg COMPR. CU ELIB. PREL. 8mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE X BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. ELIB. PREL. PRF 28 3.847713 3.847713 0.716572

13. BOLI PSIHICE (SCHIZOFRENIE, TULBURĂRI SCHIZOTIPALE ŞI DELIRANTE, TULBURĂRI AFECTIVE MAJORE, TULBURĂRI PSIHOTICE ACUTE ŞI BOLI PSIHICE COPII, AUTISM, TULBURĂRI CU DEFICIT DE
ATENŢIE/HIPERREACTIVITATE) - G15

SE ADAUGA

324 W66001004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 10 mg COMPR. ORODISPERSABILE 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0.706800 0.706800 0.000342
325 W66002004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 2.570357 2.570357 0.000000
326 W66003004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 20 mg COMPR. ORODISPERSABILE 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 2.896071 2.896071 0.000000
327 W66000004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 5 mg COMPR. ORODISPERSABILE 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0.463928 0.463928 0.000000
328 W63559001 N06BA09 ATOMOXETINUM ** BITINEX 10 mg CAPS. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 5.027142 5.027142 0.000000
329 W61181001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 10 mg CAPS. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 7 CAPS. PRF 7 6.032570 6.032570 2.434572
330 W61182001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 18 mg CAPS. 18mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 7 CAPS. PRF 7 6.286285 6.286285 2.205143
331 W65462001 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 18 mg CAPS. 18mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 7 CAPS. PRF 7 6.286285 6.286285 1.808000
332 W63560001 N06BA09 ATOMOXETINUM ** BITINEX 18 mg CAPS. 18mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 5.238571 5.238571 0.000000
333 W61183003 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 25 mg CAPS. 25mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 CAPS. PRF 28 5.700000 5.700000 1.993571
334 W63561003 N06BA09 ATOMOXETINUM ** BITINEX 25 mg CAPS. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 4.750000 4.750000 0.000000
335 W65463005 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 25 mg CAPS. 25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. PRF 28 5.700000 5.700000 1.254285
336 W65464005 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 40 mg CAPS. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. PRF 28 5.700000 5.700000 1.493928
337 W61184003 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 40 mg CAPS. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 CAPS. PRF 28 5.700000 5.700000 1.993571
338 W63562003 N06BA09 ATOMOXETINUM ** BITINEX 40 mg CAPS. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 4.750000 4.750000 0.000000
339 W65465005 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 60 mg CAPS. 60mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. PRF 28 5.700000 5.700000 2.453214
340 W63563003 N06BA09 ATOMOXETINUM ** BITINEX 60 mg CAPS. 60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 4.750000 4.750000 0.000000

SE MODIFICA

Pagina 2 din 4
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

TARA amba referinta / UT compensare 100% din din pretul de


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)

101 W63286004 N05AH04 QUETIAPINUM ** UNIQUET 400 mg COMPR. CU ELIB. PREL. 400mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 2.490166 2.490166 0.000000
103 W63280009 N05AH04 QUETIAPINUM ** UNIQUET 50 mg COMPR. CU ELIB. PREL. 50mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ELIB. PREL. PRF 60 0.444333 0.444333 0.000000
104 W63280004 N05AH04 QUETIAPINUM ** UNIQUET 50 mg COMPR. CU ELIB. PREL. 50mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 0.444333 0.444333 0.000000
188 W61718002 N05AX12 ARIPIPRAZOLUM ** ASTORET 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE PRF 28 2.040000 2.040000 0.000000
192 W61719002 N05AX12 ARIPIPRAZOLUM ** ASTORET 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE PRF 28 2.049285 2.049285 0.000000
219 W55813002 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0.615357 0.615357 0.000000
227 W60686003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 1.252142 1.252142 0.000000
290 W41829001 N06BA09 ATOMOXETINUM ** STRATTERA 10 mg CAPS. 10mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 6.032570 6.032570 7.607430
311 W65181001 N06BA09 ATOMOXETINUM ** STRATTERA 10 mg CAPS. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 6.032570 6.032570 7.607430
291 W41830001 N06BA09 ATOMOXETINUM ** STRATTERA 18 mg CAPS. 18mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 6.286285 6.286285 7.923715
312 W65186001 N06BA09 ATOMOXETINUM ** STRATTERA 18 mg CAPS. 18mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 6.286285 6.286285 7.923715
292 W41831003 N06BA09 ATOMOXETINUM ** STRATTERA 25 mg CAPS. 25mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 5.700000 5.700000 7.562500
313 W65185003 N06BA09 ATOMOXETINUM ** STRATTERA 25 mg CAPS. 25mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.700000 5.700000 7.562500
293 W41832003 N06BA09 ATOMOXETINUM ** STRATTERA 40 mg CAPS. 40mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 5.700000 5.700000 7.562500
314 W65184003 N06BA09 ATOMOXETINUM ** STRATTERA 40 mg CAPS. 40mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.700000 5.700000 7.562500
294 W41833003 N06BA09 ATOMOXETINUM ** STRATTERA 60 mg CAPS. 60mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 5.700000 5.700000 7.562500
315 W65183003 N06BA09 ATOMOXETINUM ** STRATTERA 60 mg CAPS. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.700000 5.700000 7.562500

