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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, REPUBLICATA, CU MODIFICARILE ULTERIOARE,
VALABILA INCEPAND CU 01 SEPTEMBRIE 2020
Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM
SE ADAUGA
1.035 W66688003 C01EA01 ALPROSTADILUM ** ALPROSTADIL ROMPHARM 20 micrograme PULB. PT. SOL. PERF. 20micrograme ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 15 FLAC. DE STICLA DE TIP I PR/PRF 15 49,744000 0,000000 44,769600 4,974400
1.035 W02922003 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR.P6L 60 0,165856 0,047310 0,149270 0,063896
1.035 W02923003 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR.P6L 60 0,331713 0,022453 0,298541 0,055625
1.035 W02925003 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR.P6L 60 0,082928 0,016738 0,074635 0,025031
SE MODIFICA
Pagina 1 din 4
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 2 din 4
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
SE ELIMINA
8 W57295005 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mgCAPS. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 0,375357 0,000000 0,337821 0,037536
22 W57296002 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mgCAPS. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 14 CAPS. GASTROREZ. P6L 14 0,602142 0,000000 0,541927 0,060215
Pagina 3 din 4
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 4 din 4
ANEXA 7
(ANEXA 2b la Ordinul CNAS nr. 755/2020)
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, REPUBLICATA, CU MODIFICARILE ULTERIOARE, VALABILA INCEPAND CU 01 SEPTEMBRIE 2020
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
SE ADAUGA
1.280 W66689004 M01AC05 LORNOXICAMUM LORNOXICAM ROMPHARM 8 mg PULB+SOLV. PT. SOL. INJ 8mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 SETURI CARE CONTIN CÂTE 1 FLAC. DIN STICLA BRUNA CU 8 MG PULB. PT. SOL. INJ. SI O FIOLA CU CAPACITATEA DE 2 ML CU SOLV. PT. SOL. INJ. PRF 10 2,805330 6,943670 1,402665 8,346335 2,524797 7,224203
1.281 W66689001 M01AC05 LORNOXICAMUM LORNOXICAM ROMPHARM 8 mg PULB+SOLV. PT. SOL. INJ 8mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 SET CARE CONTINE 1 FLAC. DIN STICLA BRUNA CU 8 MG PULB. PT. SOL. INJ. SI O FIOLA CU CAPACITATEA DE 2 ML CU SOLV. PT. SOL. INJ. PRF 1 2,805330 7,814670 1,402665 9,217335 2,524797 8,095203
1.282 W65840001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ACCORD 70 mg/2800 UI COMPR. 70mg/2800UIACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,965999 5,109001 3,482999 8,592001 6,269399 5,805601
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 0,633214 0,000000 0,316607 0,316607 0,569892 0,063322
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 1,112142 0,000000 0,556071 0,556071 1,000927 0,111215
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 0,693248 0,640323 0,346624 0,986947 0,623923 0,709648
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 0,693248 0,300323 0,346624 0,646947 0,623923 0,369648
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 1,386498 0,362073 0,693249 1,055322 1,247848 0,500723
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 1,386498 0,081359 0,693249 0,774608 1,247848 0,220009
29 W56303002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZISTENTE 20mg TERAPIA S.A. ROMANIA P-6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE 14 0,693248 0,300323 0,346624 0,646947 0,623923 0,369648
30 W56304002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg COMPR. GASTROREZISTENTE 40mg TERAPIA S.A. ROMANIA P-6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE 14 1,386498 0,081359 0,693249 0,774608 1,247848 0,220009
100 W60380001 B01AF01 RIVAROXABANUM **Ω # XARELTO 15mg COMPR. FILM. 15mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 98 COMPR. FILM. P-RF 98 9,420344 0,628023 4,710172 5,338195 8,478309 1,570058
101 W63897001 B01AF01 RIVAROXABANUM **Ω # XARELTO 15mg COMPR. FILM. 15mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 98 COMPR. FILM. PRF 98 9,420344 0,628023 4,710172 5,338195 8,478309 1,570058
102 W60381001 B01AF01 RIVAROXABANUM **Ω # XARELTO 20mg COMPR. FILM. 20mg BAYER PHARMA AG GERMANIA CUTIE X BLISTERE PP/AL X 98 COMPRIMATE FILMATE P-RF 98 10,048367 0,000000 5,024183 5,024184 9,043530 1,004837
103 W63898001 B01AF01 RIVAROXABANUM **Ω # XARELTO 20mg COMPR. FILM. 20mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 98 COMPR. FILM. PRF 98 10,048367 0,000000 5,024183 5,024184 9,043530 1,004837
106 W57283003 B01AF02 APIXABANUM **Ω # ELIQUIS COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 2,863666 2,755334 1,431833 4,187167 2,577299 3,041701
107 W65619003 B01AF02 APIXABANUM **Ω # ELIQUIS 2,5 mg COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG IRLANDA CUTIE CU BLIST. DIN PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 2,863666 2,755334 1,431833 4,187167 2,577299 3,041701
108 W59339004 B01AF02 APIXABANUM **Ω # ELIQUIS 5mg COMPR. FILM. 5 mg BRISTOL-MYERS SQUIBB / PFIZER EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPRIMATE FILMATE PRF 60 5,727333 0,000000 2,863666 2,863667 5,154599 0,572734
109 W65620009 B01AF02 APIXABANUM **Ω # ELIQUIS 5 mg COMPR. FILM. 5 mg BRISTOL-MYERS SQUIBB / PFIZER EEIG IRLANDA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPRIMATE FILMATE PRF 60 5,727333 0,000000 2,863666 2,863667 5,154599 0,572734
237 W56929003 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. TIP CALENDAR PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,349912 1,159373 0,174956 1,334329 0,314920 1,194365
238 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 0,349912 0,605445 0,174956 0,780401 0,314920 0,640437
239 W58948013 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,349912 0,605445 0,174956 0,780401 0,314920 0,640437
240 W56931003 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. TIP CALENDAR PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,324104 0,349912 0,674016 0,629841 0,394087
244 W55631001 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA P-6L
CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) 1 4,198948 21,121052 2,099474 23,220526 3,779053 21,540947
245 W59429005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,699824 0,139461 0,349912 0,489373 0,629841 0,209444
246 W66451005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,699824 0,139461 0,349912 0,489373 0,629841 0,209444
251 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 0,699824 0,550176 0,349912 0,900088 0,629841 0,620159
252 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 0,699824 0,488747 0,349912 0,838659 0,629841 0,558730
255 W66400002 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P6L 28 0,699824 0,488747 0,349912 0,838659 0,629841 0,558730
256 W66400006 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM.P6L 30 0,699824 0,550176 0,349912 0,900088 0,629841 0,620159
260 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 1,399649 0,264351 0,699824 0,964176 1,259684 0,404316
261 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 1,399649 0,181065 0,699824 0,880890 1,259684 0,321030
263 W66401002 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.P6L 28 1,399649 0,181065 0,699824 0,880890 1,259684 0,321030
264 W66401007 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM.P6L 30 1,399649 0,264351 0,699824 0,964176 1,259684 0,404316
291 W05785002 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 28 1,399649 0,062851 0,699824 0,762676 1,259684 0,202816
335 W51851005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 1,761071 0,172143 0,880535 1,052679 1,584963 0,348251
336 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 1,761071 0,626429 0,880535 1,506965 1,584963 0,802537
337 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 1,761071 0,503571 0,880535 1,384107 1,584963 0,679679
339 W64723005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 1,761071 0,172143 0,880535 1,052679 1,584963 0,348251
340 W51852005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 1,709274 0,223940 0,854637 1,078577 1,538346 0,394868
341 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 1,709274 0,612511 0,854637 1,467148 1,538346 0,783439
342 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 1,709274 0,496083 0,854637 1,350720 1,538346 0,667011
344 W64722005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 1,709274 0,223940 0,854637 1,078577 1,538346 0,394868
345 W51853005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L 56 0,880535 1,347143 0,440267 1,787411 0,792481 1,435197
346 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 0,880535 1,506607 0,440267 1,946875 0,792481 1,594661
347 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 0,880535 1,383572 0,440267 1,823840 0,792481 1,471626
348 W62873006 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN STADA 5 mg/80 mg COMPR. FILM. 5mg/80mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 56 COMPR. FILM. P6L 56 0,880535 1,383572 0,440267 1,823840 0,792481 1,471626
349 W64721005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 0,880535 1,347143 0,440267 1,787411 0,792481 1,435197
350 W53445002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 20 mg/5 mg COMPR. FILM. 20mg/5mg LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM.
MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. P-6L 28 0,880535 0,896965 0,440267 1,337233 0,792481 0,985019
Pagina 1 din 5
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
351 W57427002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 20 mg/5 mg COMPR. FILM. 20mg/5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 0,807679 0,440267 1,247947 0,792481 0,895733
352 W64084002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 20 mg/5 mg COMPR. FILM. 20mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 1,406607 0,440267 1,846875 0,792481 1,494661
353 W64151002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 0,754465 0,440267 1,194733 0,792481 0,842519
354 W64245001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 0,481607 0,440267 0,921875 0,792481 0,569661
355 W64245006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 0,481607 0,440267 0,921875 0,792481 0,569661
356 W64426002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 20 mg/5 mg COMPR. FILM. 20mg/5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 0,807679 0,440267 1,247947 0,792481 0,895733
357 W65814001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 0,481607 0,440267 0,921875 0,792481 0,569661
358 W65814006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA P6L
CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. 28 0,880535 0,481607 0,440267 0,921875 0,792481 0,569661
359 W66041002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SALVO 20 mg/5 mg COMPR. FILM. 20mg/5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,880535 0,753750 0,440267 1,194018 0,792481 0,841804
360 W53447002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/10 mg COMPR. FILM. 40mg/10mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 1,761071 0,147500 0,880535 1,028036 1,584963 0,323608
361 W57425002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/10 mg COMPR. FILM. 40mg/10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,761071 0,053929 0,880535 0,934465 1,584963 0,230037
362 W64086002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 40 mg/10 mg COMPR. FILM. 40mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,761071 0,769643 0,880535 1,650179 1,584963 0,945751
363 W64153002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,761071 0,000000 0,880535 0,880536 1,584963 0,176108
366 W64428002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/10 mg COMPR. FILM. 40mg/10mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,761071 0,053929 0,880535 0,934465 1,584963 0,230037
370 W53446002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/5 mg COMPR. FILM. 40mg/5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 1,584963 0,192537 0,792481 0,985019 1,426466 0,351034
371 W57426002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/5 mg COMPR. FILM. 40mg/5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,584963 0,103251 0,792481 0,895733 1,426466 0,261748
372 W64085002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 40 mg/5 mg COMPR. FILM. 40mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,584963 0,761108 0,792481 1,553590 1,426466 0,919605
373 W64152002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,584963 0,050037 0,792481 0,842519 1,426466 0,208534
376 W64427002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/5 mg COMPR. FILM. 40mg/5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,584963 0,103251 0,792481 0,895733 1,426466 0,261748
379 W66042002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SALVO 40 mg/5 mg COMPR. FILM. 40mg/5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,584963 0,049322 0,792481 0,841804 1,426466 0,207819
492 W60949001 C10AX09 EZETIMIBUM COLTOWAN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-PE-PVC/AL X 30 COMPR. PRF 30 1,567666 0,422000 0,783833 1,205833 1,410899 0,578767
819 W08360006 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL X 10 CAPS. P-RF 30 0,646874 0,315792 0,323437 0,639229 0,582186 0,380480
824 W65173006 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 0,646874 0,315792 0,323437 0,639229 0,582186 0,380480
825 W08361006 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL X 10 CAPS. P-RF 30 1,293749 0,259584 0,646874 0,906459 1,164374 0,388959
826 W08361004 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 1,293749 0,312251 0,646874 0,959126 1,164374 0,441626
831 W65174004 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 1,293749 0,312251 0,646874 0,959126 1,164374 0,441626
832 W65174006 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 1,293749 0,259584 0,646874 0,906459 1,164374 0,388959
833 W51225001 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 2,587499 0,583929 1,293749 1,877679 2,328749 0,842679
834 W51225003 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL, X 14 COMPR. FILM. P-RF 14 2,587499 0,483929 1,293749 1,777679 2,328749 0,742679
835 W62615001 M01AH05 ETORICOXIBUM IMESOL 120 mg COMPR. FILM. 120mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 7 COMPR. FILM. PRF 7 2,587499 0,553929 1,293749 1,847679 2,328749 0,812679
836 W62615002 M01AH05 ETORICOXIBUM IMESOL 120 mg COMPR. FILM. 120mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 7X1 COMPR. FILM. PRF 7 2,587499 0,553929 1,293749 1,847679 2,328749 0,812679
838 W62798002 M01AH05 ETORICOXIBUM DOLOXIB 120 mg COMPR. FILM. 120mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,584285 0,000000 1,292142 1,292143 2,325856 0,258429
841 W63220003 M01AH05 ETORICOXIBUM ROTICOX 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 2,587499 0,453215 1,293749 1,746965 2,328749 0,711965
842 W63049001 M01AH05 ETORICOXIBUM COXIENT 120 mg COMPR. FILM. 120mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,587499 0,583929 1,293749 1,877679 2,328749 0,842679
844 W63220002 M01AH05 ETORICOXIBUM ROTICOX 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,587499 0,553929 1,293749 1,847679 2,328749 0,812679
848 W62612001 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. PRF 28 0,646874 0,989554 0,323437 1,312991 0,582186 1,054242
849 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 0,646874 0,989554 0,323437 1,312991 0,582186 1,054242
851 W62795001 M01AH05 ETORICOXIBUM DOLOXIB 30 mg COMPR. FILM. 30mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 0,646874 0,928840 0,323437 1,252277 0,582186 0,993528
852 W62795002 M01AH05 ETORICOXIBUM DOLOXIB 30 mg COMPR. FILM. 30mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,646874 0,878840 0,323437 1,202277 0,582186 0,943528
853 W53204005 M01AH05 ETORICOXIBUM ARCOXIA 30 mg COMPR. FILM. 30mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. DIN PA-AL-PVC/AL X 14 COMPRIMATE FILMATE PRF 28 0,646874 0,949197 0,323437 1,272634 0,582186 1,013885
854 W63046003 M01AH05 ETORICOXIBUM COXIENT 30 mg COMPR. FILM. 30mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,646874 1,421697 0,323437 1,745134 0,582186 1,486385
855 W63090002 M01AH05 ETORICOXIBUM ETORICOXIB STADA 30 mg COMPR. FILM. 30mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,646874 0,892768 0,323437 1,216205 0,582186 0,957456
856 W63217003 M01AH05 ETORICOXIBUM ROTICOX 30 mg COMPR. FILM. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,646874 0,949197 0,323437 1,272634 0,582186 1,013885
857 W63090001 M01AH05 ETORICOXIBUM ETORICOXIB STADA 30 mg COMPR. FILM. 30mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 0,646874 0,941697 0,323437 1,265134 0,582186 1,006385
858 W63425007 M01AH05 ETORICOXIBUM KOSTAROX 30 mg COMPR. FILM. 30mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,646874 0,249554 0,323437 0,572991 0,582186 0,314242
859 W63676002 M01AH05 ETORICOXIBUM ETORICOXIB AUROBINDO 30 mg COMPR. FILM. 30mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 0,646874 0,578840 0,323437 0,902277 0,582186 0,643528
860 W63794005 M01AH05 ETORICOXIBUM GEROCOXAN 30 mg COMPR. FILM. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,646874 0,869911 0,323437 1,193348 0,582186 0,934599
