Documente Academic
Documente Profesional
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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,
VALABILA INCEPAND CU 01 IULIE 2020
Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM
1 W64020007 A02BC01 OMEPRAZOLUM OMEZ 10 mg CAPS. GASTROREZ. 10mg ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ.
DR. REDDY'S LABORATORIES P6L 30 0,207302 0,454698 0,186571 0,475429
2 W42129001 A02BC01 OMEPRAZOLUM OMEPRAZOL-RICHTER 20 mg CAPS. GASTROREZ. 20mg ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ.
GEDEON RICHTER ROMANIA SA P-6L 14 0,414604 0,319681 0,373143 0,361142
3 W51990001 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,414604 0,492062 0,373143 0,533523
4 W52044001 A02BC01 OMEPRAZOLUM OMEPRAZOL TERAPIA 20 mg CAPS. GASTROREZ. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,414604 0,420062 0,373143 0,461523
5 W52887001 A02BC01 OMEPRAZOLUM OMEPRAZOL ARENA 20 mg CAPS. GASTROREZ. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,414604 0,484062 0,373143 0,525523
6 W53138001 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,414604 0,493062 0,373143 0,534523
7 W55651001 A02BC01 OMEPRAZOLUM OMEPRAZOL ROMPHARM 20 mg CAPS. GASTROREZ. 20mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,414604 0,376729 0,373143 0,418190
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
9 W60470001 A02BC01 OMEPRAZOLUM OMEPRAZOL ATB 20 mg CAPS. GASTROREZ. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L 20 0,414604 0,492896 0,373143 0,534357
10 W60303002 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L 28 0,403928 0,000000 0,363535 0,040393
11 W59906022 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 2 BLISTERE DIN OPA-AL-PEÎD-PE-DESICANT-PEÎD/AL A CATE 14 CAPSULE GASTROREZISTENTE P6L 28 0,403928 0,000000 0,363535 0,040393
12 W59906021 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 4 BLISTERE DIN OPA-AL-PEÎD-PE-DESICANT-PEÎD/AL A CATE 7 CAPSULE GASTROREZISTENTE P6L 28 0,403928 0,000000 0,363535 0,040393
13 W42284004 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC-AL-OPA/AL X 10 CAPS. GASTROREZ P-6L 30 0,414604 0,493062 0,373143 0,534523
14 W61506002 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L 28 0,414604 0,492896 0,373143 0,534357
15 W64021007 A02BC01 OMEPRAZOLUM OMEZ 20 mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0,414604 0,378396 0,373143 0,419857
16 W64023001 A02BC01 OMEPRAZOLUM OMEPRAZOL DR. REDDY'S 20 mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P6L 30 0,414604 0,378396 0,373143 0,419857
17 W66010005 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mgCAPS. GASTROREZ. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 0,375357 0,000000 0,337821 0,037536
18 W59906030 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 4 BLIST. OPA-AL-PVC/AL X 7 CAPS. GASTROREZ. P6L 28 0,403214 0,000000 0,362892 0,040322
19 W59906031 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 14 CAPS. GASTROREZ. P6L 28 0,403214 0,000000 0,362892 0,040322
20 W61506003 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 5 BLIST. AL/AL X 6 CAPS. GASTROREZ. P6L 30 0,414604 0,436062 0,373143 0,477523
21 W14125001 A02BC01 OMEPRAZOLUM ORTANOL 40 mg CAPS. GASTROREZ. 40mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L 7 0,829209 0,005076 0,746288 0,087997
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
23 W64022007 A02BC01 OMEPRAZOLUM OMEZ 40 mg CAPS. GASTROREZ. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0,829209 0,272457 0,746288 0,355378
24 W66011002 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mgCAPS. GASTROREZ. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 14 CAPS. GASTROREZ. P6L 14 0,602142 0,000000 0,541927 0,060215
25 W56141001 A02BC01 OMEPRAZOLUM OMEZ 40 mg PULB. PT. SOL. PERF. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF. S/P-RF 1 16,227000 1,803000 14,604300 3,425700
26 W60679001 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF. 40mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 16,227000 1,783000 14,604300 3,405700
27 W42951001 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,207302 0,313412 0,186571 0,334143
28 W65062001 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg TERAPIA S.A. ROMANIA CUTIE CU 2 BLIST. AL-PVC-PA/AL X 7 CAPS. GASTROREZ. P6L 14 0,207302 0,313412 0,186571 0,334143
29 W03936001 A02BC03 LANSOPRAZOLUM LANZUL CAPS. GASTROREZ. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ. P-6L 14 0,414604 0,271824 0,373143 0,313285
30 W42952001 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,414604 0,487538 0,373143 0,528999
31 W65063001 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg TERAPIA S.A. ROMANIA CUTIE CU 2 BLIST. AL-PVC-PA/AL X 7 CAPS. GASTROREZ. P6L 14 0,414604 0,487538 0,373143 0,528999
32 W08691002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,156000 0,000000 0,140400 0,015600
33 W04254002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,156875 0,000375 0,141187 0,016063
34 W52253001 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID LAROPHARM 10 mg COMPR. 10mg LAROPHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 20 COMPR. P-6L 40 0,156875 0,000375 0,141187 0,016063
35 W54362003 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L 40 0,156750 0,000000 0,141075 0,015675
36 W52254001 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID BIOFARM 1mg/5ml SIROP 1mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 100 ML SIROP + MASURA DOZATOARE P-RF 1 10,790000 0,000000 9,711000 1,079000
37 W57360001 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID TERAPIA 5mg/ml SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 5 2,936000 0,000000 2,642400 0,293600
38 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK 250 mg CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 1,234600 0,000000 1,111140 0,123460
39 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK 250 mg CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 1,283650 0,016350 1,155285 0,144715
40 W58710002 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100 2,567300 0,338000 2,310570 0,594730
41 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 64,182561 42,767439 57,764304 49,185696
42 W62376001 A06AD11 LACTULOSUM DUPHALAC® LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,915066 3,414934 7,123559 4,206441
43 W64011001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,915066 3,764934 7,123559 4,556441
44 W64559001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% MYLAN HEALTHCARE B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,915066 3,764934 7,123559 4,556441
45 W44054002 A06AD11 LACTULOSUM LACTULOSE EIPICO 650 mg/ml SIROP 650mg/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML P-6L 1 11,570000 0,000000 10,413000 1,157000
46 W44054001 A06AD11 LACTULOSUM LACTULOSE EIPICO 650 mg/ml SIROP 650mg/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 3,840000 0,000000 3,456000 0,384000
47 W05695001 A07AA02 NYSTATINUM NISTATINA ATB 500000 UI COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 1,150000 0,000000 1,035000 0,115000
Pagina 1 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 2 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 3 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 4 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 5 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 6 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 7 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 8 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 9 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 10 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 11 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 12 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 13 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 14 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 15 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 16 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 17 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 18 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
NOTĂ:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se iniţiază de către medicul de specialitate în limita competenţei şi poate fi prescris în continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (1) se efectuează pentru pacienţii cu intoleranţă la acidum acetylsalicylicum.
Pagina 19 din 19
ANEXA 2b
SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE PERSONALA
DIN HG NR. 720/2008, REPUBLICATA, VALABILA INCEPAND CU 01 IULIE 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)
1 W56920002 A02BC02 PANTOPRAZOLUM ZENCOPAN 20 mg COMPR. GASTROREZ. 20 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ. P6L 28 0,253571 0,000000 0,126785 0,126786 0,228213 0,025358
2 W54684002 A02BC02 PANTOPRAZOLUM NOLPAZA 20 mg COMPR. GASTROREZ. 20mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L 30 0,293333 0,000000 0,146666 0,146667 0,263999 0,029334
3 W60432003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 20 mg COMPR. GASTROREZ. 20mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0,354333 0,000000 0,177166 0,177167 0,318899 0,035434
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
5 W61932062 A02BC02 PANTOPRAZOLUM CONTROLOC 20 mg COMPR. GASTROREZ. 20mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,364666 0,000000 0,182333 0,182333 0,328199 0,036467
6 W61932035 A02BC02 PANTOPRAZOLUM CONTROLOC 20 mg COMPR. GASTROREZ. 20mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL FARA RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,364666 0,000000 0,182333 0,182333 0,328199 0,036467
7 W65962005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 20 mg COMPR. GASTROREZ. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,228666 0,000000 0,114333 0,114333 0,205799 0,022867
8 W56919002 A02BC02 PANTOPRAZOLUM ZENCOPAN 40 mg COMPR. GASTROREZ. 40 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ. P6L 28 0,461785 0,000000 0,230892 0,230893 0,415606 0,046179
9 W54685002 A02BC02 PANTOPRAZOLUM NOLPAZA 40mg COMPR. GASTROREZ. 40mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L 30 0,617333 0,000000 0,308666 0,308667 0,555599 0,061734
10 W56172001 A02BC02 PANTOPRAZOLUM SELTRAZ 40 mg COMPR. GASTROREZ. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. GASTROREZ. P-6L 28 0,651071 0,000000 0,325535 0,325536 0,585963 0,065108
11 W57634001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 40 mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L 10 0,652000 0,000000 0,326000 0,326000 0,586800 0,065200
12 W57634003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 40 mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L 30 0,651333 0,000000 0,325666 0,325667 0,586199 0,065134
13 W59855003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL ATB 40 mg COMPR. GASTROREZ. 40mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ. P6L 30 0,651333 0,000000 0,325666 0,325667 0,586199 0,065134
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
15 W61933031 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg COMPR. GASTROREZ. 40mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL FARA RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,638333 0,000000 0,319166 0,319167 0,574499 0,063834
16 W61933054 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg COMPR. GASTROREZ. 40mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,638333 0,000000 0,319166 0,319167 0,574499 0,063834
17 W65963005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 40 mg COMPR. GASTROREZ. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,415666 0,000000 0,207833 0,207833 0,374099 0,041567
18 W61651001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL SUN 40 mg PULB. PT. SOL. INJ. 40mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA CU DOP DIN CAUCIUC SI CAPSA DIN AL, CU PULB. PT. SOL. INJ. PRF 1 9,430000 0,000000 4,715000 4,715000 8,487000 0,943000
19 W61931001 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg PULB. PT. SOL. INJ. 40mg TAKEDA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, CU CAPSA DIN AL SI DOP DIN CAUCIUC A 40 MG CU PULB. PT. SOL. INJ. PRF 1 12,770000 0,000000 6,385000 6,385000 11,493000 1,277000
20 W66427001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL ROMPHARM 40 mg PULB. PT. SOL. INJ. 40mg S.C. ROMPHARM COMPANY S.R.L ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC SI SIGILAT CU CAPSA DIN AL X PULB. PT. SOL. INJ. PRF 1 9,430000 0,000000 4,715000 4,715000 8,487000 0,943000
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 0,552805 0,080409 0,276402 0,356812 0,497524 0,135690
22 W56890010 A02BC05 ESOMEPRAZOLUM HELIDES 20 mg CAPS. GASTROREZ. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P-6L 28 0,417500 0,000000 0,208750 0,208750 0,375750 0,041750
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 1,105611 0,006531 0,552805 0,559337 0,995049 0,117093
24 W56889010 A02BC05 ESOMEPRAZOLUM HELIDES 40 mg CAPS. GASTROREZ. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P-6L 28 0,787500 0,000000 0,393750 0,393750 0,708750 0,078750
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 0,552805 0,780766 0,276402 1,057169 0,497524 0,836047
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 0,552805 0,440766 0,276402 0,717169 0,497524 0,496047
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 1,105611 0,642960 0,552805 1,195766 0,995049 0,753522
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 1,105611 0,362246 0,552805 0,915052 0,995049 0,472808
29 W56303002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZISTENTE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 0,552805 0,440766 0,276402 0,717169 0,497524 0,496047
30 W56304002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg COMPR. GASTROREZISTENTE 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 1,105611 0,362246 0,552805 0,915052 0,995049 0,472808
31 W53101001 A02BC05 ESOMEPRAZOLUM NEXIUM 10 mg GRAN. GASTROREZ. PT. SUSP.ORALA 10mg ASTRAZENECA AB SUEDIA CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA P-6L 28 2,673571 0,000000 1,336785 1,336786 2,406213 0,267358
32 W62392006 A02BX05 BISMUTHI OXIDE ULCAMED 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,501758 0,461277 0,250879 0,712156 0,451582 0,511453
33 W04674001 A03AB06 OTILONIUM BROMIDUM SPASMOMEN 40 mg COMPR. FILM. 40mg A. MENARINI IND. FARM. RIUNITE SRL ITALIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,858333 0,000000 0,429166 0,429167 0,772499 0,085834
34 W63734001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 12 COMPR. FILM. PRF 12 2,660138 0,112362 1,330069 1,442431 2,394124 0,378376
35 W63734002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL A CATE 12 COMPR. FILM. PRF 36 2,547777 0,000000 1,273888 1,273889 2,292999 0,254778
36 W63735001 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFASIGMA S.P.A. ITALIA CUTIE CU UN FLACON DIN STICLA BRUNA CONTINÂND GRANULE PENTRU 60 ML SUSPENSIE ORALA, ÎNSOTIT DE O MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML. PRF 1 15,960846 5,199154 7,980423 13,179577 14,364761 6,795239
37 W08631001 A07EA06 BUDESONIDUM ** # BUDENOFALK 3 mg CAPS. GASTROREZ. 3mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ. P-RF 100 3,651200 0,000000 1,825600 1,825600 3,286080 0,365120
38 W61505003 A07EA06 BUDESONIDUM ** # CORTIMENT 9mg COMPR. ELIB. PREL. 9mg FERRING GMBH GERMANIA CUTIE CU BLIST. DIN PA-AL/PVC-AL X 30 COMPRIMATE ELIBERARE PRELUNGITA PRF 30 11,851971 2,967362 5,925985 8,893348 10,666773 4,152560
39 W58169003 A07EA06 BUDESONIDUM ** # BUDENOFALK UNO 9 mg GRANULE GASTROREZ. 9mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 30 PLICURI PET/AL/PEJD CU GRANULE GASTROREZ. PRF 30 11,851971 0,898362 5,925985 6,824348 10,666773 2,083560
40 W54445001 A07EA06 BUDESONIDUM ** # BUDENOFALK 2 mg/doza SPUMA RECTALA 2mg/doza DR. FALK PHARMA GMBH GERMANIA CUTIE X 1 FLAC. DIN AL X 14 DOZE X 1,2G SPUMA RECTALA, 14 APLICATOARE LUBREFIANTE PVC SI 14 PUNGI PL P-RF 1 325,430000 0,000000 162,715000 162,715000 292,887000 32,543000
41 W41577002 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS. P-RF 20 2,878750 0,086250 1,439375 1,525625 2,590875 0,374125
42 W63750001 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg BIOPROJET PHARMAFRANTA CUTIE CU 2 BLIST. X 10 CAPS. PRF 20 2,878750 0,086250 1,439375 1,525625 2,590875 0,374125
43 W41575002 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. ORALA 10mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 16 PLICURI X 1 G P-RF 16 2,850000 0,000000 1,425000 1,425000 2,565000 0,285000
44 W63748002 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. ORALA 10mg BIOPROJET PHARMAFRANTA CUTIE CU 16 PLICURI DIN HÂRTIE/AL/PEJD X 1 G PULB. ORALA PRF 16 2,850000 0,000000 1,425000 1,425000 2,565000 0,285000
45 W60148002 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. ORALA 30mg LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 3 G P-RF 16 2,878750 0,086875 1,439375 1,526250 2,590875 0,374750
46 W63749002 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. ORALA 30mg BIOPROJET PHARMAFRANTA CUTIE CU 16 PLICURI DIN HARTIE/AL/PEJD X 3 G PULB. ORALA PRF 16 2,878750 0,086875 1,439375 1,526250 2,590875 0,374750
47 W63610002 A08AB01 ORLISTATUM **1 XENICAL 120mg CAPS. 120mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC)PRF 84 1,841666 0,000000 0,920833 0,920833 1,657499 0,184167
48 W00231001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 0,607166 0,014634 0,303583 0,318217 0,546449 0,075351
49 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,607166 0,213167 0,303583 0,516750 0,546449 0,273884
50 W44042001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF 30 1,214333 0,000000 0,607166 0,607167 1,092899 0,121434
51 W65339001 A11CC03 ALFACALCIDOLUM ALFACALCIDOL HEATON 0,50 micrograme CAPS. MOI 0,50micrograme HEATON K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 30 CAPS. MOI PRF 30 1,214333 0,000000 0,607166 0,607167 1,092899 0,121434
52 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 1,214333 0,000000 0,607166 0,607167 1,092899 0,121434
53 W60364001 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOSSEN 600 mg COMPR. FILM. 600mg AAA - PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 30 1,705333 0,000000 0,852666 0,852667 1,534799 0,170534
54 W64296002 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # ACID TIOCTIC ROMPHARM 600 mg/24 mlSOL INJ. 600mg/24ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 25 ML X 24 ML SOL. INJ. PR/PRF 5 16,744000 0,000000 8,372000 8,372000 15,069600 1,674400
55 W52808004 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 10,830000 1,267000 5,415000 6,682000 9,747000 2,350000
56 W64849001 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000UI/0,2ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA PR/PRF 10 10,830000 1,267000 5,415000 6,682000 9,747000 2,350000
Pagina 1 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
57 W62441002 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI anti-Xa/0,2ml SOL. INJ. 2000UI anti-Xa/0,2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,2 ML SOL INJ. PR/PRF 10 5,415000 1,471000 2,707500 4,178500 4,873500 2,012500
58 W63590002 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI (20 mg)/0,2 ml SOL. INJ. 2000UI(20mg)/0,2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,2 ML SOL INJ. PR/PRF 10 5,415000 1,471000 2,707500 4,178500 4,873500 2,012500
59 W62442002 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI anti-Xa/0,4ml SOL. INJ. 4000UI anti-Xa/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,4 ML SOL INJ. PR/PRF 10 10,830000 1,487000 5,415000 6,902000 9,747000 2,570000
60 W63591002 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI (40 mg)/0,4 ml SOL. INJ. 4000UI(40mg)/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,4 ML SOL INJ. PR/PRF 10 10,830000 1,487000 5,415000 6,902000 9,747000 2,570000
61 W63592002 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI (60 mg)/0,6 ml SOL. INJ. 6000UI(60mg)/0,6ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,6 ML SOL INJ. PR/PRF 10 16,245000 0,000000 8,122500 8,122500 14,620500 1,624500
62 W62443002 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI anti-Xa/0,6ml SOL. INJ. 6000UIanti-Xa/0,6ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,6 ML SOL INJ. PR/PRF 10 16,245000 0,000000 8,122500 8,122500 14,620500 1,624500
63 W62444002 B01AB05 ENOXAPARINUM ** # CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 20,456666 0,000000 10,228333 10,228333 18,410999 2,045667
64 W63593002 B01AB05 ENOXAPARINUM ** # CLEXANE 8000 UI (80 mg)/0,8 ml SOL. INJ. 8000UI(80mg)/0,8ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 20,456666 0,000000 10,228333 10,228333 18,410999 2,045667
65 W63590012 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI (20 mg)/0,2 ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI(20mg)/0,2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (STICLA TIP I) ASAMBLATE CU DOP DIN CAUCIUC (CLOROBUTILIC SAU BROMOBUTILIC) SI AC DE INJECTIE PR/PRF 10 5,415000 1,471000 2,707500 4,178500 4,873500 2,012500
66 W63591012 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI (40 mg)/0,4 ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI(40mg)/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (STICLA TIP I) ASAMBLATE CU DOP DIN CAUCIUC (CLOROBUTILIC SAU BROMOBUTILIC) SI AC DE INJECTIE PR/PRF 10 10,830000 1,487000 5,415000 6,902000 9,747000 2,570000
67 W63592012 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI (60 mg)/0,6 ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI(60mg)/0,6ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (STICLA TIP I) ASAMBLATE CU DOP DIN CAUCIUC (CLOROBUTILIC SAU BROMOBUTILIC) SI AC DE INJECTIE PR/PRF 10 16,245000 0,000000 8,122500 8,122500 14,620500 1,624500
68 W63593009 B01AB05 ENOXAPARINUM ** # CLEXANE 8000 UI (80 mg)/0,8 ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI(80mg)/0,8ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 SERINGI PREUMPLUTE (STICLA TIP I) ASAMBLATE CU DOP DIN CAUCIUC (CLOROBUTILIC SAU BROMOBUTILIC) SI AC DE INJECTIE PR/PRF 6 20,456666 0,000000 10,228333 10,228333 18,410999 2,045667
69 W61293001 B01AB06 NADROPARINUM ** # FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 7,219998 1,886002 3,609999 5,496001 6,497998 2,608002
70 W61291001 B01AB06 NADROPARINUM ** # FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 10,830000 2,755000 5,415000 8,170000 9,747000 3,838000
71 W61292001 B01AB06 NADROPARINUM ** # FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 14,439996 2,962004 7,219998 10,182002 12,995996 4,406004
72 W59473001 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE LEO PHARMA A/S DANEMARCA
10000UI anti-XA/ml PR/PRF
CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT IN AURIU SI CAPSA DE SIGURANTA DIN PP DE CULOARE PORTOCALIE 10 30,942853 24,631147 15,471426 40,102574 27,848567 27,725433
73 W59475001 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE 20000 UI anti-Xa/ml LEO PHARMA A/S DANEMARCA PR/PRF
CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT CU LAC DE CULOARE VERDE SI CAPSA DE SIGURANTA DIN PP DE CULOARE VERDE INCHIS 10 61,885711 57,393289 30,942855 88,336145 55,697139 63,581861
74 W60955001 B01AB11 SULODEXIDUM ** COREFLUX 250 ULS CAPS. MOI 250ULS SANIENCE S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. MOI PRF 50 1,769000 0,000000 0,884500 0,884500 1,592100 0,176900
75 W63737001 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVDC-PVC/AL-PVDC A CATE 25 CAPS. MOI P6L 50 1,919333 0,224467 0,959666 1,184134 1,727399 0,416401
76 W63737002 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P6L 60 1,919333 0,150333 0,959666 1,110000 1,727399 0,342267
77 W60954001 B01AB11 SULODEXIDUM ** COREFLUX 600 ULS/2 ml SOL INJ. 600ULS/2ml SANIENCE S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ.PRF 10 6,899000 0,000000 3,449500 3,449500 6,209100 0,689900
78 W63736001 B01AB11 SULODEXIDUM ** VESSEL DUE F SOL. INJ. 600ULS/2ml ALFASIGMA S.P.A. ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML PRF 10 7,353249 1,362751 3,676624 5,039376 6,617924 2,098076
79 W54317002 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 COMPR. FILM. P-RF 30 0,623000 0,000000 0,311500 0,311500 0,560700 0,062300
80 W54317003 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 90 COMPR. FILM. P-RF 90 0,593777 0,000000 0,296888 0,296889 0,534399 0,059378
81 W55445003 B01AC04 CLOPIDOGRELUM ** TESSYRON 75 mg COMPR. FILM. 75mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM. P-RF 30 0,727666 0,000000 0,363833 0,363833 0,654899 0,072767
82 W56912006 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 30 1,147333 0,000000 0,573666 0,573667 1,032599 0,114734
83 W57177005 B01AC04 CLOPIDOGRELUM ** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,828571 0,000000 0,414285 0,414286 0,745713 0,082858
84 W54317007 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA P-RF
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 30 COMPRIMATE FILMATE 30 0,613666 0,000000 0,306833 0,306833 0,552299 0,061367
85 W54317009 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA P-RF
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 90 COMPRIMATE FILMATE 90 0,593777 0,000000 0,296888 0,296889 0,534399 0,059378
86 W59687002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 1,184642 0,000000 0,592321 0,592321 1,066177 0,118465
87 W61520001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 1,355206 0,349436 0,677603 1,027039 1,219685 0,484957
88 W61520013 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 30 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 30 1,355206 0,966794 0,677603 1,644397 1,219685 1,102315
89 W65505007 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL-PA-PVC/AL X 30 COMPR. FILM. PRF 30 1,147333 0,000000 0,573666 0,573667 1,032599 0,114734
90 W66019002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 1,184642 0,000000 0,592321 0,592321 1,066177 0,118465
91 W66403001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 28 1,355206 0,349436 0,677603 1,027039 1,219685 0,484957
92 W66403013 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 30 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 30 1,355206 0,966794 0,677603 1,644397 1,219685 1,102315
93 W58717002 B01AC18 TRIFLUSALUM PLATROX 300 mg CAPS. 300 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 5 BLIST. AL-PVC/PVDC X 10 CAPS. PRF 50 0,677603 0,069397 0,338801 0,408199 0,609842 0,137158
94 W53412001 B01AC18 TRIFLUSALUM AFLEN 300 mg CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 0,677603 0,069397 0,338801 0,408199 0,609842 0,137158
95 W52943002 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg GERMANIA CUTIE X 3 BLIST. (AL/AL) X 10 CAPS. (30X1 BLISTER PERFORAT UNIDOZA ) P-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 30 5,532333 0,000000 2,766166 2,766167 4,979099 0,553234
96 W60379002 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. P-RF 10 6,280229 5,386771 3,140114 8,526886 5,652206 6,014794
97 W60379003 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. P-RF 30 6,280229 4,783437 3,140114 7,923552 5,652206 5,411460
98 W63896002 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. PRF 10 6,280229 5,386771 3,140114 8,526886 5,652206 6,014794
99 W63896003 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. PRF 30 6,280229 4,783437 3,140114 7,923552 5,652206 5,411460
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
104 W57283003 B01AF02 APIXABANUM ** ELIQUIS COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 2,863666 2,755334 1,431833 4,187167 2,577299 3,041701
105 W65619003 B01AF02 APIXABANUM ** 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
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
110 W61204003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 2,5mg/0,5ml 2,5mg/0,5ml ASPEN PHARMA TRADING LIMITED IRLANDA
SOL. INJ. IN SERINGA PREUMPLUTA P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA 10 20,042000 0,000000 10,021000 10,021000 18,037800 2,004200
111 W61202003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 7,5mg/0,6ml 7,5mg/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA
SOL. INJ. IN SERINGA PREUMPLUTA P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE 10 52,662000 7,671000 26,331000 34,002000 47,395800 12,937200
112 W51230001 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 57,774000 0,000000 28,887000 28,887000 51,996600 5,777400
113 W63258002 C01EB17 IVABRADINUM ** IVABRADINE ZENTIVA 5 mg COMPR. FILM. 5 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,967071 0,310429 0,483535 0,793965 0,870363 0,407137
114 W42777003 C01EB17 IVABRADINUM ** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 0,967071 0,766679 0,483535 1,250215 0,870363 0,863387
115 W62962004 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,967071 0,391857 0,483535 0,875393 0,870363 0,488565
116 W62962014 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA P6L
CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. 56 0,967071 0,391857 0,483535 0,875393 0,870363 0,488565
117 W63479001 C01EB17 IVABRADINUM ** RAENOM 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,967071 0,443464 0,483535 0,927000 0,870363 0,540172
118 W63443003 C01EB17 IVABRADINUM ** FELOCORD 5 mg COMPR. FILM. 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,967071 0,443464 0,483535 0,927000 0,870363 0,540172
119 W63904002 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,967071 0,469714 0,483535 0,953250 0,870363 0,566422
Pagina 2 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
120 W63775001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. PRF 56 0,967071 0,469714 0,483535 0,953250 0,870363 0,566422
121 W65679001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg SPANIA
ACCORD HEALTHCARE S.L.U. CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. PRF 56 0,967071 0,469714 0,483535 0,953250 0,870363 0,566422
122 W42779003 C01EB17 IVABRADINUM ** CORLENTOR 7,5mg COMPR. FILM. 7,5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 1,450606 0,283144 0,725303 1,008447 1,305545 0,428205
123 W62963004 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,450606 0,161179 0,725303 0,886482 1,305545 0,306240
124 W62963014 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. P6L 56 1,450606 0,161179 0,725303 0,886482 1,305545 0,306240
125 W63259002 C01EB17 IVABRADINUM ** IVABRADINE ZENTIVA 7,5 mg COMPR. FILM. 7,5mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,286785 0,000000 0,643392 0,643393 1,158106 0,128679
126 W63480001 C01EB17 IVABRADINUM ** RAENOM 7,5 mg COMPR. FILM. 7,5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,450606 0,471536 0,725303 1,196839 1,305545 0,616597
127 W63444003 C01EB17 IVABRADINUM ** FELOCORD 7,5 mg COMPR. FILM. 7,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,450606 0,327072 0,725303 1,052375 1,305545 0,472133
128 W63905001 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 7,5 mg COMPR. FILM. 7,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,436785 0,000000 0,718392 0,718393 1,293106 0,143679
129 W63776001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. P6L 56 1,436785 0,000000 0,718392 0,718393 1,293106 0,143679
130 W65680001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. P6L 56 1,436785 0,000000 0,718392 0,718393 1,293106 0,143679
131 W62327003 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 mg COMPR. FILM. 0,2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,986400 0,169671 0,493200 0,662871 0,887760 0,268311
132 W62333003 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 mg COMPR. FILM. 0,4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 1,210357 0,000000 0,605178 0,605179 1,089321 0,121036
133 W05447001 C02AC06 RILMENIDINUM TENAXUM COMPR. 1mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 1,074333 0,000000 0,537166 0,537167 0,966899 0,107434
134 W42324004 C03DA04 EPLERENONUM * # INSPRA 25 mg COMPR. FILM. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 1,750166 1,725500 0,875083 2,600583 1,575149 1,900517
135 W65282004 C03DA04 EPLERENONUM * # INSPRA 25 mg COMPR. FILM. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. PERFORATE UNIDOZA DIN PVC/AL X 10 COMPR. FILM. PRF 30 1,750166 1,725500 0,875083 2,600583 1,575149 1,900517
136 W42325004 C03DA04 EPLERENONUM * # INSPRA 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 3,500333 0,000000 1,750166 1,750167 3,150299 0,350034
137 W65283004 C03DA04 EPLERENONUM * # INSPRA 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. PERFORATE UNIDOZA DIN PVC/AL X 10 COMPR. FILM. PRF 30 3,500333 0,000000 1,750166 1,750167 3,150299 0,350034
138 W04501004 C07AB12 NEBIVOLOLUM NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,682500 0,000000 0,341250 0,341250 0,614250 0,068250
139 W53839001 C07AB12 NEBIVOLOLUM NOLET 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC- PE- PVDC/AL X 10 COMPR. P-6L 30 0,447000 0,000000 0,223500 0,223500 0,402300 0,044700
140 W55035003 C07AB12 NEBIVOLOLUM NEBINORM 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,203333 0,000000 0,101666 0,101667 0,182999 0,020334
141 W64198003 C07AB12 NEBIVOLOLUM NEBIVOLOL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. P6L 30 0,450000 0,000000 0,225000 0,225000 0,405000 0,045000
142 W64800005 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVDC/AL X 10 COMPR. P6L 30 0,435666 0,000000 0,217833 0,217833 0,392099 0,043567
143 W65312001 C07AB12 NEBIVOLOLUM NOLET 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,447000 0,000000 0,223500 0,223500 0,402300 0,044700
144 W65311001 C07AB12 NEBIVOLOLUM NEBIVOLOL ATB 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 0,447000 0,000000 0,223500 0,223500 0,402300 0,044700
145 W57345001 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
146 W57345002 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
147 W57345003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
148 W66297001 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
149 W66297002 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
150 W66297003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK ROMANIA SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
151 W57344001 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
152 W57344002 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
153 W57344003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
154 W66296001 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
155 W66296002 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
156 W66296003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK ROMANIA SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,570666 0,000000 0,285333 0,285333 0,513599 0,057067
157 W62093003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 25 mg/5 mg COMPR. FILM. 25mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,123526 0,007009 2,061763 2,068772 3,711173 0,419362
158 W62095003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 25 mg/7,5 mg COMPR. FILM. 25mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,123526 0,007009 2,061763 2,068772 3,711173 0,419362
159 W62094003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 50 mg/5 mg COMPR. FILM. 50mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,123526 0,007009 2,061763 2,068772 3,711173 0,419362
160 W62096003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 50 mg/7,5 mg COMPR. FILM. 50mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,102500 0,000000 2,051250 2,051250 3,692250 0,410250
161 W03916002 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 0,282899 0,425315 0,141449 0,566765 0,254609 0,453605
162 W03916001 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L 14 0,282899 0,424958 0,141449 0,566408 0,254609 0,453248
163 W65175002 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P6L 28 0,282899 0,425315 0,141449 0,566765 0,254609 0,453605
164 W12827004 C08CA13 LERCANIDIPINUM LERIDIP 10 mg COMPR. FILM. 10mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR.FILM. P-6L 60 0,282899 0,401767 0,141449 0,543217 0,254609 0,430057
165 W43062014 C08CA13 LERCANIDIPINUM LERIDIP 20 mg COMPR. FILM. 20mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 0,565799 0,514701 0,282899 0,797601 0,509219 0,571281
166 W56001006 C08CA13 LERCANIDIPINUM LERPIN 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-6L 50 0,565799 0,161001 0,282899 0,443901 0,509219 0,217581
167 W54042001 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,331713 0,080287 0,165856 0,246144 0,298541 0,113459
168 W54042002 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,331713 0,080287 0,165856 0,246144 0,298541 0,113459
169 W55290004 C09AA04 PERINDOPRILUM PRINDEX 4 mg COMPR. 4mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR.
P-6L 30 0,331713 0,090953 0,165856 0,256810 0,298541 0,124125
170 W61726001 C09AA04 PERINDOPRILUM ERNYOM 4 mg COMPR. 4mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,331713 0,218287 0,165856 0,384144 0,298541 0,251459
171 W64970003 C09AA04 PERINDOPRILUM PRENESSA 4 mg COMPR. 4mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 0,331713 0,067287 0,165856 0,233144 0,298541 0,100459
172 W54043001 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,663426 0,054574 0,331713 0,386287 0,597083 0,120917
173 W54043002 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,663426 0,054574 0,331713 0,386287 0,597083 0,120917
174 W55291004 C09AA04 PERINDOPRILUM PRINDEX 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU BLIST. AL/AL X 30 COMPR.
REPUBLICA CEHA P-6L 30 0,663426 0,005240 0,331713 0,336953 0,597083 0,071583
175 W58117004 C09AA04 PERINDOPRILUM PRENESSA 8 mg COMPR. 8mg KRKA POLSKA SP Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,588000 0,000000 0,294000 0,294000 0,529200 0,058800
176 W61727001 C09AA04 PERINDOPRILUM ERNYOM 8 mg COMPR. 8mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,663426 0,151240 0,331713 0,482953 0,597083 0,217583
177 W42663001 C09AA04 PERINDOPRILUM PRESTARIUM 10 mg COMPR. FILM. 10 mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,829282 0,121384 0,414641 0,536025 0,746353 0,204313
178 W59480001 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,788333 0,000000 0,394166 0,394167 0,709499 0,078834
179 W42664001 C09AA04 PERINDOPRILUM PRESTARIUM 5 mg COMPR. FILM. 5mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,414641 0,461025 0,207320 0,668346 0,373176 0,502490
180 W59479001 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 5 mg COMPR. FILM. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,414641 0,262359 0,207320 0,469680 0,373176 0,303824
181 W61396001 C09AA10 TRANDOLAPRILUM TRANDOLAPRIL ARENA 0,5 mg CAPS. 0,5mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/PE/PVDC ALB OPAC SI FOLIE DE ALUMINIU X 10 CAPS. P6L 30 0,082928 0,157405 0,041464 0,198869 0,074635 0,165698
182 W62353001 C09AA10 TRANDOLAPRILUM GOPTEN® 0,5 mg CAPS. 0,5mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0,082928 0,281572 0,041464 0,323036 0,074635 0,289865
Pagina 3 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
183 W61398001 C09AA10 TRANDOLAPRILUM TRANDOLAPRIL ARENA 2 mg CAPS. 2mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/PE/PVDC ALB OPAC SI FOLIE DE ALUMINIU X 10 CAPS.P6L 30 0,331713 0,091620 0,165856 0,257477 0,298541 0,124792
184 W62355001 C09AA10 TRANDOLAPRILUM GOPTEN® 2 mg CAPS. 2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,331713 0,309001 0,165856 0,474858 0,298541 0,342173
185 W61399001 C09AA10 TRANDOLAPRILUM TRANDOLAPRIL ARENA 4 mg CAPS. 4mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/PE/PVDC ALB OPAC SI FOLIE DE ALUMINIU X 10 CAPS.P6L 30 0,663426 0,132240 0,331713 0,463953 0,597083 0,198583
186 W62357001 C09AA10 TRANDOLAPRILUM GOPTEN® 4 mg CAPS. 4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,663426 0,540145 0,331713 0,871858 0,597083 0,606488
187 W13178003 C09AA15 ZOFENOPRILUM ZOMEN (R) 30 mg COMPR. FILM. 30mg LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.
MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. P-6L 28 0,331713 1,169001 0,165856 1,334858 0,298541 1,202173
188 W13177003 C09AA15 ZOFENOPRILUM ZOMEN 7,5 mg COMPR. FILM. 7,5mg LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.
MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. P-6L 28 0,082928 0,699214 0,041464 0,740678 0,074635 0,707507
189 W56887001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 2 mg/0,625 mg COMPR. 2 mg/0,625mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L 30 0,599333 0,000000 0,299666 0,299667 0,539399 0,059934
190 W52394004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg COMPR. 2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,394000 0,000000 0,197000 0,197000 0,354600 0,039400
191 W57158001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) DANURIT 2 mg/0,625 mg COMPR. 2mg/0,625mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,599333 0,000000 0,299666 0,299667 0,539399 0,059934
192 W65268004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg COMPR. 2mg/0,625mg KRKA D.D, NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,394000 0,000000 0,197000 0,197000 0,354600 0,039400
193 W56888001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 4 mg/1,25mg COMPR. 4 mg/1,25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L 30 0,812666 0,000000 0,406333 0,406333 0,731399 0,081267
194 W52393004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg COMPR. 4mg/1,25mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,671333 0,000000 0,335666 0,335667 0,604199 0,067134
195 W57157001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) DANURIT 4 mg/1,25mg COMPR. 4mg/1,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,839666 0,000000 0,419833 0,419833 0,755699 0,083967
196 W65269004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg COMPR. 4mg/1,25mg KRKA D.D, NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,671333 0,000000 0,335666 0,335667 0,604199 0,067134
197 W56278004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg COMPR. 8mg/2,5mg KRKA-POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,843846 0,211154 0,421923 0,633077 0,759461 0,295539
198 W65267004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg COMPR. 8mg/2,5mg KRKA D.D, NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,843846 0,211154 0,421923 0,633077 0,759461 0,295539
199 W54255004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLITERAX 10 mg/2,5mg COMPR. FILM. 10mg/2,5mg LES LAB. SERVIER FRANTA CUTIE X 1 FLAC. DIN PP CU CAPAC PEJD CU SILICAGEL X 30 COMPR. FILM. P-6L 30 0,843846 0,330154 0,421923 0,752077 0,759461 0,414539
200 W63520001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 10 mg/2,5 mg COMPR. FILM. 10mg/2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. X 30 COMPR. FILM. P6L 30 0,843846 0,391820 0,421923 0,813743 0,759461 0,476205
201 W52783004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG 2,5mg/0,625mg COMPR. FILM. 2,5mg/0,625mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 0,843846 0,351487 0,421923 0,773410 0,759461 0,435872
202 W60020001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 2,5 mg/0,625 mg COMPR. FILM. 2,5mg/0,625mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L 30 0,353333 0,000000 0,176666 0,176667 0,317999 0,035334
203 W52784004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG FORTE 5mg/1,25mg COMPR. FILM. 5mg/1,25mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 0,843846 0,348154 0,421923 0,770077 0,759461 0,432539
204 W60021001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 5 mg/1,25 mg COMPR. FILM. 5mg/1,25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L 30 0,639000 0,000000 0,319500 0,319500 0,575100 0,063900
205 W43136001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE COMPR. FILM. 10mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,567000 0,000000 0,283500 0,283500 0,510300 0,056700
206 W64843001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE COMPR. FILM. 10mg/12,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,567000 0,000000 0,283500 0,283500 0,510300 0,056700
207 W43137001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE FORTE COMPR. FILM. 20mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,843846 0,192154 0,421923 0,614077 0,759461 0,276539
208 W64844001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE FORTE COMPR. FILM. 20mg/12,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,843846 0,192154 0,421923 0,614077 0,759461 0,276539
209 W53990002 C09BB02 COMBINATII (NITRENDIPINUM+ENALAPRILUM) ENEAS COMPR. 20mg+10mg GALENICA S.A. GRECIA CUTIE X 3 BLIST. PA-PVC-AL/AL X 10 COMPR. P-6L 30 3,131666 0,000000 1,565833 1,565833 2,818499 0,313167
210 W58750001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 4 mg/ 10 mg COMPR. 4mg/10 mg GEDEON RICHTER ROMÂNIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,749274 0,013392 0,374637 0,388029 0,674346 0,088320
211 W57913007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/10 mg COMPR. 4mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,650333 0,000000 0,325166 0,325167 0,585299 0,065034
212 W64004001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 4 mg/10 mg COMPR. 4mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,749274 0,034392 0,374637 0,409029 0,674346 0,109320
213 W57912007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/5 mg COMPR. 4mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,481676 0,113990 0,240838 0,354828 0,433508 0,162158
214 W58748001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 4 mg/ 5 mg COMPR. 4mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,481676 0,129657 0,240838 0,370495 0,433508 0,177825
215 W64003001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 4 mg/5 mg COMPR. 4mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,481676 0,184324 0,240838 0,425162 0,433508 0,232492
216 W57915007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/10 mg COMPR. 8mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,963353 0,134980 0,481676 0,616657 0,867017 0,231316
217 W58751001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 8 mg/ 10 mg COMPR. 8mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,963353 0,208647 0,481676 0,690324 0,867017 0,304983
218 W64006001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 8 mg/10 mg COMPR. 8mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,963353 0,127980 0,481676 0,609657 0,867017 0,224316
219 W57914007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/5 mg COMPR. 8mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,695754 0,217912 0,347877 0,565789 0,626178 0,287488
220 W58749001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 8 mg/ 5 mg COMPR. 8mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,695754 0,243246 0,347877 0,591123 0,626178 0,312822
221 W64005001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 8 mg/5 mg COMPR. 8mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,695754 0,192246 0,347877 0,540123 0,626178 0,261822
222 W62329002 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg COMPR. CU ELIB. MODIF. 240mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,983035 0,218036 0,991517 1,209554 1,784731 0,416340
223 W62331002 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg COMPR. CU ELIB. MODIF. 240mg/4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,983035 0,648393 0,991517 1,639911 1,784731 0,846697
224 W62349001 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA COMPR. ELIB. MOD. 180mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. ELIB. MODIF. P-6L 28 1,765000 0,000000 0,882500 0,882500 1,588500 0,176500
225 W60513005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 4mg/10mg/1,25mg COMPR. 4mg/10mg/1,25mgKRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,972333 0,000000 0,486166 0,486167 0,875099 0,097234
226 W60512005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 4 mg/5mg/1,25 mg COMPR. 4mg/5mg/1,25mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,788134 0,124532 0,394067 0,518599 0,709320 0,203346
227 W60515005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 8 mg/10 mg/2,5 mg COMPR. 8mg/10mg/2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 1,341000 0,000000 0,670500 0,670500 1,206900 0,134100
228 W60514005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 8 mg/5 mg/2,5 mg COMPR. 8mg/5mg/2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 1,165353 0,057980 0,582676 0,640657 1,048817 0,174516
229 W61004001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 10mg/2,5mg/10mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,585309 0,554024 0,792654 1,346679 1,426778 0,712555
230 W61003001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 10mg/2,5mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,174393 0,759607 0,587196 1,346804 1,056953 0,877047
231 W61002001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 5mg/1,25mg/10mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,203569 0,328431 0,601784 0,930216 1,083212 0,448788
232 W61001001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 5mg/1,25mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 0,792654 0,600679 0,396327 0,997006 0,713388 0,679945
233 W56930003 C09CA03 VALSARTANUM DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. TIP CALENDAR PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 1,175357 0,000000 0,587678 0,587679 1,057821 0,117536
234 W58146002 C09CA03 VALSARTANUM VALSARTAN ZENTIVA 160 mg COMPR. FILM. 160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM. P-6L 28 0,601428 0,000000 0,300714 0,300714 0,541285 0,060143
235 W58950003 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,763214 0,000000 0,381607 0,381607 0,686892 0,076322
236 W58950013 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,763214 0,000000 0,381607 0,381607 0,686892 0,076322
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 0,348021 1,161264 0,174010 1,335275 0,313218 1,196067
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 0,348021 0,607336 0,174010 0,781347 0,313218 0,642139
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 0,348021 0,607336 0,174010 0,781347 0,313218 0,642139
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 0,696042 0,327886 0,348021 0,675907 0,626437 0,397491
241 W58145002 C09CA03 VALSARTANUM VALSARTAN ZENTIVA 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM. P-6L 28 0,560357 0,000000 0,280178 0,280179 0,504321 0,056036
242 W58949003 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,422142 0,000000 0,211071 0,211071 0,379927 0,042215
243 W58949013 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,422142 0,000000 0,211071 0,211071 0,379927 0,042215
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 4,176254 21,143746 2,088127 23,231873 3,758628 21,561372
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 0,696042 0,143243 0,348021 0,491264 0,626437 0,212848
Pagina 4 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
246 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 0,696042 0,143243 0,348021 0,491264 0,626437 0,212848
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
248 W66452005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,553214 0,000000 0,276607 0,276607 0,497892 0,055322
249 W54081003 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,692857 0,000000 0,346428 0,346429 0,623571 0,069286
250 W59580002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,597500 0,000000 0,298750 0,298750 0,537750 0,059750
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 0,696042 0,553958 0,348021 0,901979 0,626437 0,623563
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 0,696042 0,492529 0,348021 0,840550 0,626437 0,562134
253 W63000003 C09CA04 IRBESARTANUM IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,477142 0,000000 0,238571 0,238571 0,429427 0,047715
254 W65123002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,597500 0,000000 0,298750 0,298750 0,537750 0,059750
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 0,696042 0,492529 0,348021 0,840550 0,626437 0,562134
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 0,696042 0,553958 0,348021 0,901979 0,626437 0,623563
257 W63001003 C09CA04 IRBESARTANUM IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,854642 0,000000 0,427321 0,427321 0,769177 0,085465
258 W54082003 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 300 mg COMPR. FILM. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 1,151785 0,000000 0,575892 0,575893 1,036606 0,115179
259 W59581002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,935357 0,000000 0,467678 0,467679 0,841821 0,093536
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 1,392084 0,271916 0,696042 0,967958 1,252875 0,411125
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 1,392084 0,188630 0,696042 0,884672 1,252875 0,327839
262 W65124002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,935357 0,000000 0,467678 0,467679 0,841821 0,093536
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 1,392084 0,188630 0,696042 0,884672 1,252875 0,327839
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 1,392084 0,271916 0,696042 0,967958 1,252875 0,411125
265 W55622005 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 1,137857 0,000000 0,568928 0,568929 1,024071 0,113786
266 W54889004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P-6L 28 0,535357 0,000000 0,267678 0,267679 0,481821 0,053536
267 W55592003 C09CA06 CANDESARTANUM CILEXETIL KARBIS 16 mg COMPR. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,750000 0,000000 0,375000 0,375000 0,675000 0,075000
268 W58808002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,273928 0,000000 0,636964 0,636964 1,146535 0,127393
269 W58874004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,802333 0,000000 0,401166 0,401167 0,722099 0,080234
270 W60125003 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,784333 0,000000 0,392166 0,392167 0,705899 0,078434
271 W61496002 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 16 mg COMPR. 16mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 1,101000 0,000000 0,550500 0,550500 0,990900 0,110100
272 W62724001 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN ATB 16 mg COMPR. 16mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,770333 0,000000 0,385166 0,385167 0,693299 0,077034
273 W66434003 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,784333 0,000000 0,392166 0,392167 0,705899 0,078434
274 W55593003 C09CA06 CANDESARTANUM CILEXETIL KARBIS 32 mg COMPR. 32mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 1,387333 0,000000 0,693666 0,693667 1,248599 0,138734
275 W58806001 C09CA06 CANDESARTANUM CILEXETIL ATACAND 32 mg COMPR. 32mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,881071 0,000000 0,940535 0,940536 1,692963 0,188108
276 W58875004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 1,094000 0,000000 0,547000 0,547000 0,984600 0,109400
277 W61497002 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 32 mg COMPR. 32mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 1,550666 0,000000 0,775333 0,775333 1,395599 0,155067
278 W64539008 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 32 mg COMPR. 32mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P6L 28 1,497500 0,000000 0,748750 0,748750 1,347750 0,149750
279 W55621005 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 8 mg COMPR. 8mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 0,567857 0,000000 0,283928 0,283929 0,511071 0,056786
280 W55591003 C09CA06 CANDESARTANUM CILEXETIL KARBIS 8 mg COMPR. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,554666 0,000000 0,277333 0,277333 0,499199 0,055467
281 W58807002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,620357 0,000000 0,310178 0,310179 0,558321 0,062036
282 W58873004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,545000 0,000000 0,272500 0,272500 0,490500 0,054500
283 W60124003 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,567666 0,000000 0,283833 0,283833 0,510899 0,056767
284 W61495004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 8 mg COMPR. 8mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,569000 0,000000 0,284500 0,284500 0,512100 0,056900
285 W62723001 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN ATB 8 mg COMPR. 8mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,568666 0,000000 0,284333 0,284333 0,511799 0,056867
286 W66433003 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,567666 0,000000 0,283833 0,283833 0,510899 0,056767
287 W56746002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 40mg COMPR. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,562857 0,000000 0,281428 0,281429 0,506571 0,056286
288 W55585002 C09CA07 TELMISARTANUM TOLURA 40 mg COMPR. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,615714 0,000000 0,307857 0,307857 0,554142 0,061572
289 W55534001 C09CA07 TELMISARTANUM TEZEO 40 mg COMPR. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,566666 0,000000 0,283333 0,283333 0,509999 0,056667
290 W56747002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 80mg COMPR. 80 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,761071 0,000000 0,380535 0,380536 0,684963 0,076108
291 W05785002 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 1,392084 0,070416 0,696042 0,766458 1,252875 0,209625
292 W55586002 C09CA07 TELMISARTANUM TOLURA 80 mg COMPR. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,771428 0,000000 0,385714 0,385714 0,694285 0,077143
293 W55535001 C09CA07 TELMISARTANUM TEZEO 80 mg COMPR. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,801666 0,000000 0,400833 0,400833 0,721499 0,080167
294 W57129003 C09CA07 TELMISARTANUM TELMARK 40 mg COMPR. FILM. 40mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,635714 0,000000 0,317857 0,317857 0,572142 0,063572
295 W57130003 C09CA07 TELMISARTANUM TELMARK 80 mg COMPR. FILM. 80mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,666428 0,000000 0,333214 0,333214 0,599785 0,066643
296 W56252005 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA HL 100 mg/12,5 mg COMPR.FILM 100mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,653214 0,000000 0,326607 0,326607 0,587892 0,065322
297 W43460003 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA H COMPR.FILM50mg+ 12,50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,487142 0,000000 0,243571 0,243571 0,438427 0,048715
298 W07646001 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. 150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,716699 0,513301 0,358349 0,871651 0,645029 0,584971
299 W07647001 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. 300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,716699 0,836158 0,358349 1,194508 0,645029 0,907828
300 W59584002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,645000 0,000000 0,322500 0,322500 0,580500 0,064500
301 W65144002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5 mg COMPR. FILM150mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P6L 28 0,645000 0,000000 0,322500 0,322500 0,580500 0,064500
302 W59585002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 0,716699 0,326515 0,358349 0,684865 0,645029 0,398185
303 W65145002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5 mg COMPR. FILM300mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P6L 28 0,716699 0,326515 0,358349 0,684865 0,645029 0,398185
304 W60639002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. FILM. 150mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,716699 0,513301 0,358349 0,871651 0,645029 0,584971
305 W61154002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,716699 0,108658 0,358349 0,467008 0,645029 0,180328
306 W61154011 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,716699 0,108658 0,358349 0,467008 0,645029 0,180328
307 W66394002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. FILM. 150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P6L 28 0,716699 0,513301 0,358349 0,871651 0,645029 0,584971
308 W60640002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. FILM. 300mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,716699 0,836158 0,358349 1,194508 0,645029 0,907828
Pagina 5 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
309 W61158002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,716699 0,212229 0,358349 0,570579 0,645029 0,283899
310 W61158011 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,716699 0,212229 0,358349 0,570579 0,645029 0,283899
311 W66395002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. FILM. 300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,716699 0,836872 0,358349 1,195222 0,645029 0,908542
312 W60641002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg COMPR. FILM. 300mg/25mg SANOFI CLIR SNC FRANTA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,716699 0,839015 0,358349 1,197365 0,645029 0,910685
313 W61159002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,716699 0,177943 0,358349 0,536293 0,645029 0,249613
314 W61159011 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,716699 0,177943 0,358349 0,536293 0,645029 0,249613
315 W66396002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg COMPR. FILM. 300mg/25mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 0,716699 0,839015 0,358349 1,197365 0,645029 0,910685
316 W57536004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 16 mg/12,5 mg COMPR. 16mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIT. PVC-PVDC/AL X 30 COMPR. P6L 30 0,716699 0,085634 0,358349 0,443984 0,645029 0,157304
317 W57536013 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 16 mg/12,5 mg COMPR. 16mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,716699 0,085634 0,358349 0,443984 0,645029 0,157304
318 W58871004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 16mg/12,5mg COMPR. 16mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,716699 0,085634 0,358349 0,443984 0,645029 0,157304
319 W64690001 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN HCT SWYSSI 16 mg/12,5 mg COMPR. 16mg/12,5mg SWYSSI AG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,716699 0,074301 0,358349 0,432651 0,645029 0,145971
320 W57535004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 8 mg/12,5 mg COMPR. 8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIT. PVC-PVDC/AL X 30 COMPR. P6L 30 0,471000 0,000000 0,235500 0,235500 0,423900 0,047100
321 W57535013 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 8 mg/12,5 mg COMPR. 8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,471000 0,000000 0,235500 0,235500 0,423900 0,047100
322 W58870004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 8mg/12,5mg COMPR. 8mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,463666 0,000000 0,231833 0,231833 0,417299 0,046367
323 W64688001 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN HCT SWYSSI 8 mg/12,5 mg COMPR. 8mg/12,5mg SWYSSI AG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,463666 0,000000 0,231833 0,231833 0,417299 0,046367
324 W59718002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/12,5 mg COMPR. 80 mg/12,5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,716699 0,349372 0,358349 0,707722 0,645029 0,421042
325 W59819005 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/12,5mg COMPR. 80 mg/12,5mgKRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,716699 0,084967 0,358349 0,443317 0,645029 0,156637
326 W59820005 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/25mg COMPR. 80 mg/25mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,716699 0,084967 0,358349 0,443317 0,645029 0,156637
327 W59719001 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/25mg COMPR. 80 mg/25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,716699 0,439372 0,358349 0,797722 0,645029 0,511042
328 W12033002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/12,5mg COMPR. 80/12,5mg GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 28 0,716699 0,927229 0,358349 1,285579 0,645029 0,998899
329 W53178002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/25mg COMPR. 80/25mg GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 28 0,716699 1,006515 0,358349 1,364865 0,645029 1,078185
330 W59921007 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg COMPR. 80mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 0,716699 0,084967 0,358349 0,443317 0,645029 0,156637
331 W60206003 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/12,5 mg COMPR. 80mg/12,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,716699 0,022967 0,358349 0,381317 0,645029 0,094637
332 W65924001 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELHYCAR 80 mg/12,5 mg COMPR. 80mg/12,5mg SWYSSI AG. GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P6L 28 0,716699 0,409372 0,358349 0,767722 0,645029 0,481042
333 W60207003 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/25 mg COMPR. 80mg/25mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,716699 0,381301 0,358349 0,739651 0,645029 0,452971
334 W65925001 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELHYCAR 80 mg/25 mg COMPR. 80mg/25mg SWYSSI AG. GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P6L 28 0,716699 0,409372 0,358349 0,767722 0,645029 0,481042
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 1,815000 0,118214 0,907500 1,025714 1,633500 0,299714
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 1,815000 0,572500 0,907500 1,480000 1,633500 0,754000
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 1,815000 0,449642 0,907500 1,357142 1,633500 0,631142
338 W62875006 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN STADA 10 mg/160 mg COMPR. FILM. 10mg/160mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 56 COMPR. FILM. P6L 56 1,635714 0,000000 0,817857 0,817857 1,472142 0,163572
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 1,815000 0,118214 0,907500 1,025714 1,633500 0,299714
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 1,761617 0,171597 0,880808 1,052406 1,585455 0,347759
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 1,761617 0,560168 0,880808 1,440977 1,585455 0,736330
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 1,761617 0,443740 0,880808 1,324549 1,585455 0,619902
343 W62874006 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN STADA 5 mg/160 mg COMPR. FILM. 5mg/160mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 56 COMPR. FILM. P6L 56 1,635714 0,000000 0,817857 0,817857 1,472142 0,163572
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 1,761617 0,171597 0,880808 1,052406 1,585455 0,347759
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 0,907500 1,320178 0,453750 1,773928 0,816750 1,410928
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 0,907500 1,479642 0,453750 1,933392 0,816750 1,570392
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 0,907500 1,356607 0,453750 1,810357 0,816750 1,447357
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 0,907500 1,356607 0,453750 1,810357 0,816750 1,447357
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 0,907500 1,320178 0,453750 1,773928 0,816750 1,410928
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 0,907500 0,870000 0,453750 1,323750 0,816750 0,960750
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 0,907500 0,780714 0,453750 1,234464 0,816750 0,871464
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 0,907500 1,379642 0,453750 1,833392 0,816750 1,470392
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 0,907500 0,926071 0,453750 1,379821 0,816750 1,016821
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 0,907500 0,454642 0,453750 0,908392 0,816750 0,545392
355 W64245006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE P6L
CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. 28 0,907500 0,454642 0,453750 0,908392 0,816750 0,545392
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 0,907500 0,780714 0,453750 1,234464 0,816750 0,871464
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 0,907500 0,454642 0,453750 0,908392 0,816750 0,545392
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 0,907500 0,454642 0,453750 0,908392 0,816750 0,545392
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 0,907500 0,726785 0,453750 1,180535 0,816750 0,817535
360 W53447002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/10 mg COMPR. FILM. 40mg/10mg LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM.
MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. P-6L 28 1,815000 0,093571 0,907500 1,001071 1,633500 0,275071
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 1,815000 0,000000 0,907500 0,907500 1,633500 0,181500
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 1,815000 0,715714 0,907500 1,623214 1,633500 0,897214
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 1,815000 0,715714 0,907500 1,623214 1,633500 0,897214
364 W64247001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,528571 0,000000 0,764285 0,764286 1,375713 0,152858
365 W64247006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE P6L
CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. 28 1,528571 0,000000 0,764285 0,764286 1,375713 0,152858
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 1,815000 0,000000 0,907500 0,907500 1,633500 0,181500
367 W65816001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,528571 0,000000 0,764285 0,764286 1,375713 0,152858
368 W65816006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg 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 1,528571 0,000000 0,764285 0,764286 1,375713 0,152858
369 W66043002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SALVO 40 mg/10 mg COMPR. FILM. 40mg/10mg TERAPIA SA ROMANIA 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
370 W53446002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/5 mg COMPR. FILM. 40mg/5mg LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM.
MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. P-6L 28 1,633500 0,144000 0,816750 0,960750 1,470150 0,307350
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 1,633500 0,054714 0,816750 0,871464 1,470150 0,218064
Pagina 6 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
372 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 1,633500 0,712571 0,816750 1,529321 1,470150 0,875921
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 1,633500 0,712571 0,816750 1,529321 1,470150 0,875921
374 W64246001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,395357 0,000000 0,697678 0,697679 1,255821 0,139536
375 W64246006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,395357 0,000000 0,697678 0,697679 1,255821 0,139536
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 1,633500 0,054714 0,816750 0,871464 1,470150 0,218064
377 W65815001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,395357 0,000000 0,697678 0,697679 1,255821 0,139536
378 W65815006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/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 1,395357 0,000000 0,697678 0,697679 1,255821 0,139536
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 1,633500 0,000785 0,816750 0,817535 1,470150 0,164135
380 W57234002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,033333 0,439167 1,516666 1,955834 2,729999 0,742501
381 W64768002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,041644 0,430856 1,520822 1,951678 2,737479 0,735021
382 W57236002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,241096 0,368546 1,620548 1,989094 2,916986 0,692656
383 W64769002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/25 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,241096 0,368546 1,620548 1,989094 2,916986 0,692656
384 W57233002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 2,950229 0,054413 1,475114 1,529528 2,655206 0,349436
385 W64770002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 2,958538 0,046104 1,479269 1,525373 2,662684 0,341958
386 W57235002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,010357 0,000000 1,505178 1,505179 2,709321 0,301036
387 W64771002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,010357 0,000000 1,505178 1,505179 2,709321 0,301036
388 W51412001 C10AA04 FLUVASTATINUM LESCOL XL 80 mg COMPR. ELIB. PREL. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 (4X7) COMPR. ELIB. PREL. P-6L 28 0,672500 0,000000 0,336250 0,336250 0,605250 0,067250
389 W63181001 C10AA04 FLUVASTATINUM FLUVASTATIN ARENA 80 mg COMPR. ELIB. PREL. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. ELIB. PREL. P6L 30 0,671666 0,000000 0,335833 0,335833 0,604499 0,067167
390 W12893001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 0,257399 0,655267 0,128699 0,783967 0,231659 0,681007
391 W54696006 C10AA05 ATORVASTATINUM ATORIS 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR.FILM. P-6L 28 0,257399 0,134386 0,128699 0,263086 0,231659 0,160126
392 W55516003 C10AA05 ATORVASTATINUM ASCORD 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,257399 0,114601 0,128699 0,243301 0,231659 0,140341
393 W59346005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 10 mg COMPR. FILM. 10mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,238333 0,000000 0,119166 0,119167 0,214499 0,023834
394 W61225003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,138666 0,000000 0,069333 0,069333 0,124799 0,013867
395 W62152005 C10AA05 ATORVASTATINUM TORVACARD 10 mg COMPR. FILM. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,257399 0,039601 0,128699 0,168301 0,231659 0,065341
396 W64099007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,138666 0,000000 0,069333 0,069333 0,124799 0,013867
397 W64877001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,257399 0,655267 0,128699 0,783967 0,231659 0,681007
398 W65497005 C10AA05 ATORVASTATINUM ATORVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,238333 0,000000 0,119166 0,119167 0,214499 0,023834
399 W66304007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,138666 0,000000 0,069333 0,069333 0,124799 0,013867
400 W66444003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,138666 0,000000 0,069333 0,069333 0,124799 0,013867
401 W12894001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 0,514799 0,600201 0,257399 0,857601 0,463319 0,651681
402 W54697006 C10AA05 ATORVASTATINUM ATORIS 20 mg COMPR. FILM. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR.FILM. P-6L 28 0,361428 0,000000 0,180714 0,180714 0,325285 0,036143
403 W55517003 C10AA05 ATORVASTATINUM ASCORD 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,514799 0,074867 0,257399 0,332267 0,463319 0,126347
404 W59347005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 20 mg COMPR. FILM. 20mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,286000 0,000000 0,143000 0,143000 0,257400 0,028600
405 W61226003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,299333 0,000000 0,149666 0,149667 0,269399 0,029934
406 W62153005 C10AA05 ATORVASTATINUM TORVACARD 20 mg COMPR. FILM. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,437666 0,000000 0,218833 0,218833 0,393899 0,043767
407 W64100007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,270000 0,000000 0,135000 0,135000 0,243000 0,027000
408 W64878001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,514799 0,600201 0,257399 0,857601 0,463319 0,651681
409 W65499005 C10AA05 ATORVASTATINUM ATORVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,286000 0,000000 0,143000 0,143000 0,257400 0,028600
410 W66305007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,270000 0,000000 0,135000 0,135000 0,243000 0,027000
411 W66445003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,299333 0,000000 0,149666 0,149667 0,269399 0,029934
412 W57506007 C10AA05 ATORVASTATINUM ATORIS 30 mg COMPR. FILM. 30mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,651333 0,000000 0,325666 0,325667 0,586199 0,065134
413 W12895001 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. P-6L 14 1,029599 0,209686 0,514799 0,724486 0,926639 0,312646
414 W54698004 C10AA05 ATORVASTATINUM ATORIS 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 14 COMPR.FILM. P-6L 14 1,029599 0,075401 0,514799 0,590201 0,926639 0,178361
415 W54698007 C10AA05 ATORVASTATINUM ATORIS 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,692333 0,000000 0,346166 0,346167 0,623099 0,069234
416 W55518003 C10AA05 ATORVASTATINUM ASCORD 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 1,029599 0,113734 0,514799 0,628534 0,926639 0,216694
417 W59348005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 40 mg COMPR. FILM. 40mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,029599 0,061734 0,514799 0,576534 0,926639 0,164694
418 W61227003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,551000 0,000000 0,275500 0,275500 0,495900 0,055100
419 W62154005 C10AA05 ATORVASTATINUM TORVACARD 40 mg COMPR. FILM. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,678333 0,000000 0,339166 0,339167 0,610499 0,067834
420 W64101007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,569000 0,000000 0,284500 0,284500 0,512100 0,056900
421 W61227016 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,551000 0,000000 0,275500 0,275500 0,495900 0,055100
422 W64879006 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1,029599 0,209686 0,514799 0,724486 0,926639 0,312646
423 W65501005 C10AA05 ATORVASTATINUM ATORVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,029599 0,061734 0,514799 0,576534 0,926639 0,164694
424 W66306007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,569000 0,000000 0,284500 0,284500 0,512100 0,056900
425 W66446003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,551000 0,000000 0,275500 0,275500 0,495900 0,055100
426 W66446016 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,551000 0,000000 0,275500 0,275500 0,495900 0,055100
427 W57507007 C10AA05 ATORVASTATINUM ATORIS 60 mg COMPR. FILM. 60mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,072333 0,000000 0,536166 0,536167 0,965099 0,107234
428 W12897001 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. P-6L 14 1,120714 0,000000 0,560357 0,560357 1,008642 0,112072
429 W55519003 C10AA05 ATORVASTATINUM ASCORD 80 mg COMPR. FILM. 80mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 1,130333 0,000000 0,565166 0,565167 1,017299 0,113034
430 W57508007 C10AA05 ATORVASTATINUM ATORIS 80 mg COMPR. FILM. 80mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,090000 0,000000 0,545000 0,545000 0,981000 0,109000
431 W59349005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 80 mg COMPR. FILM. 80mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,130333 0,000000 0,565166 0,565167 1,017299 0,113034
432 W61228003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,545333 0,000000 0,272666 0,272667 0,490799 0,054534
433 W62155005 C10AA05 ATORVASTATINUM TORVACARD 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,130333 0,000000 0,565166 0,565167 1,017299 0,113034
434 W61228013 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,545333 0,000000 0,272666 0,272667 0,490799 0,054534
Pagina 7 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
435 W64880006 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1,120714 0,000000 0,560357 0,560357 1,008642 0,112072
436 W65503005 C10AA05 ATORVASTATINUM ATORVASTATIN TERAPIA 80 mg COMPR. FILM. 80mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,130333 0,000000 0,565166 0,565167 1,017299 0,113034
437 W66447003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,545333 0,000000 0,272666 0,272667 0,490799 0,054534
438 W66447013 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,545333 0,000000 0,272666 0,272667 0,490799 0,054534
439 W57308006 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBHGERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,416000 0,000000 0,208000 0,208000 0,374400 0,041600
440 W13864001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 0,514799 0,688058 0,257399 0,945458 0,463319 0,739538
441 W55327002 C10AA07 ROSUVASTATINUM ROSUCARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,514799 0,153867 0,257399 0,411267 0,463319 0,205347
442 W57059005 C10AA07 ROSUVASTATINUM ROSWERA 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,514799 0,124201 0,257399 0,381601 0,463319 0,175681
443 W59899004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,514799 0,142343 0,257399 0,399743 0,463319 0,193823
444 W59899017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,514799 0,142343 0,257399 0,399743 0,463319 0,193823
445 W59657004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,413333 0,000000 0,206666 0,206667 0,371999 0,041334
446 W60392003 C10AA07 ROSUVASTATINUM ROVASTAMED 10mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,383571 0,000000 0,191785 0,191786 0,345213 0,038358
447 W61054001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,514799 0,393201 0,257399 0,650601 0,463319 0,444681
448 W62399024 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30X1 COMPR. FILM. P6L 30 0,514799 0,078867 0,257399 0,336267 0,463319 0,130347
449 W63623003 C10AA07 ROSUVASTATINUM ASTRIUM 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,260333 0,000000 0,130166 0,130167 0,234299 0,026034
450 W64682002 C10AA07 ROSUVASTATINUM ROSI 10 mg COMPR. FILM. 10mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,514799 0,253534 0,257399 0,510934 0,463319 0,305014
451 W65079001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 0,514799 0,688058 0,257399 0,945458 0,463319 0,739538
452 W66314003 C10AA07 ROSUVASTATINUM ASTRIUM 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,260333 0,000000 0,130166 0,130167 0,234299 0,026034
453 W66470004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,413333 0,000000 0,206666 0,206667 0,371999 0,041334
454 W57309006 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBHGERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,824333 0,000000 0,412166 0,412167 0,741899 0,082434
455 W13865001 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 1,029599 0,168258 0,514799 0,683058 0,926639 0,271218
456 W55328002 C10AA07 ROSUVASTATINUM ROSUCARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,901000 0,000000 0,450500 0,450500 0,810900 0,090100
457 W57061005 C10AA07 ROSUVASTATINUM ROSWERA 20 mg COMPR. FILM. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,972333 0,000000 0,486166 0,486167 0,875099 0,097234
458 W59900004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,029599 0,149686 0,514799 0,664486 0,926639 0,252646
459 W59900017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 1,029599 0,149686 0,514799 0,664486 0,926639 0,252646
460 W59658004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,821666 0,000000 0,410833 0,410833 0,739499 0,082167
461 W60393003 C10AA07 ROSUVASTATINUM ROVASTAMED 20mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,029599 0,190401 0,514799 0,705201 0,926639 0,293361
462 W61055001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 1,029599 0,043401 0,514799 0,558201 0,926639 0,146361
463 W62400024 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30X1 COMPR. FILM. P6L 30 1,029599 0,168401 0,514799 0,683201 0,926639 0,271361
464 W63624003 C10AA07 ROSUVASTATINUM ASTRIUM 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,489000 0,000000 0,244500 0,244500 0,440100 0,048900
465 W64684002 C10AA07 ROSUVASTATINUM ROSI 20 mg COMPR. FILM. 20mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,029599 0,457401 0,514799 0,972201 0,926639 0,560361
466 W65078001 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 1,029599 0,168258 0,514799 0,683058 0,926639 0,271218
467 W66315003 C10AA07 ROSUVASTATINUM ASTRIUM 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,489000 0,000000 0,244500 0,244500 0,440100 0,048900
468 W66471004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,821666 0,000000 0,410833 0,410833 0,739499 0,082167
469 W55329002 C10AA07 ROSUVASTATINUM ROSUCARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,563333 0,000000 0,781666 0,781667 1,406999 0,156334
470 W57063005 C10AA07 ROSUVASTATINUM ROSWERA 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,177000 0,000000 0,588500 0,588500 1,059300 0,117700
471 W59901017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 1,563571 0,000000 0,781785 0,781786 1,407213 0,156358
472 W59901004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,563571 0,000000 0,781785 0,781786 1,407213 0,156358
473 W59659004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,755666 0,000000 0,377833 0,377833 0,680099 0,075567
474 W60394003 C10AA07 ROSUVASTATINUM ROVASTAMED 40mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,831428 0,000000 0,915714 0,915714 1,648285 0,183143
475 W61056001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 2,059199 0,617134 1,029599 1,646734 1,853279 0,823054
476 W63625003 C10AA07 ROSUVASTATINUM ASTRIUM 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,882333 0,000000 0,441166 0,441167 0,794099 0,088234
477 W64686002 C10AA07 ROSUVASTATINUM ROSI 40 mg COMPR. FILM. 40mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 2,059199 0,923134 1,029599 1,952734 1,853279 1,129054
478 W66316003 C10AA07 ROSUVASTATINUM ASTRIUM 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,882333 0,000000 0,441166 0,441167 0,794099 0,088234
479 W66472004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,755666 0,000000 0,377833 0,377833 0,680099 0,075567
480 W43678001 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 0,257399 0,649386 0,128699 0,778086 0,231659 0,675126
481 W57058005 C10AA07 ROSUVASTATINUM ROSWERA 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,257399 0,070267 0,128699 0,198967 0,231659 0,096007
482 W59898004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,257399 0,077243 0,128699 0,205943 0,231659 0,102983
483 W59898017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,257399 0,077243 0,128699 0,205943 0,231659 0,102983
484 W59656004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 5 mg COMPR. FILM. 5mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,206333 0,000000 0,103166 0,103167 0,185699 0,020634
485 W60391003 C10AA07 ROSUVASTATINUM ROVASTAMED 5mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,257399 1,046172 0,128699 1,174872 0,231659 1,071912
486 W61053001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,257399 0,567934 0,128699 0,696634 0,231659 0,593674
487 W63622003 C10AA07 ROSUVASTATINUM ASTRIUM 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,153000 0,000000 0,076500 0,076500 0,137700 0,015300
488 W65077001 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 0,257399 0,649386 0,128699 0,778086 0,231659 0,675126
489 W66313003 C10AA07 ROSUVASTATINUM ASTRIUM 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,153000 0,000000 0,076500 0,076500 0,137700 0,015300
490 W66469004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,206333 0,000000 0,103166 0,103167 0,185699 0,020634
491 W51918006 C10AX09 EZETIMIBUM EZETROL 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 28 1,567666 0,714834 0,783833 1,498667 1,410899 0,871601
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 1,032000 0,783833 1,815833 1,410899 1,188767