SE ELIMINA

226 W59846001 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 1.014285 1.014285 0.000000
281 W62007001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 60 mg CAPS. GASTROREZ. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 1.263856 1.263856 1.337215

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

SE ADAUGA

88 W66008004 N06DX01 MEMANTINUM ** MEMANTINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0.571250 0.571250 0.000000

SE MODIFICA

13 W53424001 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1.029333 1.029333 0.000000
14 W53424002 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 1.029333 1.029333 0.000000
63 W60183005 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0.595713 0.595713 0.000001
64 W60183015 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR 56 0.595713 0.595713 0.000001

SE ELIMINA

60 W59977004 N06DX01 MEMANTINUM ** MEMANTINA DR. REDDY'S 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0.595713 0.595713 0.005537

19. BOALA WILSON - G23

SE ELIMINA

1 W61063002 M01CC01 PENICILLAMINUM ** 4) CUPRIPEN 250mg CAPS. 250mg CN UNIFARM S.A. ROMANIA CUTIE X 3 BLIST. X 10 CAPS. PRF 30 1.503666 1.503666 0.000000

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

SE MODIFICA

47 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 0.466285 0.466285 0.215143

21. GLAUCOM - G 26

SE ADAUGA

Pagina 3 din 4
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

TARA amba referinta / UT compensare 100% din din pretul de


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
44 W65442001 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) FIXANPOST 50 micrograme/ml+5 mg/ml PICATURI OFT.-SOL., IN RECIPIENT UNIDOZA 50micrograme/ml+5mg/ml LABORATOIRES THEA FRANTA CUTIE CU 6 PLICURI DIN PP/AL/POLIESTER A CATE 5 RECIPIENTE UNIDOZA DIN PEJD CE CONTIN FIECARE 0,2 ML PIC. OFT., SOL. P6L 30 5.593000 5.593000 0.000000

SE ELIMINA

7 W55650001 S01ED01 TIMOLOLUM TIMOLOL ROMPHARM 0,25% PIC. OFT., SOL. 2,5mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL. P-6L 1 3.280000 3.280000 0.000000

Pagina 4 din 4
ANEXA 9
(ANEXA 2d la Ordinul CNAS nr. 1611/2018)

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREȚUL DE REFERINȚĂ - CONFORM DCI-URILOR, ALTELE DECÂT CELE DIN
SUBLISTELE A, B, SUBLISTA C SECŢIUNEA C1 ŞI SUBLISTA D, CORESPUNZĂTOARE MEDICAMENTELOR, DE CARE BENEFICIAZĂ COPIII PÂNĂ LA 18 ANI, TINERII DE LA 18
LA 26 DE ANI DACĂ SUNT ELEVI, UCENICI SAU STUDENŢI, DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LEHUZE, ÎN TRATAMENTUL AMBULATORIU,
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILĂ ÎNCEPÂND CU 01 SEPTEMBRIE 2019

Contributie
Val. maxima suportata de maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

Tara det. amba referinta / UT compensare 100% din din pretul de


cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)