861 W51227002 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1,293749 0,946965 0,646874 1,593840 1,164374 1,076340
862 W51227003 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 1,293749 0,946965 0,646874 1,593840 1,164374 1,076340
863 W62613001 M01AH05 ETORICOXIBUM IMESOL 60 mg COMPR. FILM. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1,293749 0,983393 0,646874 1,630268 1,164374 1,112768
864 W62613002 M01AH05 ETORICOXIBUM IMESOL 60 mg COMPR. FILM. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 14X1 COMPR. FILM. PRF 14 1,293749 0,983393 0,646874 1,630268 1,164374 1,112768
866 W62796001 M01AH05 ETORICOXIBUM DOLOXIB 60 mg COMPR. FILM. 60mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 1,293749 0,697679 0,646874 1,344554 1,164374 0,827054
867 W62796002 M01AH05 ETORICOXIBUM DOLOXIB 60 mg COMPR. FILM. 60mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,293749 0,651251 0,646874 1,298126 1,164374 0,780626
868 W62796004 M01AH05 ETORICOXIBUM DOLOXIB 60 mg COMPR. FILM. 60mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1,293749 0,587679 0,646874 1,234554 1,164374 0,717054
869 W63047002 M01AH05 ETORICOXIBUM COXIENT 60 mg COMPR. FILM. 60mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,293749 0,374822 0,646874 1,021697 1,164374 0,504197
870 W63091003 M01AH05 ETORICOXIBUM ETORICOXIB STADA 60 mg COMPR. FILM. 60mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,293749 0,621251 0,646874 1,268126 1,164374 0,750626
871 W63218002 M01AH05 ETORICOXIBUM ROTICOX 60 mg COMPR. FILM. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,293749 0,875536 0,646874 1,522411 1,164374 1,004911
872 W63218004 M01AH05 ETORICOXIBUM ROTICOX 60 mg COMPR. FILM. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1,293749 0,805179 0,646874 1,452054 1,164374 0,934554
873 W63426004 M01AH05 ETORICOXIBUM KOSTAROX 60 mg COMPR. FILM. 60mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1,293749 0,499108 0,646874 1,145983 1,164374 0,628483
874 W63677002 M01AH05 ETORICOXIBUM ETORICOXIB AUROBINDO 60 mg COMPR. FILM. 60mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,293749 0,435536 0,646874 1,082411 1,164374 0,564911
875 W63795005 M01AH05 ETORICOXIBUM GEROCOXAN 60 mg COMPR. FILM. 60mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,293749 0,392679 0,646874 1,039554 1,164374 0,522054
876 W51226003 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 1,940624 0,507233 0,970312 1,477545 1,746561 0,701296
877 W51226002 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1,940624 0,507233 0,970312 1,477545 1,746561 0,701296
Pagina 2 din 5
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
878 W62614001 M01AH05 ETORICOXIBUM IMESOL 90 mg COMPR. FILM. 90mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1,940624 0,482233 0,970312 1,452545 1,746561 0,676296
879 W62614002 M01AH05 ETORICOXIBUM IMESOL 90 mg COMPR. FILM. 90mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 14X1 COMPR. FILM. PRF 14 1,940624 0,482233 0,970312 1,452545 1,746561 0,676296
881 W62797001 M01AH05 ETORICOXIBUM DOLOXIB 90 mg COMPR. FILM. 90mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 1,940624 0,179376 0,970312 1,149688 1,746561 0,373439
882 W62797002 M01AH05 ETORICOXIBUM DOLOXIB 90 mg COMPR. FILM. 90mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,940624 0,179376 0,970312 1,149688 1,746561 0,373439
883 W62797004 M01AH05 ETORICOXIBUM DOLOXIB 90 mg COMPR. FILM. 90mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1,940624 0,111161 0,970312 1,081473 1,746561 0,305224
884 W63048002 M01AH05 ETORICOXIBUM COXIENT 90 mg COMPR. FILM. 90mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,940624 0,480090 0,970312 1,450402 1,746561 0,674153
886 W63219003 M01AH05 ETORICOXIBUM ROTICOX 90 mg COMPR. FILM. 90mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,940624 0,362947 0,970312 1,333259 1,746561 0,557010
887 W63219005 M01AH05 ETORICOXIBUM ROTICOX 90 mg COMPR. FILM. 90mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1,940624 0,288661 0,970312 1,258973 1,746561 0,482724
888 W63427004 M01AH05 ETORICOXIBUM KOSTAROX 90 mg COMPR. FILM. 90mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1,940624 0,179376 0,970312 1,149688 1,746561 0,373439
889 W63678002 M01AH05 ETORICOXIBUM ETORICOXIB AUROBINDO 90 mg COMPR. FILM. 90mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,940624 0,000804 0,970312 0,971116 1,746561 0,194867
894 W58352002 M05BA04 ACIDUM ALENDRONICUM * ACID ALENDRONIC AUROBINDO 70 mgCOMPR. 70mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR. P6L 4 6,965999 2,204001 3,482999 5,687001 6,269399 2,900601
895 W60296004 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 6,965999 2,289001 3,482999 5,772001 6,269399 2,985601
896 W60296002 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 4 COMPR. P6L 4 6,965999 1,989001 3,482999 5,472001 6,269399 2,685601
897 W66435002 M05BA04 ACIDUM ALENDRONICUM * ACID ALENDRONIC AUROBINDO 70 mg COMPR. 70mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 4 COMPR. P6L 4 6,965999 2,204001 3,482999 5,687001 6,269399 2,900601
899 W56763001 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L 12 6,965999 1,743167 3,482999 5,226167 6,269399 2,439767
900 W56763002 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM. P-6L 2 6,965999 2,509001 3,482999 5,992001 6,269399 3,205601
901 W56763003 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 6,965999 2,204001 3,482999 5,687001 6,269399 2,900601
903 W59460003 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 35 mg COMPR. FILM. 35mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L 4 6,965999 0,774001 3,482999 4,257001 6,269399 1,470601
904 W61163003 M05BA07 ACIDUM RISEDRONICUM * ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 6,965999 4,781501 3,482999 8,264501 6,269399 5,478101
905 W66431003 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 35 mg COMPR. FILM. 35mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L 4 6,965999 0,774001 3,482999 4,257001 6,269399 1,470601
906 W66497003 M05BA07 ACIDUM RISEDRONICUM * ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg THERAMEX IRELAND LIMITED IRLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 6,965999 4,781501 3,482999 8,264501 6,269399 5,478101
907 W61164001 M05BA07 ACIDUM RISEDRONICUM * ACTONEL 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 14,927142 8,982858 7,463571 16,446429 13,434427 10,475573
909 W66214001 M05BA07 ACIDUM RISEDRONICUM * ACTONEL 75 mg COMPR. FILM. 75mg THERAMEX IRELAND LIMITED IRLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 14,927142 8,982858 7,463571 16,446429 13,434427 10,475573
910 W66432001 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 14,620000 0,000000 7,310000 7,310000 13,158000 1,462000
911 W42702002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UIMERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P-6L 4 6,965999 2,219001 3,482999 5,702001 6,269399 2,915601
912 W63914002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/2800 UI COMPR. 70mg/2800UIAUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,547500 0,000000 3,273750 3,273750 5,892750 0,654750
913 W63922002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/2800 UI COMPR. 70mg/2800UIZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,965999 5,049001 3,482999 8,532001 6,269399 5,745601
914 W64728002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UIMERCK SHARP & DOHME OLANDA CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P6L 4 6,965999 2,219001 3,482999 5,702001 6,269399 2,915601
915 W52559001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UIMERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P-6L 2 6,965999 2,524001 3,482999 6,007001 6,269399 3,220601
916 W62143003 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UITEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR., AMBALAJ TIP CALENDAR P6L 4 6,965999 5,336501 3,482999 8,819501 6,269399 6,033101