493 W63969006 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR.
PRF 30 1,567666 0,000000 0,783833 0,783833 1,410899 0,156767
494 W63969016 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL-PVC/ACLAR X 30 COMPR. PRF 30 1,567666 0,000000 0,783833 0,783833 1,410899 0,156767
495 W65800006 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 1,567666 0,000000 0,783833 0,783833 1,410899 0,156767
496 W65800016 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. AL-PVC/ACLAR X 30 COMPR. PRF 30 1,567666 0,000000 0,783833 0,783833 1,410899 0,156767
497 W61288003 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** LIPOCOMB 10 mg/10 mg CAPS. 10mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 3,660582 0,113084 1,830291 1,943375 3,294523 0,479143
Pagina 8 din 21
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
498 W61295003 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** LIPOCOMB 20 mg/10 mg CAPS. 20mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 3,660582 0,351751 1,830291 2,182042 3,294523 0,717810
499 W65411002 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** TWICOR 10 mg/10 mg COMPR. FILM. 10mg/10mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CONPR. FILM. P6L 30 2,796333 0,000000 1,398166 1,398167 2,516699 0,279634
500 W65535004 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** CO-ROSWERA 10 mg/10 mg COMPR. FILM. 10mg/10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 3,660582 0,511418 1,830291 2,341709 3,294523 0,877477
501 W65827001 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** SUVEZEN 10 mg/10 mg COMPR. FILM. 10mg/10mg SANOFI ROMANIA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 3,660582 0,511418 1,830291 2,341709 3,294523 0,877477
502 W65828001 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** SUVEZEN 20 mg/10 mg COMPR. FILM. 20mg/10mg SANOFI ROMANIA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 3,660582 0,912751 1,830291 2,743042 3,294523 1,278810
503 W65412002 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** TWICOR 20 mg/10 mg COMPR. FILM. 20mg/10mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CONPR. FILM. P6L 30 3,321333 0,000000 1,660666 1,660667 2,989199 0,332134
504 W65537004 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** CO-ROSWERA 20 mg/10 mg COMPR. FILM. 20mg/10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 3,660582 0,912751 1,830291 2,743042 3,294523 1,278810
505 W43316001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/10mg COMPR. FILM. 10mg/10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,792166 0,031167 0,396083 0,427250 0,712949 0,110384
506 W56680001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 10 mg/10 mg COMPR. FILM. 10mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,721666 0,000000 0,360833 0,360833 0,649499 0,072167
507 W64962001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/10mg COMPR. FILM. 10mg/10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,792166 0,031167 0,396083 0,427250 0,712949 0,110384
508 W43315001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/5mg COMPR. FILM. 10mg/5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,792166 0,023500 0,396083 0,419583 0,712949 0,102717
509 W56679001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 10 mg/5 mg COMPR. FILM. 10mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,587000 0,000000 0,293500 0,293500 0,528300 0,058700
510 W64961001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/5mg COMPR. FILM. 10mg/5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,792166 0,023500 0,396083 0,419583 0,712949 0,102717
511 W56682001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 20 mg/10 mg COMPR. FILM. 20mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,792166 0,432500 0,396083 0,828583 0,712949 0,511717
512 W56681001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 20 mg/5 mg COMPR. FILM. 20mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,792166 0,156834 0,396083 0,552917 0,712949 0,236051
513 W05806001 D01BA02 TERBINAFINUM LAMISIL (R) COMPR. 250mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. X 14 COMPR. P-RF 14 1,489642 0,264643 0,744821 1,009464 1,340677 0,413608
514 W53418001 D01BA02 TERBINAFINUM TERBINAFINA SLAVIA 250mg COMPR. 250mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR. P-RF 14 1,489642 0,260358 0,744821 1,005179 1,340677 0,409323
515 W61192002 D01BA02 TERBINAFINUM TERBINAFINA ARENA 250 mg COMPR. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-RF 28 1,229285 0,000000 0,614642 0,614643 1,106356 0,122929
516 W58498001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * DAIVOBET 50 micrograme/0,5 mg/g GEL 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLAC. PEID CU DUZA DIN PEJD SI CAPAC DIN PEID X 15 G GEL PRF 1 52,755000 2,225000 26,377500 28,602500 47,479500 7,500500
517 W62934001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * ENSTILUM 50 micrograme/0,5 mg/g SPUMA CUT. 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA PRF
CUTIE CU 1 RECIPIENT PRESURIZAT DIN AL, CU UN STRAT INTERIOR DIN LAC POLIAMID-IMIDIC PREVAZUT CU VALVA DOZATOARE SI SISTEM DE ACTIONARE CARE CONTINE 60 G SPUMA CUTANATA 1 211,020000 13,230000 105,510000 118,740000 189,918000 34,332000
518 W56194001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * DAIVOBET 50 micrograme/0,5mg/g UNGUENT 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL/EPOXID-FENOL X 15 G UNGUENT P-RF 1 50,530000 0,000000 25,265000 25,265000 45,477000 5,053000
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
520 W63433001 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml LEO PHARMA A/S DANEMARCA P-RF
CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE 1 41,150000 0,000000 20,575000 20,575000 37,035000 4,115000
521 W66142001 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml KARO PHARMA AB SUEDIA P-RF
CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE 1 41,150000 0,000000 20,575000 20,575000 37,035000 4,115000
522 W07761001 D06BB10 IMIQUIMODUM * ALDARA 5% CREMA 5% MEDA AB SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA P-RF 12 22,912500 0,000000 11,456250 11,456250 20,621250 2,291250
523 W63158001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID 1 mg/g CREMA 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN AL CU 30 G CREMA PRF 1 12,707500 0,022500 6,353750 6,376250 11,436750 1,293250
524 W63159001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID LIPOCREAM 1mg/g CREMA 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN AL X 30 G CREMA PRF 1 12,700000 0,000000 6,350000 6,350000 11,430000 1,270000
525 W57223001 D07AC13 MOMETASONUM ELOCOM 1 mg/g CREMA 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P6L 1 3,780000 2,060000 1,890000 3,950000 3,402000 2,438000
526 W59624001 D07AC13 MOMETASONUM MOMETAZONA ATB 1 mg/g CREMA 1mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA P6L 1 3,780000 0,000000 1,890000 1,890000 3,402000 0,378000
527 W57222001 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3,780000 2,060000 1,890000 3,950000 3,402000 2,438000
528 W59623001 D07AC13 MOMETASONUM MOMETAZONA ATB 1 mg/g UNGUENT 1mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG. P6L 1 3,780000 0,000000 1,890000 1,890000 3,402000 0,378000
529 W61468004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 22,860000 2,950000 11,430000 14,380000 20,574000 5,236000
530 W63875004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 22,860000 2,950000 11,430000 14,380000 20,574000 5,236000
531 W66063004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g INTENDIS GMBH GERMANIA PRF
CUTIE CU 1 TUB DIN AL SIGILAT CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 30 G CREMA 1 22,860000 2,950000 11,430000 14,380000 20,574000 5,236000
532 W66594004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g LEO PHARMA A/S DANEMARCA PRF
CUTIE CU 1 TUB DIN AL SIGILAT CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 30 G CREMA 1 22,860000 2,950000 11,430000 14,380000 20,574000 5,236000
533 W61468005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G CREMA P-RF 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
534 W63875005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G CREMA PRF 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
535 W66063005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g INTENDIS GMBH GERMANIA PRF
CUTIE CU 1 TUB DIN AL SIGILAT CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G CREMA 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
536 W66594005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g LEO PHARMA A/S DANEMARCA PRF
CUTIE CU 1 TUB DIN AL SIGILAT CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G CREMA 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
537 W61466002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g BAYER PHARMA AG GERMANIA PRF
CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA 1 35,560000 0,000000 17,780000 17,780000 32,004000 3,556000
538 W63873002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g BAYER AG GERMANIA PRF
CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA 1 35,560000 0,000000 17,780000 17,780000 32,004000 3,556000
539 W66062002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g INTENDIS GMBH GERMANIA PRF
CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA 1 35,560000 0,000000 17,780000 17,780000 32,004000 3,556000
540 W66593002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g LEO PHARMA A/S DANEMARCA PRF
CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA 1 35,560000 0,000000 17,780000 17,780000 32,004000 3,556000
541 W61467004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT P-RF 1 22,860000 3,720000 11,430000 15,150000 20,574000 6,006000
542 W63874004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G UNGUENT PRF 1 22,860000 3,720000 11,430000 15,150000 20,574000 6,006000
543 W66064004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g INTENDIS GMBH GERMANIA PRF
CUTIE CU 1 TUB DIN AL CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 30 G UNGUENT 1 22,860000 3,720000 11,430000 15,150000 20,574000 6,006000
544 W66595004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g LEO PHARMA A/S DANEMARCA PRF
CUTIE CU 1 TUB DIN AL CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 30 G UNGUENT 1 22,860000 3,720000 11,430000 15,150000 20,574000 6,006000
545 W61467005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G UNGUENT P-RF 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
546 W63874005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G UNGUENT PRF 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
547 W66064005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g INTENDIS GMBH GERMANIA PRF
CUTIE CU 1 TUB DIN AL CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G UNGUENT 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
548 W66595005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g LEO PHARMA A/S DANEMARCA PRF
CUTIE CU 1 TUB DIN AL CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G UNGUENT 1 38,100000 0,000000 19,050000 19,050000 34,290000 3,810000
549 W13497001 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE CREMA 0,05% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 10,540000 0,000000 5,270000 5,270000 9,486000 1,054000
550 W65212001 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE 0,5mg/g CREMA 0,5mg/g GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 10,540000 0,000000 5,270000 5,270000 9,486000 1,054000
551 W13088001 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE UNGUENT 0,005% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 10,540000 0,000000 5,270000 5,270000 9,486000 1,054000
552 W65211001 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE 0,05 mg/g UNGUENT 0,05mg/g GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 TUB DIN AL X 15 G UNGUENT PRF 1 10,540000 0,000000 5,270000 5,270000 9,486000 1,054000
553 W55012001 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g CREMA 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G CREMA P-RF 1 6,337500 6,712500 3,168750 9,881250 5,703750 7,346250
554 W63648001 D07AD01 CLOBETASOLUM * CLOBETAZOL ATB 0,5 mg/g CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 25 G CREMA PRF 1 6,337500 2,232500 3,168750 5,401250 5,703750 2,866250
555 W64939001 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g CREMA 0,5mg/g GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 TUB AL X 25 G CREMA PRF 1 6,337500 6,712500 3,168750 9,881250 5,703750 7,346250
556 W12704002 D07AD01 CLOBETASOLUM * DERMOVATE (R) SOL. CUT. 0,05% GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON CU PICURATOR DIN PP X 25 ML P-RF 1 6,060000 0,000000 3,030000 3,030000 5,454000 0,606000
557 W64943001 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/ml SOL. CUT. 0,5mg/ml GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 FLAC. CU PICURATOR DIN PP X 25 ML SOL. CUTANATA PRF 1 6,060000 0,000000 3,030000 3,030000 5,454000 0,606000
558 W55013001 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g UNGUENT 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G UNGUENT P-RF 1 6,337500 3,572500 3,168750 6,741250 5,703750 4,206250
559 W61823001 D07AD01 CLOBETASOLUM * CLOBETAZOL ATB 0,5 mg/g UNGUENT 0,5mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 25 G UNGUENT PRF 1 6,337500 0,092500 3,168750 3,261250 5,703750 0,726250
560 W64941001 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g UNGUENT 0,5mg/g GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 TUB AL X 25 G UNGUENT PRF 1 6,337500 3,572500 3,168750 6,741250 5,703750 4,206250
Pagina 9 din 21
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)
561 W60525001 D07CA01 FUCIDIN H
COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) CREMA 20mg/g+10mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 22,530000 0,000000 11,265000 11,265000 20,277000 2,253000
562 W59984002 D07CC01 FUCICORT 20 mg/1mg pe gram
COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) CREMA 20mg/1mg pe gram LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL X 20 G CREMA PRF 1 30,120000 0,000000 15,060000 15,060000 27,108000 3,012000
563 W56787001 D10AD54 COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL GEL 0.5mg/g+20mg/g GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 TUB DIN AL X 30 G GEL P6L 1 78,040000 0,000000 39,020000 39,020000 70,236000 7,804000
564 W61504001 D10AX03 ACIDUM AZELAICUM SKINOREN CREMA 200mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 32,560000 0,000000 16,280000 16,280000 29,304000 3,256000
565 W63891001 D10AX03 ACIDUM AZELAICUM SKINOREN 200 mg/g CREMA 200mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 32,560000 0,000000 16,280000 16,280000 29,304000 3,256000
566 W66057001 D10AX03 ACIDUM AZELAICUM SKINOREN 200 mg/g CREMA 200mg/g INTENDIS GMBH GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 32,560000 0,000000 16,280000 16,280000 29,304000 3,256000
567 W66597001 D10AX03 ACIDUM AZELAICUM SKINOREN 200 mg/g CREMA 200mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 32,560000 0,000000 16,280000 16,280000 29,304000 3,256000
568 W61503002 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB AL X 50 G GEL P-RF 1 40,700000 11,190000 20,350000 31,540000 36,630000 15,260000
569 W64050003 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g BAYER AG GERMANIA CUTIE CU 1 TUB AL X 50 G GEL PRF 1 40,700000 11,190000 20,350000 31,540000 36,630000 15,260000
570 W66056003 D10AX03 ACIDUM AZELAICUM SKINOREN 150 mg/g GEL 150mg/g INTENDIS GMBH GERMANIA CUTIE CU 1 TUB AL X 50 G GEL PRF 1 40,700000 11,190000 20,350000 31,540000 36,630000 15,260000
571 W66596003 D10AX03 ACIDUM AZELAICUM SKINOREN 150 mg/g GEL 150mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB AL X 50 G GEL PRF 1 40,700000 11,190000 20,350000 31,540000 36,630000 15,260000
572 W03829001 D10BA01 ISOTRETINOINUM ** ROACCUTANE 10 mg CAPS. MOI 10mg ROCHE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. MOI P-RF 30 1,128166 1,016167 0,564083 1,580250 1,015349 1,128984
573 W65390002 D10BA01 ISOTRETINOINUM ** SOTRET 10 mg CAPS. MOI 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PE-HARTIE X 30 CAPS. MOI PRF 30 1,105333 0,000000 0,552666 0,552667 0,994799 0,110534
574 W65391002 D10BA01 ISOTRETINOINUM ** SOTRET 20 mg CAPS. MOI 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PE-HARTIE X 30 CAPS. MOI PRF 30 2,256333 0,045667 1,128166 1,173834 2,030699 0,271301
575 W51716002 G01AA51 COMBINATII MACMIROR COMPLEX CAPS. MOI VAG. 500mg/200000UI POLICHEM SA LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG. P-RF 12 2,196749 1,252417 1,098374 2,350792 1,977074 1,472092
576 W64599001 G01AA51 COMBINATII POLYGYNAX VIRGO CAPS. MOI VAG. FARA FRANTA CUTIE CU 1 BLIST. PVC/PVDC TRANSPARENT/AL X 6 CAPS. VAG. MOI
LABORATOIRE INNOTECH INTERNATIONAL PRF 6 2,196749 0,319917 1,098374 1,418292 1,977074 0,539592
577 W01949002 G01AA51 COMBINATII POLYGYNAX CAPS. MOI VAG. FARA CONCENTRATIE LAB. INNOTECH INT.FRANTA CUTIE CU 2 BLIST. PVC-PVDC/AL X 6 CAPS. MOI. VAG. P-RF 12 2,196749 0,550751 1,098374 1,649126 1,977074 0,770426
578 W51914001 G01AA51 COMBINATII MACMIROR COMPLEX CREMA VAG. 10g/400000UI POLICHEM SA LUXEMBURG CUTIE X 1 TUB DIN AL CREMA VAG. X 30 G + APLICATOR P-RF 1 37,110000 0,000000 18,555000 18,555000 33,399000 3,711000
579 W03126002 G01AF12 FENTICONAZOLUM LOMEXIN 1000 mg CAPS. MOI VAG. 1000mg RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 2 CAPS. VAG. MOI P-RF 2 18,578942 15,511058 9,289471 24,800529 16,721047 17,368953
580 W03125002 G01AF12 FENTICONAZOLUM LOMEXIN 600 mg CAPS. MOI VAG. 600mg RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE P-RF 1 11,147365 4,972635 5,573682 10,546318 10,032628 6,087372
581 W03123004 G01AF12 FENTICONAZOLUM LOMEXIN 20 mg/g CREMA VAG. 20mg/g RECORDATI SPA ITALIA CUTIE CU 1 TUB AL X 78 G CREMA SI UN APLICATOR DIN PEID P-RF 1 28,983149 9,566851 14,491574 24,058426 26,084834 12,465166
582 W54844001 G01AF15 BUTOCONAZOLUM GYNOFORT 2% CREMA VAG. 20mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 APLICATOR PREUMPLUT UNIDOZA DIN PP CU 5 G CREMA VAG. P-RF 1 1,857894 34,032106 0,928947 34,961053 1,672104 34,217896
583 W52516001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLODIN COMPR. VAG. 500mg/200mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. TRANSPARENT DIN AL/PVC X 5 COMPR. VAG. P-RF 10 1,651071 0,015929 0,825535 0,841465 1,485963 0,181037
584 W63731001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON CREMA VAG. 40mg/g+200mg/g ALFASIGMA S.P.A. ITALIA CUTIE CU 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN PP PRF 1 9,906426 4,373574 4,953213 9,326787 8,915783 5,364217
585 W63733001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON OVULE 500mg/100mg ALFASIGMA S.P.A. ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULEPRF 10 1,651071 2,456929 0,825535 3,282465 1,485963 2,622037
586 W61909001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC-PE X 7 OVULE PRF 7 1,651071 0,000357 0,825535 0,825893 1,485963 0,165465
587 W61909002 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC X 7 OVULE PRF 7 1,651071 0,000357 0,825535 0,825893 1,485963 0,165465
588 W61909003 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE DIN PVC-PE X 7 OVULE PRF 14 1,650000 0,000000 0,825000 0,825000 1,485000 0,165000
589 W61909004 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE DIN PVC X 7 OVULE PRF 14 1,650000 0,000000 0,825000 0,825000 1,485000 0,165000
590 W63732001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE ALFASIGMA S.P.A. ITALIA P-RF
CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE 5 1,650575 3,239425 0,825287 4,064713 1,485517 3,404483
591 W58814001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore 20micrograme/24ore
SISTEM CU CEDARE INTRAUTERINA BAYER OY FINLANDA P-RF
CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR 1 526,800000 0,000000 263,400000 263,400000 474,120000 52,680000
592 W64655001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore 20micrograme/24ore
SISTEM CU CEDARE INTRAUTERINA BAYER AG GERMANIA PRF
CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR 1 526,800000 0,000000 263,400000 263,400000 474,120000 52,680000
593 W00716002 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 10,618750 0,731250 5,309375 6,040625 9,556875 1,793125
594 W00716001 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 10,618750 0,000000 5,309375 5,309375 9,556875 1,061875
595 W65037001 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 2 COMPR. P6L 2 10,618750 0,731250 5,309375 6,040625 9,556875 1,793125
596 W65037002 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 8 COMPR. P6L 8 10,618750 0,000000 5,309375 5,309375 9,556875 1,061875
597 W65037003 G02CB03 CABERGOLINUM * DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA P6L
CUTIE CU 1 FLAC. DIN PEID, INCHIS CU CAPAC DIN PP CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 2 COMPR. 2 10,618750 0,731250 5,309375 6,040625 9,556875 1,793125
598 W65037004 G02CB03 CABERGOLINUM * DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA P6L
CUTIE CU 1 FLAC. DIN PEID, INCHIS CU CAPAC DIN PP CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 8 COMPR. 8 10,618750 0,000000 5,309375 5,309375 9,556875 1,061875
599 W63310001 G03CA04 ESTRIOLUM * OVESTIN 0,5 mg OVULE 0,5 mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 3 BLIST. PVC/PE X 5 OVULE PRF 15 1,527333 0,000000 0,763666 0,763667 1,374599 0,152734
600 W12902001 G03CX01 TIBOLONUM ** LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 1,699285 0,000000 0,849642 0,849643 1,529356 0,169929
601 W63437001 G03CX01 TIBOLONUM ** LIVIAL 2,5 mg COMPR. 2,5mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 28 COMPR. PRF 28 1,699285 0,000000 0,849642 0,849643 1,529356 0,169929
602 W61647001 G03DA04 PROGESTERONUM * AREFAM 100 mg CAPS. MOI 100mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPSULE MOI P-6L 30 0,587666 0,000000 0,293833 0,293833 0,528899 0,058767
603 W61648001 G03DA04 PROGESTERONUM * AREFAM 200 mg CAPS. MOI 200mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI PRF 30 1,210499 0,105501 0,605249 0,710751 1,089449 0,226551
604 W62500001 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 TUB DIN AL X 45 G GEL + DISPOZITIV DE DOZARE (APLICATOR GRADAT DIN PP, PREVAZUT CU FANTA DOZATOARE PT. ETALAREA A 2,5 G GEL 1 8,565625 0,004375 4,282812 4,287188 7,709062 0,860938
605 W62500002 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE (APLICATOR GRADAT DIN PP, PREVAZUT CU FANTA DOZATOARE PT. ETALAREA A 2,5 G GEL 1 15,220000 0,000000 7,610000 7,610000 13,698000 1,522000
606 W60214001 G03DA04 PROGESTERONUM * MASTOPROFEN 10 mg/g GEL 10mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GELP6L 1 7,613888 0,026112 3,806944 3,833056 6,852499 0,787501
607 W61888001 G03DA04 PROGESTERONUM * CRINONE 80 mg/g GEL VAGINAL 80mg/g MERCK ROMANIA SRL ROMANIA P6L
CUTIE CU 6 APLICATOARE DOZA UNICA DIN PE, CONTINÂND GEL VAGINAL, PREVAZUTE CU VÂRF CARE SE DESFACE PRIN RASUCIRE, AMBALATE SEPARAT ÎNTR-O FOLIE DIN HÂRTIE/AL/RASINA IONOMERICA 6 12,638333 0,000000 6,319166 6,319167 11,374499 1,263834
608 W62383002 G03DB01 DYDROGESTERONUM * DUPHASTON 10 mg COMPR. FILM. 10mg BGP PRODUCTS B.V.OLANDA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. PRF 20 1,193500 0,000000 0,596750 0,596750 1,074150 0,119350
609 W64558002 G03DB01 DYDROGESTERONUM * DUPHASTON 10 mg COMPR. FILM. 10mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. PRF 20 1,193500 0,000000 0,596750 0,596750 1,074150 0,119350
610 W04045001 G03DC03 LYNESTRENOLUM * ORGAMETRIL 5 mg COMPR. 5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 30 COMPR. P-6L 30 0,338333 0,000000 0,169166 0,169167 0,304499 0,033834
611 W63440001 G03DC03 LYNESTRENOLUM * ORGAMETRIL 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 30 COMPR. P6L 30 0,338333 0,000000 0,169166 0,169167 0,304499 0,033834
612 W58801001 G03FA17 COMBINATII ** ANGELIQ COMPR. FILM. 1mg+2mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P6L 28 2,110000 0,000000 1,055000 1,055000 1,899000 0,211000
613 W64042001 G03FA17 COMBINATII (ESTRADIOLUM + DROSPIRENONUM) ** ANGELIQ 1 mg + 2 mg COMPR. FILM. 1mg+2mg BAYER AG GERMANIA P6L
CUTIE CU 1 ETUI DE CARTON X 1 BLIST. TIP CALENDAR PVC/AL X 28 COMPR. FILM. 28 2,110000 0,000000 1,055000 1,055000 1,899000 0,211000
614 W58805001 G03FB01 COMBINATII ** CYCLO-PROGYNOVA DRAJ. FARA CONCENTRATIE BAYER PHARMA AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P-6L 21 0,403333 0,000000 0,201666 0,201667 0,362999 0,040334
615 W64044001 G03FB01 COMBINATII ** CYCLO-PROGYNOVA DRAJ. FARA CONCENTRATIE BAYER AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P6L 21 0,403333 0,000000 0,201666 0,201667 0,362999 0,040334
616 W61928001 G03FB08 ESTRADIOL + DIDROGESTERON **FEMOSTON 2/10, comprimate filmate COMPR. FILM. 2 mg/10 mg BGP PRODUCTS B.V.OLANDA P-RF
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) 28 0,403333 0,696309 0,201666 0,897976 0,362999 0,736643
617 W64557001 G03FB08 ESTRADIOL + DIDROGESTERON **FEMOSTON 2/10 COMPR. FILM. FARA MYLAN HEALTHCARE B.V. OLANDA P-RF
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) 28 0,403333 0,696309 0,201666 0,897976 0,362999 0,736643
618 W60481002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE P-RF/R
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. 1 104,980000 22,530000 52,490000 75,020000 94,482000 33,028000
619 W65133002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK EUROPE B.V.OLANDA PR/PRF
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. 1 104,980000 22,530000 52,490000 75,020000 94,482000 33,028000
620 W65720001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 300 UI/0,5 ml SOL INJ. 300UI/0,5ml THERAMEX IRELAND LIMITED IRLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.5 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 419,920000 6,930000 209,960000 216,890000 377,928000 48,922000
621 W65721001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 450 UI/0,75 ml SOL INJ. 450UI/0,75ml THERAMEX IRELAND LIMITED IRLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.75 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 604,870000 0,000000 302,435000 302,435000 544,383000 60,487000
622 W65722001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 900 UI/ 1,5ml SOL INJ. 900UI/1,5ml THERAMEX IRELAND LIMITED IRLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 1.5ML SOLUTIE INJECTABILA + 20 ACE PENTRU INJECTIE 1 1.109,210000 0,000000 554,605000 554,605000 998,289000 110,921000
623 W63834001 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 150 UI/0,25 ml 150UI/0,25ml GEDEON RICHTER PLC
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT UNGARIA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 209,960000 5,060000 104,980000 110,040000 188,964000 26,056000
Pagina 10 din 21
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)
624 W63837001 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 225 UI/0,375 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 225UI/0,375ml GEDEON RICHTER PLC UNGARIA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 314,940000 7,590000 157,470000 165,060000 283,446000 39,084000
625 W63835001 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 300 UI/0,50 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 300UI/0,50ml GEDEON RICHTER PLC UNGARIA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 419,920000 0,000000 209,960000 209,960000 377,928000 41,992000
626 W63836001 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 450 UI/0,75 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 450UI/0,75ml GEDEON RICHTER PLC UNGARIA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 607,570000 0,000000 303,785000 303,785000 546,813000 60,757000
627 W63833001 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 75 UI/0,125 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 75UI/0,125ml GEDEON RICHTER PLC UNGARIA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 104,980000 8,880000 52,490000 61,370000 94,482000 19,378000
628 W60480002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 300 UI/0,5 ml ( 22 µg/0,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. P-RF/R 1 419,920000 23,570000 209,960000 233,530000 377,928000 65,562000
629 W65135002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 300 UI/0,5 ml ( 22 µg/0,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml MERCK EUROPE B.V.OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. PR/PRF 1 419,920000 23,570000 209,960000 233,530000 377,928000 65,562000
630 W60485002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA P-RF/R 1 629,880000 10,830000 314,940000 325,770000 566,892000 73,818000
631 W65134002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml MERCK EUROPE B.V.OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA PR/PRF 1 629,880000 10,830000 314,940000 325,770000 566,892000 73,818000
632 W60477002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 900 UI/1,5ml (66 µg/1,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 900UI/1,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA P-RF/R 1 1.196,620000 0,000000 598,310000 598,310000 1.076,958000 119,662000
633 W65136002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 900 UI/1,5ml (66 µg/1,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 900UI/1,5ml MERCK EUROPE B.V.OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA PR/PRF 1 1.196,620000 0,000000 598,310000 598,310000 1.076,958000 119,662000
634 W61937001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS + 6 ACE PR/PRF 1 419,752032 0,167968 209,876016 210,043984 377,776828 42,143172
635 W64697001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml MERCK SHARP & DOHME OLANDA CUTIE CU 1 CARTUS + 6 ACE PR/PRF 1 419,752032 0,167968 209,876016 210,043984 377,776828 42,143172
636 W43251001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.259,256096 69,853904 629,628048 699,481952 1.133,330486 195,779514
637 W61938001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.259,256096 69,853904 629,628048 699,481952 1.133,330486 195,779514
638 W64696001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml MERCK SHARP & DOHME OLANDA CUTIE CU 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.259,256096 69,853904 629,628048 699,481952 1.133,330486 195,779514
639 W63489007 G03GA07 LUTROPINUM ALFA **1 # LUVERIS 75UI PULB+SOLV.PT.SOL.INJ 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ.+ 1 FLAC. A 2 ML SAU 3 ML X 1 ML SOLV. P-RF/R 1 136,130000 0,000000 68,065000 68,065000 122,517000 13,613000
640 W65137004 G03GA07 LUTROPINUM ALFA **1 # LUVERIS 75UI PULB+SOLV.PT.SOL.INJ 75UI MERCK EUROPE B.V.OLANDA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ.+ 1 FLAC. A 2 ML SAU 3 ML X 1 ML SOLV. PR/PRF 1 136,130000 0,000000 68,065000 68,065000 122,517000 13,613000
641 W53455002 G03XC01 RALOXIFENUM EVISTA 60mg COMPR. FILM. 60mg DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR) P-RF 28 1,654166 0,035119 0,827083 0,862202 1,488749 0,200536
642 W62041001 G03XC01 RALOXIFENUM RALOXIFEN ARENA 60 mg COMPR. FILM. 60mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P6L 14 1,654166 0,091548 0,827083 0,918631 1,488749 0,256965
643 W62041002 G03XC01 RALOXIFENUM RALOXIFEN ARENA 60 mg COMPR. FILM. 60mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P6L 28 1,654166 0,035119 0,827083 0,862202 1,488749 0,200536
644 W62041003 G03XC01 RALOXIFENUM RALOXIFEN ARENA 60 mg COMPR. FILM. 60mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P6L 84 1,548809 0,000000 0,774404 0,774405 1,393928 0,154881
645 W62337001 G04BD04 OXYBUTYNINUM DRIPTANE® 5 mg COMPR. 5mg MYLAN MEDICAL SAS FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. PRF 60 0,382833 0,000000 0,191416 0,191417 0,344549 0,038284
646 W57773001 G04BD07 TOLTERODINUM ** # UROFLOW 1 COMPR. FILM. 1mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,321743 0,552542 0,160871 0,713414 0,289568 0,584717
647 W57774001 G04BD07 TOLTERODINUM ** # UROFLOW 2 COMPR. FILM. 2mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,643487 0,171513 0,321743 0,493257 0,579138 0,235862
648 W56677002 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 10 mg COMPR. FILM. 10 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 2,573949 0,695384 1,286974 1,982359 2,316554 0,952779
649 W43104001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 10 mg COMPR. FILM. 10mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 2,573949 1,248051 1,286974 2,535026 2,316554 1,505446
650 W62757002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 2,573949 0,546717 1,286974 1,833692 2,316554 0,804112
651 W63709008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 2,573949 0,392051 1,286974 1,679026 2,316554 0,649446
652 W63709010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 2,573949 0,153051 1,286974 1,440026 2,316554 0,410446
653 W63709013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 2,573949 0,011828 1,286974 1,298803 2,316554 0,269223
654 W63709001 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 2,573949 0,392051 1,286974 1,679026 2,316554 0,649446
655 W63709003 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 2,573949 0,153051 1,286974 1,440026 2,316554 0,410446
656 W63709006 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 2,573949 0,011828 1,286974 1,298803 2,316554 0,269223
657 W65416003 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 10 mg COMPR. FILM. 10mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 2,573949 0,272051 1,286974 1,559026 2,316554 0,529446
658 W65416017 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 10 mg COMPR. FILM. 10mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 2,573949 0,272051 1,286974 1,559026 2,316554 0,529446
659 W65416031 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 10 mg COMPR. FILM. 10mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 2,573949 0,272051 1,286974 1,559026 2,316554 0,529446
660 W65952003 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN MSN LABORATORIES 10 mg COMPR. FILM. 10mg VIVANTA GENERICS S.R.O., REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE DIN PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 2,573949 0,154051 1,286974 1,441026 2,316554 0,411446
661 W65899002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 2,573949 0,546717 1,286974 1,833692 2,316554 0,804112
662 W56676002 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 5 mg COMPR. FILM. 5 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 1,286974 0,831026 0,643487 1,474513 1,158276 0,959724
663 W43105001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 5 mg COMPR. FILM. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 1,286974 1,808692 0,643487 2,452179 1,158276 1,937390
664 W62756002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 1,286974 0,735359 0,643487 1,378846 1,158276 0,864057
665 W63708008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 1,286974 0,348026 0,643487 0,991513 1,158276 0,476724
666 W63708010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 1,286974 0,295026 0,643487 0,938513 1,158276 0,423724
667 W63708013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 1,286974 0,163914 0,643487 0,807401 1,158276 0,292612
668 W63708001 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 1,286974 0,348026 0,643487 0,991513 1,158276 0,476724
669 W63708003 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 1,286974 0,295026 0,643487 0,938513 1,158276 0,423724
670 W63708006 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 1,286974 0,163914 0,643487 0,807401 1,158276 0,292612
671 W65415003 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 5 mg COMPR. FILM. 5mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 1,286974 1,808692 0,643487 2,452179 1,158276 1,937390
672 W65415017 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 5 mg COMPR. FILM. 5mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 1,286974 1,808692 0,643487 2,452179 1,158276 1,937390
673 W65415031 G04BD08 SOLIFENACINUM SUCCINATE ** # VESISTAD 5 mg COMPR. FILM. 5mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,286974 1,808692 0,643487 2,452179 1,158276 1,937390
674 W65951003 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN MSN LABORATORIES 5 mg COMPR. FILM. 5mg VIVANTA GENERICS S.R.O., REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE DIN PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,286974 0,436359 0,643487 1,079846 1,158276 0,565057
675 W65898002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 1,286974 0,735359 0,643487 1,378846 1,158276 0,864057
676 W62488001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 1 mg/ml SUSP. ORALA 1mg/ml ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA BRUNA DIN PET CARE CONTINE 150 ML SUSP. ORALA P6L 1 38,609244 90,890756 19,304622 110,195378 34,748319 94,751681
677 W43786001 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. P-6L 30 0,482615 0,929051 0,241307 1,170359 0,434353 0,977313
678 W43789001 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. P-6L 30 0,965231 1,309769 0,482615 1,792385 0,868707 1,406293
679 W43038001 G04CA01 ALFUZOSINUM ALFURAN MR 10 mg COMPR. ELIB. PREL. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,757000 0,000000 0,378500 0,378500 0,681300 0,075700
680 W62086002 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-6L 30 1,465666 0,000000 0,732833 0,732833 1,319099 0,146567
681 W62086003 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL CU 30 COMPR. ELIB. PREL. P-6L 30 1,465666 0,000000 0,732833 0,732833 1,319099 0,146567
682 W62397002 G04CA01 ALFUZOSINUM XATRAL LP 5 mg COMPR. ELIB. PREL. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. ELIB. PREL. P-6L 28 0,623928 0,000000 0,311964 0,311964 0,561535 0,062393
683 W42715001 G04CA02 TAMSULOSINUM TAMSOL 0,4 mg CAPS. ELIB. MODIF. 0,4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-6L 30 0,946666 0,000000 0,473333 0,473333 0,851999 0,094667
684 W56791001 G04CA02 TAMSULOSINUM FOKUSIN CAPS. ELIB. MODIF. 0,4mg ZENTIVA KS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF. P-6L 30 0,650666 0,000000 0,325333 0,325333 0,585599 0,065067
685 W56791004 G04CA02 TAMSULOSINUM FOKUSIN 0,4 mg CAPS. ELIB. MODIF. 0,4mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 2 BLIST. PVC-PVDC/AL X 15 CAPS. ELIB. MODIF. P6L 30 0,627666 0,000000 0,313833 0,313833 0,564899 0,062767
686 W63984001 G04CA02 TAMSULOSINUM SELDONO 0,4 mg CAPS. ELIB. MODIF. 0,4mg ALKALOID - INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. ELIB. MODIF. P6L 30 1,089000 0,000000 0,544500 0,544500 0,980100 0,108900
Pagina 11 din 21
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)
687 W42850001 G04CA02 TAMSULOSINUM CONTIFLO MR CAPS. ELIB. PREL.0,4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,531666 0,000000 0,265833 0,265833 0,478499 0,053167
688 W65058001 G04CA02 TAMSULOSINUM CONTIFLO MR 0,4 mg CAPS. ELIB. PREL.0,4mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 0,531666 0,000000 0,265833 0,265833 0,478499 0,053167
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
690 W64286008 G04CA02 TAMSULOSINUM TAMSULOSIN AUROBINDO 400 micrograme CAPS. ELIB. PREL.400micrograme AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA 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
691 W43106001 G04CA02 TAMSULOSINUM OMNIC TOCAS (R) 0,4 0,4mg
COMPR. FILM. ELIB. PREL. ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 FOLII AL/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 1,017000 0,000000 0,508500 0,508500 0,915300 0,101700
692 W51273002 G04CB01 FINASTERIDUM * PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM. P-6L 28 1,003303 0,195268 0,501651 0,696920 0,902972 0,295599
693 W60376002 G04CB01 FINASTERIDUM * FINASTERIDA ARENA 5 mg COMPR. FILM. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,938214 0,000000 0,469107 0,469107 0,844392 0,093822
694 W13534002 G04CB02 DUTASTERIDUM * AVODART 0,5 mg CAPS. MOI 0,5mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 3 BLIST.PVC-PVDC/AL X 10 CAPS. MOI P-6L 30 1,170749 0,508584 0,585374 1,093959 1,053674 0,625659
695 W62669002 G04CB02 DUTASTERIDUM * MAXTRID 0,5 mg CAPS. MOI 0,5mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. P6L 30 1,170749 1,069251 0,585374 1,654626 1,053674 1,186326
696 W62973002 G04CB02 DUTASTERIDUM * DUTASTERIDA ZENTIVA 0,5 mg CAPS. MOI 0,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. MOI P6L 30 1,170749 0,024584 0,585374 0,609959 1,053674 0,141659
697 W63226002 G04CB02 DUTASTERIDUM * DUTALAN 0,5 mg CAPS. MOI 0,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. MOI P6L 30 1,010666 0,000000 0,505333 0,505333 0,909599 0,101067
698 W63663002 G04CB02 DUTASTERIDUM * DERIDUST 0,5 mg CAPS. MOI 0,5mg HEATON K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE TIP TRIPLEX (PVC-PE-PVDC)/AL X 30 CAPS. MOI P6L 30 1,170749 1,069251 0,585374 1,654626 1,053674 1,186326
699 W63801002 G04CB02 DUTASTERIDUM * DUTASTERIDA AUROBINDO 0,5 mg CAPS. MOI 0,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. MOI P6L 30 1,170749 0,024584 0,585374 0,609959 1,053674 0,141659
700 W63857002 G04CB02 DUTASTERIDUM * AVATERID 0,5 mg CAPS. MOI 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. MOI P6L 30 1,170749 0,024584 0,585374 0,609959 1,053674 0,141659
701 W65417002 G04CB02 DUTASTERIDUM * ASIUM 0,5 mg CAPS. MOI 0,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TRANSPARENTE DIN TRIPLEX (PVC-PE-PVDC)AL X 30 CAPS. MOI P6L 30 1,097000 0,000000 0,548500 0,548500 0,987300 0,109700
702 W05539002 H01AC01 SOMATROPINUM ** # GENOTROPIN 16 UI/ml (5,3 mg/ml) PULB. + SOLV. PT. SOL. INJ. 16UI/ml (5,3mg/ml) PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ.P-RF 1 408,190000 0,000000 204,095000 204,095000 367,371000 40,819000
703 W64823002 H01AC01 SOMATROPINUM ** # GENOTROPIN 16 UI/ml (5,3 mg/ml) PULB. + SOLV. PT. SOL. INJ. 16UI/ml(5,3mg/ml) PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 CARTUS BICAMERAL MULTIDOZA CARE CONTINE PULB. SI SOLV. PT. SOL. INJ. PRF 1 408,190000 0,000000 204,095000 204,095000 367,371000 40,819000
704 W07530001 H01AC01 SOMATROPINUM ** # ZOMACTON PULB. + SOLV. PT. SOL. INJ. 4mg (12ui) FERRING GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV. PR/PRF 1 306,142500 163,207500 153,071250 316,278750 275,528250 193,821750
705 W63194001 H01AC01 SOMATROPINUM ** # OMNITROPE 10 mg/1,5 ml SOL INJ. IN CARTUS 10mg/1,5ml SANDOZ GMBH AUSTRIA CUTIE X 1 CARTUS X 1,5 ML SOL.INJ. (PENTRU SUREPAL 10) PR/PRF 1 736,300000 0,000000 368,150000 368,150000 662,670000 73,630000
706 W63193001 H01AC01 SOMATROPINUM ** # OMNITROPE 5 mg/1,5 ml SOL INJ. IN CARTUS 5mg/1,5ml SANDOZ GMBH AUSTRIA CUTIE X 1 CARTUS X 1,5 ML SOL.INJ. (PENTRU SUREPAL 5) PR/PRF 1 382,678125 15,921875 191,339062 207,260938 344,410312 54,189688
707 W55322001 H01AC01 SOMATROPINUM ** # NUTROPINAq 10 mg/2 ml SOL. INJ. 10mg/2ml IPSEN PHARMA FRANTA CUTIE X 1 CARTUS X 2 ML. SOL. INJ. P-RF/R 1 765,356250 235,813750 382,678125 618,491875 688,820625 312,349375
708 W52345001 H01AC01 SOMATROPINUM ** # OMNITROPE 3,3mg/ml SOL. INJ. 3,3mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ. P-RF/R 1 382,678125 25,311875 191,339062 216,650938 344,410312 63,579688
709 W66036001 H01AC01 SOMATROPINUM ** # SAIZEN 5,83 mg/ml SOL. INJ. 5,83mg/ml MERCK ROMANIA SRL ROMANIA CUTIE CU 1 CARTUS DIN STICLA CU DOP CU PISTON DIN CAUCIUC SI CAPSA DIN AL CU INSERTIE DE CAUCIUC X 1,03 ML SOL. INJ. (6 MG SOMATROPINA) PR/PRF 1 459,326002 153,463998 229,663001 383,126999 413,393401 199,396599
710 W52346001 H01AC01 SOMATROPINUM ** # OMNITROPE 6,7mg/ml SOL. INJ. 6,7mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ.