SE ADAUGA

246 W63888004 C08CA06 NIMODIPINUM NIMOTOP 30 mg COMPR. FILM. 30mg BAYER AG GERMANIA CUTIE CU 10 BLIST. DIN PVC-PVDC/AL A X 10 COMPR. FILM. PRF 100 0.724300 0.724300 0.000000
247 W65525002 J01DB04 CEFAZOLINUM ZOLINEF 1 g 1g
PULB. PT. SOL. INJ./PERF. MEDOCHEMIE ROMANIA SRL ROMANIA
CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML, INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC SI CAPSA DETASABILA DIN AL CU PULB. PT. SOL. INJ./PERF. PRF 10 4.162000 4.162000 0.000000
248 W65626001 M01AE01 IBUPROFENUM IBUPROFEN AUROBINDO 600 mg COMPR. FILM. 600 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L 10 0.227000 0.227000 0.000000
249 W59074003 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.427333 0.427333 0.000000
250 W59075003 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.564333 0.564333 0.000000
251 W12022001 N02BB02 METAMIZOLUM NATRIUM ALGIOTOP 500 mg COMPR. 500mg SANTA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0.300500 0.300500 0.000000

SE ELIMINA

233 W64965001 J01DB04 CEFAZOLINUM CEFAZOLIN 1 g PULB. PT. SOL. INJ. I.V./I.M. 1g CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC. PULB. PT. SOL. INJ. PR 1 4.994400 4.994400 337.775600
149 W60143001 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 600 COMPR. FILM. 600mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 0.272400 0.272400 0.127600
161 W59074001 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L 10 0.512799 0.512799 0.542201
162 W59074002 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P6L 20 0.512799 0.512799 0.389201
163 W59075001 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L 10 0.677199 0.677199 0.909801
164 W59075002 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P6L 20 0.677199 0.677199 0.582301
176 W42786002 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN (R) 500 mg COMPR. 500mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.360600 0.360600 0.089900
177 W41738001 N02BB02 METAMIZOLUM NATRIUM ALINDOR 500 mg COMPR. 500mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0.360600 0.360600 0.089900
179 W08609001 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN COMPR. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0.360600 0.360600 0.085400
181 W42786004 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN 500 mg COMPR. 500mg ZENTIVA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 0.360600 0.360600 0.085733
182 W57650001 N02BB02 METAMIZOLUM NATRIUM ALGOZONE 500mg COMPR. 500mg LABORMED PHARMA S.A. ROMANIA CUTIE X 2 BLIST.PVC-PVDC/AL A CATE 10 COMPR. P-RF 20 0.360600 0.360600 0.010900
183 W63055002 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg COMPR. 500mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 20 COMPR. PRF 20 0.360600 0.360600 0.030900
200 W13160002 N07CA02 CINNARIZINUM CINARIZINA LAROPHARM 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0.082166 0.082166 0.000000

Pagina 1 din 1
ANEXA 10
(ANEXA 2e la Ordinul CNAS nr. 1611/2018)

SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, CU COMPLETARILE SI MODIFICARILE ULTERIOARE,
VALABILA INCEPAND CU 01 SEPTEMBRIE 2019

Contributie maxima Val. maxima suportata de Contributie maxima


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

Prescriptie
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de compensare 100% beneficiaza de compensare 20%


Nr crt.

tara det. amba referinta / UT din pretul de compensare 20% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)

SE MODIFICA

68 W08513001 M01AX17 NIMESULIDUM LEMESIL COMPR. 100mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0.364837 0.052663 0.072967 0.344533
69 W08886001 M01AX17 NIMESULIDUM NIMESULID 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.364837 0.053163 0.072967 0.345033
70 W42589001 M01AX17 NIMESULIDUM NIMESULID SLAVIA COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0.364837 0.053163 0.072967 0.345033
71 W43252002 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.364837 0.051163 0.072967 0.343033
72 W43252001 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.364837 0.051163 0.072967 0.343033
73 W51945001 M01AX17 NIMESULIDUM NIMESULID ARENA 100 mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.364837 0.053163 0.072967 0.345033
74 W63141001 M01AX17 NIMESULIDUM AULIN 100 mg COMPR. 100mg ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU BLIST. AL/PVC X 10 COMPR. PRF 10 0.364837 0.271163 0.072967 0.563033
75 W63142009 M01AX17 NIMESULIDUM AULIN 100 mg GRAN. PT. SUSP. ORALA 100mg/plic ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU 15 PLICURI DIN AL/HÂRTIE/PE SAU AL/HÂRTIE/PE/FOLIE SURLYN A CÂTE 2 G GRANULE PENTRU SUSPENSIE ORALA PRF 15 0.364837 0.269829 0.072967 0.561699
76 W61456002 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 10 0.364837 0.053163 0.072967 0.345033
77 W61456003 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 30 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 30 0.364837 0.052163 0.072967 0.344033

Pagina 1 din 1