917 W62143001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UITEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. P6L 4 6,965999 5,336501 3,482999 8,819501 6,269399 6,033101
918 W62143002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UITEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4X1 COMPR. P6L 4 6,965999 5,336501 3,482999 8,819501 6,269399 6,033101
919 W63074002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL SANDOZ 70 mg/5600 UI COMPR. 70mg/5600UISANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 4 COMPR.P6L 4 6,965999 4,896501 3,482999 8,379501 6,269399 5,593101
920 W63915002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/5600 UI COMPR. 70mg/5600UIAUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,932500 0,000000 3,466250 3,466250 6,239250 0,693250
921 W63923002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/5600 UI COMPR. 70mg/5600UIZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,965999 5,336501 3,482999 8,819501 6,269399 6,033101
922 W64729001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UIMERCK SHARP & DOHME OLANDA CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P6L 2 6,965999 2,524001 3,482999 6,007001 6,269399 3,220601
923 W65841001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ACCORD 70 mg/5600 UI COMPR. 70mg/5600UIACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,965999 4,084001 3,482999 7,567001 6,269399 4,780601
944 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 1,203158 1,548984 0,601579 2,150563 1,082842 1,669300
945 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 1,203158 1,275234 0,601579 1,876813 1,082842 1,395550
946 W63613008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,203158 1,548984 0,601579 2,150563 1,082842 1,669300
947 W63613010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,203158 1,275234 0,601579 1,876813 1,082842 1,395550
953 W62312005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 1,443792 0,146208 0,721896 0,868104 1,299412 0,290588
954 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 1,443792 1,605493 0,721896 2,327389 1,299412 1,749873
955 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 1,443792 1,269243 0,721896 1,991139 1,299412 1,413623
956 W62572008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,443792 1,605493 0,721896 2,327389 1,299412 1,749873
957 W62572011 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,443792 1,269243 0,721896 1,991139 1,299412 1,413623
960 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 1,443792 1,269243 0,721896 1,991139 1,299412 1,413623
977 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 1,443792 0,146208 0,721896 0,868104 1,299412 0,290588
978 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 2,406320 2,382251 1,203160 3,585411 2,165688 2,622883
979 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 2,406320 2,054930 1,203160 3,258090 2,165688 2,295562
980 W63615008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2,406320 2,382251 1,203160 3,585411 2,165688 2,622883
981 W63615010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 2,406320 2,054930 1,203160 3,258090 2,165688 2,295562
985 W62313005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 2,887585 0,100248 1,443792 1,544041 2,598826 0,389007
987 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 2,887585 1,103486 1,443792 2,547279 2,598826 1,392245
1.000 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 2,887585 0,100248 1,443792 1,544041 2,598826 0,389007
1.001 W41743001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 0,721896 0,334532 0,360948 0,695480 0,649706 0,406722
1.002 W41743002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 0,721896 0,300604 0,360948 0,661552 0,649706 0,372794
1.006 W62311005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 75 mg CAPS. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 0,721896 0,367604 0,360948 0,728552 0,649706 0,439794
1.007 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 0,721896 1,172389 0,360948 1,533337 0,649706 1,244579
1.008 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 0,721896 1,018996 0,360948 1,379944 0,649706 1,091186
1.009 W62571008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,721896 1,172389 0,360948 1,533337 0,649706 1,244579
1.010 W62571011 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,721896 1,018996 0,360948 1,379944 0,649706 1,091186
1.013 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 0,721896 0,989354 0,360948 1,350302 0,649706 1,061544
Pagina 3 din 5
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
1.019 W64906002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA
CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0,721896 0,300604 0,360948 0,661552 0,649706 0,372794
1.020 W64906001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA
CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0,721896 0,334532 0,360948 0,695480 0,649706 0,406722
1.030 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 0,721896 0,367604 0,360948 0,728552 0,649706 0,439794
1.031 W64181001 N03AX16 PREGABALINUM ** # SIRANALEN 20 mg/ml SOL. ORALA 20mg/ml MEDOCHEMIE LTD. CIPRU PRF
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 1 91,055185 55,194815 45,527592 100,722408 81,949666 64,300334
1.032 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 0,270120 0,144213 0,135060 0,279273 0,243108 0,171225
1.033 W53525002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,270120 0,125213 0,135060 0,260273 0,243108 0,152225
1.034 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 0,270120 0,306213 0,135060 0,441273 0,243108 0,333225
1.035 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 0,270120 0,061213 0,135060 0,196273 0,243108 0,088225
1.036 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 1,050469 1,133864 0,525234 1,659099 0,945422 1,238911
1.037 W53527002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 1,050469 0,982531 0,525234 1,507766 0,945422 1,087578
1.038 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 1,050469 1,121531 0,525234 1,646766 0,945422 1,226578
1.039 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 1,050469 0,941197 0,525234 1,466432 0,945422 1,046244
1.040 W60244001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA P-RF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 30 0,390174 0,290826 0,195087 0,485913 0,351156 0,329844
1.041 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 0,390174 0,290826 0,195087 0,485913 0,351156 0,329844
1.042 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 0,780348 1,448985 0,390174 1,839159 0,702313 1,527020
1.043 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 0,780348 0,718652 0,390174 1,108826 0,702313 0,796687
1.044 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 0,780348 0,718652 0,390174 1,108826 0,702313 0,796687
1.045 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 1,575704 2,604629 0,787852 3,392481 1,418133 2,762200
1.046 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 1,575704 0,366296 0,787852 1,154148 1,418133 0,523867
1.047 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 3,151408 0,537258 1,575704 2,112962 2,836267 0,852399
1.048 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 3,151408 4,004258 1,575704 5,579962 2,836267 4,319399
1.049 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 3,151408 0,834925 1,575704 2,410629 2,836267 1,150066
1.050 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 4,727112 3,593221 2,363556 5,956777 4,254400 4,065933
1.051 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 0,937919 0,105081 0,468959 0,574041 0,844127 0,198873
1.057 W13298008 N06AB10 ESCITALOPRAMUM ** CIPRALEX 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 1,002599 0,414543 0,501299 0,915843 0,902339 0,514803