P-RF/R 1 758,430000 0,000000 379,215000 379,215000 682,587000 75,843000
711 W66037003 H01AC01 SOMATROPINUM ** # SAIZEN 8 mg/ml SOL. INJ. 8mg/ml MERCK ROMANIA SRL ROMANIA CUTIE CU 1 CARTUS DIN STICLA CU DOP CU PISTON DIN CAUCIUC SI CAPSA DIN AL CU INSERTIE DE CAUCIUC X 2,50 ML SOL. INJ. (20 MG SOMATROPINA) PR/PRF 1 1.530,712500 346,587500 765,356250 1.111,943750 1.377,641250 499,658750
712 W66037001 H01AC01 SOMATROPINUM ** # SAIZEN 8 mg/ml SOL. INJ. 8mg/ml MERCK ROMANIA SRL ROMANIA CUTIE CU 1 CARTUS DIN STICLA CU DOP CU PISTON DIN CAUCIUC SI CAPSA DIN AL CU INSERTIE DE CAUCIUC X 1,50 ML SOL. INJ. (12 MG SOMATROPINA) PR/PRF 1 918,427500 236,282500 459,213750 695,496250 826,584750 328,125250
713 W54046001 H01AC01 SOMATROPINUM ** # NORDITROPIN SIMPLEXx 10 mg/1,5ml SOL. INJ. IN CARTUS 10mg/1,5ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ. P-RF 1 765,356250 394,513750 382,678125 777,191875 688,820625 471,049375
714 W61936001 H01CC01 GANIRELIXUM ** # ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT P-RF/R 1 117,682857 6,707143 58,841428 65,548572 105,914571 18,475429
715 W64695001 H01CC01 GANIRELIXUM ** # ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml MERCK SHARP & DOHME OLANDA CUTIE CU 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT PR/PRF 1 117,682857 6,707143 58,841428 65,548572 105,914571 18,475429
716 W06895002 H01CC02 CETRORELIXUM ** # CETROTIDE 0,25 mg PULB+SOLV. PT. SOL. INJ. 0,25mg SERONO EUROPE LTD. MAREA BRITANIE CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII + 7 ACE PT. INJECTII SUBCUTANATE + 14 TAMPOANE IMBIBATE IN ALCOOL P-RF 7 117,682857 0,000000 58,841428 58,841429 105,914571 11,768286
717 W65132002 H01CC02 CETRORELIXUM ** # CETROTIDE 0,25 mg PULB+SOLV. PT. SOL. INJ. 0,25mg MERCK EUROPE B.V.OLANDA CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII + 7 ACE PT. INJECTII SUBCUTANATE + 14 TAMPOANE IMBIBATE IN ALCOOL PRF 7 117,682857 0,000000 58,841428 58,841429 105,914571 11,768286
718 W03165001 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 0,425800 0,000000 0,212900 0,212900 0,383220 0,042580
719 W66284001 H02AA02 FLUDROCORTISONUM ASTONIN H 0,1 mg COMPR. 0,1mg MERCK ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN PP DE CULOARE ALBA X 50 COMPR. PRF 50 0,425800 0,000000 0,212900 0,212900 0,383220 0,042580
720 W57960002 H02AB01 BETAMETHASONUM DIPROPHOS SUSP. INJ. 7mg/ml MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 FIOLE DIN STICLA TIP I X 1 ML SUSP. INJ. PRF 1 16,960000 0,000000 8,480000 8,480000 15,264000 1,696000
721 W54546003 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,296595 0,170205 0,148297 0,318503 0,266935 0,199865
722 W66144003 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK ROMANIA SRL ROMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. (2 BLIST. X 25 COMPR. FILM.) P6L 50 0,296595 0,170205 0,148297 0,318503 0,266935 0,199865
723 W54545003 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,567600 0,000000 0,283800 0,283800 0,510840 0,056760
724 W66145003 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK ROMANIA SRL ROMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. (2 BLIST. X 25 COMPR. FILM.) P6L 50 0,567600 0,000000 0,283800 0,283800 0,510840 0,056760
725 W54547004 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 0,148297 0,189103 0,074148 0,263252 0,133467 0,203933
726 W66143004 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK ROMANIA SRL ROMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. (4 BLIST. X 25 COMPR. FILM.) P6L 100 0,148297 0,189103 0,074148 0,263252 0,133467 0,203933
727 W58901001 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 1 18,829750 4,280250 9,414875 13,695125 16,946775 6,163225
728 W58901002 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 50 17,767000 0,000000 8,883500 8,883500 15,990300 1,776700
729 W58901004 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 25 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 25 18,829750 0,354250 9,414875 9,769125 16,946775 2,237225
730 W58901003 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 10 18,829750 1,313250 9,414875 10,728125 16,946775 3,196225
731 W05764001 J01CR04 SULTAMICILLINUM UNASYN COMPR. FILM. 375mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC/PVDC X 6 COMPR. P-RF 12 2,900000 0,000000 1,450000 1,450000 2,610000 0,290000
732 W65045001 J01CR04 SULTAMICILLINUM UNASYN 375 mg COMPR. FILM. 375mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. AL/PVC/PVDC X 6 COMPR. FILM. P6L 12 2,900000 0,000000 1,450000 1,450000 2,610000 0,290000
733 W05765001 J01CR04 SULTAMICILLINUM UNASYN PULB. PT. SUSP. ORALA 250mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID CU PULBERE PT. 60 ML SUSP. ORALA P-RF 1 23,200000 3,920000 11,600000 15,520000 20,880000 6,240000
734 W65046001 J01CR04 SULTAMICILLINUM UNASYN 250 mg/ml PULB. PT. SUSP. ORALA 250mg/5ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. DIN PEID CU PULBERE PT. 60 ML SUSP. ORALA RECONSTITUITA SI 1 LINGURITA DOZATOARE CU 2 CUPE PRF 1 23,200000 3,920000 11,600000 15,520000 20,880000 6,240000
735 W05561001 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 1,5 Mil. UI COMPR. FILM. 1,5 M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF 16 0,683750 0,000000 0,341875 0,341875 0,615375 0,068375
736 W63533001 J01FA02 SPIRAMYCINUM ROVAMYCINE® 1,5 Mil. UI COMPR. FILM. 1,5 Mil.U.I. SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF 16 0,683750 0,000000 0,341875 0,341875 0,615375 0,068375
737 W13604002 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 3 Mil. UI COMPR. FILM. 3M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 10 1,522283 1,314717 0,761141 2,075859 1,370054 1,466946
738 W13604003 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. LABORATOIRES AVENTIS FRANTA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM. PRF 10 1,522283 1,314717 0,761141 2,075859 1,370054 1,466946
739 W63534001 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 5 COMPR. FILM. PRF 10 1,522283 1,314717 0,761141 2,075859 1,370054 1,466946
740 W63534002 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM. PRF 10 1,522283 1,314717 0,761141 2,075859 1,370054 1,466946
741 W00517001 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,805712 1,050954 1,902856 2,953810 3,425140 1,431526
742 W64359001 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg TEVA B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,805712 1,050954 1,902856 2,953810 3,425140 1,431526
743 W00518001 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM. P-RF 6 1,902853 2,523813 0,951426 3,475240 1,712567 2,714099
744 W64356001 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg TEVA B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 6 COMPR. FILM. PRF 6 1,902853 2,523813 0,951426 3,475240 1,712567 2,714099
745 W42879004 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 6 COMPR. FILM.P-RF 6 2,821666 0,000000 1,410833 1,410833 2,539499 0,282167
746 W63094004 J01FA10 AZITHROMYCINUM AZITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 6 COMPR. FILM. PRF 6 3,526666 0,000000 1,763333 1,763333 3,173999 0,352667
747 W42878001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 COMPR. FILM.P-RF 3 3,476666 0,000000 1,738333 1,738333 3,128999 0,347667
748 W43486001 J01FA10 AZITHROMYCINUM AZIBIOT 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 5,696666 0,000000 2,848333 2,848333 5,126999 0,569667
749 W52840001 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 5,980000 0,000000 2,990000 2,990000 5,382000 0,598000
Pagina 12 din 21
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)
750 W52840002 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. 3 P-RF 5,980000 0,000000 2,990000 2,990000 5,382000 0,598000
751 W57032001 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. 3 P-RF 5,450000 0,000000 2,725000 2,725000 4,905000 0,545000
752 W63095002 J01FA10 AZITHROMYCINUM AZITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 3 COMPR. FILM. PRF 3 5,980000 0,000000 2,990000 2,990000 5,382000 0,598000
753 W64357001 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg TEVA B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 3 COMPR. FILM. PRF 3 7,611424 1,581909 3,805712 5,387621 6,850281 2,343052
754 W53281001 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA P-RF 1
CUTIE X 1 FLACON DIN PE CU PULBERE PENTRU 15ML SUSPENSIE ORALA RECONSTITUITA + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENTRU ADMINISTRAREA ORALA + O LINGURITA DOZATOARE 15,490000 0,000000 7,745000 7,745000 13,941000 1,549000
755 W42901001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA 13,195196 7,514804 6,597598 14,112402 11,875676 8,834324
756 W42877002 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (800 MG) SUSP. ORALA 20,650000 0,000000 10,325000 10,325000 18,585000 2,065000
757 W00520003 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 44,730000 0,000000 22,365000 22,365000 40,257000 4,473000
758 W64358003 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA PRF 1
CUTIE CU 1 FLAC. DIN PEID CONTINAND PULB. PT. 37,5 ML SUSP. ORALA, O SERINGA PT. ADMINISTRARE ORALA DIN PE/PS SAU PP/PP SI O LINGURITA DOZATOARE 44,730000 0,000000 22,365000 22,365000 40,257000 4,473000
759 W00520001 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 33,490000 0,000000 16,745000 16,745000 30,141000 3,349000
760 W64358002 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA PRF 1
CUTIE CU 1 FLAC. DIN PEID CONTINAND PULB. PT. 30 ML SUSP. ORALA, O SERINGA PT. ADMINISTRARE ORALA DIN PE/PS SAU PP/PP SI O LINGURITA DOZATOARE 33,490000 0,000000 16,745000 16,745000 30,141000 3,349000
761 W08637001 J01FF01 CLINDAMYCINUM DALACIN C 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 8 CAPS.P-RF 16 0,503307 0,269193 0,251653 0,520847 0,452976 0,319524
762 W65032001 J01FF01 CLINDAMYCINUM DALACIN C 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. PVC/AL X 8 CAPS. PRF 16 0,503307 0,269193 0,251653 0,520847 0,452976 0,319524
763 W08638001 J01FF01 CLINDAMYCINUM DALACIN C 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 8 CAPS.P-RF 16 0,946875 0,000000 0,473437 0,473438 0,852187 0,094688
764 W65033001 J01FF01 CLINDAMYCINUM DALACIN C 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. PVC/AL X 8 CAPS. PRF 16 0,946875 0,000000 0,473437 0,473438 0,852187 0,094688
765 W53634002 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 600 mg COMPR. FILM. 600mg MIP PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF 16 2,013229 0,776146 1,006614 1,782761 1,811906 0,977469
766 W53634003 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 600 mg COMPR. FILM. 600mg MIP PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM. P-RF 30 2,013229 0,358437 1,006614 1,365052 1,811906 0,559760
767 W52786004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 250 mg COMPR. FILM. 250mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 1,657142 0,000000 0,828571 0,828571 1,491427 0,165715
768 W55699003 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 2,642400 0,016171 1,321200 1,337371 2,378160 0,280411
769 W60574001 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 1,674000 0,000000 0,837000 0,837000 1,506600 0,167400
770 W60574002 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 1,650000 0,000000 0,825000 0,825000 1,485000 0,165000
771 W61631003 J01MA12 LEVOFLOXACINUM LEVALOX 250 mg COMPR. FILM. 250mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 2,642400 0,040457 1,321200 1,361657 2,378160 0,304697
772 W66212001 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ATB 250 mg COMPR. FILM. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM PRF 10 2,642400 0,021600 1,321200 1,342800 2,378160 0,285840
773 W56939002 J01MA12 LEVOFLOXACINUM FLERADAY 500 mg COMPR. FILM. 500 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/PVDC - AL X 7 COMPR. FILM. PRF 7 4,738571 0,000000 2,369285 2,369286 4,264713 0,473858
774 W52787004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 4,110000 0,000000 2,055000 2,055000 3,699000 0,411000
775 W55700002 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 5,284800 0,230914 2,642400 2,873314 4,756320 0,759394
776 W60575001 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 4,736000 0,000000 2,368000 2,368000 4,262400 0,473600
777 W60575002 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 4,472000 0,000000 2,236000 2,236000 4,024800 0,447200
778 W61706003 J01MA12 LEVOFLOXACINUM LEVALOX 500 mg COMPR. FILM. 500mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 4,374285 0,000000 2,187142 2,187143 3,936856 0,437429
779 W66213001 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ATB 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM PRF 10 4,549000 0,000000 2,274500 2,274500 4,094100 0,454900
780 W57939001 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF 5 5,284800 2,595200 2,642400 5,237600 4,756320 3,123680
781 W59332001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 5,284800 2,201200 2,642400 4,843600 4,756320 2,729680
782 W60943001 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA PRF
CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINÂND 5 COMPRIMATE FILMATE 5 5,284800 1,423200 2,642400 4,065600 4,756320 1,951680
783 W63876001 J01MA14 MOXIFLOXACINUM AVELOX 400 mg COMPR. FILM. 400mg BAYER AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. PRF 5 5,284800 2,595200 2,642400 5,237600 4,756320 3,123680
784 W65543001 J01MA14 MOXIFLOXACINUM ERELAN 400 mg COMPR. FILM. 400mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 5 COMPR. FILM. PRF 5 5,284800 1,777200 2,642400 4,419600 4,756320 2,305680
785 W63876017 J01MA14 MOXIFLOXACINUM AVELOX 400 mg COMPR. FILM. 400mg BAYER AG GERMANIA CUTIE CU 1 BLIST. TRANSPARENT PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 5,284800 2,595200 2,642400 5,237600 4,756320 3,123680
786 W66222001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 5,284800 2,201200 2,642400 4,843600 4,756320 2,729680
787 W66200001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA VIVANTA 400 mg COMPR. FILM. 400mg VIVANTA GENERICS S.R.O., REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 4,822000 0,000000 2,411000 2,411000 4,339800 0,482200
788 W66200002 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA VIVANTA 400 mg COMPR. FILM. 400mg VIVANTA GENERICS S.R.O., REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 4,452857 0,000000 2,226428 2,226429 4,007571 0,445286
789 W03837002 J02AC02 ITRACONAZOLUM * ORUNGAL 100 mg CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 3,421333 0,000000 1,710666 1,710667 3,079199 0,342134
790 W43051001 J02AC02 ITRACONAZOLUM * ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS.P-RF 15 2,224000 0,000000 1,112000 1,112000 2,001600 0,222400
791 W53958001 J02AC02 ITRACONAZOLUM * MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 2,224000 0,000000 1,112000 1,112000 2,001600 0,222400
792 W59235001 J02AC02 ITRACONAZOLUM * ITRACONAZOL ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS.P-RF 15 2,224000 0,000000 1,112000 1,112000 2,001600 0,222400
793 W61929006 J02AC02 ITRACONAZOLUM * OMICRAL 100 mg CAPS. 100mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 2,224000 0,000000 1,112000 1,112000 2,001600 0,222400
794 W62619001 J02AC02 ITRACONAZOLUM * ITRACONAZOL FARMEX 100 mg CAPS. 100mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. PVCA/AL X 5 CAPS. PRF 15 2,224000 0,000000 1,112000 1,112000 2,001600 0,222400
795 W58707001 J05AB11 VALACYCLOVIRUM * # VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF 10 4,933000 0,000000 2,466500 2,466500 4,439700 0,493300
796 W65100001 J05AB11 VALACYCLOVIRUM * # VALTREX 500 mg COMPR. FILM. 500 mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF 10 4,933000 0,000000 2,466500 2,466500 4,439700 0,493300
797 W60087001 J05AB11 VALACYCLOVIRUM * # VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM. PRF 10 3,354000 0,000000 1,677000 1,677000 3,018600 0,335400
798 W12651002 J05AB15 BRIVUDINUM * # BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF 7 51,422857 0,000000 25,711428 25,711429 46,280571 5,142286
799 W12490001 L01AA01 CYCLOPHOSPHAMIDUM * ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 1,271000 0,000000 0,635500 0,635500 1,143900 0,127100
800 W10173001 L02AE03 GOSERELINUM ** # ZOLADEX (R) IMPLANT 3,6mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG S/P-RF 1 200,440000 0,000000 100,220000 100,220000 180,396000 20,044000
801 W65081001 L02AE03 GOSERELINUM ** # ZOLADEX 3,6 mg IMPLANT 3,6mg ASTRAZENECA AB SUEDIA PR/PRF
CUTIE CU 1 PUNGA X 1 SERINGA PREUMPLUTA MONODOZA A 3,6 MG GASORELINA 1 200,440000 0,000000 100,220000 100,220000 180,396000 20,044000
802 W62378001 L02AE03 GOSERELINUM ** # RESELIGO 3,6 mg 3,6mg
IMPLANT IN SERINGA PREUMPLUTA ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 PUNGA CU UN IMPLANT IN SERINGA PREUMPLUTA PR/PRF 1 200,440000 10,580000 100,220000 110,800000 180,396000 30,624000
803 W55725001 L02AE04 TRIPTORELINUM ** # DIPHERELINE 0,1 mg PULB+SOLV. PT. SOL. INJ. 0,1mg IPSEN PHARMA FRANTA CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF 7 13,187571 1,465286 6,593785 8,059072 11,868813 2,784044
804 W55726001 L02AE04 TRIPTORELINUM ** # DIPHERELINE PR 11,25 mg 11,25mg
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. IPSEN PHARMA FRANTA S/P-RF 1
CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU 1 SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE 692,220000 0,000000 346,110000 346,110000 622,998000 69,222000
805 W55727001 L02AE04 TRIPTORELINUM ** # DIPHERELINE 3,75 mg 3,75mg
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. IPSEN PHARMA FRANTA S/P-RF 1
CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU O SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE 368,030000 0,000000 184,015000 184,015000 331,227000 36,803000
806 W58059001 L02AE04 TRIPTORELINUM ** # GONAPEPTYL ZILNIC 0,1 mg/ml SOL. INJ. 0,1mg/ml FERRING GMBH GERMANIA CUTIE X 7 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF 7 1,767136 24,955721 0,883568 25,839289 1,590422 25,132435
807 W60846001 L04AX01 AZATHIOPRINUM * IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,650400 0,000000 0,325200 0,325200 0,585360 0,065040
808 W62178002 M01AC05 LORNOXICAMUM XEFO RAPID 8 mg COMPR. FILM. 8mg TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 10 0,726149 0,313851 0,363074 0,676926 0,653534 0,386466
809 W06864001 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 0,406800 0,502200 0,203400 0,705600 0,366120 0,542880
810 W60403002 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN TROMETAMOL SANDOZ 25mg COMPR. FILM. 25mg SANDOZ S.R.L. ROMANIA CUTIE BLIST. DIN PVC-PVDC/AL X 20 COMPRIMATE FILMATE P6L 20 0,406800 0,200200 0,203400 0,403600 0,366120 0,240880
811 W64497002 M01AE17 DEXKETOPROFENUM XEDOFEN 50 mg/2 ml SOL INJ./PERF. 50mg/2ml AS KALCEKS LETONIA CUTIE CU 5 FIOLE DIN STICLA BRUNA A CATE 2 ML SOL. INJ./PERF. PRF 5 2,682000 0,000000 1,341000 1,341000 2,413800 0,268200
812 W64522002 M01AE17 DEXKETOPROFENUM DEKENOR 50 mg/2 ml SOL INJ./PERF. 50mg/2ml KRKA, D.D., NOVO MESTO SLOVENIA PRF 5
CUTIE CU 5 FIOLE DIN STICLA BRUNA, CU PUNCT DE CULOARE ALBA SI INEL DE CULOARE ALBASTRA X 2 ML SOL. INJ./PERF. 2,730000 0,000000 1,365000 1,365000 2,457000 0,273000
Pagina 13 din 21
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)
813 W64522003 M01AE17 DEXKETOPROFENUM DEKENOR 50 mg/2 ml SOL INJ./PERF. 50mg/2ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 10 FIOLE DIN STICLA BRUNA, CU PUNCT DE CULOARE ALBA SI INEL DE CULOARE ALBASTRA X 2 ML SOL. INJ./PERF. PRF 10 2,730000 0,000000 1,365000 1,365000 2,457000 0,273000
814 W43063001 M01AE17 DEXKETOPROFENUM TADOR INJECT SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF. P-RF 5 3,976000 0,000000 1,988000 1,988000 3,578400 0,397600
815 W61199001 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA (UN SUPORT A 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF. PRF 5 2,826000 0,000000 1,413000 1,413000 2,543400 0,282600
816 W61199002 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA (DOUA SUPORTURI A CATE 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF. PRF 10 2,826000 0,000000 1,413000 1,413000 2,543400 0,282600
817 W57029003 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA PRF
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 30 COMPR. ELIB. MODIF. 30 1,811499 0,120501 0,905749 1,026251 1,630349 0,301651
818 W57029004 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA PRF
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 60 COMPR. ELIB. MODIF. 60 1,771333 0,000000 0,885666 0,885667 1,594199 0,177134
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 0,642345 0,320321 0,321172 0,641494 0,578110 0,384556
820 W60458003 M01AH01 CELECOXIBUM ALGOXIB 100 mg CAPS. 100mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 0,625666 0,000000 0,312833 0,312833 0,563099 0,062567
821 W60519003 M01AH01 CELECOXIBUM ACLEXA 100 mg CAPS. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,625666 0,000000 0,312833 0,312833 0,563099 0,062567
822 W60596003 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,625666 0,000000 0,312833 0,312833 0,563099 0,062567
823 W61088003 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 0,626000 0,000000 0,313000 0,313000 0,563400 0,062600
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 0,642345 0,320321 0,321172 0,641494 0,578110 0,384556
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 1,284690 0,268643 0,642345 0,910988 1,156221 0,397112
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 1,284690 0,321310 0,642345 0,963655 1,156221 0,449779
827 W60459003 M01AH01 CELECOXIBUM ALGOXIB 200 mg CAPS. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 1,262333 0,000000 0,631166 0,631167 1,136099 0,126234
828 W60520003 M01AH01 CELECOXIBUM ACLEXA 200 mg CAPS. 200mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,262333 0,000000 0,631166 0,631167 1,136099 0,126234
829 W60597003 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 200 mg CAPS. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,262333 0,000000 0,631166 0,631167 1,136099 0,126234
830 W61089003 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 200 mg CAPS. 200mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 1,262333 0,000000 0,631166 0,631167 1,136099 0,126234
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 1,284690 0,321310 0,642345 0,963655 1,156221 0,449779
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 1,284690 0,268643 0,642345 0,910988 1,156221 0,397112
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 2,569380 0,602048 1,284690 1,886738 2,312442 0,858986
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 2,569380 0,502048 1,284690 1,786738 2,312442 0,758986
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 2,569380 0,572048 1,284690 1,856738 2,312442 0,828986
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 2,569380 0,572048 1,284690 1,856738 2,312442 0,828986
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
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 2,569380 0,014905 1,284690 1,299595 2,312442 0,271843
839 W62798003 M01AH05 ETORICOXIBUM DOLOXIB 120 mg COMPR. FILM. 120mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 2,500714 0,000000 1,250357 1,250357 2,250642 0,250072
840 W62798005 M01AH05 ETORICOXIBUM DOLOXIB 120 mg COMPR. FILM. 120mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 2,295714 0,000000 1,147857 1,147857 2,066142 0,229572
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 2,569380 0,471334 1,284690 1,756024 2,312442 0,728272
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 2,569380 0,602048 1,284690 1,886738 2,312442 0,858986
843 W63093002 M01AH05 ETORICOXIBUM ETORICOXIB STADA 120 mg COMPR. FILM. 120mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,491428 0,000000 1,245714 1,245714 2,242285 0,249143
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 2,569380 0,572048 1,284690 1,856738 2,312442 0,828986
845 W63428002 M01AH05 ETORICOXIBUM KOSTAROX 120 mg COMPR. FILM. 120mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P6L 7 2,365714 0,000000 1,182857 1,182857 2,129142 0,236572
846 W63679002 M01AH05 ETORICOXIBUM ETORICOXIB AUROBINDO 120 mg COMPR. FILM. 120mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 2,431428 0,000000 1,215714 1,215714 2,188285 0,243143
847 W63797003 M01AH05 ETORICOXIBUM GEROCOXAN 120 mg COMPR. FILM. 120mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,327142 0,000000 1,163571 1,163571 2,094427 0,232715
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 0,642345 0,994083 0,321172 1,315256 0,578110 1,058318
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 0,642345 0,994083 0,321172 1,315256 0,578110 1,058318
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
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 0,642345 0,933369 0,321172 1,254542 0,578110 0,997604
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 0,642345 0,883369 0,321172 1,204542 0,578110 0,947604
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 0,642345 0,953726 0,321172 1,274899 0,578110 1,017961
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 0,642345 1,426226 0,321172 1,747399 0,578110 1,490461
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 0,642345 0,897297 0,321172 1,218470 0,578110 0,961532
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 0,642345 0,953726 0,321172 1,274899 0,578110 1,017961
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 0,642345 0,946226 0,321172 1,267399 0,578110 1,010461
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 0,642345 0,254083 0,321172 0,575256 0,578110 0,318318
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 0,642345 0,583369 0,321172 0,904542 0,578110 0,647604
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 0,642345 0,874440 0,321172 1,195613 0,578110 0,938675
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 1,284690 0,956024 0,642345 1,598369 1,156221 1,084493
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 1,284690 0,956024 0,642345 1,598369 1,156221 1,084493
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 1,284690 0,992452 0,642345 1,634797 1,156221 1,120921
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 1,284690 0,992452 0,642345 1,634797 1,156221 1,120921
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
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 1,284690 0,706738 0,642345 1,349083 1,156221 0,835207
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 1,284690 0,660310 0,642345 1,302655 1,156221 0,788779
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 1,284690 0,596738 0,642345 1,239083 1,156221 0,725207
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 1,284690 0,383881 0,642345 1,026226 1,156221 0,512350
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 1,284690 0,630310 0,642345 1,272655 1,156221 0,758779
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 1,284690 0,884595 0,642345 1,526940 1,156221 1,013064
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 1,284690 0,814238 0,642345 1,456583 1,156221 0,942707
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 1,284690 0,508167 0,642345 1,150512 1,156221 0,636636
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 1,284690 0,444595 0,642345 1,086940 1,156221 0,573064
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 1,284690 0,401738 0,642345 1,044083 1,156221 0,530207
Pagina 14 din 21
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)
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 1,927035 0,520822 0,963517 1,484340 1,734331 0,713526
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 1,927035 0,520822 0,963517 1,484340 1,734331 0,713526
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 1,927035 0,495822 0,963517 1,459340 1,734331 0,688526
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 1,927035 0,495822 0,963517 1,459340 1,734331 0,688526
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
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 1,927035 0,192965 0,963517 1,156483 1,734331 0,385669
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 1,927035 0,192965 0,963517 1,156483 1,734331 0,385669
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 1,927035 0,124750 0,963517 1,088268 1,734331 0,317454
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 1,927035 0,493679 0,963517 1,457197 1,734331 0,686383
885 W63092003 M01AH05 ETORICOXIBUM ETORICOXIB STADA 90 mg COMPR. FILM. 90mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,747857 0,000000 0,873928 0,873929 1,573071 0,174786
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 1,927035 0,376536 0,963517 1,340054 1,734331 0,569240
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 1,927035 0,302250 0,963517 1,265768 1,734331 0,494954
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 1,927035 0,192965 0,963517 1,156483 1,734331 0,385669
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 1,927035 0,014393 0,963517 0,977911 1,734331 0,207097
890 W63796005 M01AH05 ETORICOXIBUM GEROCOXAN 90 mg COMPR. FILM. 90mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,855714 0,000000 0,927857 0,927857 1,670142 0,185572
891 W10193001 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,418967 0,017633 0,209483 0,227117 0,377070 0,059530
892 W10194001 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,703600 0,000000 0,351800 0,351800 0,633240 0,070360
893 W54297001 M05BA04 ACIDUM ALENDRONICUM * TEVANAT 70 mg COMPR. 70 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L 4 2,900000 0,000000 1,450000 1,450000 2,610000 0,290000
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
898 W52948001 M05BA04 ACIDUM ALENDRONICUM * ALENDRONAT SANDOZ 70 mg COMPR. FILM. 70mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM P-6L 2 5,160000 0,000000 2,580000 2,580000 4,644000 0,516000
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
902 W60074002 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT SODIC ZENTIVA 35mg COMPR. FILM. 35mg ZENTIVA KS REPUBLICA CEHA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE P-6L 4 3,975000 0,000000 1,987500 1,987500 3,577500 0,397500
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
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 14,620000 0,000000 7,310000 7,310000 13,158000 1,462000
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 14,927142 7,782858 7,463571 15,246429 13,434427 9,275573
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
924 W55687009 N02AA05 OXYCODONUM * # OXIDOLOR 20 mg COMPR. ELIB. PREL. 20mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 0,960185 0,324648 0,480092 0,804741 0,864166 0,420667
925 W55688009 N02AA05 OXYCODONUM * # OXIDOLOR 40 mg COMPR. ELIB. PREL. 40mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 1,920375 0,161625 0,960187 1,121813 1,728337 0,353663
926 W59147002 N02AA05 OXYCODONUM * # OXICODONA SANDOZ 40 mg COMPR. ELIB. PREL. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 1,920375 0,271625 0,960187 1,231813 1,728337 0,463663
927 W59148002 N02AA05 OXYCODONUM * # OXICODONA SANDOZ 60 mg COMPR. ELIB. PREL. 60mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 2,880564 3,003936 1,440282 4,444218 2,592507 3,291993
928 W55689009 N02AA05 OXYCODONUM * # OXIDOLOR 80 mg COMPR. ELIB. PREL. 80mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 3,539166 0,000000 1,769583 1,769583 3,185249 0,353917
929 W59149002 N02AA05 OXYCODONUM * # OXICODONA SANDOZ 80 mg COMPR. ELIB. PREL. 80mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 3,733000 0,000000 1,866500 1,866500 3,359700 0,373300
930 W44121001 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 120 mg COMPR. ELIB. PREL. 120mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1,741010 0,440418 0,870505 1,310923 1,566909 0,614519
931 W44119001 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 0,853392 0,000000 0,426696 0,426696 0,768052 0,085340
932 W44120001 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1,305758 0,025670 0,652879 0,678549 1,175182 0,156246
933 W61518001 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 10 0,282708 0,497292 0,141354 0,638646 0,254437 0,525563
934 W61518002 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 2 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 20 0,282708 0,497792 0,141354 0,639146 0,254437 0,526063
935 W61518003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 3 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 30 0,282708 0,497625 0,141354 0,638979 0,254437 0,525896
936 W61518004 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 5 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 50 0,282708 0,386492 0,141354 0,527846 0,254437 0,414763
937 W54375003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-RF 20 0,282500 0,000000 0,141250 0,141250 0,254250 0,028250
938 W54375004 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 0,282708 0,000292 0,141354 0,141646 0,254437 0,028563
Pagina 15 din 21
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)
939 W62652002 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAMADOL/PARACETAMOL AUROBINDO 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. PRF 20 0,282708 0,278292 0,141354 0,419646 0,254437 0,306563
940 W66473002 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAMADOL/PARACETAMOL AUROBINDO 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. PRF 20 0,282708 0,278292 0,141354 0,419646 0,254437 0,306563
941 W58620002 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF 20 0,565416 0,000084 0,282708 0,282792 0,508874 0,056626
942 W58620003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMP. FILM. PRF 30 0,565333 0,000000 0,282666 0,282667 0,508799 0,056534
943 W61588003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) PALGOTAL 75 mg/650 mg COMPR. FILM. 75mg/650mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVCDC/AL X 30 COMPR. FILM. PRF 30 0,553666 0,000000 0,276833 0,276833 0,498299 0,055367
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 1,220783 1,531359 0,610391 2,141751 1,098704 1,653438
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 1,220783 1,257609 0,610391 1,868001 1,098704 1,379688
946 W63613008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,220783 1,531359 0,610391 2,141751 1,098704 1,653438
947 W63613010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,220783 1,257609 0,610391 1,868001 1,098704 1,379688
948 W41745001 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 1,430000 0,000000 0,715000 0,715000 1,287000 0,143000
949 W41745002 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 1,313392 0,000000 0,656696 0,656696 1,182052 0,131340
950 W61765001 N03AX16 PREGABALINUM ** # PRAGIOLA 150 mg CAPS. 150mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0,687857 0,000000 0,343928 0,343929 0,619071 0,068786
951 W61765004 N03AX16 PREGABALINUM ** # PRAGIOLA 150 mg CAPS. 150mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,664285 0,000000 0,332142 0,332143 0,597856 0,066429
952 W62280006 N03AX16 PREGABALINUM ** # PREGAMID 150 mg CAPS. 150mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,658000 0,000000 0,329000 0,329000 0,592200 0,065800
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 1,464942 0,125058 0,732471 0,857529 1,318447 0,271553
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 1,464942 1,584343 0,732471 2,316814 1,318447 1,730838
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 1,464942 1,248093 0,732471 1,980564 1,318447 1,394588
956 W62572008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,464942 1,584343 0,732471 2,316814 1,318447 1,730838
957 W62572011 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,464942 1,248093 0,732471 1,980564 1,318447 1,394588
958 W62610001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 0,779285 0,000000 0,389642 0,389643 0,701356 0,077929
959 W62610002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 56 CPAS. PRF 56 0,754107 0,000000 0,377053 0,377054 0,678696 0,075411
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 1,464942 1,248093 0,732471 1,980564 1,318447 1,394588
961 W62901001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ GMBH 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,634285 0,000000 0,317142 0,317143 0,570856 0,063429
962 W63186001 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,655000 0,000000 0,327500 0,327500 0,589500 0,065500
963 W63186004 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,634285 0,000000 0,317142 0,317143 0,570856 0,063429
964 W63186008 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0,655000 0,000000 0,327500 0,327500 0,589500 0,065500
965 W63186011 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,634285 0,000000 0,317142 0,317143 0,570856 0,063429
966 W64907002 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 1,313392 0,000000 0,656696 0,656696 1,182052 0,131340
967 W64907001 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 1,430000 0,000000 0,715000 0,715000 1,287000 0,143000
968 W65243001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,634285 0,000000 0,317142 0,317143 0,570856 0,063429
969 W65702001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,779285 0,000000 0,389642 0,389643 0,701356 0,077929
970 W65702002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,754107 0,000000 0,377053 0,377054 0,678696 0,075411
971 W65823001 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 150 mg CAPS. 150mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 14 CAPS. PRF 14 0,779285 0,000000 0,389642 0,389643 0,701356 0,077929
972 W65823002 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 150 mg CAPS. 150mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 21 CAPS. PRF 21 0,779047 0,000000 0,389523 0,389524 0,701142 0,077905
973 W65823003 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 150 mg CAPS. 150mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 56 CAPS. PRF 56 0,754107 0,000000 0,377053 0,377054 0,678696 0,075411
974 W65823004 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 150 mg CAPS. 150mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 70 CAPS. PRF 70 0,754142 0,000000 0,377071 0,377071 0,678727 0,075415
975 W65823005 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 150 mg CAPS. 150mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 84 CAPS. PRF 84 0,754047 0,000000 0,377023 0,377024 0,678642 0,075405
976 W65823006 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 150 mg CAPS. 150mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 100 CAPS. PRF 100 0,716000 0,000000 0,358000 0,358000 0,644400 0,071600
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 1,464942 0,125058 0,732471 0,857529 1,318447 0,271553
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 2,441570 2,347001 1,220785 3,567786 2,197413 2,591158
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 2,441570 2,019680 1,220785 3,240465 2,197413 2,263837
980 W63615008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2,441570 2,347001 1,220785 3,567786 2,197413 2,591158
981 W63615010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 2,441570 2,019680 1,220785 3,240465 2,197413 2,263837
982 W41747001 N03AX16 PREGABALINUM ** # LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 2,581428 0,000000 1,290714 1,290714 2,323285 0,258143
983 W61768001 N03AX16 PREGABALINUM ** # PRAGIOLA 300 mg CAPS. 300mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 1,580714 0,000000 0,790357 0,790357 1,422642 0,158072
984 W61768004 N03AX16 PREGABALINUM ** # PRAGIOLA 300 mg CAPS. 300mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1,451964 0,000000 0,725982 0,725982 1,306767 0,145197
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 2,929885 0,057948 1,464942 1,522891 2,636896 0,350937
986 W62611001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 300 mg CAPS. 300mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 2,410000 0,000000 1,205000 1,205000 2,169000 0,241000
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 2,929885 1,061186 1,464942 2,526129 2,636896 1,354175
988 W63187001 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,489285 0,000000 0,744642 0,744643 1,340356 0,148929
989 W63187004 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,368571 0,000000 0,684285 0,684286 1,231713 0,136858
990 W63187008 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 1,489285 0,000000 0,744642 0,744643 1,340356 0,148929
991 W63187011 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1,368571 0,000000 0,684285 0,684286 1,231713 0,136858
992 W64908001 N03AX16 PREGABALINUM ** # LYRICA 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 2,581428 0,000000 1,290714 1,290714 2,323285 0,258143
993 W65703001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 300 mg CAPS. 300mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2,410000 0,000000 1,205000 1,205000 2,169000 0,241000
994 W65824001 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 300 mg CAPS. 300mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 14 CAPS. PRF 14 1,770714 0,000000 0,885357 0,885357 1,593642 0,177072
995 W65824002 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 300 mg CAPS. 300mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 21 CAPS. PRF 21 1,714285 0,000000 0,857142 0,857143 1,542856 0,171429
996 W65824003 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 300 mg CAPS. 300mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 56 CAPS. PRF 56 1,629821 0,000000 0,814910 0,814911 1,466838 0,162983
997 W65824004 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 300 mg CAPS. 300mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 70 CAPS. PRF 70 1,627714 0,000000 0,813857 0,813857 1,464942 0,162772
998 W65824005 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 300 mg CAPS. 300mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 84 CAPS. PRF 84 1,571547 0,000000 0,785773 0,785774 1,414392 0,157155
999 W65824006 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 300 mg CAPS. 300mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 100 CAPS. PRF 100 1,543500 0,000000 0,771750 0,771750 1,389150 0,154350
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 2,929885 0,057948 1,464942 1,522891 2,636896 0,350937
1.001 W41743001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 0,732471 0,323957 0,366235 0,690193 0,659223 0,397205
Pagina 16 din 21
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)
1.002 W41743002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 0,732471 0,290029 0,366235 0,656265 0,659223 0,363277
1.003 W61763001 N03AX16 PREGABALINUM ** # PRAGIOLA 75 mg CAPS. 75mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0,596428 0,000000 0,298214 0,298214 0,536785 0,059643
1.004 W61763004 N03AX16 PREGABALINUM ** # PRAGIOLA 75 mg CAPS. 75mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,596785 0,000000 0,298392 0,298393 0,537106 0,059679
1.005 W62278006 N03AX16 PREGABALINUM ** # PREGAMID 75 mg CAPS. 75mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,579000 0,000000 0,289500 0,289500 0,521100 0,057900
1.006 W62311005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 75 mg CAPS. 75mg MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF
AUROBINDO PHARMA (MALTA) LIMITED 60 0,732471 0,357029 0,366235 0,723265 0,659223 0,430277
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 0,732471 1,161814 0,366235 1,528050 0,659223 1,235062
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 0,732471 1,008421 0,366235 1,374657 0,659223 1,081669
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 0,732471 1,161814 0,366235 1,528050 0,659223 1,235062
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 0,732471 1,008421 0,366235 1,374657 0,659223 1,081669
1.011 W62609001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 0,682142 0,000000 0,341071 0,341071 0,613927 0,068215
1.012 W62609002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 56 CPAS. PRF 56 0,660535 0,000000 0,330267 0,330268 0,594481 0,066054
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 0,732471 0,978779 0,366235 1,345015 0,659223 1,052027
1.014 W62900001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ GMBH 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,575892 0,000000 0,287946 0,287946 0,518302 0,057590
1.015 W63185001 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,576428 0,000000 0,288214 0,288214 0,518785 0,057643
1.016 W63185004 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,577321 0,000000 0,288660 0,288661 0,519588 0,057733
1.017 W63185008 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0,576428 0,000000 0,288214 0,288214 0,518785 0,057643
1.018 W63185011 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,577321 0,000000 0,288660 0,288661 0,519588 0,057733
1.019 W64906002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0,732471 0,290029 0,366235 0,656265 0,659223 0,363277
1.020 W64906001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0,732471 0,323957 0,366235 0,690193 0,659223 0,397205
1.021 W65242001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,575892 0,000000 0,287946 0,287946 0,518302 0,057590
1.022 W65701001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,682142 0,000000 0,341071 0,341071 0,613927 0,068215
1.023 W65701002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,660535 0,000000 0,330267 0,330268 0,594481 0,066054
1.024 W65822001 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 75 mg CAPS. 75mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 14 CAPS. PRF 14 0,682142 0,000000 0,341071 0,341071 0,613927 0,068215
1.025 W65822002 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 75 mg CAPS. 75mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 21 CAPS. PRF 21 0,683333 0,000000 0,341666 0,341667 0,614999 0,068334
1.026 W65822003 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 75 mg CAPS. 75mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 56 CAPS. PRF 56 0,658214 0,000000 0,329107 0,329107 0,592392 0,065822
1.027 W65822004 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 75 mg CAPS. 75mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 70 CAPS. PRF 70 0,660714 0,000000 0,330357 0,330357 0,594642 0,066072
1.028 W65822005 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 75 mg CAPS. 75mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 84 CAPS. PRF 84 0,660833 0,000000 0,330416 0,330417 0,594749 0,066084
1.029 W65822006 N03AX16 PREGABALINUM ** # PREGABALINA VIVANTA 75 mg CAPS. 75mg VIVANTA GENERICS S.R.O., CEHIA CUTIE CU BLIST. PVC-ACLAR/AL X 100 CAPS. PRF 100 0,638800 0,000000 0,319400 0,319400 0,574920 0,063880
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 0,732471 0,357029 0,366235 0,723265 0,659223 0,430277
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 92,389045 53,860955 46,194522 100,055478 83,150140 63,099860
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 0,231322 0,183011 0,115661 0,298672 0,208189 0,206144
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 0,231322 0,225678 0,115661 0,341339 0,208189 0,248811
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 0,231322 0,345011 0,115661 0,460672 0,208189 0,368144
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 0,231322 0,100011 0,115661 0,215672 0,208189 0,123144
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 0,899587 1,284746 0,449793 1,734540 0,809628 1,374705
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 0,899587 1,133413 0,449793 1,583207 0,809628 1,223372
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 0,899587 1,272413 0,449793 1,722207 0,809628 1,362372
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 0,899587 1,092079 0,449793 1,541873 0,809628 1,182038
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 0,334132 0,346868 0,167066 0,513934 0,300718 0,380282
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 0,334132 0,346868 0,167066 0,513934 0,300718 0,380282
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 0,668265 1,561068 0,334132 1,895201 0,601438 1,627895
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 0,668265 0,830735 0,334132 1,164868 0,601438 0,897562
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 0,668265 0,830735 0,334132 1,164868 0,601438 0,897562
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 1,349381 2,830952 0,674690 3,505643 1,214442 2,965891
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 1,349381 0,592619 0,674690 1,267310 1,214442 0,727558
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 2,698763 0,989903 1,349381 2,339285 2,428886 1,259780
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 2,698763 4,456903 1,349381 5,806285 2,428886 4,726780
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 2,698763 1,287570 1,349381 2,636952 2,428886 1,557447
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 4,048144 4,272189 2,024072 6,296261 3,643329 4,677004
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 0,803203 0,239797 0,401601 0,641399 0,722882 0,320118
1.052 W63530001 N05AL03 TIAPRIDUM TIAPRIDAL 100 mg COMPR. 100mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,519500 0,000000 0,259750 0,259750 0,467550 0,051950
1.053 W08133001 N05BE01 BUSPIRONUM SPITOMIN 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF 60 0,263500 0,000000 0,131750 0,131750 0,237150 0,026350
1.054 W08134001 N05BE01 BUSPIRONUM SPITOMIN 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF 60 0,139020 0,021813 0,069510 0,091323 0,125118 0,035715
1.055 W54498006 N06AB10 ESCITALOPRAMUM ** DEPRESINAL 10 mg COMPR. FILM. 10 mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 0,829333 0,000000 0,414666 0,414667 0,746399 0,082934
1.056 W59844001 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 0,660357 0,000000 0,330178 0,330179 0,594321 0,066036
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 0,990748 0,426394 0,495374 0,921768 0,891673 0,525469
1.058 W55522003 N06AB10 ESCITALOPRAMUM ** LENUXIN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,908928 0,000000 0,454464 0,454464 0,818035 0,090893
1.059 W54882002 N06AB10 ESCITALOPRAMUM ** ESLOREX 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,660333 0,000000 0,330166 0,330167 0,594299 0,066034
1.060 W55813002 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0,625714 0,000000 0,312857 0,312857 0,563142 0,062572
1.061 W59746003 N06AB10 ESCITALOPRAMUM ** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. PRF 14 0,527142 0,000000 0,263571 0,263571 0,474427 0,052715
1.062 W59746005 N06AB10 ESCITALOPRAMUM ** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PRF 28 0,527142 0,000000 0,263571 0,263571 0,474427 0,052715
1.063 W60685003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0,458571 0,000000 0,229285 0,229286 0,412713 0,045858
1.064 W60692004 N06AB10 ESCITALOPRAMUM ** ELICEA 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,531666 0,000000 0,265833 0,265833 0,478499 0,053167
Pagina 17 din 21
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)
1.065 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
1.066 W61414004 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 0,819285 0,000000 0,409642 0,409643 0,737356 0,081929
1.067 W65341003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,521785 0,000000 0,260892 0,260893 0,469606 0,052179
1.068 W60686003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 1,273214 0,000000 0,636607 0,636607 1,145892 0,127322
1.069 W13019001 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 1,172833 0,093167 0,586416 0,679584 1,055549 0,210451
1.070 W13019004 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 60 1,172833 0,000000 0,586416 0,586417 1,055549 0,117284
1.071 W13019002 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 60 1,172833 0,000000 0,586416 0,586417 1,055549 0,117284
1.072 W13019003 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF 20 1,172833 0,093167 0,586416 0,679584 1,055549 0,210451
1.073 W08616002 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-RF 30 0,586416 0,106584 0,293208 0,399792 0,527774 0,165226
1.074 W55427002 N06AX12 BUPROPIONUM ** # ELONTRIL 150 mg COMPR. ELIB. MODIF. 150mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 1 FLAC. PEID CU DESICANT X 30 COMPR. ELIB. MODIF. P-RF 30 2,165000 0,000000 1,082500 1,082500 1,948500 0,216500
1.075 W57667003 N06AX14 TIANEPTINUM ** LYXIT 12,5 mg COMPR. FILM. 12,5 mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 0,492999 0,000001 0,246499 0,246501 0,443699 0,049301
1.076 W57667005 N06AX14 TIANEPTINUM ** LYXIT 12,5 mg COMPR. FILM. 12,5 mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 0,476777 0,000000 0,238388 0,238389 0,429099 0,047678
1.077 W60648003 N06AX14 TIANEPTINUM ** NOBIXAL 12,5 mg COMPR. FILM. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF 30 0,492999 0,000001 0,246499 0,246501 0,443699 0,049301
1.078 W60648008 N06AX14 TIANEPTINUM ** NOBIXAL 12,5 mg COMPR. FILM. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. PRF 30 0,492999 0,000001 0,246499 0,246501 0,443699 0,049301
1.079 W41558001 N06AX14 TIANEPTINUM ** COAXIL 12,5 mg DRAJ. 12,5mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 0,492999 0,254667 0,246499 0,501167 0,443699 0,303967
1.080 W43297002 N06AX21 DULOXETINUM ** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 0,634830 1,175170 0,317415 1,492585 0,571347 1,238653
1.081 W61820005 N06AX21 DULOXETINUM ** DULSEVIA 30 mg CAPS. GASTROREZ. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 0,634830 0,313836 0,317415 0,631251 0,571347 0,377319
1.082 W61959001 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0,634830 0,607670 0,317415 0,925085 0,571347 0,671153
1.083 W61959002 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 0,634830 0,607670 0,317415 0,925085 0,571347 0,671153
1.084 W62305004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 30 mg CAPS. GASTROREZ. 30mg MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ.
AUROBINDO PHARMA (MALTA) LIMITED PRF 30 0,634830 0,703836 0,317415 1,021251 0,571347 0,767319
1.085 W62054001 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0,634830 0,628741 0,317415 0,946156 0,571347 0,692224
1.086 W62274004 N06AX21 DULOXETINUM ** DULASOLAN 30 mg CAPS. GASTROREZ. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 0,634830 0,488503 0,317415 0,805918 0,571347 0,551986
1.087 W62301003 N06AX21 DULOXETINUM ** DULOXETINA STADA 30 mg CAPS. GASTROREZ. 30mg STADA M&D SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0,634830 0,225170 0,317415 0,542585 0,571347 0,288653
1.088 W62801002 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 0,634830 0,542670 0,317415 0,860085 0,571347 0,606153
1.089 W62801012 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0,634830 0,542670 0,317415 0,860085 0,571347 0,606153
1.090 W63955004 N06AX21 DULOXETINUM ** DOZZEX 30 mg CAPS. GASTROREZ. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0,634830 0,639098 0,317415 0,956513 0,571347 0,702581
1.091 W66466004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 30 mg CAPS. GASTROREZ. 30mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 0,634830 0,703836 0,317415 1,021251 0,571347 0,767319
1.092 W43298001 N06AX21 DULOXETINUM ** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 1,269660 1,484625 0,634830 2,119455 1,142694 1,611591
1.093 W61821005 N06AX21 DULOXETINUM ** DULSEVIA 60 mg CAPS. GASTROREZ. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 1,040666 0,000000 0,520333 0,520333 0,936599 0,104067
1.094 W61960001 N06AX21 DULOXETINUM ** ZATINEX 60 mg CAPS. GASTROREZ. 60mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 1,264642 0,000000 0,632321 0,632321 1,138177 0,126465
1.095 W61960002 N06AX21 DULOXETINUM ** ZATINEX 60 mg CAPS. GASTROREZ. 60mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1,264642 0,000000 0,632321 0,632321 1,138177 0,126465
1.096 W62055001 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 60 mg CAPS. GASTROREZ. 60mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,228214 0,000000 0,614107 0,614107 1,105392 0,122822
1.097 W62302003 N06AX21 DULOXETINUM ** DULOXETINA STADA 60 mg CAPS. GASTROREZ. 60mg STADA M&D SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 1,099642 0,000000 0,549821 0,549821 0,989677 0,109965
1.098 W62306004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 60 mg CAPS. GASTROREZ. 60mg MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ.
AUROBINDO PHARMA (MALTA) LIMITED PRF 30 1,269660 0,001673 0,634830 0,636503 1,142694 0,128639
1.099 W62275004 N06AX21 DULOXETINUM ** DULASOLAN 60 mg CAPS. GASTROREZ. 60mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 1,101666 0,000000 0,550833 0,550833 0,991499 0,110167
1.100 W62803003 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. GASTROREZ. PRF 30 1,269660 0,556340 0,634830 1,191170 1,142694 0,683306
1.101 W62803013 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,269660 0,556340 0,634830 1,191170 1,142694 0,683306
1.102 W63956004 N06AX21 DULOXETINUM ** DOZZEX 60 mg CAPS. GASTROREZ. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,269660 0,052125 0,634830 0,686955 1,142694 0,179091
1.103 W66467004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 60 mg CAPS. GASTROREZ. 60mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,269660 0,001673 0,634830 0,636503 1,142694 0,128639
1.104 W08060001 N06BX16 PRAMIRACETAMUM ** # PRAMISTAR COMPR. FILM. 600mg F.I.R.M.A. S.P.A. (MENARINI GROUP) ITALIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR.FILM. P-6L 20 3,922500 0,000000 1,961250 1,961250 3,530250 0,392250
1.105 W58635002 N06BX18 VINPOCETINUM VINPOCETINA VIM SPECTRUM 5 mg CAPS. 5mg VIM SPECTRUM SRLROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L 50 0,175000 0,000000 0,087500 0,087500 0,157500 0,017500
1.106 W54827001 N06BX18 VINPOCETINUM CAVINTON(R) FORTE COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-6L 30 0,367500 0,052500 0,183750 0,236250 0,330750 0,089250
1.107 W57876003 N07CA01 BETAHISTINUM VERTIMED 16 mg COMPR. 16mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR.P6L 30 0,339999 0,073334 0,169999 0,243334 0,305999 0,107334
1.108 W56369001 N07CA01 BETAHISTINUM BETAHISTINA LPH 16 mg COMPR. 16mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,339999 0,283667 0,169999 0,453667 0,305999 0,317667
1.109 W61221004 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,339999 0,054001 0,169999 0,224001 0,305999 0,088001
1.110 W66442004 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,339999 0,054001 0,169999 0,224001 0,305999 0,088001
1.111 W57057005 N07CA01 BETAHISTINUM EMPERIN 24 mg COMPR. 24 mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. P6L 60 0,463000 0,000000 0,231500 0,231500 0,416700 0,046300
1.112 W57312003 N07CA01 BETAHISTINUM BETAHISTINA LPH 24 mg COMPR. 24 mg LABORMED PHARMA SA ROMANIA CUTIE CU 6 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 60 0,510000 0,000000 0,255000 0,255000 0,459000 0,051000
1.113 W65860004 N07CA01 BETAHISTINUM DICLORHIDRAT DE BETAHISTINA ACCORD 24 mg COMPR. 24 mg POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. P6L
ACCORD HEALTHCARE POLSKA SP. Z O.O. 60 0,494666 0,000000 0,247333 0,247333 0,445199 0,049467
1.114 W55890001 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 20 0,510000 0,000000 0,255000 0,255000 0,459000 0,051000
1.115 W55890002 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 5 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 50 0,510000 0,000000 0,255000 0,255000 0,459000 0,051000
1.116 W57877003 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR.P6L 30 0,489000 0,000000 0,244500 0,244500 0,440100 0,048900
1.117 W57877006 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 60 COMPR.P6L 60 0,489166 0,000000 0,244583 0,244583 0,440249 0,048917
1.118 W55890003 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 6 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 60 0,510000 0,000000 0,255000 0,255000 0,459000 0,051000
1.119 W61222003 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 24 mg COMPR. 24mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,510000 0,000000 0,255000 0,255000 0,459000 0,051000
1.120 W61967003 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg BGP PRODUCTS B.V.OLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 60 0,510000 0,231333 0,255000 0,486333 0,459000 0,282333
1.121 W61967001 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg BGP PRODUCTS B.V.OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0,510000 0,256000 0,255000 0,511000 0,459000 0,307000
1.122 W63739001 N07CA01 BETAHISTINUM BETAHISTINA ATB 24 mg COMPR. 24mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 COMPR. P6L 20 0,441500 0,000000 0,220750 0,220750 0,397350 0,044150
1.123 W63739004 N07CA01 BETAHISTINUM BETAHISTINA ATB 24 mg COMPR. 24mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 6 BLIST. PVC/PVDC/AL X 10 COMPR. P6L 60 0,441166 0,000000 0,220583 0,220583 0,397049 0,044117
1.124 W64556001 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0,510000 0,256000 0,255000 0,511000 0,459000 0,307000
1.125 W64556003 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 60 0,510000 0,231333 0,255000 0,486333 0,459000 0,282333
1.126 W66443003 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 24 mg COMPR. 24mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,510000 0,000000 0,255000 0,255000 0,459000 0,051000
1.127 W55889001 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 30 0,169999 0,021001 0,084999 0,106001 0,152999 0,038001
Pagina 18 din 21
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)
1.128 W55889002 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 10 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 100 0,169999 0,021101 0,084999 0,106101 0,152999 0,038101
1.129 W57875009 N07CA01 BETAHISTINUM VERTIMED 8 mg COMPR. 8mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 100 COMPR. P6L 100 0,169999 0,021101 0,084999 0,106101 0,152999 0,038101
1.130 W56368004 N07CA01 BETAHISTINUM BETAHISTINA LPH 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 90 0,169999 0,021112 0,084999 0,106112 0,152999 0,038112
1.131 W61220006 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg COMPR. 8mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 0,169999 0,021101 0,084999 0,106101 0,152999 0,038101
1.132 W62009002 N07CA01 BETAHISTINUM BETASERC 8 mg COMPR. 8mg BGP PRODUCTS B.V.OLANDA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 0,169999 0,116701 0,084999 0,201701 0,152999 0,133701
1.133 W64555002 N07CA01 BETAHISTINUM BETASERC 8 mg COMPR. 8mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR. P6L 100 0,169999 0,116701 0,084999 0,201701 0,152999 0,133701
1.134 W66441006 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 0,169999 0,021101 0,084999 0,106101 0,152999 0,038101
1.135 W62326004 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. ORODISPERSABILE 24mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ORODISPERSABILE P6L 60 0,510000 0,415000 0,255000 0,670000 0,459000 0,466000
1.136 W66245004 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. ORODISPERSABILE 24mg MYLAN IRE HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ORODISPERSABILE P6L 60 0,510000 0,415000 0,255000 0,670000 0,459000 0,466000
1.137 W02144003 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT 20mg + 40mg COMPR. 20mg+40mg HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-RF 100 1,104625 0,000075 0,552312 0,552388 0,994162 0,110538
1.138 W02144006 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT 20mg + 40mg COMPR. 20mg+40mg HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 24 COMPR. P-RF 48 1,104625 0,058500 0,552312 0,610813 0,994162 0,168963
1.139 W64195001 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) VERTIGIX 20 mg/40 mg COMPR. 20mg/40mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC-PVDC/AL-PVDC X 50 COMPR. PRF 50 1,104625 0,011975 0,552312 0,564288 0,994162 0,122438
1.140 W66044003 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) AZALONUM 20 mg/40 mg COMPR. 20mg/40mg MEDOCHEMIE LIMITED CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 50 COMPR. PRF 50 1,104400 0,000000 0,552200 0,552200 0,993960 0,110440
1.141 W55730003 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml 215,2mg/ml
SOL. INJ./CONC. PT. SOL. PERF. EVER NEURO PHARMA GMBH AUSTRIA PR/PRF
CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF. 5 27,164000 0,000000 13,582000 13,582000 24,447600 2,716400
1.142 W55730002 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml 215,2mg/ml
SOL. INJ./CONC. PT. SOL. PERF. EVER NEURO PHARMA GMBH AUSTRIA PR/PRF
CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML SOL. INJ./CONC. PT. SOL. PERF. 5 14,933499 4,054501 7,466749 11,521251 13,440149 5,547851
1.143 W54357001 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL® COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 0,562333 0,000000 0,281166 0,281167 0,506099 0,056234
1.144 W62084002 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL 200 mg COMPR. FILM. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM. P-6L 60 0,562333 0,000000 0,281166 0,281167 0,506099 0,056234
1.145 W66244001 R01AD09 MOMETASONUM * FUROAT DE MOMETAZONA AMRING 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza AMRING FARMA S.R.L. ROMANIA CUTIE CU UN FLAC. DIN PEÎD, PREVAZUT CU POMPA DOZATOARE MANUALA DIN PP CARE CONTINE 18 G SUSPENSIE, ECHIVALENT CU 140 DOZE PRF 1 17,730000 4,230000 8,865000 13,095000 15,957000 6,003000
1.146 W59422002 R01AD09 MOMETASONUM * MOMETAZONA FUROAT SANDOZ 50 micrograme/doza SPRAY NAZ.,SUSP. 50micrograme/doza SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID PREVAZUT CU O POMPA PULVERIZATOARE NAZALA DIN PE/PP CARE CONTINE 18 G SUSP. NAZALA CORESPUNZATOR LA 140 DOZE MASURATE PRF 1 13,500000 0,000000 6,750000 6,750000 12,150000 1,350000
1.147 W57437001 R01AD09 MOMETASONUM * NASONEX 50mcg/doza SPRAY NAZAL SUSP. 50mcg/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DIN PE PREVAZUT CU POMPA DOZATOARE, DISPOZITIV DE ACTIONARE DIN PP SI CAPAC, CU UN VOLUM DE 23,5 ML SUSPENSIE PT. 140 PULVERIZARI SPRAY NAZAL, SUSPENSIE P-RF 1 17,730000 9,700000 8,865000 18,565000 15,957000 11,473000
1.148 W59866003 R01AD58 COMBINATII (AZELASTINUM+FLUTICASONUM) ** DYMISTA 137 micrograme/50 micrograme/doza SPRAY NAZ.,SUSP. 137micrograme/50micrograme/doz MEDA PHARMA GMBH & CO KG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, DE CAPACITATE 25 ML, A 23 G SPRAY NAZAL, SUSP. (CEL PUTIN 120 DOZE ELIBERATE), PREVAZUT CU POMPA DE PULVERIZARE + APLICATOR NAZAL DIN PP PRF 1 88,380000 0,000000 44,190000 44,190000 79,542000 8,838000
1.149 W57928002 R03AC13 FORMOTEROLUM ** ATIMOS 0,012mg/doza SOL. DE INHALAT PRESURIZATA 0,012mg/doza TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FLACON X 100 DOZE + VALVA DOZATOARE P-6L 1 83,010000 0,000000 41,505000 41,505000 74,709000 8,301000
1.150 W57033002 R03AC18 INDACATEROLUM ** ONBREZ BREEZHALER 150 µg CAPS. CU PULB.INHAL. 150 µg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIECU BLIST. DIN PA/AL/PVC X 30 CAPSULE (3 BIST X10)+ UN INHALATOR PRF 30 2,271333 2,079000 1,135666 3,214667 2,044199 2,306134
1.151 W64463002 R03AC18 INDACATEROLUM ** ONBREZ BREEZHALER 150 µg CAPS. CU PULB.INHAL. 150µg NOVARTIS EUROPHARM LTD. IRLANDA CUTIECU BLIST. DIN PA/AL/PVC X 30 CAPSULE (3 BIST X10)+ UN INHALATOR PRF 30 2,271333 2,079000 1,135666 3,214667 2,044199 2,306134
1.152 W57034002 R03AC18 INDACATEROLUM ** ONBREZ BREEZHALER 300 µg CAPS. CU PULB.INHAL. 300 µg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X BLISTER DIN PA/AL/PVC X 30 CAPSULE (3 BLIST. X 10 CAPSULE) + UN INHALATOR PRF 30 4,542666 0,000000 2,271333 2,271333 4,088399 0,454267
1.153 W64464002 R03AC18 INDACATEROLUM ** ONBREZ BREEZHALER 300 µg CAPS. CU PULB.INHAL. 300µg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PA/AL/PVC X 30 CAPSULE (1 BLIST. X10)+ UN INHALATOR PRF 30 4,542666 0,000000 2,271333 2,271333 4,088399 0,454267
1.154 W60119001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/100 micrograme PULB. INHAL. 50micrograme/100micrograme GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL. P6L 1 30,171000 71,589000 15,085500 86,674500 27,153900 74,606100
1.155 W65108002 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/100 micrograme PULB. INHAL. 50micrograme/100micrograme GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU UN BLISTER IN FORMA DE BANDA X 60 DOZE PULB. DE INHAL. P6L 1 30,171000 71,589000 15,085500 86,674500 27,153900 74,606100
1.156 W60522001 R03AK06 SALMETEROLUM+FLUTICASONUM * AIRFLUSAL FORSPIRO 50 micrograme/500 micrograme/doza PULB. UNIDOZA DE INHAL. 50micrograme/500micrograme/doz SANDOZ S.R.L. ROMANIA CUTIE CU BLISTER OPA-AL-PVC/AL CONTINAND 1 DISPOZITIV X 60 DOZE CU PULB. DE INHALAT P6L 1 103,660000 0,000000 51,830000 51,830000 93,294000 10,366000
1.157 W61757001 R03AK06 SALMETEROLUM+FLUTICASONUM * AIRFLUSAL FORSPIRO 50 micrograme/250 micrograme/doza PULB. UNIDOZA DE INHALAT 50micrograme/250micrograme/doz SANDOZ S.R.L. ROMANIA CUTIE CU 1 DISPOZITIV INHALATOR DIN PLASTIC CONTINAND BLISTERE DIN OPA-AL-PVC/AL X 60 UNIDOZE PULBERE DE INHALAT P6L 1 75,427500 4,502500 37,713750 42,216250 67,884750 12,045250
1.158 W12105001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE 25 mcg/50 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/50mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L 1 30,171000 78,999000 15,085500 94,084500 27,153900 82,016100
1.159 W65229001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/125 micrograme/doza SUSP. INHAL. PRESURIZATA 25micrograme/125micrograme/doz AMRING FARMA S.R.L. ROMANIA CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS ÎNTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA PRF 1 75,427500 22,012500 37,713750 59,726250 67,884750 29,555250
1.160 W65230001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/250 micrograme/doza SUSP. INHAL. PRESURIZATA 25micrograme/250micrograme/doz AMRING FARMA S.R.L. ROMANIA CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS ÎNTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA PRF 1 123,840000 0,000000 61,920000 61,920000 111,456000 12,384000
1.161 W65218001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE INHALER CFC FREE 25 µg/50 µg SUSP. INHAL. PRESURIZATA 25µg/50µg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA P-6L
CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA 1 30,171000 78,999000 15,085500 94,084500 27,153900 82,016100
1.162 W63867001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * DUORESP SPIROMAX 160 micrograme/4,5 micrograme PULB. DE INHAL. 160micrograme/4,5micrograme TEVA PHARMA B.V. OLANDA 1 INHALATOR CE CONTINE 120 DOZE PRF 1 125,780000 0,000000 62,890000 62,890000 113,202000 12,578000
1.163 W56427001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 160micrograme/4,5micrograme/in ASTRAZENECA AB SUEDIA P6L
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 1 64,010000 14,220000 32,005000 46,225000 57,609000 20,621000
1.164 W63868001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * DUORESP SPIROMAX 320 micrograme/9 micrograme PULB. DE INHAL. 320micrograme/9micrograme TEVA PHARMA B.V. OLANDA 1 INHALATOR CE CONTINE 60 DOZE PRF 1 120,270000 0,000000 60,135000 60,135000 108,243000 12,027000
1.165 W56428001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie PULB. DE INHAL. 320micrograme/9micrograme/inha ASTRAZENECA AB SUEDIA P6L
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 1 128,020000 20,800000 64,010000 84,810000 115,218000 33,602000
1.166 W56426001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 80micrograme/4,5micrograme/inh ASTRAZENECA AB SUEDIA P6L
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 1 64,010000 16,700000 32,005000 48,705000 57,609000 23,101000
1.167 W65024001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * AIRBUFO FORSPIRO 160 micrograme/4,5 micrograme PULB. DE INHAL. UNIDOZA 160micrograme/4,5micrograme SANDOZ S.R.L. ROMANIA CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC DE CULOARE ROSIE/ALBA CE CONTINE 1 BLIST. OPA-AL-PVC/AL X 60 DOZE CU PULB. DE INHALAT UNIDOZA P6L 1 64,010000 0,000000 32,005000 32,005000 57,609000 6,401000
1.168 W62789001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT 160 micrograme/4,5 micrograme/inhalatie SUSP. DE INHALAT PRESURIZATA 160micrograme/4,5micrograme ASTRAZENECA AB SUEDIA CUTIE CU 1 PUNGA DIN FOLIE LAMINATA+1 DISPOZITIV DE INHALARE ALCATUIT DINTR-UN FLAC. PRESURIZAT,INCHIS CU O VALVA DOZATOARE SI ATASAT UNUI INDICATOR AL DOZELOR,INCLUS INTR-UN DIAPOZITIV INHALATOR DIN PLASTIC DE CULOARE ROSIE CU 120 ACTIONARI P6L 1 128,020000 17,290000 64,010000 81,300000 115,218000 30,092000
1.169 W60547004 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER NEXTHALER 100/6 micrograme pe doza PULB. DE INHAL. 100/6micrograme pe doza CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 INHALATOR MULTIDOZA INTRODUS INTR-O PUNGA SIGILATA DIN PET/AL/PE X 180 DOZE PULBERE DE INHALAT PRF 1 192,030000 26,970000 96,015000 122,985000 172,827000 46,173000
1.170 W57995002 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER 100/6 micrograme pe doza SOL. DE INHALAT PRESURIZATA 100/6micrograme pe doza CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS IN DISPOZITIVUL DE ADMINISTRARE DIN PE CU CAPAC PROTECTOR DIN PLASTIC A 180 DOZE SOL. DE INHALAT PRF 1 192,030000 22,250000 96,015000 118,265000 172,827000 41,453000
1.171 W59645001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 125 micrograme/5 micrograme SUSP. INHAL. PRESURIZATA 125micrograme/5micrograme MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU 1 FLAC. DIN AL (INHALATOR) PREVAZUT CU VALVA DOZATOARE SI DISPOZITIV DE ADMINISTRARE DIN PP X 120 DOZE SUSP. DE INHALAT PRESURIZATA P6L 1 133,845000 28,605000 66,922500 95,527500 120,460500 41,989500
1.172 W59644001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 50 micrograme/5 microgrameSUSP. INHAL. PRESURIZATA 50micrograme/5micrograme MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU 1 FLAC. DIN AL (INHALATOR) PREVAZUT CU VALVA DOZATOARE SI DISPOZITIV DE ADMINISTRARE DIN PP X 120 DOZE SUSP. DE INHALAT PRESURIZATA P6L 1 124,310000 0,000000 62,155000 62,155000 111,879000 12,431000
1.173 W60712001 R03AL04 COMBINATII (INDACATEROLUM+GLICOPIRONIUM) ** ULTIBRO BREEZHALER 85 micrograme/43 micrograme CAPS. CU PULB. DE INHAL. 85micrograme/43micrograme NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 BLISTERE PERFORATE PA-AL-PVC/AL PENTRU ELIBERAREA UNEI UNITATI DOZATE X 1 CAPSULA CU PULBERE DE INHALAT + 1 INHALATOR PR/PRF 30 6,896665 0,000001 3,448332 3,448334 6,206998 0,689668
1.174 W64767001 R03AL04 COMBINATII (INDACATEROLUM+GLICOPIRONIUM) ** ULTIBRO BREEZHALER 85 micrograme/43 micrograme CAPS. CU PULB. DE INHAL. 85micrograme/43micrograme IRLANDA
NOVARTIS EUROPHARM LTD. CUTIE X 30 BLISTERE PERFORATE PA-AL-PVC/AL PENTRU ELIBERAREA UNEI UNITATI DOZATE X 1 CAPSULA CU PULBERE DE INHALAT + 1 INHALATOR PR/PRF 30 6,896665 0,000001 3,448332 3,448334 6,206998 0,689668