1.207 W51362004 R03DC03 MONTELUKASTUM * SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L 28 1,009285 1,529286 0,504642 2,033929 0,908356 1,630215
1.209 W56686005 R03DC03 MONTELUKASTUM * MONKASTA 10 mg COMPR. FILM. 10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. FILM. P6L 28 1,009285 0,035715 0,504642 0,540358 0,908356 0,136644
1.210 W58991005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,009285 0,000000 0,504642 0,504643 0,908356 0,100929
1.211 W66468005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,009285 0,000000 0,504642 0,504643 0,908356 0,100929
1.212 W56567005 R03DC03 MONTELUKASTUM * MONTELUKAST ACTAVIS 4 mg COMPR. MAST. 4mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L 30 0,662856 0,156810 0,331428 0,488238 0,596570 0,223096
1.215 W58747005 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,662856 1,867501 0,331428 2,198929 0,596570 1,933787
1.216 W66475005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 4 mg COMPR. MAST. 4mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,662856 0,107501 0,331428 0,438929 0,596570 0,173787
1.217 W57011004 R03DC03 MONTELUKASTUM * ASTHATOR 5 mg COMPR. MAST. 5 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 0,828571 1,010357 0,414285 1,424643 0,745713 1,093215
1.218 W51361004 R03DC03 MONTELUKASTUM * SINGULAIR (R) COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 28 0,828571 1,710000 0,414285 2,124286 0,745713 1,792858
1.221 W66474005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 5 mg COMPR. MAST. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,828571 0,000000 0,414285 0,414286 0,745713 0,082858
1.222 W58090003 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg GRANULE 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 0,662856 1,867501 0,331428 2,198929 0,596570 1,933787
1.233 W58148003 R06AE09 LEVOCETIRIZINUM XYZAL PIC. ORALE, SOL. 5mg/ml UCB PHARMA GMBHGERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR P-6L 1 23,940000 3,630000 11,970000 15,600000 21,546000 6,024000
SE ELIMINA
4 W61230005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 20 mg COMPR. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,228666 0,000000 0,114333 0,114333 0,205799 0,022867
14 W61231005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 40 mg COMPR. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,415666 0,000000 0,207833 0,207833 0,374099 0,041567
247 W59430005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 1,151785 0,000000 0,575892 0,575893 1,036606 0,115179
519 W54309001 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA CUTIE X 500 G CREMA PRF 1 120,370000 0,000000 60,185000 60,185000 108,333000 12,037000
689 W59360008 G04CA02 TAMSULOSINUM TAMSULOSIN AUROBINDO 400 micrograme CAPS. ELIB. PREL.400micrograme AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 CAPS. ELIB. PREL. P6L 30 0,632333 0,000000 0,316166 0,316167 0,569099 0,063234
837 W62716002 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 120 mg COMPR. FILM. 120mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,422857 0,000000 1,211428 1,211429 2,180571 0,242286
850 W62713003 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 30 mg COMPR. FILM. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,642345 1,370512 0,321172 1,691685 0,578110 1,434747
865 W62714002 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 60 mg COMPR. FILM. 60mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,284690 0,673167 0,642345 1,315512 1,156221 0,801636
880 W62715004 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 90 mg COMPR. FILM. 90mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,760714 0,000000 0,880357 0,880357 1,584642 0,176072
908 W62565001 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 13,369821 1,250179 6,684910 7,935090 12,032838 2,587162
1.065 W60777003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,521785 0,000000 0,260892 0,260893 0,469606 0,052179
1.214 W58990005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 4 mg COMPR. MAST. 4mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 1,145404 0,555667 0,572702 1,128369 1,030863 0,670208
1.220 W58989005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 5 mg COMPR. MAST. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 1,431755 0,407173 0,715877 1,123051 1,288579 0,550349
1.234 W58334001 R06AE09 LEVOCETIRIZINUM ZENARO 0,5 mg/ml SIROP 0,5mg/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPAC DIN PP PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 200ML SIROP + 1 LINGURITA DOZATOARE DE 5ML P6L 1 25,092000 0,428000 12,546000 12,974000 22,582800 2,937200
NOTĂ:
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu * se iniţiază de medicul de specialitate în limita competenţei şi poate fi prescris în continuare de medicul de familie pe baza scrisorii medicale emise de medicul de specialitate.
Pagina 4 din 5
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu ** se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (2) se prescrie numai în etapa pregătitoare pentru colonoscopie.
Pentru medicamentele corespunzătoare DCI-urilor notate cu # regulile de prescriere sunt stabilite prin contractul-cadru.
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu **1 se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii şi pot fi administrate şi în regim de spitalizare de zi.
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu
Ω se efectueaz ă în baza contractelor cost-volum încheiate.
Pagina 5 din 5
ANEXA 8
(ANEXA 2c la Ordinul CNAS nr. 755/2020)
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, REPUBLICATA, CU MODIFICARILE 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 2020
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
SE ADAUGA
235 W02922003 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0,213166 0,213166 0,000000
236 W02923003 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0,354166 0,354166 0,000000
237 W02925003 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0,099666 0,099666 0,000000
SE ELIMINA
170 W55273002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,204285 0,204285 0,000000
190 W55272005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,142500 0,142500 0,000000
SE MODIFICA
1 W60057003 J05AP01 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2,502070 2,502070 5,772430
2 W61374009 J05AP01 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,085059 2,085059 0,000000
3 W66449009 J05AP01 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,085059 2,085059 0,000000
52 W64953003 J05AP01 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME OLANDA CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) PR 140 2,502070 2,502070 5,772430
26 W63755002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 5,463199 5,463199 0,000134
28 W64664003 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANIENCE 0,5 mg COMPR. FILM. 0,5mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. AL/PVC-PVDC(120) X 10 COMPR. FILM. PR 30 5,103000 5,103000 0,000000
29 W64664002 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANIENCE 0,5 mg COMPR. FILM. 0,5mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. AL/PVC-PVDC(60) X 10 COMPR. FILM. PR 30 5,103000 5,103000 0,000000
30 W64664001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANIENCE 0,5 mg COMPR. FILM. 0,5mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. AL/OPA-AL-PVC X 10 COMPR. FILM. PR 30 5,103000 5,103000 0,000000
32 W65716001 J05AF10 ENTECAVIRUM **1 ENTECAVIR KRKA 0,5 mg COMPR. FILM. 0,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 5,463199 5,463199 0,000134
55 W64756001 J05AP51 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
Tratamentul se iniţiază de către medicul în specialitatea gastroenterologie, boli infecţioase, nefrologie (doar pentru pacienţii cu afectare renală consecutivă infecţiei cu virusuri hepatitice), gastroenterologie pediatrică şi pediatrie cu
supraspecializare/competenţă/atestat în gastroenterologie pediatrică.
7. CIROZA HEPATICA - G7
SE MODIFICA
26 W60057003 J05AP01 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2,502070 2,502070 5,772430
27 W61374009 J05AP01 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,085059 2,085059 0,000000
28 W66449009 J05AP01 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,085059 2,085059 0,000000
69 W64953003 J05AP01 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME OLANDA CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) PR 140 2,502070 2,502070 5,772430
43 W63755002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 5,463199 5,463199 0,000134
45 W64664003 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANIENCE 0,5 mg COMPR. FILM. 0,5mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. AL/PVC-PVDC(120) X 10 COMPR. FILM. PR 30 5,103000 5,103000 0,000000
46 W64664002 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANIENCE 0,5 mg COMPR. FILM. 0,5mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. AL/PVC-PVDC(60) X 10 COMPR. FILM. PR 30 5,103000 5,103000 0,000000
Pagina 1 din 8
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se iniţiază de către medicul în specialitatea gastroenterologie, boli infecţioase, nefrologie (doar pentru pacienţii cu afectare renală consecutivă infecţiei cu virusuri hepatitice), gastroenterologie pediatrică şi pediatrie cu
supraspecializare/competenţă/atestat în gastroenterologie pediatrică.
8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10
SE ADAUGA
235 W66540001 J02AC03 VORICONAZOLUM ** VORICONAZOL ACCORDPHARMA 200 mg PULB. PT. SOL. PERF. 200mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. PERF. PRF 1 361,170000 361,170000 0,000000
236 W65474003 L01XX35ANAGRELIDUM ** ANAGRELIDA AUROBINDO 0,5 mg CAPS. 0,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 100 CAPS. PR 100 6,251900 6,251900 0,000000
SE MODIFICA
136 W64277002 L01XX35ANAGRELIDUM ** ANAGRELIDA ZENTIVA 0,5 mg CAPS. 0,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 0,463420
138 W64221001 L01XX35ANAGRELIDUM ** ANAGRELIDA DR. REDDY'S 0,5 mg CAPS. 0,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 2,460620
139 W64241001 L01XX35ANAGRELIDUM ** ANAGRELIDA ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 2,202820
140 W64564002 L01XX35ANAGRELIDUM ** GRENALVON 0,5 mg CAPS. 0,5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 2,304520
142 W64540001 L01XX35ANAGRELIDUM ** ANAGRELIDA TERAPIA 0,5 mg CAPS. 0,5mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 1,992520
143 W64672001 L01XX35ANAGRELIDUM ** ANAGRELIDA GLENMARK 0,5 mg CAPS. 0,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 0,746820
144 W64671001 L01XX35ANAGRELIDUM ** ANAGRELIDA SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 0,190920
145 W65794001 L01XX35ANAGRELIDUM ** ANAGRELIDA ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 7,502280 7,502280 2,202820
SE ELIMINA
69 W66220001 H02AB02 DEXAMETHASONUM PERAZONE 0,5 mg COMPR. 0,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 COMPR. PRF 100 0,492100 0,492100 0,000000
Tratamentul se iniţiază de către medicul în specialitatea oncologie, hematologie, oncologie şi hematologie pediatrică sau pediatrie cu supraspecializarea în hematooncologie pediatrică/oncologie pediatrică sau competenţă în oncopediatrie sau atestat de studii complementare în oncologie şi hematologie pediatrică.
9. EPILEPSIE - G11
SE ADAUGA
201 W65101010 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. MAST./DISP. 5mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU FLAC. DIN PEID X 30 COMPR. MAST./DISP. P6L 30 0,027666 0,027666 0,000000
SE ELIMINA
65 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 0,160000 0,160000 0,000000
77 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 0,640000 0,640000 0,000000
93 W58294002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,857199 0,857199 0,135467
Pagina 2 din 8
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
SE MODIFICA
42 W53525002 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,395333 0,395333 0,000000
SE ELIMINA
36 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 0,981785 0,981785 0,000000
38 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 1,898928 1,898928 0,000000
40 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 3,261785 3,261785 0,000000
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
317 W65101010 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. MAST./DISP. 5mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU FLAC. DIN PEID X 30 COMPR. MAST./DISP. P6L 30 0,027666 0,027666 0,000000
SE MODIFICA
84 W56903001 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 20 mg COMPR. ORODISPERSABILE 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,064642 2,064642 0,000000
107 W59533007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 150 mg COMPR. ELIB. PREL. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,313400 1,313400 0,000100
112 W58674007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 200 mg COMPR. ELIB. PREL. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,896833 0,896833 0,000000
114 W58675007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 300 mg COMPR. ELIB. PREL. 300mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,590799 1,590799 0,000034
118 W58673007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 50 mg COMPR. ELIB. PREL. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,467666 0,467666 0,000000
156 W61492003 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 10mg COMPR. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,040333 2,040333 0,000000
168 W61493003 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 15mg COMPR. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1,855000 1,855000 0,000000
239 W61609006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,712399 0,712399 0,002934
240 W66465006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,712399 0,712399 0,002934
250 W61608006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,418399 0,418399 0,001601
251 W66464006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,418399 0,418399 0,001601
SE ELIMINA
71 W60951004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 10 mg COMPR. ORODISPERSABILE 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0,717999 0,717999 1,566286
78 W60952004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 3,051428 3,051428 3,234286
85 W60953004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 20 mg COMPR. ORODISPERSABILE 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 1,720714 1,720714 0,000000
90 W60950004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 5 mg COMPR. ORODISPERSABILE 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0,478399 0,478399 0,813029
128 W63222003 N05AL05 AMISULPRIDUM ** AMISULPRIDA AUROBINDO 200 mg COMPR. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 1,630333 1,630333 0,000000
219 W60777003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,521785 0,521785 0,000000
SE MODIFICA
Pagina 3 din 8
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
12 W52397001 N06DA02 DONEPEZILUM ** YASNAL 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 0,990000 0,990000 0,000000
16. POLIARTRITA REUMATOIDĂ, ARTROPATIA PSORIAZICĂ, PSORIAZIS CRONIC SEVER ŞI ARTRITA JUVENILĂ - G 18
SE ADAUGA
58 W66270001 L04AX03 METHOTREXATUM NORDIMET 12,5 mg SOL INJ. IN SERINGA PREUMPLUTA 12,5mg NORDIC GROUP BV OLANDA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA X 0,5 ML SOL. INJ. + 2 TAMPOANE DE ALCOOLPRF 1 76,330000 76,330000 0,000000
Tratamentul se iniţiază de către medicul din specialitatea reumatologie, nefrologie, medicină internă, pediatrie, reabilitare medicală şi dermatovenerologie.