1.175 W61579001 R03AL05 ACLIDINIUM BROMIDUM+FORMOTEROLUM FUMARAT ** DUAKLIR GENUAIR 340 micrograme/12 micrograme PULB. DE INHAL. 340 micrograme/12 micrograme ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR A 60 DE DOZE PRF 1 232,445000 0,045000 116,222500 116,267500 209,200500 23,289500
1.176 W62377001 R03AL05 ACLIDINIUM BROMIDUM+FORMOTEROLUM FUMARAT ** BRIMICA GENUAIR 340 micrograme/12 micrograme PULB. DE INHAL. 340 micrograme/12 micrograme ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR A 60 DE DOZE PRF 1 232,430000 0,000000 116,215000 116,215000 209,187000 23,243000
1.177 W61818005 R03AL06 COMBINATII (TIOTROPIUM+OLODATEROLUM) ** SPIOLTO RESPIMAT 2,5 micrograme/2,5 micrograme SOL. DE INHALAT 2,5 micrograme/2,5 micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU AMBALAJ UNIC FORMAT DIN 1 INHALATOR RESPIMAT REUTILIZABIL SI 1 CARTUS X 60 PUFURI (30 DOZE) SOL. DE INHALAT PRF 1 204,195000 5,295000 102,097500 107,392500 183,775500 25,714500
1.178 W61818007 R03AL06 COMBINATII (TIOTROPIUM+OLODATEROLUM) ** SPIOLTO RESPIMAT 2,5 micrograme/2,5 micrograme SOL. DE INHALAT 2,5 micrograme/2,5 micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU AMBALAJ UNIC PENTRU REINCARCARE FORMAT DIN 1 CARTUS X 60 PUFURI (30 DOZE) SOL. DE INHALAT PRF 1 202,430000 0,000000 101,215000 101,215000 182,187000 20,243000
1.179 W41902002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 100 mcg PULB. INHAL.100mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 20,082150 16,907850 10,041075 26,948925 18,073935 18,916065
1.180 W65206002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 100 micrograme PULB. INHAL.100micrograme GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE INDIVIDUALE P-RF 1 20,082150 17,027850 10,041075 27,068925 18,073935 19,036065
1.181 W41903002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 250 mcg PULB. INHAL.250mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 50,205375 8,394625 25,102687 33,497313 45,184837 13,415163
1.182 W65207002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 250 micrograme PULB. INHAL.250micrograme GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE INDIVIDUALE P-RF 1 50,205375 8,394625 25,102687 33,497313 45,184837 13,415163
1.183 W41904002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 500 mcg PULB. INHAL.500mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 94,670000 0,000000 47,335000 47,335000 85,203000 9,467000
1.184 W65208002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 500 micrograme PULB. INHAL.500micrograme GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE INDIVIDUALE P-RF 1 94,670000 0,000000 47,335000 47,335000 85,203000 9,467000
1.185 W03222001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE 125 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 125mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA P-RF 1 25,102687 11,327313 12,551343 23,878657 22,592418 13,837582
1.186 W63693001 R03BA05 FLUTICASONUM PROPIONAT * ARQUIST 125 micrograme SUSP. INHAL. PRESURIZATA AMRING FARMA SRLROMANIA
125micrograme CUTIE CU 1 RECIPIENT DIN AL SUB PRESIUNE PREVAZUT CU O VALVA DE MASURARE, UN DOZATOR DIN PP CU CAPAC, INTRODUS ÎNTR-O PUNGA DE AL CU SACULET DE SILICAGEL CARE CONTINE 120 DOZE SUSP. DE INHALAT PRESURIZATA PRF 1 46,880000 0,000000 23,440000 23,440000 42,192000 4,688000
1.187 W65201001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE 125 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 125µg/doza GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA P-RF 1 25,102687 11,327313 12,551343 23,878657 22,592418 13,837582
1.188 W63695001 R03BA05 FLUTICASONUM PROPIONAT * ARQUIST 250 micrograme SUSP. INHAL. PRESURIZATA 250micrograme AMRING FARMA SRLROMANIA CUTIE CU 1 RECIPIENT DIN AL SUB PRESIUNE PREVAZUT CU O VALVA DE MASURARE, UN DOZATOR DIN PP CU CAPAC, INTRODUS ÎNTR-O PUNGA DE AL CU SACULET DE SILICAGEL CARE CONTINE 120 DOZE SUSP. DE INHALAT PRESURIZATA PRF 1 80,520000 0,000000 40,260000 40,260000 72,468000 8,052000
1.189 W41591001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE (R) 50 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 50mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE P-RF 1 20,082150 14,167850 10,041075 24,208925 18,073935 16,176065
1.190 W65209001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE 50 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 50µg/doza GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE P-RF 1 20,082150 14,167850 10,041075 24,208925 18,073935 16,176065
Pagina 19 din 21
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)
1.191 W12420003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 0,5 mg/2 ml 0,5mg/2ml
SUSP. INHAL. PRIN NEBULIZATOR GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP PRF 10 0,669404 3,244596 0,334702 3,579298 0,602463 3,311537
1.192 W65204003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 0,5 mg/2 ml 0,5mg/2ml
SUSP. INHAL. PRIN NEBULIZATOR GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP. INHAL. PRIN NEBULIZATOR PRF 10 0,669404 3,244596 0,334702 3,579298 0,602463 3,311537
1.193 W12419003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 2 mg/2 ml 2mg/2ml
SUSP. INHAL. PRIN NEBULIZATOR GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP PRF 10 2,677619 6,582381 1,338809 7,921191 2,409857 6,850143
1.194 W65205003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 2 mg/2 ml 2mg/2ml
SUSP. INHAL. PRIN NEBULIZATOR GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP. INHAL. PRIN NEBULIZATOR PRF 10 2,677619 6,582381 1,338809 7,921191 2,409857 6,850143
1.195 W57957001 R03BA07 MOMETASONUM * ASMANEX TWISTHALER 200 µg PULB. INHAL.200µg/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L 1 32,435000 4,995000 16,217500 21,212500 29,191500 8,238500
1.196 W57956002 R03BA07 MOMETASONUM * ASMANEX TWISTHALER 400 µg PULB. INHAL.400µg/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L 1 61,540000 0,000000 30,770000 30,770000 55,386000 6,154000
1.197 W64226001 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER 160micrograme/doza
SOL. DE INHALAT PRESURIZATA ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA PRF 1 90,390000 0,000000 45,195000 45,195000 81,351000 9,039000
1.198 W57488004 R03BB04 TIOTROPIUM * SPIRIVA 18 micrograme CAPS. CU PULB. INHAL. 18micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. AL/PVC/AL X 10 CAPS. CU PULB. DE INHALAT + 1 DISPOZITIV HANDIHALER PRF 30 4,563416 0,118250 2,281708 2,399958 4,107074 0,574592
1.199 W63214002 R03BB04 TIOTROPIUM * GREGAL 10 micrograme PULB. DE INHAL. CAPSULA 10micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEÎD CU CAPAC CU FILET DIN PP, FOLIE PROTECTOARE DIN PE, INEL DE SIGILARE SI CU REZERVOR DIN PEÎD CARE CONTINE SILICAGEL CU 30 CAPSULE SI UN INHALATOR ZONDA PRF 30 4,103333 0,000000 2,051666 2,051667 3,692999 0,410334
1.200 W58575005 R03BB04 TIOTROPIUM * SPIRIVA RESPIMAT 2,5 micrograme SOL. DE INHALAT 2,5micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 INHALATOR RESPIMAT RE-UTILIZABIL SI 1 CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. DE INHALAT PRF 1 136,902495 3,547505 68,451247 71,998753 123,212245 17,237755
1.201 W58575007 R03BB04 TIOTROPIUM * SPIRIVA RESPIMAT 2,5 micrograme SOL. DE INHALAT 2,5micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. DE INHALAT PRF 1 135,720000 0,000000 67,860000 67,860000 122,148000 13,572000
1.202 W59574003 R03BB06 GLICOPIRONIUM BROMIDUM ** SEEBRI BREEZHALER CAPS. CU PULB. INHAL. 44 micrograme NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. PERFORATE PA-AL-PVC/AL CE CONTINE 30 X 1 CAPSULA CU PULBERE PENTRU INHALAT INSOTITE DE UN INHALATOR PRF 30 4,563416 0,288917 2,281708 2,570625 4,107074 0,745259
1.203 W64726003 R03BB06 GLICOPIRONIUM BROMIDUM ** SEEBRI BREEZHALER CAPS. CU PULB. INHAL. 44 micrograme NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. PERFORATE PA-AL-PVC/AL CE CONTINE 30 X 1 CAPSULA CU PULBERE PENTRU INHALAT INSOTITE DE UN INHALATOR PRF 30 4,563416 0,288917 2,281708 2,570625 4,107074 0,745259
1.204 W42796002 R03DA05 AMINOPHYLLINUM MIOFILIN 100 mg CAPS. 100mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,150481 0,250019 0,075240 0,325260 0,135432 0,265068
1.205 W42330001 R03DA05 AMINOPHYLLINUM AMINOFILINA EEL COMPR. 100mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0,150481 0,042119 0,075240 0,117360 0,135432 0,057168
1.206 W57342001 R03DA05 AMINOPHYLLINUM MIOFILIN 24mg/ml SOL. INJ. 24mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU INEL DE RUPERE X 10 ML SOL.INJ. S/P-RF 5 5,252000 0,000000 2,626000 2,626000 4,726800 0,525200
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 1,045000 1,493571 0,522500 2,016071 0,940500 1,598071
1.208 W56500003 R03DC03 MONTELUKASTUM * MONTELUKAST ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,873000 0,000000 0,436500 0,436500 0,785700 0,087300
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 1,045000 0,000000 0,522500 0,522500 0,940500 0,104500
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 1,045000 0,793928 0,522500 1,316428 0,940500 0,898428
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 1,045000 0,793928 0,522500 1,316428 0,940500 0,898428
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 0,819666 0,000000 0,409833 0,409833 0,737699 0,081967
1.213 W56684005 R03DC03 MONTELUKASTUM * MONKASTA 4 mg COMPR. MAST. 4mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L 28 0,607142 0,000000 0,303571 0,303571 0,546427 0,060715
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
1.215 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 1,145404 1,384953 0,572702 1,957655 1,030863 1,499494
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 1,145404 0,555667 0,572702 1,128369 1,030863 0,670208
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 1,431755 0,407173 0,715877 1,123051 1,288579 0,550349
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 1,431755 1,106816 0,715877 1,822694 1,288579 1,249992
1.219 W56685005 R03DC03 MONTELUKASTUM * MONKASTA 5 mg COMPR. MAST. 5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L 28 0,769285 0,000000 0,384642 0,384643 0,692356 0,076929
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
1.221 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 1,431755 0,407173 0,715877 1,123051 1,288579 0,550349
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 1,145404 1,384953 0,572702 1,957655 1,030863 1,499494
1.223 W61978001 R05DA09 DEXTROMETHORPHANUM ROFEDEX 10 mg COMPR. 10mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,218187 0,166813 0,109093 0,275907 0,196368 0,188632
1.224 W59312001 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE 20 mg COMPR. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,376500 0,000000 0,188250 0,188250 0,338850 0,037650
1.225 W61979001 R05DA09 DEXTROMETHORPHANUM ROFEDEX 20 mg COMPR. 20mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,376500 0,000000 0,188250 0,188250 0,338850 0,037650
1.226 W06856002 R05DA09 DEXTROMETHORPHANUM ROFEDEX SIROP 15mg/5ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOARE P-RF 1 6,545628 2,694372 3,272814 5,967186 5,891065 3,348935
1.227 W54808002 R05DA09 DEXTROMETHORPHANUM TUSSIN 6,5mg/5ml SIROP 6,5mg/5ml ROPHARMA S.A. ROMANIA CUTIE X 1 FLAC. X 115ML SIROP + O LINGURITA DOZATOARE GRADATA LA 1,25ML; 2,5ML SI 5 ML P-RF 1 3,261905 12,148095 1,630952 13,779048 2,935714 12,474286
1.228 W56019002 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN JUNIOR SOL. ORALA 3,75mg/5ml PFIZER CORPORATION AUSTRIA GMBH AUSTRIA CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M P-RF 1 9,550000 0,000000 4,775000 4,775000 8,595000 0,955000
1.229 W56020002 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN ANTITUSSICUM SOL. ORALA 7,5mg/5ml PFIZER CORPORATION AUSTRIA GMBH AUSTRIA CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M P-RF 1 3,272813 6,277187 1,636406 7,913594 2,945531 6,604469
1.230 W60140007 R06AE09 LEVOCETIRIZINUM ZENARO 5 mg COMPR. FILM. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 20 COMPR. FILM. P6L 20 0,601000 0,000000 0,300500 0,300500 0,540900 0,060100
1.231 W60140017 R06AE09 LEVOCETIRIZINUM ZENARO 5 mg COMPR. FILM. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L 20 0,601000 0,000000 0,300500 0,300500 0,540900 0,060100
1.232 W65372011 R06AE09 LEVOCETIRIZINUM XYZAL 5 mg COMPR. FILM. 5mg UCB PHARMA GMBHGERMANIA CUTIE CU 3 BLIST. PVC-AL-OPA/AL X 10 COMPR. FILM. P6L 30 0,810000 0,000000 0,405000 0,405000 0,729000 0,081000
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 25,092000 2,478000 12,546000 15,024000 22,582800 4,987200
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
1.235 W58016006 R06AX27 DESLORATADINUM DESLORATADINA ACTAVIS COMPR. FILM. 5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X30 PRF 30 0,265000 0,000000 0,132500 0,132500 0,238500 0,026500
1.236 W58162004 R06AX27 DESLORATADINUM DASSELTA COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE PRF 30 0,389333 0,000000 0,194666 0,194667 0,350399 0,038934
1.237 W58483007 R06AX27 DESLORATADINUM DESLORATADINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. PCTFE-PVC/AL X 30 COMPR. FILM. P6L 30 0,453833 0,138500 0,226916 0,365417 0,408449 0,183884
1.238 W58380003 R06AX27 DESLORATADINUM LORDESTIN 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,453833 0,088500 0,226916 0,315417 0,408449 0,133884
1.239 W60471006 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 10 0,453833 0,286167 0,226916 0,513084 0,408449 0,331551
1.240 W60471011 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 30 0,453833 0,285167 0,226916 0,512084 0,408449 0,330551
1.241 W63751004 R06AX27 DESLORATADINUM DESLORATADINA AMRING 5 mg COMPR. FILM. 5mg AMRING FARMA SRLROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 COMPR. FILM. P6L 30 0,453833 0,138500 0,226916 0,365417 0,408449 0,183884
1.242 W64162003 R06AX27 DESLORATADINUM DESLORATADINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,424333 0,000000 0,212166 0,212167 0,381899 0,042434
1.243 W64699011 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME OLANDA CUTIE CU 30 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 30 0,453833 0,285167 0,226916 0,512084 0,408449 0,330551
1.244 W64699006 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME OLANDA CUTIE CU 10 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 10 0,453833 0,286167 0,226916 0,513084 0,408449 0,331551
1.245 W58720004 R06AX27 DESLORATADINUM DESLORATADINA SANDOZ 0.5 mg/ml SOL. ORALA 0,5 mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 125 ML X 120 ML, SOL. ORALA + LINGURITA DOZATOARE DE 2,5 ML SI 5 ML SAU CU SERINGA DOZATOARE DE 5 ML, MARCATA LA FIECARE 0,5ML P6L 1 11,390000 0,000000 5,695000 5,695000 10,251000 1,139000
1.246 W60474006 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SOL. ORALA 0,5mg/ml MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML P-RF 1 11,390000 2,030000 5,695000 7,725000 10,251000 3,169000
1.247 W60622002 R06AX27 DESLORATADINUM LORDESTIN 0,5 mg/ml SOL. ORALA 0,5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU O LINGURITA DOZATOARE GRADATA LA 2,5 ML SI 5 ML X 120 ML SOL. P6L 1 11,390000 0,000000 5,695000 5,695000 10,251000 1,139000
1.248 W64712005 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SOL. ORALA 0,5mg/ml MERCK SHARP & DOHME OLANDA CUTIE CU 1 FLAC. DIN STICLA X 120 ML SOL. ORALA + LINGURITA DOZATOARE DE 2,5 ML SI 5 ML PRF 1 11,390000 2,030000 5,695000 7,725000 10,251000 3,169000
1.249 W44051001 S01AA11 GENTAMICINUM GENTAMICINA SULFAT EIPICO 3 mg/ml PIC. OFT., SOL 3mg/ml E.I.P.I.CO. MED S.R.L.ROMANIA CUTIE CU 1 FLAC. DIN PEJD PREVAZUT CU PICURATOR X 10 ML PIC. OFT. SOL. P-RF 1 9,940000 0,000000 4,970000 4,970000 8,946000 0,994000
1.250 W53829001 S01AA12 TOBRAMYCINUM TOBROM 3 mg/ml PIC. OFT., SOL 3mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE C 1 FLAC. PEJD X 5 ML PIC. OFT. SOL P-RF 1 4,380000 0,000000 2,190000 2,190000 3,942000 0,438000
1.251 W10602001 S01AA12 TOBRAMYCINUM TOBREX PIC. OFT.,SOL. 3mg/ml ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD CU PICURATOR X 5 ML PIC. OFTALMICE, SOL. P-RF 1 8,415833 0,044167 4,207916 4,252084 7,574249 0,885751
1.252 W63542001 S01AA12 TOBRAMYCINUM TOBREX 3 mg/ml PIC. OFT.,SOL. 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 1 FLACON DIN PEJD, PREVAZUT CU PICURATOR DIN PEJD CARE CONTINE 5 ML PIC. OFTALMICE, SOL. PRF 1 8,415833 0,044167 4,207916 4,252084 7,574249 0,885751
1.253 W42218001 S01AA12 TOBRAMYCINUM TOBREX 2 X PICATURI OFT.-SOL. 0,3% ALCON COUVREUR NV BELGIA CUTIE CU 1 FLAC. DIN PEJD, PREVAZUT CU PICURATOR DIN PEJD CARE CONTINE 5 ML PIC. OFT., SOL. P-RF 1 8,415833 12,744167 4,207916 16,952084 7,574249 13,585751
Pagina 20 din 21
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)
1.254 W63544001 S01AA12 TOBRAMYCINUM TOBREX 2 X 3 mg/ml PICATURI OFT.-SOL. 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN PEJD, PREVAZUT CU PICURATOR DIN PEJD CARE CONTINE 5 ML PIC. OFT., SOL. PRF 1 8,415833 12,744167 4,207916 16,952084 7,574249 13,585751
1.255 W05932001 S01AA12 TOBRAMYCINUM TOBREX (R) UNG. OFT. 0,3% ALCON COUVREUR NV BELGIA CUTIE X 1 TUB DIN AL X 3,5 G UNGUENT OFTALMIC P-RF 1 6,311875 2,868125 3,155937 6,024063 5,680687 3,499313
1.256 W63543001 S01AA12 TOBRAMYCINUM TOBREX 3 mg/g UNG. OFT. 3mg/g NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 TUB DIN AL X 3,5 G UNGUENT OFTALMIC P-RF 1 6,311875 2,868125 3,155937 6,024063 5,680687 3,499313
1.257 W12757001 S01AA23 NETILMICINUM NETTACIN 3 mg/ml PIC. OFT., SOL 3mg/ml S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 15,760000 0,000000 7,880000 7,880000 14,184000 1,576000
1.258 W41510001 S01AA23 NETILMICINUM NETTACIN 3 mg/ml PICATURI OFT.-SOL. 3mg/ml S.I.F.I. SPA ITALIA CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML P-RF 15 1,368900 0,775100 0,684450 1,459550 1,232010 0,911990
1.259 W65421001 S01AA23 NETILMICINUM NETTACIN 3 mg/g UNG. OFT. 3mg/g SIFI S.P.A. ITALIA CUTIE CU 1 TUB DIN AL PREVAZUT CU APLICATOR DIN PEJD X 5 G UNG. OFT. PRF 1 22,815000 12,125000 11,407500 23,532500 20,533500 14,406500
1.260 W41891001 S01AE01 OFLOXACINUM FLOXAL 3 mg/ml PICATURI OFT.-SOL. 3mg/ml DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE CU 1 FLACON PICURATOR DIN PEJD X 5 ML PICATURI OFT., SOL. P6L 1 11,212500 2,637500 5,606250 8,243750 10,091250 3,758750
1.261 W41890001 S01AE01 OFLOXACINUM FLOXAL 3 mg/g UNG. OFT. 3mg/g DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE CU 1 TUB DIN AL LAMINAT, CU DOP PREVAZUT CU VARF APLICATOR DIN PEID SI CAPAC DIN PEID X 3 G UNGUENT P6L 1 15,500000 0,000000 7,750000 7,750000 13,950000 1,550000
1.262 W55648001 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT., SUSPENSIE P-RF 1 5,860000 0,000000 2,930000 2,930000 5,274000 0,586000
1.263 W02427001 S01BA01 DEXAMETHASONUM MAXIDEX (R) PICATURI OFT.-SUSP. 0,1% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 6,205000 0,115000 3,102500 3,217500 5,584500 0,735500
1.264 W63597001 S01BA01 DEXAMETHASONUM MAXIDEX 1 mg/ml PICATURI OFT.-SUSP. 1 mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 6,205000 0,115000 3,102500 3,217500 5,584500 0,735500
1.265 W60319001 S01BA06 BETAMETHASONUM OPHTAMESONE 1 mg/ml PIC. OFT./AURIC./NAZALE SOL. 1 mg/ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD, PREVAZUT CU APLICATOR PT. PICURARE DIN PEJD A 10 ML PIC. OFT., AURICULARE, NAZALE SOL. P6L 1 11,000000 0,000000 5,500000 5,500000 9,900000 1,100000
1.266 W43769001 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX 3 mg/1 mg/ml PIC. OFT.,SOL. 3mg/1mg/ml S.I.F.I. SPA ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.SOL. P-RF 1 7,488000 26,282000 3,744000 30,026000 6,739200 27,030800
1.267 W43768002 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) Netildex 3 mg/1 mg/ml PIC. OFT.SOL. UNIDOZA 3mg/1mg/ml S.I.F.I. SPA ITALIA CUTIE X 20 FLAC. UNIDOZA DIN PEJD X 0,3 ML PIC.OFT. SOL. P-RF 20 0,449280 2,401720 0,224640 2,626360 0,404352 2,446648
1.268 W58786001 S01CA01 COMBINATII (CLORAMPHENICOLUM+DEXAMETHASONUM) SPERSADEX COMP PICATURI OFT.-SOL. 5mg/ml+1mg/ml LABORATOIRES THEA FRANTA CUTIE X 1 FLACON X 5 ML SOL. OFT. + PICURATOR P-RF 1 7,488000 6,392000 3,744000 10,136000 6,739200 7,140800
1.269 W55127001 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) DEXATOBROM 3 mg+1 mg/ml PIC. OFT. SUSP. 3mg+1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD A 5 ML + PICURATOR P-RF 1 5,410000 0,000000 2,705000 2,705000 4,869000 0,541000
1.270 W11950002 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX ( R ) PICATURI OFT.-SUSP. 3mg+1mg/ml ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR PEJD X 5 ML P-RF 1 7,488000 0,832000 3,744000 4,576000 6,739200 1,580800
1.271 W63594001 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX PICATURI OFT.-SUSP. 3mg/1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN PEJD, PREVAZUT CU PICURATOR DIN PEJD X 5 ML PIC. OFT., SUSP. PRF 1 7,488000 0,832000 3,744000 4,576000 6,739200 1,580800
1.272 W02225001 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX (R) UNG. OFT. 3 mg/1 mg/g ALCON COUVREUR NV BELGIA CUTIE X 1 TUB AL, PREVAZUT CU APLICATOR PEID X 3,5 G P-RF 1 5,241600 8,778400 2,620800 11,399200 4,717440 9,302560
1.273 W63595001 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX UNG. OFT. 3mg/1mg/g NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 1 TUB AL, PREVAZUT CU APLICATOR DIN PEJD X 3,5 G UNG. OFT. PRF 1 5,241600 8,778400 2,620800 11,399200 4,717440 9,302560
1.274 W12189001 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML P-RF 1 19,439999 0,050001 9,719999 9,770001 17,495999 1,994001
1.275 W63173001 S01GX09 OLOPATADINUM OLOPATADINA ROMPHARM 1 mg/ml PIC. OFT., SOL. 1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB. DIN PEJD X 5 ML PIC. OFT. SOL., PREVAZUT CU PICURATOR ALB DIN PEJD PRF 1 19,290000 0,000000 9,645000 9,645000 17,361000 1,929000
1.276 W63546001 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml NOVARTIS EUROPHARM LTD. CUTIE X 1 FLACON X 5 ML
MAREA BRITANIE P-RF 1 19,439999 0,050001 9,719999 9,770001 17,495999 1,994001
1.277 W64476001 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. X 5 ML PRF 1 19,439999 0,050001 9,719999 9,770001 17,495999 1,994001
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;
- 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;
- 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.
Pagina 21 din 21
ANEXA 2c
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;
MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE
VALABILĂ ÎNCEPÂND CU 01 IULIE 2020
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,242000 0,242000 0,000000
2 W62461001 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg MERUS LABS LUXCO II S.A.R.L. LUXEMBURGCUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,362000 0,362000 0,000000
3 W58535002 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,297200 0,297200 0,000000
4 W66390001 C01AA05 DIGOXINUM DIGOXIN LECIVA 0,25 mg COMPR. 0,25mg S.C. ZENTIVA S.A. ROMANIA CUTIE CU 1 BLISTER X 30 COMPR. PRF 30 0,282000 0,282000 0,000000
5 W60427001 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,5 mg/2ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ROSU SI PORTOCALIU)X 2 ML SOL. INJ. P-RF 5 3,538000 3,538000 0,000000
6 W43198002 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0,369600 0,369600 0,000000
7 W03265002 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,201600 0,201600 0,069400
8 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,201600 0,201600 0,129900
9 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,201600 0,201600 0,132900
10 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,201600 0,201600 0,132900
11 W03264003 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L 30 0,201600 0,201600 0,132733
12 W03265003 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0,168000 0,168000 0,000000
13 W65259002 C03CA01 FUROSEMIDUM FUROSEMID HAMELN 10 mg/ml SOL INJ. 10mg/ml HAMELN PHARMA PLUS GMBH GERMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA DE TIP I, PREVAZUTE CU PUNCT DE RUPERE A CATE 2 ML SOL. INJ. PRF 10 1,350000 1,350000 0,000000
14 W58282001 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,350000 1,350000 0,000000
15 W54824001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,795666 0,795666 0,000000
16 W55360002 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 25 mg CAPS. 25mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L 50 0,396200 0,396200 0,000000
17 W57830002 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 0,396166 0,396166 0,000000
18 W54823001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,467000 0,467000 0,000000
19 W55359001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L 30 0,560400 0,560400 0,173933
20 W60370001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,396000 0,396000 0,000000
21 W08893001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 0,396200 0,396200 0,000000
22 W52138001 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,396000 0,396000 0,000000
23 W41550001 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,560400 0,560400 0,175100
24 W04263002 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,262399 0,262399 0,054601
25 W04266001 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,262399 0,262399 0,055101
26 W07222003 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,262399 0,262399 0,054601
27 W42176001 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,262399 0,262399 0,054601
28 W52230001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,262399 0,262399 0,054601
29 W53669001 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mg COMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,262399 0,262399 0,055101
30 W53941002 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,262399 0,262399 0,050934
31 W57206001 C07AB02 METOPROLOLUM METOPROLOL SLAVIA 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,262399 0,262399 0,045601
32 W59297001 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 0,218666 0,218666 0,000000
33 W42025001 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,149000 0,149000 0,000000
34 W53922001 C07AB02 METOPROLOLUM METOPROLOL ARENA 25 MG COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,154000 0,154000 0,000000
35 W42973003 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0,159500 0,159500 0,000000
36 W04264002 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,220200 0,220200 0,040800
37 W04268001 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 0,183500 0,183500 0,000000
38 W07223003 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,220200 0,220200 0,040800
39 W42197001 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,220200 0,220200 0,036133
40 W52231001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,220200 0,220200 0,040800
41 W53670001 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,185000 0,185000 0,000000
42 W53940001 C07AB02 METOPROLOLUM METOPROLOL ARENA 50 MG COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,192000 0,192000 0,000000
43 W57205001 C07AB02 METOPROLOLUM METOPROLOL SLAVIA 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,220200 0,220200 0,040800
44 W61714001 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 50 mg COMPR. 50mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,220200 0,220200 0,035466
Pagina 1 din 42
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
Pagina 2 din 42
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
Pagina 3 din 42
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
Pagina 4 din 42
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
1 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,242000 0,242000 0,000000
2 W62461001 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg MERUS LABS LUXCO II S.A.R.L. LUXEMBURG CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,362000 0,362000 0,000000
Tratamentul se iniţiază de către medicul în specialitatea cardiologie, chirurgie cardiovasculară şi chirurgie vasculară.
3. BOLNAVI CU PROCEDURI INTERVENTIONALE PERCUTANE, NUMAI DUPA IMPLANTAREA UNEI PROTEZE ENDOVASCULARE (STENT)- G3
1 W54317002 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 COMPR. FILM. P-RF 30 0,623000 0,623000 0,000000
2 W54317003 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 90 COMPR. FILM. P-RF 90 0,593777 0,593777 0,000000
3 W55445003 B01AC04 CLOPIDOGRELUM ** TESSYRON 75 mg COMPR. FILM. 75mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM. P-RF 30 0,712532 0,712532 0,015134
4 W56912006 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 30 0,712532 0,712532 0,434801
5 W57177005 B01AC04 CLOPIDOGRELUM ** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,712532 0,712532 0,116039
6 W54317007 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 30 COMPRIMATE FILMATE P-RF 30 0,613666 0,613666 0,000000
7 W54317009 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 90 COMPRIMATE FILMATE P-RF 90 0,593777 0,593777 0,000000
8 W59687002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,712532 0,712532 0,472110
9 W61520001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 0,712532 0,712532 0,992110
10 W61520013 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 30 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 30 0,712532 0,712532 1,609468
11 W65505007 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL-PA-PVC/AL X 30 COMPR. FILM. PRF 30 0,712532 0,712532 0,434801
12 W66019002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,712532 0,712532 0,472110
13 W66403001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 28 0,712532 0,712532 0,992110
14 W66403013 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 30 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 30 0,712532 0,712532 1,609468
15 W56291004 B01AC24 TICAGRELOR ** Ω BRILIQUE COMPR. FILM. 90 mg ASTRA ZENECA AB SUEDIA CUTIE X 4 BLISTERE CALENDAR DIN PVC-PVDC/AL X 14 COMPRIMATE FILMATE P-RF 56 5,835357 5,835357 0,000000
Tratamentul se iniţiază de către medicul în specialitatea cardiologie, chirurgie cardiovasculară şi chirurgie vasculară.
Pagina 5 din 42
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
1 W60057003 J05AB04 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )
MAREA BRITANIE P-RF/R 140 2,502070 2,502070 5,772430
2 W61374009 J05AB04 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,085059 2,085059 0,000000
3 W66449009 J05AB04 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
4 W62522002 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF 30 3,038000 3,038000 0,000000
5 W07518002 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 3,645600 3,645600 0,786542
6 W65306001 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) PR 28 3,645600 3,645600 0,786542
7 W60828015 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA PR
CUTIE CU 1 FLAC. DIN PEÎD CU CAPAC CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. 30 15,105999 15,105999 7,833667
8 W62771001 J05AF07 TENOFOVIRUM DISOPROXIL **1 VIROFOB 245 mg COMPR. FILM. 245mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID CU CAPAC DIN PP X 30 COMPR. FILM. PR 30 13,760666 13,760666 0,000000
9 W63256001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL MYLAN COMPR. FILM. 245mg MYLAN S.A.S FRANTA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM PR 30 13,761000 13,761000 0,000000
10 W63499004 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL SANDOZ 245 mg COMPR. FILM. 245mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID X 30 COMPR. FILM. PR 30 15,105999 15,105999 6,378001
11 W63769001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL ACCORD 245 mg COMPR. FILM. 245mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 15,105999 15,105999 7,537667
12 W64012002 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL AUROBINDO 245 mg COMPR. FILM. 245mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 12,588333 12,588333 0,000000
13 W65376001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL GLENMARK 245 mgCOMPR. FILM. 245mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. ALB DIN PEID X 30 COMPR. FILM. PR 30 15,095333 15,095333 0,000000
14 W65812001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL ACCORD 245 mg COMPR. FILM. 245mg POLONIA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM.
ACCORD HEALTHCARE POLSKA SP. Z O.O. PR 30 15,105999 15,105999 7,537667
15 W51522001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg MAREA BRITANIE
GILEAD SCIENCE INTERNATIONAL LIMITED CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 36,960666 36,960666 0,000000
16 W64757001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. DIN PEID X 30 COMPR. PR 30 36,960666 36,960666 0,000000
17 W51442002 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 5,463199 5,463199 20,158801
18 W63755007 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 5,463199 5,463199 5,298134
19 W63932001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANDOZ 0,5 mg COMPR. FILM. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 5,463199 5,463199 12,872467
20 W63755010 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 5,298134
21 W63777001 J05AF10 ENTECAVIRUM **1 ENTECAVIR GLENMARK 0,5 mg COMPR. FILM. 0,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 4,369467
22 W63911001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 30 X 1 COMPR. FILM. PR 30 5,463199 5,463199 12,892467
23 W63864001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 5,463199 5,463199 2,930801
24 W63812002 J05AF10 ENTECAVIRUM **1 ENTECAVIR DR. REDDY'S 0,5 mg COMPR. FILM. 0,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 34,637467
25 W63803001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 0,5 mg COMPR. FILM. 0,5mg MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM.
ALVOGEN MALTA OPERATIONS (ROW) LTD. PR 30 5,463199 5,463199 15,891467
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 15,891467
27 W64007001 J05AF10 ENTECAVIRUM **1 ENTECAVIR AUROBINDO 0,5 mg COMPR. FILM. 0,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 4,552666 4,552666 0,000000
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 5,463199 5,463199 2,594134
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 5,463199 5,463199 2,594134
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 5,463199 5,463199 2,594134
31 W63864002 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE DIN (OPA/AL/PVC-AL) X 30X1 COMPR. PR 30 5,463199 5,463199 2,930801
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 1,531467
33 W65671001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 30 X 1 COMPR. FILM. PR 30 5,463199 5,463199 12,892467
34 W65515002 J05AF10 ENTECAVIRUM **1 VIREN 0,5 mg COMPR. FILM. 0,5mg S.C. TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE AL/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 4,371134
35 W65556002 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5 mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) PR 30 5,463199 5,463199 20,158801
36 W51443002 J05AF10 ENTECAVIRUM **1 BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 10,927200 10,927200 14,694800
37 W63756007 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 10,927200 10,927200 17,578133
38 W63933001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANDOZ 1 mg COMPR. FILM. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 10,927200 10,927200 18,690800
39 W63756010 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 10,927200 10,927200 17,578133
40 W63843001 J05AF10 ENTECAVIRUM **1 ENTECAVIR GLENMARK 1 mg COMPR. FILM. 1mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 10,927200 10,927200 20,690133
41 W63912001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 30 X 1 COMPR. FILM. PR 30 10,927200 10,927200 14,658466
42 W63865001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 1 mg COMPR. FILM. 1mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 10,927200 10,927200 14,316133
43 W63813002 J05AF10 ENTECAVIRUM **1 ENTECAVIR DR. REDDY'S 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 10,927200 10,927200 32,160466
44 W63814001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 1 mg COMPR. FILM. 1mg MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM.
ALVOGEN MALTA OPERATIONS (ROW) LTD. PR 30 10,927200 10,927200 29,419800
45 W63756002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 10,927200 10,927200 18,690800
46 W63756005 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X 30X1 COMPR. FILM.PR 30 10,927200 10,927200 18,690800
47 W64008001 J05AF10 ENTECAVIRUM **1 ENTECAVIR AUROBINDO 1 mg COMPR. FILM. 1mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 9,106000 9,106000 0,000000
48 W65672001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 30 X 1 COMPR. FILM. PR 30 10,927200 10,927200 14,658466
49 W65516002 J05AF10 ENTECAVIRUM **1 VIREN 1 mg COMPR. FILM. 1mg S.C. TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE AL/AL X 30X1 COMPR. FILM. PR 30 10,927200 10,927200 20,690133
50 W65557002 J05AF10 ENTECAVIRUM **1 BARACLUDE 1 mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) PR 30 10,927200 10,927200 14,694800
51 W65558001 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,05 mg/ml SOL. ORALA 0,05mg/ml BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA CUTIE X 1 FLAC. DIN PEID X 210 ML SOL. ORALA + LINGURITA DOZATOARE PR 1 2.364,690000 2.364,690000 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
Pagina 6 din 42
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.