SE ELIMINA
55 W59430005 C09CA04 IRBESARTANUM ** IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 1,025570 1,025570 0,126215
SE ADAUGA
50 W65460001 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM)COSOPT FARA CONSERVANT 20 mg/ml+5 mg/ml PIC. OFT. SUSP. 20mg/ml+5mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLAC. DIN PEJD CU CAPACITATEA DE 10 ML PREVAZUT CU PICURATOR NOVELIA DIN PEID CU PIC. OFT., SOL. P6L 1 102,600000 102,600000 0,000000
22. PEMFIGUS - G 27
SE ELIMINA
1 W66220001 H02AB02 DEXAMETHASONUM PERAZONE 0,5 mg COMPR. 0,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 COMPR. PRF 100 0,492100 0,492100 0,000000
SE ADAUGA
75 W66687001 J01FA10 AZITHROMYCINUM AZITROMICINA ROMPHARM 500 mg PULB. PT. SOL. PERF. 500mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA PRF 1 38,680000 38,680000 0,000000
76 W66687002 J01FA10 AZITHROMYCINUM AZITROMICINA ROMPHARM 500 mg PULB. PT. SOL. PERF. 500mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FLAC. DIN STICLA TRANSPARENTA PRF 5 34,834000 34,834000 0,000000
Pagina 4 din 8
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se iniţiază de către medicul în specialitatea dermatologie şi obstetrică-ginecologie (pentru gonoree şi infecţia cu Chlamidia).
SE ADAUGA
22 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
23 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
24 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
25 W66531006 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
26 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
27 W66531004 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
28 W66531003 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
29 W66531002 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
30 W66531001 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
31 W65919001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg/0,8 ml SOL. INJ. 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA X 0,8 ML SOL. INJ. + 1 SERINGA + 1 AC + 1 ADAPTOR + 2 TAMPOANE CU ALCOOL PR 1 942,710000 942,710000 0,000000
SE MODIFICA
6 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
7 W64710001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
8 W64887001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN PEN PREUMPLUT 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 50,168000
9 W65224001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN PEN PREUMPLUT 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
14 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
15 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
16 W64886001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN SERINGA PREUMPLUTA 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE AUTOMATA A ACULUI + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 82,958000
17 W65223001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN SERINGA PREUMPLUTA 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
18 W65083001 L04AB04 ADALIMUMABUM **1 AMGEVITA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0.8ml AMGEN EUROPE B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE CE CONTIN 40 MG ADALIMUMAB IN 0,8 ML SOLUTIE (50 MG/ML) PR 2 1.131,252000 1.131,252000 3,518000
19 W65920001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 SERINGI PREUMPLUTE (STICLA) X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
20 W65921001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
SE ADAUGA
53 W65630001 L04AA37 BARICITINIBUM **1 OLUMIANT 2 mg COMPR. FILM. 2mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC/PE/PCTFE/ALU X 35 COMPR. FILM. PR 35 117,636571 117,636571 0,000000
54 W66531004 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
55 W66531001 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
56 W66531002 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
57 W66531003 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
58 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
59 W66531006 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
60 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
61 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
62 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
Pagina 5 din 8
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
SE MODIFICA
30 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
31 W64710001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
32 W64887001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN PEN PREUMPLUT 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 50,168000
33 W65224001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN PEN PREUMPLUT 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
35 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
36 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
37 W64886001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN SERINGA PREUMPLUTA 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE AUTOMATA A ACULUI + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 82,958000
38 W65223001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN SERINGA PREUMPLUTA 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
39 W65083001 L04AB04 ADALIMUMABUM **1 AMGEVITA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0.8ml AMGEN EUROPE B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE CE CONTIN 40 MG ADALIMUMAB IN 0,8 ML SOLUTIE (50 MG/ML) PR 2 1.131,252000 1.131,252000 3,518000
40 W65920001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 SERINGI PREUMPLUTE (STICLA) X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
41 W65921001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
Tratamentul se iniţiază de către medicul în specialitatea reumatologie, medicină internă, nefrologie (pentru pacienţii cu afectare renală) şi reabilitarea medicală.
SE ADAUGA
41 W66531004 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
42 W66531003 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
43 W66531006 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
44 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
45 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
46 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
47 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
48 W66531001 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
49 W66531002 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
SE MODIFICA
18 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
19 W64710001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
20 W64887001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN PEN PREUMPLUT 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 50,168000
21 W65224001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN PEN PREUMPLUT 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
23 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
24 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
25 W64886001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN SERINGA PREUMPLUTA 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE AUTOMATA A ACULUI + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 82,958000
26 W65223001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN SERINGA PREUMPLUTA 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
27 W65083001 L04AB04 ADALIMUMABUM **1 AMGEVITA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0.8ml AMGEN EUROPE B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE CE CONTIN 40 MG ADALIMUMAB IN 0,8 ML SOLUTIE (50 MG/ML) PR 2 1.131,252000 1.131,252000 3,518000
28 W65920001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 SERINGI PREUMPLUTE (STICLA) X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
29 W65921001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
Pagina 6 din 8
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
SE ADAUGA
41 W66531002 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
42 W66531006 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
43 W66531003 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
44 W66531004 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
45 W66531001 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
46 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
47 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
48 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
49 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
SE MODIFICA
18 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
19 W64710001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
20 W64887001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN PEN PREUMPLUT 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 50,168000
21 W65224001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN PEN PREUMPLUT 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
23 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
24 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
25 W64886001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN SERINGA PREUMPLUTA 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE AUTOMATA A ACULUI + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 82,958000
26 W65223001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN SERINGA PREUMPLUTA 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
27 W65083001 L04AB04 ADALIMUMABUM **1 AMGEVITA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0.8ml AMGEN EUROPE B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE CE CONTIN 40 MG ADALIMUMAB IN 0,8 ML SOLUTIE (50 MG/ML) PR 2 1.131,252000 1.131,252000 3,518000
28 W65920001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 SERINGI PREUMPLUTE (STICLA) X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
29 W65921001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
Tratamentul se iniţiază de către medicul în specialitatea reumatologie, medicină internă şi reabilitare medicală.