5. HEPATITA AUTOIMUNA - G5
1 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,573800 0,573800 0,000000
2 W65156001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 5 BLIST. AL-PVC/PVC X 10 COMPR. PRF 50 0,573800 0,573800 0,000000
3 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,303500 1,303500 0,000000
4 W65157001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. AL-PVC/PVC X 10 COMPR. PRF 20 1,303500 1,303500 0,000000
5 W08307001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg PULB+SOLV. PT. SOL. INJ./PERF. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML PRF 1 19,260000 19,260000 0,000000
6 W08310001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg PULB+SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML PRF 1 60,390000 60,390000 0,000000
7 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,650400 0,650400 0,000000
6. CIROZA BILIARA PRIMARA, COLANGITA SCLEROZANTA PRIMITIVA, HEPATITA CRONICA SI CIROZE DE ALTE ETIOLOGII CU COLESTAZA - G6
1 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. 100 1,234600 P6L 1,234600 0,000000
2 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. 50 1,300000 P-6L 1,300000 0,000000
3 W58710002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100 2,905300 2,905300 0,000000
4 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA P6L
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP 1 106,950000 106,950000 0,000000
Pagina 7 din 42
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
1 W62376001 A06AD11 LACTULOSUM DUPHALAC® LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML 1 P6L 11,330000 11,330000 0,000000
2 W64011001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML 1 P6L 11,680000 11,680000 0,000000
3 W64559001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% MYLAN HEALTHCARE B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 11,680000 11,680000 0,000000
4 W44054002 A06AD11 LACTULOSUM LACTULOSE EIPICO 650 mg/ml SIROP 650mg/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML P-6L 1 11,570000 11,570000 0,000000
5 W44054001 A06AD11 LACTULOSUM LACTULOSE EIPICO 650 mg/ml SIROP 650mg/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 3,840000 3,840000 0,000000
6 W63734001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 12 COMPR. FILM. PRF 12 2,772500 2,772500 0,000000
7 W63734002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL A CATE 12 COMPR. FILM. PRF 36 2,547777 2,547777 0,000000
8 W63735001 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFASIGMA S.P.A. ITALIA PRF 1
CUTIE CU UN FLACON DIN STICLA BRUNA CONTINÂND GRANULE PENTRU 60 ML SUSPENSIE ORALA, ÎNSOTIT DE O MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML. 21,160000 21,160000 0,000000
9 W03265002 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,201600 0,201600 0,069400
10 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,201600 0,201600 0,129900
11 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,201600 0,201600 0,132900
12 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,201600 0,201600 0,132900
13 W03264003 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L 30 0,201600 0,201600 0,132733
14 W03265003 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0,168000 0,168000 0,000000
15 W65259002 C03CA01 FUROSEMIDUM FUROSEMID HAMELN 10 mg/ml SOL INJ. 10mg/ml HAMELN PHARMA PLUS GMBH GERMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA DE TIP I, PREVAZUTE CU PUNCT DE RUPERE A CATE 2 ML SOL. INJ. PRF 10 1,350000 1,350000 0,000000
16 W58282001 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,350000 1,350000 0,000000
17 W54824001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,795666 0,795666 0,000000
18 W55360002 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 25 mg CAPS. 25mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L 50 0,396200 0,396200 0,000000
19 W57830002 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 0,396166 0,396166 0,000000
20 W54823001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,467000 0,467000 0,000000
21 W55359001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L 30 0,560400 0,560400 0,173933
22 W60370001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,396000 0,396000 0,000000
23 W08893001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 0,396200 0,396200 0,000000
24 W52138001 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,396000 0,396000 0,000000
25 W41550001 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,560400 0,560400 0,175100
26 W60057003 J05AB04 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2,502070 2,502070 5,772430
27 W61374009 J05AB04 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,085059 2,085059 0,000000
28 W66449009 J05AB04 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
29 W62522002 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF 30 3,038000 3,038000 0,000000
30 W07518002 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 3,645600 3,645600 0,786542
31 W65306001 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) PR 28 3,645600 3,645600 0,786542
32 W51522001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg MAREA BRITANIE
GILEAD SCIENCE INTERNATIONAL LIMITED CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 36,960666 36,960666 0,000000
33 W64757001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. DIN PEID X 30 COMPR. PR 30 36,960666 36,960666 0,000000
34 W51442002 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 5,463199 5,463199 20,158801
35 W63755007 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 5,463199 5,463199 5,298134
36 W63932001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANDOZ 0,5 mg COMPR. FILM. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 5,463199 5,463199 12,872467
37 W63755010 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 5,298134
38 W63777001 J05AF10 ENTECAVIRUM **1 ENTECAVIR GLENMARK 0,5 mg COMPR. FILM. 0,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 4,369467
39 W63911001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 30 X 1 COMPR. FILM. PR 30 5,463199 5,463199 12,892467
40 W63864001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 5,463199 5,463199 2,930801
41 W63812002 J05AF10 ENTECAVIRUM **1 ENTECAVIR DR. REDDY'S 0,5 mg COMPR. FILM. 0,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 34,637467
42 W63803001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 0,5 mg COMPR. FILM. 0,5mg MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM.
ALVOGEN MALTA OPERATIONS (ROW) LTD. PR 30 5,463199 5,463199 15,891467
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 15,891467
44 W64007001 J05AF10 ENTECAVIRUM **1 ENTECAVIR AUROBINDO 0,5 mg COMPR. FILM. 0,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 4,552666 4,552666 0,000000
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 5,463199 5,463199 2,594134
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 5,463199 5,463199 2,594134
47 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 5,463199 5,463199 2,594134
48 W63864002 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE DIN (OPA/AL/PVC-AL) X 30X1 COMPR. PR 30 5,463199 5,463199 2,930801
49 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 1,531467
50 W65671001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 30 X 1 COMPR. FILM. PR 30 5,463199 5,463199 12,892467
51 W65515002 J05AF10 ENTECAVIRUM **1 VIREN 0,5 mg COMPR. FILM. 0,5mg S.C. TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE AL/AL X 30X1 COMPR. FILM. PR 30 5,463199 5,463199 4,371134
52 W65556002 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5 mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) PR 30 5,463199 5,463199 20,158801
53 W51443002 J05AF10 ENTECAVIRUM **1 BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 10,927200 10,927200 14,694800
Pagina 8 din 42
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
1 W56153001 A04AA01 ONDANSETRONUM ** OSETRON 4 mg COMPR. FILM. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 2,116000 2,116000 0,000000
2 W56154001 A04AA01 ONDANSETRONUM ** OSETRON 8 mg COMPR. FILM. 8mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 3,580000 3,580000 0,000000
3 W63617002 A04AA01 ONDANSETRONUM ** ONDANSETRON AUROBINDO 2 mg/ml SOL INJ./PERF. 2mg/ml AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA TIP I, PREVAZUTE CU PUNCT DE RUPERE SAU MARCAJ LINIAR X 2 ML SOL. INJ./PERF. PR 5 5,232000 5,232000 0,000000
4 W63617005 A04AA01 ONDANSETRONUM ** ONDANSETRON AUROBINDO 2 mg/ml SOL INJ./PERF. 2mg/ml AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA TIP I, PREVAZUTE CU PUNCT DE RUPERE SAU MARCAJ LINIAR X 4 ML SOL. INJ./PERF. PR 5 9,624000 9,624000 0,000000
5 W57423001 A04AA01 ONDANSETRONUM ** OSETRON 4 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE 1 BLIST. AL/PVC X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 5,288000 5,288000 0,000000
6 W57424001 A04AA01 ONDANSETRONUM ** OSETRON 8 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 5 FIOLE X 4 ML SOL. INJ. S/P-RF 5 9,726000 9,726000 0,000000
Pagina 9 din 42
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
Pagina 10 din 42
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
Pagina 11 din 42
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
Pagina 12 din 42
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
Pagina 13 din 42
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 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
1 W42801002 N03AA02 PHENOBARBITALUM FENOBARBITAL ZENTIVA 100 mg COMPR. 100 mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,195200 0,195200 0,000000
2 W57366002 N03AA02 PHENOBARBITALUM FENOBARBITAL ARENA 100mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLISTERE DIN PVC/AL A CÂTE 10 COMPRIMATE P-RF 30 0,200333 0,200333 0,000000
3 W42870001 N03AA02 PHENOBARBITALUM FENOBARBITAL ZENTIVA 100 mg/ml SOL. INJ. 100 mg/ml ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 5 3,652000 3,652000 0,000000
4 W12143001 N03AB02 PHENYTOINUM FENITOINA RICHTER 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,153500 0,153500 0,000000
5 W64010002 N03AB02 PHENYTOINUM FENITOINA SODICA ACCORD 50 mg/ml SOL INJ./PERF. 50mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 5 FIOLE IN TAVITA DIN POLISTIREN, DIN STICLA TRANSPARENTA CU CAPACITATEA DE 5 ML X 5 ML SOL. INJ./PERF. PRF 5 14,790000 14,790000 0,000000
6 W64010005 N03AB02 PHENYTOINUM FENITOINA SODICA ACCORD 50 mg/ml SOL INJ./PERF. 50mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 5 FIOLE IN BLISTER DIN PVC/HARTIE, DIN STICLA TRANSPARENTA CU CAPACITATEA DE 5 ML X 5 ML SOL. INJ./PERF. PRF 5 14,790000 14,790000 0,000000
7 W55235001 N03AB02 PHENYTOINUM PHENHYDAN 250 mg/5 ml SOL. INJ. 250mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 5 ML SOL. INJ.P-RF 5 14,790000 14,790000 0,000000
8 W00806001 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,151600 0,151600 0,000000
9 W00797001 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN BIOEEL 200 mg COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,152000 0,152000 0,000000
10 W00798002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,152000 0,152000 0,000000
11 W12403003 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA SLAVIA 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,151600 0,151600 0,000000
12 W62172002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA TERAPIA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,151600 0,151600 0,000000
13 W62477001 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA FARMEX 200 mg COMPR. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,151000 0,151000 0,000000
14 W00807001 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,420400 0,420400 0,000000
15 W53816001 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 400 mg COMPR. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,420000 0,420000 0,000000
16 W58631001 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 150 mg COMPR. CU ELIB. PRELUNGITA 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA P6L 50 0,325400 0,325400 0,000000
17 W58632001 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 300 mg COMPR. CU ELIBERARE PRELUNGITA 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,421200 0,421200 0,020800
18 W58633001 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 600 mg COMPR. CU ELIBERARE PRELUNGITA 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 0,783400 0,783400 0,000000
19 W12426001 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L 50 0,351000 0,351000 0,000000
20 W63239001 N03AF01 CARBAMAZEPINUM NEUROTOP RETARD 300 mg COMPR. ELIB. PREL. 300mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P6L 50 0,351000 0,351000 0,000000
21 W12428001 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P-6L 50 0,712200 0,712200 0,000000
22 W63238001 N03AF01 CARBAMAZEPINUM NEUROTOP RETARD 600 mg COMPR. ELIB. PREL. 600mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P6L 50 0,712200 0,712200 0,000000
23 W00825001 N03AF01 CARBAMAZEPINUM TIMONIL 100 mg/5 ml SUSP. ORALA 100mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 25,010000 25,010000 0,000000
24 W51417002 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 300 mg COMPR. FILM. 300mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 0,950200 0,950200 0,000000
25 W51416002 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 600 mg COMPR. FILM. 600mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 1,444200 1,444200 0,000000
26 W08721001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 150 mg CAPS. ELIB. PREL. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 0,213960 0,213960 0,166840
27 W60320001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,178300 0,178300 0,000000
28 W63234001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,178300 0,178300 0,000000
29 W60321001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,248500 0,248500 0,000000
30 W63235001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,248500 0,248500 0,000000
31 W60322001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,322800 0,322800 0,000000
32 W63236001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,322800 0,322800 0,000000
33 W06973001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100 0,298200 0,298200 0,070300
34 W64667001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI ROMANIA SRL ROMANIA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100 0,298200 0,298200 0,070300
35 W10512001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. PP X 30 COMPR. ELIB. PREL. P-RF 30 0,387360 0,387360 0,130306
36 W64666001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PP X 30 COMPR. ELIB. PREL. P-RF 30 0,387360 0,387360 0,130306
37 W07649002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,321000 0,321000 0,000000
38 W64668001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,321000 0,321000 0,000000
39 W08325001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 50 MINI-PLICURI DIN HARTIE/AL/PE CU MINI-COMPR. CU ELIB. PRELUNG. P-6L 50 2,026400 2,026400 0,000000
40 W43170001 N03AG01 ACIDUM VALPROICUM + SARURI VALEPIL 200 mg/5 ml SIROP 200mg/5ml ARENA GROUP S.A. ROMANIA P-6L
CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 100 ML SI O LINGURITA DOZATOARE DUBLA (2,5/5 ML) 1 17,980000 17,980000 0,000000
41 W06972001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 19,770000 19,770000 0,000000
42 W06972002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P-6L 1 19,770000 19,770000 0,000000
Pagina 14 din 42
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
Pagina 15 din 42
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
Pagina 16 din 42
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
Pagina 17 din 42
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
Pagina 18 din 42
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
1 W05242001 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,146500 0,146500 0,000000
2 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,147000 0,147000 0,000000
3 W53341001 H02AB07 PREDNISONUM PREDNISONA-RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,142500 0,142500 0,000000
4 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,650400 0,650400 0,000000
5 W52868002 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. P-6L 60 0,869833 0,869833 0,000000
6 W57190001 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg MEDA AB SUEDIA CUTIE X 1 FLAC. X 20 DRAJ. P-RF 20 0,685500 0,685500 0,000000
1 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR.
MAREA BRITANIE P-RF 50 0,573800 0,573800 0,000000
2 W65156001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG BELGIA
CUTIE CU 5 BLIST. AL-PVC/PVC X 10 COMPR. PRF 50 0,573800 0,573800 0,000000
3 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,303500 1,303500 0,000000
4 W65157001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. AL-PVC/PVC X 10 COMPR. PRF 20 1,303500 1,303500 0,000000
5 W08307001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg PULB+SOLV. PT. SOL. INJ./PERF. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML PRF 1 19,260000 19,260000 0,000000
6 W08310001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg PULB+SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML PRF 1 60,390000 60,390000 0,000000
7 W05242001 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,146500 0,146500 0,000000
8 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,147000 0,147000 0,000000
9 W53341001 H02AB07 PREDNISONUM PREDNISONA-RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,142500 0,142500 0,000000
10 W42735002 L01DB07 MITOXANTRONUM ** ONKOTRONE CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. PR 1 614,130000 614,130000 0,000000
11 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,650400 0,650400 0,000000
Pagina 19 din 42
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
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
1 W08721001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 150 mg CAPS. ELIB. PREL. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 0,213960 0,213960 0,166840
2 W60320001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,178300 0,178300 0,000000
3 W63234001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,178300 0,178300 0,000000
4 W60321001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,248500 0,248500 0,000000
5 W63235001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,248500 0,248500 0,000000
6 W60322001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,322800 0,322800 0,000000
7 W63236001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,322800 0,322800 0,000000
8 W06973001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100 0,298200 0,298200 0,070300
9 W64667001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI ROMANIA SRL ROMANIA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100 0,298200 0,298200 0,070300
10 W10512001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. PP X 30 COMPR. ELIB. PREL. P-RF 30 0,387360 0,387360 0,130306
11 W64666001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PP X 30 COMPR. ELIB. PREL. P-RF 30 0,387360 0,387360 0,130306
12 W07649002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,321000 0,321000 0,000000
13 W64668001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,321000 0,321000 0,000000
14 W08325001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 50 MINI-PLICURI DIN HARTIE/AL/PE CU MINI-COMPR. CU ELIB. PRELUNG. P-6L 50 2,026400 2,026400 0,000000
15 W43170001 N03AG01 ACIDUM VALPROICUM + SARURI VALEPIL 200 mg/5 ml SIROP 200mg/5ml ARENA GROUP S.A. ROMANIA P-6L
CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 100 ML SI O LINGURITA DOZATOARE DUBLA (2,5/5 ML) 1 17,980000 17,980000 0,000000
16 W06972001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 19,770000 19,770000 0,000000
17 W06972002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P-6L 1 19,770000 19,770000 0,000000
18 W64489001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 57,64 mg/ml SIROP 57,64mg/ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P6L 1 19,770000 19,770000 0,000000
19 W64489002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 57,64 mg/ml SIROP 57,64mg/ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P6L 1 19,770000 19,770000 0,000000
20 W42997002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,943333 0,943333 0,000000
21 W03925008 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 1,131999 1,131999 0,140858
22 W65105001 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 1,131999 1,131999 0,140858
23 W42996002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1,893666 1,893666 0,000000
24 W12304010 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 0,159642 0,159642 0,000000
25 W65103003 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,159642 0,159642 0,000000
26 W42995002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,531666 0,531666 0,000000
27 W09000001 N03AX09 LAMOTRIGINUM ** LAMICTAL 2 mg COMPR. DISP./MAST. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST. P-6L 30 0,009333 0,009333 0,000000
28 W03929004 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. DISP./MAST. 5mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST. P-6L 30 0,027666 0,027666 0,000000
29 W65102001 N03AX09 LAMOTRIGINUM ** LAMICTAL 2 mg COMPR. MAST./DISP. 2mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 FLAC. DIN PEID X 30 COMPR. MAST./DISP. P6L 30 0,009333 0,009333 0,000000
30 W65101004 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. MAST./DISP. 5mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. MAST./DISP. P6L 30 0,027666 0,027666 0,000000
31 W06002001 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,602200 0,602200 0,000000
32 W52419001 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,179500 0,179500 0,000000
33 W60383001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,285666 0,285666 0,000000
34 W60384001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF 30 0,399666 0,399666 0,000000
35 W56620001 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF 1 5,780000 5,780000 0,000000
36 W61980001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg/ml PIC. ORALE, SOL. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CARE CONTINE 10 ML PICATURI ORALE, SOL., PREVAZUT CU PICURATOR DIN PEJD PRF 1 6,936000 6,936000 0,444000
37 W03427002 N05AD01 HALOPERIDOLUM HALOPERIDOL - RICHTER 2mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 FLAC. PICURATOR DIN STICLA BRUNA X 10 ML PICATURI ORALE, SOLUTIE P-RF 1 6,936000 6,936000 0,444000
38 W61141001 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 50 mg/ml SOL. INJ. 50mg/ml GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 5 9,054000 9,054000 0,000000
39 W54845001 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/ml SOL. INJ. 5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 5 2,332000 2,332000 0,000000
40 W44015001 N05AE03 SERTINDOL ** SERDOLECT 16 mg COMPR. FILM. 16mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 15,103928 15,103928 0,000000
41 W44017001 N05AE03 SERTINDOL ** SERDOLECT 4 mg COMPR. FILM. 4mg H. LUNDBECK A/S DANEMARCA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 3,869000 3,869000 0,000000
42 W59272007 N05AE04 ZIPRASIDONUM ** ZYPSILA 40 mg CAPS. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 60 2,986166 2,986166 0,000000
43 W59273007 N05AE04 ZIPRASIDONUM ** ZYPSILA 60 mg CAPS. 60mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 60 4,512333 4,512333 0,000000
44 W59274007 N05AE04 ZIPRASIDONUM ** ZYPSILA 80 mg CAPS. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 60 4,311166 4,311166 0,000000
45 W03207001 N05AF01 FLUPENTIXOLUM ** FLUANXOL DEPOT SOL. INJ. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 7,456000 7,456000 0,000000
46 W12437003 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. DIN PEID X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII P-RF 50 0,375600 0,375600 0,000000
47 W10638002 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL 20 mg/ml PIC. ORALE-SOL. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. + CAPAC SECURIZAT PT. COPII X 20 ML P-RF 1 31,370000 31,370000 0,000000
48 W12431001 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL DEPOT 200 mg/ml SOL. INJ. 200mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE X 1 ML P-RF 10 13,343000 13,343000 0,000000
Pagina 20 din 42
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
Pagina 21 din 42
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
Pagina 22 din 42
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
Pagina 23 din 42
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
Pagina 24 din 42
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
1 W52398001 N06DA02 DONEPEZILUM ** YASNAL 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU, BLIST., DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 1,195714 1,195714 0,000000
Pagina 25 din 42
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
Pagina 26 din 42
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
15. COLAGENOZE MAJORE (LUPUS ERITEMATOS SISTEMIC, SCLERODERMIE, POLI/DERMATOMIOZITA, VASCULITE SISTEMICE) - G 17
1 W04224001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,573800 0,573800 0,000000
2 W65156001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 5 BLIST. AL-PVC/PVC X 10 COMPR. PRF 50 0,573800 0,573800 0,000000
3 W04222001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,303500 1,303500 0,000000
4 W65157001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. AL-PVC/PVC X 10 COMPR. PRF 20 1,303500 1,303500 0,000000
5 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 1,271000 1,271000 0,000000
6 W52215001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. INJ. / PERF. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 28,380000 28,380000 0,000000
7 W64372001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. 200mg TEVA B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA PULB. PT. SOL. PERF./INJ PR 1 28,380000 28,380000 0,000000
8 W64422001 L01XC02 RITUXIMABUM **1 BLITZIMA 100 mg CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 FLAC. DIN STICLA X 10 ML (100 MG RITUXIMAB IN 10 ML-10MG/ML) PR 2 675,455000 675,455000 0,000000
9 W64512001 L01XC02 RITUXIMABUM **1 RIXATHON 100 mg CONC. PT. SOL. PERF. 100mg SANDOZ GMBH AUSTRIA CUTIE CU 2 FLAC. DIN STICLA DE 10 ML X 100 MG RITUXIMAB PR 2 759,805000 759,805000 0,000000
10 W64512002 L01XC02 RITUXIMABUM **1 RIXATHON 100 mg CONC. PT. SOL. PERF. 100mg SANDOZ GMBH AUSTRIA CUTIE CU 3 FLAC. DIN STICLA DE 10 ML X 100 MG RITUXIMAB PR 3 747,996666 747,996666 0,000000
11 W07199001 L01XC02 RITUXIMABUM **1 MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 810,546000 810,546000 79,419000
12 W64385001 L01XC02 RITUXIMABUM **1 MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 2 FLACOANE X 10 ML CARE CONTIN 100 MG RITUXIMABUM PR 2 810,546000 810,546000 79,419000
13 W07200001 L01XC02 RITUXIMABUM **1 MABTHERA 500 mg CONC. PT. SOL. PERF. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) S 1 4.357,540000 4.357,540000 0,000000
14 W64421001 L01XC02 RITUXIMABUM **1 BLITZIMA 500 mg CONC. PT. SOL. PERF. 500mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 FLAC. DIN STICLA X 50 ML (500 MG RITUXIMAB IN 50 ML-10MG/ML) PR 1 3.749,030000 3.749,030000 0,000000
15 W64386001 L01XC02 RITUXIMABUM **1 MABTHERA 500 mg CONC. PT. SOL. PERF. 500mg ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLACON X 50 ML (500MG RITUXIMAB IN 50ML- 10MG/ML) PR 1 4.357,540000 4.357,540000 0,000000
16 W64513001 L01XC02 RITUXIMABUM **1 RIXATHON 500 mg CONC. PT. SOL. PERF. 500mg SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA DE 50 ML X 500 MG RITUXIMAB PR 1 3.749,040000 3.749,040000 0,000000
17 W64513002 L01XC02 RITUXIMABUM **1 RIXATHON 500 mg CONC. PT. SOL. PERF. 500mg SANDOZ GMBH AUSTRIA CUTIE CU 2 FLAC. DIN STICLA DE 50 ML X 500 MG RITUXIMAB PR 2 3.713,615000 3.713,615000 0,000000
18 W57242001 L04AA26 BELIMUMABUM **1 BENLYSTA PULB. PT. CONC. PT. SOL. PERF. 120 mg GLAXO GROUP LIMITED MAREA BRITANIE CUTIE CU 1 FL. DIN STICLA A 5ML X 120MG S 1 730,290000 730,290000 0,000000
19 W65195001 L04AA26 BELIMUMABUM **1 BENLYSTA PULB. PT. CONC. PT. SOL. PERF. 120 mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 FL. DIN STICLA A 5ML X 120MG PR 1 730,290000 730,290000 0,000000
20 W57243001 L04AA26 BELIMUMABUM **1 BENLYSTA PULB. PT.CONC. PT.SOL. PERF. 400mg GLAXO GROUP LIMITED MAREA BRITANIE CUTIE CU 1 FL. DIN STICLA A 20ML X 400MG S 1 2.264,160000 2.264,160000 0,000000
21 W65197001 L04AA26 BELIMUMABUM **1 BENLYSTA PULB. PT.CONC. PT.SOL. PERF. 400mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 FL. DIN STICLA A 20ML X 400MG PR 1 2.264,160000 2.264,160000 0,000000
22 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,650400 0,650400 0,000000
23 W54357001 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL® COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 0,562333 0,562333 0,000000
24 W62084002 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL 200 mg COMPR. FILM. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM. P-6L 60 0,562333 0,562333 0,000000
Pagina 27 din 42
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 şi se monitorizează de către medicul în specialitatea reumatologie, nefrologie, boli infecţioase, pediatrie sau medicină internă, iar pentru medicamentele corespunzătoare DCI RITUXIMABUM şi de către medicul în specialitatea pneumologie.
16. POLIARTRITA REUMATOIDĂ, ARTROPATIA PSORIAZICĂ, PSORIAZIS CRONIC SEVER ŞI ARTRITA JUVENILĂ - G 18
1 W07440001 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. 50 0,625800 P-6L 0,625800 0,000000
2 W59162002 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. 50 0,626800 P6L 0,626800 0,000000
3 W57960002 H02AB01 BETAMETHASONUM DIPROPHOS SUSP. INJ. 7mg/ml MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 FIOLE DIN STICLA TIP I X 1 ML SUSP. INJ. PRF 1 16,960000 16,960000 0,000000
4 W04224001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,573800 0,573800 0,000000
5 W65156001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 5 BLIST. AL-PVC/PVC X 10 COMPR. PRF 50 0,573800 0,573800 0,000000
6 W04222001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,303500 1,303500 0,000000
7 W65157001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. AL-PVC/PVC X 10 COMPR. PRF 20 1,303500 1,303500 0,000000
8 W65904001 L01BA01 METHOTREXATUM JYLAMVO 2 mg/ml SOL. ORALA 2mg/ml THERAKIND (EUROPE) LIMITED IRLANDA PR 1 728,260000
CUTIE CU 1 FLAC. DIN STICLA, CU ADAPTOR DIN PEJD PENTRU FLACON SI O SERINGA DOZATOARE DIN PP X 60 ML SOL. ORALA 728,260000 0,000000
9 W62665001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PA/AL/PVC-AL X 3 COMPR. FILM. PR 3 13,743333 13,743333 0,000000
10 W55460001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE WINTHROP 10mg COMPR. FILM. 10mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 2,035000 2,035000 0,000000
11 W62663001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE ARENA 10 mg COMPR. FILM. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PA/AL/PVC-AL X 10 COMPR. FILM. PR 30 2,035000 2,035000 0,000000
12 W65126001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE ZENTIVA COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 2,035000 2,035000 0,000000
13 W56602005 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDA SANDOZ 20 mg COMPR. FILM. 20 mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP DESICANT X 30 COMPR. FILM. PR 30 3,843999 3,843999 0,021667
14 W55461001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE WINTHROP 20mg COMPR. FILM. 20mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 3,843999 3,843999 0,021667
15 W60267002 L04AA13 LEFLUNOMIDUM ** LEFLON 20 mg COMPR. FILM. 20mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PR 30 3,843999 3,843999 0,021667
16 W62664001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE ARENA 20 mg COMPR. FILM. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PA/AL/PVC-AL X 10 COMPR. FILM. PR 30 3,203333 3,203333 0,000000
17 W65128001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE ZENTIVA COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 3,843999 3,843999 0,021667
18 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 1,802400 1,802400 0,000000
19 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 50 mg CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 2,798600 2,798600 0,000000
20 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,650400 0,650400 0,000000
21 W62602001 L04AX03 METHOTREXATUM METHOTREXATE 2,5 mg COMPR. FILM. 2,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLIST. X 10 COMPR. FILM. PR 100 0,372800 0,372800 0,000000
22 W62233002 L04AX03 METHOTREXATUM NAMAXIR 10 mg 10mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4 31,410000
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. 31,410000 0,000000
23 W63589004 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1 37,692000
CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 1 ML, CARE CONTINE 1 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA 37,692000 11,858000
24 W63589010 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1 67,206000
CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 2,25 ML, CARE CONTINE 2 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA 67,206000 67,564000
25 W63589001 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1 28,752000
CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 1 ML, CARE CONTINE 0,75 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA 28,752000 34,688000
26 W63589007 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1 50,406000
CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 2,25 ML, CARE CONTINE 1,5 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA 50,406000 34,104000
27 W62235002 L04AX03 METHOTREXATUM NAMAXIR 15 mg 15mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4 42,005000
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. 42,005000 0,000000
28 W64738001 L04AX03 METHOTREXATUM NORDIMET 15 mg 15mg
SOL INJ. IN SERINGA PREUMPLUTA NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 50,406000 50,406000 41,264000
29 W64739001 L04AX03 METHOTREXATUM NORDIMET 17,5 mg 17,5mg
SOL INJ. IN SERINGA PREUMPLUTA NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 106,690000 106,690000 0,000000
30 W62237002 L04AX03 METHOTREXATUM NAMAXIR 20 mg 20mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4 56,005000
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,50 ML SOL. INJ. 56,005000 0,000000
31 W64740001 L04AX03 METHOTREXATUM NORDIMET 20 mg 20mg
SOL INJ. IN SERINGA PREUMPLUTA NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 67,206000 67,206000 46,124000
32 W64741001 L04AX03 METHOTREXATUM NORDIMET 22,5 mg 22,5mg
SOL INJ. IN SERINGA PREUMPLUTA NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 118,690000 118,690000 0,000000
33 W62239002 L04AX03 METHOTREXATUM NAMAXIR 25 mg 25mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4 70,007500
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. 70,007500 0,000000
34 W64742001 L04AX03 METHOTREXATUM NORDIMET 25 mg 25mg
SOL INJ. IN SERINGA PREUMPLUTA NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 84,009000 84,009000 38,151000
35 W62232002 L04AX03 METHOTREXATUM NAMAXIR 7,5 mg 7,5mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4 23,960000
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. 23,960000 0,000000
36 W58316004 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 37,692000 37,692000 12,378000
37 W58316010 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 67,206000 67,206000 64,284000
38 W58316001 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 28,752000 28,752000 35,318000
39 W58316007 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 50,406000 50,406000 34,974000
40 W63806001 L04AX03 METHOTREXATUM NORDIMET 12,5 mg 12,5mg
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT NORDIC GROUP BV OLANDA PRF 1 77,670000
CUTIE CU 1 STILOU INJECTOR PREUMPLUT CARE CONTINE 1 SERINGA PREUMPLUTA DIN STICLA CU AC ATASAT SI UN PISTON X 0,5 ML SOL. PT. INJECTARE 77,670000 0,000000
41 W63730001 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P6L 20 2,647500 2,647500 0,000000
42 W53220001 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,569666 0,569666 0,000000
43 W02472002 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 20 0,379000 0,379000 0,000000
44 W51307003 M01AB05 DICLOFENACUM REFEN RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P6L 20 0,379000 0,379000 0,000000
45 W51307002 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,379000 0,379000 0,000000
46 W02459003 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,125500 0,125500 0,000000
47 W60292001 M01AB05 DICLOFENACUM DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,125500 0,125500 0,000000
48 W54363004 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 0,125333 0,125333 0,000000
49 W55024001 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF. P-RF 5 1,776000 1,776000 0,000000
Pagina 28 din 42
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 din specialitatea reumatologie, nefrologie, medicină internă, pediatrie, reabilitare medicală şi dermatovenerologie.
1 W07440001 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0,625800 0,625800 0,000000
2 W59162002 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L 50 0,626800 0,626800 0,000000
3 W57960002 H02AB01 BETAMETHASONUM DIPROPHOS SUSP. INJ. 7mg/ml MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 FIOLE DIN STICLA TIP I X 1 ML SUSP. INJ. PRF 1 16,960000 16,960000 0,000000
4 W63730001 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P6L 20 2,647500 2,647500 0,000000
5 W53220001 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,569666 0,569666 0,000000
6 W02472002 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 20 0,379000 0,379000 0,000000
7 W51307003 M01AB05 DICLOFENACUM REFEN RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P6L 20 0,379000 0,379000 0,000000
8 W51307002 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,379000 0,379000 0,000000
9 W02459003 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,125500 0,125500 0,000000
10 W60292001 M01AB05 DICLOFENACUM DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,125500 0,125500 0,000000
11 W54363004 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 0,125333 0,125333 0,000000
12 W55024001 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF. P-RF 5 1,776000 1,776000 0,000000
13 W14114001 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0,601666 0,601666 0,000000
14 W12288001 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,607000 0,607000 0,000000
15 W02480002 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0,607000 0,607000 0,000000
16 W14114003 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC/PE X 6 SUPOZ. P6L 6 0,601666 0,601666 0,000000
17 W60401001 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 3 SUPOZITOARE P6L 6 0,646666 0,646666 0,000000
18 W60401002 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 5 SUPOZITOARE P6L 10 0,643000 0,643000 0,000000
Tratamentul se iniţiază de către medicul din specialitatea reumatologie sau reabilitare medicală.
18. BOLI ENDOCRINE ŞI METABOLICE (GUŞĂ ENDEMICĂ, INSUFICIENŢĂ SUPRARENALĂ CRONICĂ, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARĂ, TUMORI NEUROENDOCRINE ŞI OSTEOPOROZĂ SEVERĂ,
HIPERCOLESTEROLEMIE HETEROZIGOTĂ FAMILIALĂ ŞI NONFAMILIALĂ, HIPOFOSFATEMIA X-LINKATA, TULBURĂRI ALE CICLULUI UREIC) - G 22
1 W66278001 A16AX03 NATRII PHENYLBUTYRATE ** AMMONAPS 500mg COMPR. 500mg IMMEDICA PHARMA AB SUEDIA CUTIE X 1 FLAC DIN PEID X 250 COMPR. P-RF/R 250 12,558160 12,558160 0,000000
2 W66279001 A16AX03 NATRII PHENYLBUTYRATE ** AMMONAPS 940mg/g GRAN. ORALE 940mg/g IMMEDICA PHARMA AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 266 G GRAN. ORALE + 3 LINGURI DOZATOARE P-RF/R 1 5.524,780000 5.524,780000 0,000000
3 W62404002 C10AX14 ALIROCUMABUM ** Ω PRALUENT 150 mg SOL INJ. IN SERINGA PREUMPLUTA 150mg SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE DE UNICA FOLOSINTA X 1 ML PRF 2 1.002,065000 1.002,065000 0,000000
4 W62402002 C10AX14 ALIROCUMABUM ** Ω PRALUENT 75 mg SOL INJ. IN SERINGA PREUMPLUTA 75mg SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE PRF 2 1.002,065000 1.002,065000 0,000000
5 W62403002 C10AX14 ALIROCUMABUM ** Ω PRALUENT 150 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 150mg SANOFI - AVENTIS GROUPE FRANTA CUTIE X 2 STILOURI INJECTOARE (PEN) PREUMPLUT X 1ML PRF 2 1.002,065000 1.002,065000 0,000000
6 W62401002 C10AX14 ALIROCUMABUM ** Ω PRALUENT 75 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 75mg SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE PRF 2 1.002,065000 1.002,065000 0,000000
7 W00716002 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 11,350000 11,350000 0,000000
8 W00716001 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 10,618750 10,618750 0,000000
9 W65037001 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 2 COMPR. P6L 2 11,350000 11,350000 0,000000
10 W65037002 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 8 COMPR. P6L 8 10,618750 10,618750 0,000000
11 W65037003 G02CB03 CABERGOLINUM ** DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. DIN PEID, INCHIS CU CAPAC DIN PP CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 2 COMPR. P6L 2 11,350000 11,350000 0,000000
12 W65037004 G02CB03 CABERGOLINUM ** DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. DIN PEID, INCHIS CU CAPAC DIN PP CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 8 COMPR. P6L 8 10,618750 10,618750 0,000000
13 W42027002 H01AX01 PEGVISOMANTUM **1 SOMAVERT 10 mg PULB+SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 30 FLAC. CU PULB. + 30 SERINGI PREUMPLUTE CONTINAND 1 ML PR 30 287,254666 287,254666 0,000000
Pagina 29 din 42
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
Pagina 30 din 42
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 endocrinologie sau oncologie, cu excepţia medicamentelor corespunzătoare DCI ALIROCUMABUM pentru care tratamentul se iniţiază de către medicul în specialitatea
cardiologie, medicină internă, diabet şi boli de nutriţie, a medicamentelor corespunzătoare DCI DENOSUMAB pentru care tratamentul se iniţiază şi de către medicul în specialitatea reumatologie şi a medicamentelor
corespunzătoare DCI: BUROSUMABUM, NATRII PHENYLBUTYRATE pentru care tratamentul se iniţiază şi de către medicul în specialitatea pediatrie.
Pagina 31 din 42
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
1 W61063002 M01CC01 PENICILLAMINUM ** 4) CUPRIPEN 250mg CAPS. 250mg CN UNIFARM S.A. ROMANIA CUTIE X 3 BLIST. X 10 CAPS. PRF 30 2,690666 2,690666 0,000000
Tratamentul se iniţiază de către medicul din specialitatea endocrinologie, neurologie sau neurologie pediatrică.