SE ADAUGA
37 W65919001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg/0,8 ml SOL. INJ. 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA X 0,8 ML SOL. INJ. + 1 SERINGA + 1 AC + 1 ADAPTOR + 2 TAMPOANE CU ALCOOL PR 1 942,710000 942,710000 0,000000
38 W64404001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 162mg SOL INJ. IN SERINGA PRE-UMPLUTA 162mg ROCHE REGISTRATION GMBH GERMANIA CUTIE CU 4 SERINGI PREUMPLUTE SISTEM DE PROTECTIE PENTRU AC A CATE 0.9ML SOL. PR 4 1.073,655000 1.073,655000 0,000000
39 W61487001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 162mg SOL INJ. IN SERINGA PRE-UMPLUTA 162mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE SISTEM DE PROTECTIE PENTRU AC A CATE 0.9ML SOL. PR 4 1.073,655000 1.073,655000 0,000000
SE MODIFICA
16 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
17 W64710001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
18 W64887001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN PEN PREUMPLUT 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 50,168000
19 W65224001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN PEN PREUMPLUT 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
22 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
23 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
24 W64886001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN SERINGA PREUMPLUTA 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE AUTOMATA A ACULUI + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 82,958000
Pagina 7 din 8
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
SE ADAUGA
43 W66531001 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
44 W66531002 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
45 W66531003 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
46 W66531004 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
47 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
48 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1.630,250000 1.630,250000 0,000000
49 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1.665,670000 1.665,670000 0,000000
50 W66531006 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
51 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 1.612,535000 1.612,535000 0,000000
52 W65919001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg/0,8 ml SOL. INJ. 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA X 0,8 ML SOL. INJ. + 1 SERINGA + 1 AC + 1 ADAPTOR + 2 TAMPOANE CU ALCOOL PR 1 942,710000 942,710000 0,000000
SE MODIFICA
18 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
19 W64710001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
20 W64887001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN PEN PREUMPLUT 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 50,168000
21 W65224001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN PEN PREUMPLUT 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
26 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
27 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
28 W64886001 L04AB04 ADALIMUMABUM **1 HULIO SOL INJ. IN SERINGA PREUMPLUTA 40mg MYLAN S.A.S. FRANTA CUTIE CU 1 SERINGA PREUMPLUTA CU PROTECTIE AUTOMATA A ACULUI + 2 TAMPOANE ALCOOL PR 1 1.131,252000 1.131,252000 82,958000
29 W65223001 L04AB04 ADALIMUMABUM **1 IMRALDI SOL INJ. IN SERINGA PREUMPLUTA 40mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE, FIECARE CU CÂTE 1TAMPON CU ALCOOL PR 2 1.131,252000 1.131,252000 3,513000
30 W65083001 L04AB04 ADALIMUMABUM **1 AMGEVITA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0.8ml AMGEN EUROPE B.V. OLANDA CUTIE CU 2 SERINGI PREUMPLUTE CE CONTIN 40 MG ADALIMUMAB IN 0,8 ML SOLUTIE (50 MG/ML) PR 2 1.131,252000 1.131,252000 3,518000
31 W65920001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 SERINGI PREUMPLUTE (STICLA) X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
32 W65921001 L04AB04 ADALIMUMABUM **1 IDACIO 40 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 40mg/0,8ml FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 0,8 ML SOL. INJ. + 2 TAMPOANE CU ALCOOL PR 2 1.131,252000 1.131,252000 3,518000
Pagina 8 din 8
ANEXA 9
(ANEXA 2d la Ordinul CNAS nr. 755/2020)
SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PRE ȚUL 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, REPUBLICATA, CU MODIFICARILE ULTERIOARE,
VALABILĂ ÎNCEPÂND CU 01 SEPTEMBRIE 2020
Contributie
Val. maxima suportata de maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
Cod_CIM
SE ADAUGA
238 W08541001 D01AC05 ISOCONAZOLUM IZOCON 10 mg/g CREMA 10mg/g ROMINKO S.A. ROMANIA CUTIE X 1 TUB DIN AL X 25 G CREMA P-RF 1 10,030000 10,030000 0,000000
239 W63415002 G01BA COMBINATII ZIFEX COMPLEX OVULE FARA CONCENTRATIE ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC X 7 OVULE PRF 7 4,578571 4,578571 0,000000
240 W63415001 G01BA COMBINATII ZIFEX COMPLEX OVULE FARA CONCENTRATIE ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC/PE X 7 OVULE PRF 7 4,578571 4,578571 0,000000
241 W08363002 G01BA COMBINATII CERVUGID OVULE FARA CONCENTRATIE IRCON SRL ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC-PE X 6 OVULE P-RF 12 2,630833 2,630833 0,000000
SE MODIFICA
108 W01963001 G01BA COMBINATII TERGYNAN FLORA COMPR. VAG. FARA CONCENTRATIE LAB. BOUCHARA-RECORDATI FRANTA CUTIE X 1 FOLIE HARTIE/PE/AL/PE X 10 COMPR. VAG. P-RF 10 2,798000 2,798000 0,000000
NOTĂ:
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu ** se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu **1 se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii şi pot fi administrate şi în regim de spitalizare de zi.
Medicamentele din această sublistă corespund DCI-urilor din nomenclatorul de produse, altele decât cele din sublistele A, B, sublista C secţiunea C1 şi sublista D.
Pentru categoriile de asiguraţi menţionate în această sublistă, medicamentele corespunzătoare denumirilor comune internaţionale din sublista A, sublista B, secţiunea C1 a sublistei C şi sublista D se vor acorda în regim de compensare de 100% la preţ de referinţă,
indiferent de indicaţia pentru care sunt prevăzute în aceste subliste.
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ANEXA 10
(ANEXA 2e la Ordinul CNAS nr. 755/2020)
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, REPUBLICATA, CU MODIFICARILE ULTERIOARE,
VALABILA INCEPAND CU 01 SEPTEMBRIE 2020
Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM
SE ADAUGA
104 W42867002 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 40 mg COMPR. FILM. 40mg ZENTIVA S.A ROMANIA CUTIE CU 3 BLIST.DIN PVC-PE-PVDC/AL A CATE 10 COMPR. FILM. P-6L 30 0,439000 0,000000 0,087800 0,351200
SE MODIFICA
1 W52514001 A02BA02 RANITIDINUM RANITIDINA ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-6L 10 0,439650 0,278350 0,087930 0,630070
2 W05395003 A02BA02 RANITIDINUM RANITIDIN ARENA 150mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,219825 0,032675 0,043965 0,208535
3 W05401002 A02BA02 RANITIDINUM RANITIDINA 150 mg COMPR. 150mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,219825 0,033675 0,043965 0,209535
4 W07339001 A02BA02 RANITIDINUM RANITIDINA SLAVIA 150 mg COMPR. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,219825 0,032675 0,043965 0,208535
5 W53915001 A02BA02 RANITIDINUM RANITIDINA ATB 150 MG COMPR. FILM. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 0,219825 0,033675 0,043965 0,209535
6 W61345001 A02BA02 RANITIDINUM RANITIDINA LAROPHARM 150 mgCOMPR. FILM. 150mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 0,219825 0,033675 0,043965 0,209535
7 W42722004 A02BA02 RANITIDINUM RANITIDINA LPH 150 mg COMPR. FILM. 150mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLISTERE DIN FOLIE PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,219825 0,033841 0,043965 0,209701
9 W03078002 A02BA03 FAMOTIDINUM FAMODIN 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,219825 0,149841 0,043965 0,325701
10 W42868002 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 20mg COMPR. FILM. 20mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,219825 0,149841 0,043965 0,325701
75 W55441001 M05BA06 ACIDUM IBANDRONICUM * OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC.UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P-6L 1 29,854285 3,885715 5,970857 27,769143
76 W56947001 M05BA06 ACIDUM IBANDRONICUM * QUODIXOR 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P-6L 1 29,854285 8,365715 5,970857 32,249143
78 W58574001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L 1 29,340000 0,000000 5,868000 23,472000
79 W60664001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P6L 1 29,854285 8,365715 5,970857 32,249143
81 W66455001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM.
AUROBINDO PHARMA ROMANIA S.R.L. P6L 1 29,854285 8,365715 5,970857 32,249143
82 W57932001 M05BA06 ACIDUM IBANDRONICUM * OSSICA 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE P6L 1 87,842500 22,047500 17,568500 92,321500
83 W61791001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC ACCORD 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE PR/P6L 1 87,842500 20,127500 17,568500 90,401500
84 W65656001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC ACCORD 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE PR/P6L 1 87,842500 20,127500 17,568500 90,401500
85 W57484001 M05BA06 ACIDUM IBANDRONICUM * OSAGRAND 3 mg/3 ml SOL. INJ. 3mg/3ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ. P6L 1 87,842500 24,427500 17,568500 94,701500
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