1 W51230001 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA ** VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 57,774000 57,774000 0,000000
2 W52283002 B03XA01 EPOETINUM ALFA ** BINOCRIT 2000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. PR 6 48,485000 48,485000 0,000000
3 W55046001 B03XA01 EPOETINUM ALFA ** BINOCRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. P-RF/R 1 473,960000 473,960000 0,000000
4 W57497004 B03XA01 EPOETINUM ALFA ** EPREX 40000 UI/ml SOL. INJ. IN SERINGA PREUMPLUTA 40 000UI/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. PR 1 736,164000 736,164000 420,066000
5 W55048001 B03XA01 EPOETINUM ALFA ** BINOCRIT 40000 UI/1 ml SOL. INJ. IN SERINGA PREUMPLUTA 40000 UI/1 ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. P-RF/R 1 613,470000 613,470000 0,000000
6 W52285002 B03XA01 EPOETINUM ALFA ** BINOCRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. PR 6 91,161666 91,161666 0,000000
7 W07740002 B03XA01 EPOETINUM BETA ** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 282,881666 282,881666 0,000000
8 W64395002 B03XA01 EPOETINUM BETA ** NEORECORMON 10000 UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE PR 6 282,881666 282,881666 0,000000
9 W07741002 B03XA01 EPOETINUM BETA ** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 49,616666 49,616666 0,000000
10 W64396002 B03XA01 EPOETINUM BETA ** NEORECORMON 2000 UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE PR 6 49,616666 49,616666 0,000000
11 W42097001 B03XA01 EPOETINUM BETA ** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 906,800000 906,800000 0,000000
12 W64397001 B03XA01 EPOETINUM BETA ** NEORECORMON 30000 UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC PR 1 906,800000 906,800000 0,000000
13 W07742002 B03XA01 EPOETINUM BETA ** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 91,161666 91,161666 0,000000
14 W64398002 B03XA01 EPOETINUM BETA ** NEORECORMON 4000 UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE PR 6 91,161666 91,161666 0,000000
15 W07744002 B03XA01 EPOETINUM BETA ** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 129,268333 129,268333 0,000000
16 W64399002 B03XA01 EPOETINUM BETA ** NEORECORMON 5000 UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE PR 6 129,268333 129,268333 0,000000
17 W60969001 B03XA01 EPOETINUM ZETA ** RETACRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 235,470000 235,470000 0,000000
18 W64987001 B03XA01 EPOETINUM ZETA ** RETACRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. PR 1 235,470000 235,470000 0,000000
19 W60964001 B03XA01 EPOETINUM ZETA ** RETACRIT 2000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,6ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 54,440000 54,440000 0,000000
20 W64990001 B03XA01 EPOETINUM ZETA ** RETACRIT 2000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,6ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 0,6 ML SOL. INJ. PR 1 54,440000 54,440000 0,000000
21 W60967001 B03XA01 EPOETINUM ZETA ** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. PR 1 514,000000 514,000000 0,000000
22 W64991001 B03XA01 EPOETINUM ZETA ** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 0,75 ML SOL. INJ. PR 1 514,000000 514,000000 0,000000
23 W60965001 B03XA01 EPOETINUM ZETA ** RETACRIT 3000UI/0,9ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,9ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,9ML SOL. INJ. PR 1 77,550000 77,550000 0,000000
24 W64992001 B03XA01 EPOETINUM ZETA ** RETACRIT 3000UI/0,9ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,9ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 0,9 ML SOL. INJ. PR 1 77,550000 77,550000 0,000000
25 W60966001 B03XA01 EPOETINUM ZETA ** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 607,530000 607,530000 0,000000
26 W64993001 B03XA01 EPOETINUM ZETA ** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. PR 1 607,530000 607,530000 0,000000
27 W60973001 B03XA01 EPOETINUM ZETA ** RETACRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,4ML SOL. INJ. PR 1 103,390000 103,390000 0,000000
28 W64994001 B03XA01 EPOETINUM ZETA ** RETACRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 0,4 ML SOL. INJ. PR 1 103,390000 103,390000 0,000000
29 W60972001 B03XA01 EPOETINUM ZETA ** RETACRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL. INJ. PR 1 124,810000 124,810000 0,000000
30 W64995001 B03XA01 EPOETINUM ZETA ** RETACRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. PR 1 124,810000 124,810000 0,000000
31 W60971001 B03XA01 EPOETINUM ZETA ** RETACRIT 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 147,090000 147,090000 0,000000
32 W64996001 B03XA01 EPOETINUM ZETA ** RETACRIT 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 0,6 ML SOL. INJ. PR 1 147,090000 147,090000 0,000000
33 W60970001 B03XA01 EPOETINUM ZETA ** RETACRIT 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,8ML SOL. INJ. PR 1 209,970000 209,970000 0,000000
34 W64997001 B03XA01 EPOETINUM ZETA ** RETACRIT 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 SERINGA PREUMPLUTA X 0,8 ML SOL. INJ. PR 1 209,970000 209,970000 0,000000
35 W41530002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 100mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 644,105000 644,105000 0,000000
36 W41522002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 10mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 78,592500 78,592500 0,000000
37 W41524002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 20mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 142,922500 142,922500 0,000000
38 W41532001 B03XA02 DARBEPOETINUM ALFA ** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1.949,900000 1.949,900000 0,000000
39 W41525002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 205,617500 205,617500 0,000000
40 W41526002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 40mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 268,240000 268,240000 0,000000
41 W41533001 B03XA02 DARBEPOETINUM ALFA ** ARANESP 500mcg/ml SOL. INJ. IN SERINGA PREUMPLUTA 500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R 1 3.201,980000 3.201,980000 0,000000
42 W41527002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 50mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R 4 330,885000 330,885000 0,000000
43 W41528002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 60mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R 4 393,490000 393,490000 0,000000
44 W41529002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 80mcg/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R 4 518,780000 518,780000 0,000000
45 W52309001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 100mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 818,550000 818,550000 0,000000
46 W64391001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 100 micrograme/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 100µg/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. PR 1 818,550000 818,550000 0,000000
Pagina 32 din 42
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
1 W53830001 S01EC03 DORZOLAMIDUM DORZOPT 20 mg/ml PIC. OFT., SOL 20mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEJD X 5 ML PIC. OFT., SOL P-RF 1 15,560000 15,560000 0,000000
2 W61012001 S01EC03 DORZOLAMIDUM DORZOLAMIDA ARENA 20 mg/ml PIC. OFT., SOL. 20mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. ALB, OPAC DIN PE DE DENSITATE MEDIE, CU CAPACITATEA DE 10 ML, PREVAZUT CU PICURATOR SIGILAT SI UN CAPAC ASAMBLATE DIN 2 PIESE, CU 5 ML PIC. OFT., SOL. P6L 1 15,560000 15,560000 0,000000
3 W62676001 S01EC03 DORZOLAMIDUM TRUSOPT 20 mg/ml PIC. OFT., SOL. 20mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLAC. DE TIP OCUMETER PLUS ALCATUIT DINTR-UN FLAC. TRANSLUCID DIN PEÎD,CU CAPACITATEA DE 8 ML,CU PICURATOR DIN PEÎD,ÎNCHIS CU UN CAPAC ALCATUIT DIN 2 COMPONENTE SI PREVAZUT CU BANDA DE SIGURANTA, CA PARTE A ETICHETEI PROD.X5 ML SOL.OFT. P6L 1 18,672000 18,672000 5,258000
4 W62676002 S01EC03 DORZOLAMIDUM TRUSOPT 20 mg/ml PIC. OFT., SOL. 20mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLACON DIN PEJD X 5 ML PIC. OFT., SOL. P6L 1 18,672000 18,672000 5,258000
5 W07615001 S01EC04 BRINZOLAMIDUM AZOPT 10mg/ml PICATURI OFT.-SUSP. 10mg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON, PEJD X 5 ML P-6L 1 33,560000 33,560000 0,000000
6 W63645001 S01EC04 BRINZOLAMIDUM AZOPT 10mg/ml PICATURI OFT.-SUSP. 10mg/ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 FLACON PEJD X 5 ML P6L 1 33,560000 33,560000 0,000000
7 W64500001 S01EC04 BRINZOLAMIDUM AZOPT 10mg/ml PICATURI OFT.-SUSP. 10mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. PEJD X 5 ML P6L 1 33,560000 33,560000 0,000000
8 W55649001 S01ED01 TIMOLOLUM TIMOLOL ROMPHARM 0,5% PIC. OFT.,SOL. 5mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL.P-6L 1 5,330000 5,330000 0,000000
9 W44059001 S01ED01 TIMOLOLUM TIMOLOL EIPICO 2,5 mg/ml PICATURI OFT.-SOL. 2,5mg/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD, PREVAZUT CU APLICATOR PT. PICURARE X 5 ML PIC. OFT., SOL. P-6L 1 3,360000 3,360000 0,000000
10 W44058002 S01ED01 TIMOLOLUM TIMOLOL EIPICO 5 mg/ml PICATURI OFT.-SOL. 5mg/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD, PREVAZUT CU APLICATOR PT. PICURARE X 5 ML PIC. OFT., SOL. P-6L 1 5,670000 5,670000 0,000000
11 W43453001 S01ED02 BETAXOLOLUM BETAX PIC. OFT.-SOL. 5mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L 1 5,690000 5,690000 0,000000
12 W00605001 S01ED02 BETAXOLOLUM BETOPTIC - S PICATURI OFT.-SUSP. 0,25% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 14,590000 14,590000 0,000000
13 W63541001 S01ED02 BETAXOLOLUM BETOPTIC - S PICATURI OFT.-SUSP. 0,25% NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 14,590000 14,590000 0,000000
Pagina 33 din 42
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
22. PEMFIGUS - G 27
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
2 W63171002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVACIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 10,284000 10,284000 0,000000
3 W63169002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 4 mg COMPR. 4mg KRKA D.D. NOVO MESTO SLOVACIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 1,728000 1,728000 0,000000
4 W59780001 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 10 0,891000 0,891000 0,000000
5 W59780003 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 25 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 25 0,875200 0,875200 0,000000
6 W59780004 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 100 0,788900 0,788900 0,000000
7 W59780005 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 10 1,485000 1,485000 0,000000
8 W59780007 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 25 1,421200 1,421200 0,000000
9 W59780008 H02AB02 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ. 4mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF 100 1,288900 1,288900 0,000000
10 W44063002 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE 8 mg/2 ml SOL. INJ. 8mg/2ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 100 1,353600 1,353600 0,000000
11 W44063001 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE 8 mg/2 ml SOL. INJ. 8mg/2ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 5 1,526000 1,526000 0,000000
12 W08299001 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF 10 1,527000 1,527000 0,000000
13 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 mg COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,573800 0,573800 0,000000
Pagina 34 din 42
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
1 W08253003 A16AB02 IMIGLUCERASUM **1 CEREZYME 400U PULB. PT.CONC. PT.SOL. PERF. 400U GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. PR 1 6.393,920000 6.393,920000 0,000000
2 W61994001 A16AB10 VELAGLUCERASE ALFA **1 VPRIV 400 unitati PULB. PT. SOL. PERF. 400unitati IRLANDA 5 FLAC. DIN STICLA X 400 UNITATI PULBERE PT. SOL. PERF. PR
Shire Pharmaceuticals Ireland Limited 5 6.782,954000 6.782,954000 0,000000
3 W64524002 A16AX06 MIGLUSTATUM **1 MIGLUSTAT ACCORD 100 mg CAPS. 100mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PE-PCTFE/AL X 84X1 PR 84 199,131190 199,131190 0,000000
4 W65802002 A16AX06 MIGLUSTATUM **1 MIGLUSTAT ACCORD 100 mg CAPS. 100mg POLONIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 84X1
ACCORD HEALTHCARE POLSKA SP. Z O.O. PR 84 199,131190 199,131190 0,000000
5 W63456001 A16AX10 ELIGLUSTAT **1 CERDELGA 84 mg CAPS. 84mg GENZYME EUROPE B.V., OLANDA CUTIE CU BLIST. DIN PETG/COC.PETG/PCTFE-ALUMINIU X 56 CAPS. PR 56 1.735,997500 1.735,997500 0,000000
După precizarea diagnosticului de către laboratoarele de specialitate, tratamentul se iniţiază de către medicul din specialitatea gastroenterologie, hematologie, neurologie, neurologie pediatrică şi pediatrie.
1 W56642001 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,445000 0,445000 0,000000
2 W56910001 J01AA07 TETRACYCLINUM TETRACICLINA ATB 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 0,360000 0,360000 0,000000
3 W00574005 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 1000000UI PULB. PT. SOL. INJ. 1 000 000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. PRF 100 10,518500 10,518500 0,000000
4 W00574004 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 1000000UI PULB. PT. SOL. INJ. 1 000 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 12,622200 12,622200 1,247800
5 W00574003 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 1000000 UI PULB. PT. SOL. INJ. 1000000UI ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 50 11,227000 11,227000 0,000000
6 W58283004 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA ATB 1000000 UI PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 12,622200 12,622200 1,247800
7 W58283001 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA ATB 1000000 UI PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CARE CONTIN PULB. PT. SOL. INJ. P-RF 50 11,227000 11,227000 0,000000
8 W58283005 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA ATB 1000000 UI PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF/S 100 10,518500 10,518500 0,000000
9 W00574006 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 1000000 UI PULB. PT. SOL. INJ. 1000000UI ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CARE CONTIN PULB. PT. SOL. INJ. PRF 10 12,306000 12,306000 0,000000
10 W58283006 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA ATB 1000000 UI PULB. PT. SOL. INJ. 1000000UI ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CARE CONTIN PULB. PT. SOL. INJ. PRF 10 12,306000 12,306000 0,000000
11 W00576005 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 400000 UI PULB. PT. SOL. INJ. 400 000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. PRF 100 8,338500 8,338500 0,000000
12 W00576004 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 400000 UI PULB. PT. SOL. INJ. 400 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 10,006200 10,006200 0,783800
13 W00576003 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 400000 UI PULB. PT. SOL. INJ. 400000UI ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 50 9,047000 9,047000 0,000000
14 W00576006 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA ATB 400000 UI PULB. PT. SOL. INJ. 400000UI ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. PRF 10 9,913000 9,913000 0,000000
15 W41595001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,507500 0,507500 0,000000
16 W41594003 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN® 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. P-RF 12 0,747500 0,747500 0,000000
17 W41596001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,285000 0,285000 0,000000
18 W55413001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE P-RF 1 9,550000 9,550000 0,000000
19 W55416003 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA, CAPACITATE 10 ML CONTINAND PULB. PT. SUSP. INJ. I.M. P-RF 1 37,756080 37,756080 4,323920
20 W55416001 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA, CAPACITATE 10 ML CONTINAND PULB. PT. SUSP. INJ. I.M. PRF 50 32,172000 32,172000 0,000000
21 W55416002 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA, CAPACITATE 10 ML CONTINAND PULB. PT. SUSP. INJ. I.M. P-RF 100 31,463400 31,463400 0,000000
22 W55416004 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 10 ML CONTINAND PULB. PT. SUSP. INJ. I.M. PRF 10 37,646000 37,646000 0,000000
Pagina 35 din 42
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).
Pagina 36 din 42
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
1 W61129001 L04AA33 VEDOLIZUMABUM **1 ENTYVIO 300mg PULB. PT.CONC. PT.SOL. PERF. 300mg TAKEDA PHARMA A/S DANEMARCA CUTIE CU 1 FLACON X 300MG PULBERE PENTRU CONCENTRAT PENTRU SOLUTIE PERFUZABILA PR 1 7.867,890000 7.867,890000 0,000000
2 W57617003 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.085,148000 1.085,148000 533,865333
3 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.085,148000 1.085,148000 27,502000
4 W64826001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.029,400000 1.029,400000 0,000000
5 W65000001 L04AB02 INFLIXIMABUM **1 ZESSLY 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 904,290000 904,290000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 24,074000
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 1.134,765000 1.134,765000 0,000000
10 W64999001 L04AB04 ADALIMUMABUM **1 HYRIMOZ 40 mg SOL INJ. IN PEN PREUMPLUT 40mg/0,8ml SANDOZ GMBH AUSTRIA CUTIE CU 2 PEN-URI PREUMPLUTE CONTINAND 0,8 ML SOL. PR 2 964,455000 964,455000 0,000000
11 W64056001 L04AB04 ADALIMUMABUM **1 HUMIRA 80 mg SOL INJ. IN PEN PREUMPLUT 80mg ABBVIE LTD MAREA BRITANIE CUTIE CU 1 BLIST. CE CONTINE UN PEN PREUMPLUT (0,8 ML SOLUTIE STERILA) SI DOUA TAMPOANE CU ALCOOL. PR 1 2.950,840000 2.950,840000 0,000000
12 W64711001 L04AB04 ADALIMUMABUM **1 HUMIRA 80 mg SOL INJ. IN PEN PREUMPLUT 80mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 1 BLIST. CE CONTINE UN PEN PREUMPLUT (0,8 ML SOLUTIE STERILA) SI DOUA TAMPOANE CU ALCOOL. PR 1 2.950,840000 2.950,840000 0,000000
13 W64674001 L04AB04 ADALIMUMABUM **1 HUMIRA 20 mg SOL INJ. IN SERINGA PREUMPLUTA 20mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 1 BLIST. CE CONTINE 2 SERINGI PREUMPLUTE (0,2 ML SOLUTIE STERILA) SI DOUA TAMPOANE CU ALCOOL PR 2 585,100000 585,100000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 56,864000
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 1.134,765000 1.134,765000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
21 W64276001 L04AC05 USTEKINUMAB **1 STELARA 90 mg SOL INJ. IN SERINGA PREUMPLUTA 90mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA DE STICLA CU CAPACITATE DE 1 ML X 1 ML SOL. PR 1 11.333,690000 11.333,690000 0,000000
Pagina 37 din 42
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
1 W07200001 L01XC02 RITUXIMABUM **1 MABTHERA 500 mg CONC. PT. SOL. PERF. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) S 1 4.357,540000 4.357,540000 0,000000
2 W64386001 L01XC02 RITUXIMABUM **1 MABTHERA 500 mg CONC. PT. SOL. PERF. 500mg ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLACON X 50 ML (500MG RITUXIMAB IN 50ML- 10MG/ML) PR 1 4.357,540000 4.357,540000 0,000000
3 W64513001 L01XC02 RITUXIMABUM **1 RIXATHON 500 mg CONC. PT. SOL. PERF. 500mg SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA DE 50 ML X 500 MG RITUXIMAB PR 1 3.749,040000 3.749,040000 0,000000
4 W64513002 L01XC02 RITUXIMABUM **1 RIXATHON 500 mg CONC. PT. SOL. PERF. 500mg SANDOZ GMBH AUSTRIA CUTIE CU 2 FLAC. DIN STICLA DE 50 ML X 500 MG RITUXIMAB PR 2 3.713,615000 3.713,615000 0,000000
5 W52073001 L04AA24 ABATACEPTUM **1 ORENCIA PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA S 1 1.468,210000 1.468,210000 0,000000
6 W65570001 L04AA24 ABATACEPTUM **1 ORENCIA 250 mg PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA S 1 1.468,210000 1.468,210000 0,000000
7 W59338005 L04AA24 ABATACEPTUM **1 ORENCIA SOL INJ. IN SERINGA PRE-UMPLUTA 125mg/ml BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA CU AC CU GARDA X 125 MG/ML SOL INJ. PR 4 1.037,485000 1.037,485000 0,000000
8 W65571005 L04AA24 ABATACEPTUM **1 ORENCIA 125 mg/ml SOL INJ. IN SERINGA PRE-UMPLUTA 125mg/ml BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA CU AC CU GARDA X 125 MG/ML SOL INJ. PR 4 1.037,485000 1.037,485000 0,000000
9 W65572001 L04AA24 ABATACEPTUM **1 ORENCIA 125 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 125mg BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA 4 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE PR 4 1.102,505000 1.102,505000 0,000000
10 W63432001 L04AA29 TOFACITINIB **1 XELJANZ 5 mg COMPR. FILM. 5mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 4 BLISTERE DIN AL/PVC/AL X 14 COMPR. FILM. PR 56 60,654464 60,654464 0,000000
11 W65118001 L04AA29 TOFACITINIB **1 XELJANZ 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 4 BLISTERE DIN AL/PVC/AL X 14 COMPR. FILM PR 56 60,654464 60,654464 0,000000
12 W63493001 L04AA37 BARICITINIB **1 OLUMIANT 4 mg COMPR. FILM. 4mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC/PE/PCTFE/ALU X 35 COMPR. FILM. PR 35 111,856000 111,856000 0,000000
13 W61297001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
14 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
15 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 579,902500 579,902500 0,000000
16 W65221001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. 50mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
17 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
18 W64810001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
19 W64811002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 695,883000 695,883000 142,912000
20 W64812002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL MEDICINALPR 4 695,883000 695,883000 142,912000
21 W65222001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. 50mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
22 W61299001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
23 W61300002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 695,883000 695,883000 142,912000
24 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
25 W61303002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 695,883000 695,883000 142,912000
26 W57617003 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.085,148000 1.085,148000 533,865333
27 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.085,148000 1.085,148000 27,502000
28 W64826001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.029,400000 1.029,400000 0,000000
29 W65000001 L04AB02 INFLIXIMABUM **1 ZESSLY 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 904,290000 904,290000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 24,074000
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 1.134,765000 1.134,765000 0,000000
34 W64999001 L04AB04 ADALIMUMABUM **1 HYRIMOZ 40 mg SOL INJ. IN PEN PREUMPLUT 40mg/0,8ml SANDOZ GMBH AUSTRIA CUTIE CU 2 PEN-URI PREUMPLUTE CONTINAND 0,8 ML SOL. PR 2 964,455000 964,455000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 56,864000
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 1.134,765000 1.134,765000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
42 W54992001 L04AB05 CERTOLIZUMAB PEGOL **1 CIMZIA SOL. INJ. IN SERINGA PREUMPLUTA 200 mg UCB PHARMA SA BELGIA CUTIE X 2 SERINGI PREUMPLUTE DIN STICLA CU PISTON A 1 ML + 2 TAMPOANE CU ALCOOL P-RF/R 2 1.657,500000 1.657,500000 0,000000
43 W57618001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.787,190000 3.787,190000 0,000000
44 W57619001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML PR 1 3.787,190000 3.787,190000 0,000000
45 W53869001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. S 1 614,380000 614,380000 0,000000
46 W64403001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. PR 1 614,380000 614,380000 0,000000
47 W53869003 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF. S 1 1.429,630000 1.429,630000 0,000000
48 W64403003 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF. PR 1 1.429,630000 1.429,630000 0,000000
49 W53869005 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF. S 1 2.788,430000 2.788,430000 0,000000
50 W64403005 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF. PR 1 2.788,430000 2.788,430000 0,000000
51 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
52 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
Pagina 38 din 42
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 reumatologie, medicină internă, nefrologie (pentru pacienţii cu afectare renală) şi reabilitarea medicală.
1 W61297001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
2 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
3 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 579,902500 579,902500 0,000000
4 W65221001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. 50mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
5 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
6 W64810001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
7 W64811002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 695,883000 695,883000 142,912000
8 W64812002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL MEDICINALPR 4 695,883000 695,883000 142,912000
9 W65222001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. 50mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
10 W61299001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
11 W61300002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 695,883000 695,883000 142,912000
12 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
13 W61303002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 695,883000 695,883000 142,912000
14 W57617003 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.085,148000 1.085,148000 533,865333
15 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.085,148000 1.085,148000 27,502000
16 W64826001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.029,400000 1.029,400000 0,000000
17 W65000001 L04AB02 INFLIXIMABUM **1 ZESSLY 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 904,290000 904,290000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 24,074000
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 1.134,765000 1.134,765000 0,000000
22 W64999001 L04AB04 ADALIMUMABUM **1 HYRIMOZ 40 mg SOL INJ. IN PEN PREUMPLUT 40mg/0,8ml SANDOZ GMBH AUSTRIA CUTIE CU 2 PEN-URI PREUMPLUTE CONTINAND 0,8 ML SOL. PR 2 964,455000 964,455000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 56,864000
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 1.134,765000 1.134,765000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
30 W54992001 L04AB05 CERTOLIZUMAB PEGOL **1 CIMZIA SOL. INJ. IN SERINGA PREUMPLUTA 200 mg UCB PHARMA SA BELGIA CUTIE X 2 SERINGI PREUMPLUTE DIN STICLA CU PISTON A 1 ML + 2 TAMPOANE CU ALCOOL P-RF/R 2 1.657,500000 1.657,500000 0,000000
31 W57618001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.787,190000 3.787,190000 0,000000
32 W57619001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML PR 1 3.787,190000 3.787,190000 0,000000
33 W62169001 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN SERINGA PREUMPLUTA 150 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 2 SERINGI PREUMPLUTE X 1ML SOL. INJ. PR 2 2.480,905000 2.480,905000 0,000000
34 W62169002 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN SERINGA PREUMPLUTA 150 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 2.516,310000 2.516,310000 0,000000
35 W64459001 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN SERINGA PREUMPLUTA 150 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 2.516,310000 2.516,310000 0,000000
36 W64459002 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN SERINGA PREUMPLUTA 150 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 2 SERINGI PREUMPLUTE X 1ML SOL. INJ. PR 2 2.480,905000 2.480,905000 0,000000
37 W62170001 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 150 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 2 STILOURI PREUMPLUTE (STILOU SENSO READY) X 1ML SOL. INJ. PR 2 2.480,905000 2.480,905000 0,000000
38 W62170002 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 150 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 STILOU PREUMPLUT (STILOU SENSO READY) X 1ML SOL. INJ. PR 1 2.516,310000 2.516,310000 0,000000
39 W64460001 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 150 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 STILOU PREUMPLUT (STILOU SENSO READY) X 1ML SOL. INJ. PR 1 2.516,310000 2.516,310000 0,000000
40 W64460002 L04AC10 SECUKINUMABUM **1 COSENTYX 150 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 150 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 2 STILOURI PREUMPLUTE (STILOU SENSO READY) X 1ML SOL. INJ. PR 2 2.480,905000 2.480,905000 0,000000
1 W61297001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
2 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
Pagina 39 din 42
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 reumatologie, medicină internă şi reabilitare medicală.
Pagina 40 din 42
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
1 W52073001 L04AA24 ABATACEPTUM **1 ORENCIA PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA
MAREA BRITANIE S 1 1.468,210000 1.468,210000 0,000000
2 W65570001 L04AA24 ABATACEPTUM **1 ORENCIA 250 mg PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB PHARMA EEIG IRLANDA CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA S 1 1.468,210000 1.468,210000 0,000000
3 W61297001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
4 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
5 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 579,902500 579,902500 0,000000
6 W65221001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. 50mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
7 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
8 W64810001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
9 W64811002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 695,883000 695,883000 142,912000
10 W64812002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL MEDICINALPR 4 695,883000 695,883000 142,912000
11 W65222001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. 50mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
12 W61299001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
13 W61300002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 695,883000 695,883000 142,912000
14 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
15 W61303002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 695,883000 695,883000 142,912000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 24,074000
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 1.134,765000 1.134,765000 0,000000
20 W64999001 L04AB04 ADALIMUMABUM **1 HYRIMOZ 40 mg SOL INJ. IN PEN PREUMPLUT 40mg/0,8ml SANDOZ GMBH AUSTRIA CUTIE CU 2 PEN-URI PREUMPLUTE CONTINAND 0,8 ML SOL. PR 2 964,455000 964,455000 0,000000
21 W64674001 L04AB04 ADALIMUMABUM **1 HUMIRA 20 mg SOL INJ. IN SERINGA PREUMPLUTA 20mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 1 BLIST. CE CONTINE 2 SERINGI PREUMPLUTE (0,2 ML SOLUTIE STERILA) SI DOUA TAMPOANE CU ALCOOL PR 2 585,100000 585,100000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.134,770000 1.134,770000 0,000000
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 1.157,346000 1.157,346000 56,864000
25 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 1.134,765000 1.134,765000 0,000000
26 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 1.134,770000 1.134,770000 0,000000
27 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 1.134,770000 1.134,770000 0,000000
28 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 1.134,770000 1.134,770000 0,000000
29 W57618001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.787,190000 3.787,190000 0,000000
30 W57619001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML PR 1 3.787,190000 3.787,190000 0,000000
31 W53869001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. S 1 614,380000 614,380000 0,000000
32 W64403001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. PR 1 614,380000 614,380000 0,000000
33 W53869003 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF. S 1 1.429,630000 1.429,630000 0,000000
34 W64403003 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF. PR 1 1.429,630000 1.429,630000 0,000000
35 W53869005 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF. S 1 2.788,430000 2.788,430000 0,000000
36 W64403005 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF. PR 1 2.788,430000 2.788,430000 0,000000
1 W61297001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 428,692500 428,692500 0,000000
2 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
3 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 579,902500 579,902500 0,000000
4 W65221001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. 50mg SAMSUNG BIOEPIS NL B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
5 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 647,280000 647,280000 0,000000
6 W64810001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 428,692500 428,692500 0,000000
7 W64811002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL MEDICINAL PR 4 695,883000 695,883000 142,912000
Pagina 41 din 42
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
NOTA:
Pentru medicamentele corespunzătoare acestei secţiuni, iniţierea tratamentului se face de către medicul de specialitate, altul decât medicul de familie, excepţie făcând medicamentele din G1 «Insuficienţă cardiacă cronică
(clasa III sau IV Nyha)» corespunzătoare DCI: DIGOXINUM, HYDROCHLOROTHIAZIDUM, FUROSEMIDUM, SPIRONOLACTONUM, METOPROLOLUM, BISOPROLOLUM, CARVEDILOLUM, pentru care iniţierea tratamentului
poate fi efectuată şi de către medicul de familie.
Medicamentele corespunzătoare DCI COMBINATII (SACUBITRILUM+VALSARTANUM) de la punctul G1 se adresează pacienţilor adulţi cu insuficienţă cardiacă cronică, indiferent de clasa Nyha.
Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.
Pagina 42 din 42
ANEXA 2d
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,
VALABILĂ ÎNCEPÂND CU 01 IULIE 2020
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W02902002 A03AD02 DROTAVERINUM NO - SPA 40 mg/2 ml SOL. INJ. 40mg/2ml CHINOIN PRIVATE CO. LTD.UNGARIA CUTIE X 25 FIOLE X 2ML SOL. INJ. P-RF 25 1,050400 1,050400 0,000000
2 W64401002 A03AD02 DROTAVERINUM NO-SPA 40 mg/2 ml SOL. INJ. 40mg/2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 2 ML SOL. INJ. PRF 25 1,050400 1,050400 0,000000
3 W60351002 A03BA01 ATROPINUM SULFAT DE ATROPINA TAKEDA 1 mg/ml SOL. INJ. 1mg/ml TAKEDA GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. PR 5 1,716000 1,716000 0,000000
4 W43286001 A03DA02 COMBINATII ALGIFEN COMPRIMATE COMPR. 500mg/5mg/0,1mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,401500 0,401500 0,000000
5 W01509001 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,401500 0,401500 0,000000
6 W43285003 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. 500mg/2mg/0,02mg/ml ZENTIVA SA ROMANIA PRF
CUTIE CU 5 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI 2 INELE COLORATE PE GÂTUL FIOLEI (GALBEN SI ALB), A CÂTE 5 ML SOL. INJ. 5 4,078000 4,078000 0,000000
7 W43285004 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. 500mg/2mg/0,02mg/ml ZENTIVA SA ROMANIA PRF
CUTIE CU 10 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI 2 INELE COLORATE PE GÂTUL FIOLEI (GALBEN SI ALB), A CÂTE 5 ML SOL. INJ. 10 3,948000 3,948000 0,000000
8 W43285001 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 5 ML SOL. INJ.P-RF 5 4,078000 4,078000 0,000000
9 W01529001 A05BAN3 COMBINATII ASPATOFORT (R) SOL. INJ. FARA CONCENTRATIE TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 10 ML P-RF 10 3,371000 3,371000 0,000000
10 W55728001 A06AD65 COMBINATII FORTRANS PULB. PT. SOL. ORALA FARA CONCENTRATIE IPSEN PHARMA FRANTA CUTIE CU 4 PLICURI DIN HARTIE-AL-PE X 73,69 G PULB. PT. SOL. ORALA P-RF 4 10,397500 10,397500 0,000000
11 W66208001 A06AD65 COMBINATII FORTRANS PULB. PT. SOL. ORALA FARA CONCENTRATIE IPSEN CONSUMER HEALTHCARE FRANTA CUTIE CU 4 PLICURI DIN HARTIE-AL-PE X 73,69 G PULB. PT. SOL. ORALA P-RF 4 10,397500 10,397500 0,000000
12 W64825001 A06AD65 COMBINATII CLENSIA PULB. PT. SUSP. ORALAFARA CONCENTRATIE ALFASIGMA ROMANIA S.R.L. ROMANIA PRF
CUTIE CU 8 PLICURI (4 PLICURI A (MARI) + 4 PLICURI B (MICI)) DIN HARTIE-AL-PE CARE CONTIN PULB. PT. SOL. ORALA, CORESP. UNEI SINGURE CURE DE TRATAMENT 4 14,702500 14,702500 0,000000
13 W66223001 A06AD65 COMBINATII CLENSIA PULB. PT. SUSP. ORALAFARA CONCENTRATIE ADDENDA PHARMACEUTICALS S.R.L. ROMANIA PRF
CUTIE CU 8 PLICURI (4 PLICURI A (MARI) + 4 PLICURI B (MICI)) DIN HARTIE-AL-PE CARE CONTIN PULB. PT. SOL. ORALA, CORESP. UNEI SINGURE CURE DE TRATAMENT 4 14,702500 14,702500 0,000000
14 W04551001 A07AX03 NIFUROXAZIDUM ERCEFURYL (R) 200 mg CAPS. 200mg SANOFI-SYNTHELABO OTCFRANTA CUTIE X 2 BLIST. X 14 CAPS. P-RF 28 0,470357 0,470357 0,000000
15 W63531001 A07AX03 NIFUROXAZIDUM ERCEFURYL 200 mg CAPS. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 CAPS. PRF 28 0,470357 0,470357 0,000000
16 W05420003 A11CA01 RETINOLUM VITAMINA A 50000 ui CAPS. MOI 50000ui PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 12 CAPS. MOIP-6L 24 0,203333 0,203333 0,000000
17 W60620001 A11CA01 RETINOLUM VITAMINA A FORTE BIOFARM 50000 UI CAPS. MOI 50000ui BIOFARM SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. MOIP6L 30 0,243999 0,243999 0,115667
18 W08876001 A11CA01 RETINOLUM VITAMINA A BIOFARM 20mg/ml PIC. ORALE, SOL. 20mg/ml BIOFARM SA ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-6L 1 9,240000 9,240000 0,000000
19 W01433001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,281333 0,281333 0,000000
20 W01433003 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE CU 2 BLIST. AL/PVC X 15 COMPR. P6L 30 0,281333 0,281333 0,000000
21 W01434001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 500 COMPR. 500UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,268666 0,268666 0,000000
22 W53793001 A11CC05 COLECALCIFEROLUM VITAMINA D3 BIOFARM 18000UI/mlPIC. ORALE, SOL. 0,45mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLACON X 10 ML PIC. ORALE, SOL. P-6L 1 7,700000 7,700000 0,000000
23 W01432001 A11CC05 COLECALCIFEROLUM VIGANTOL OIL 0,5 mg/ml PIC. ORALE, SOL. 0,5mg/ml MERCK KGAA GERMANIA P-6L
CUTIE CU UN FLACON DIN STICA BRUNA A 10 ML PICATURI ORALE SOLUTIE, PREVAZUT CU PICURATOR DIN PE 1 7,070000 7,070000 0,000000
24 W01608001 A11CC20 COMBINATII FLUOR-VIGANTOLETTEN 1000 UI/0,55 mg COMPR. 1000 UI/0,55 mg MERCK KGAA GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,479333 0,479333 0,000000
25 W01609001 A11CC20 COMBINATII FLUOR-VIGANTOLETTEN 500 UI/0,55 mg COMPR. 500 UI/0,55 mg MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 30 COMPR. P-6L 30 0,420666 0,420666 0,000000
26 W56759001 A11DA01 THIAMINUM VITAMINA B1 ZENTIVA 100 mg/2 mlSOL. INJ. 100mg/2ml ZENTIVA SA ROMANIA P-RF
CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ALBASTRU SI VERDE) X 2 ML SOL. INJ. 5 2,320000 2,320000 0,000000
27 W62898002 A11DA03 BENFOTIAMINUM NEUROSSEN 300 mg COMPR. FILM. 300mg AAA-PHARMA GMBH GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 2,749333 2,749333 0,000000
28 W66482006 A11DA03 BENFOTIAMINUM TIAVELLA 300 mg COMPR. FILM. 300mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 2,794000 2,794000 0,000000
29 W01610002 A11DBN1 COMBINATII MILGAMMA N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 50 1,031200 1,031200 0,000000
30 W56297001 A11DBN1 COMBINATII NEUROMULTIVIT COMPR. FILM. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. P-6L 20 0,474480 0,474480 0,011020
31 W56297002 A11DBN1 COMBINATII NEUROMULTIVIT COMPR. FILM. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVC/AL X 20 COMPR. FILM. P-6L 100 0,395400 0,395400 0,000000
32 W42092002 A11DBN1 COMBINATII MILGAMMA (R) 100+100mg DRAJ. 100mg+100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 DRAJ.P-6L 60 1,666333 1,666333 0,000000
33 W01731002 A11DBN1 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 1,042000 1,042000 0,000000
34 W01731002 A11DBN1 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 1,042000 1,042000 0,000000
35 W41647001 A11DBN1 COMBINATII MILGAMMA NA SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 1 ML P-RF 5 4,118000 4,118000 0,000000
36 W58389001 A11GA01 ACIDUM ASCORBICUM ACID ASCORBIC ARENA 750 mg SOL INJ. 750mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ.PRF 5 2,192000 2,192000 0,000000
37 W52512001 A11GA01 ACIDUM ASCORBICUM VITAMINA C ARENA 750 mg SOL. INJ. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ. P-RF 5 2,630400 2,630400 2,993600
38 W56760001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 0,505500 0,505500 0,000000
39 W42822002 A11HA02 PYRIDOXINUM VITAMINA B6 ARENA 250 mg COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE CU 2 BLIST. DIN FOLIE PVC ALBA OPACA/AL X 10 COMPR. P6L 20 0,505500 0,505500 0,000000
40 W42822003 A11HA02 PYRIDOXINUM VITAMINA B6 ARENA 250 mg COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE CU 5 BLIST. DIN FOLIE PVC ALBA OPACA/AL X 10 COMPR. P6L 50 0,501400 0,501400 0,000000
41 W56758001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg/5 mlSOL. INJ. 250mg/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 3,448000 3,448000 0,000000
42 W56757001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 50 mg/2ml SOL. INJ. 50mg/2ml ZENTIVA SA ROMANIA P-RF
CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE SAU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI 2 INELE COLORATE PE GATUL FIOLEI PT. IDENTIFICARE X 2 ML SOL. INJ. 5 2,320000 2,320000 0,000000
43 W51342001 A11HA03 TOCOFEROLUM VITAMINA E 400 mg CAPS. MOI 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 12 CAPS. MOI P-6L 24 0,432916 0,432916 0,000000
44 W57681001 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU 94mg/ml SOL. INJ. 94mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FIOLE DIN PEJD X 10 ML SOL. INJ. P-RF 20 1,860000 1,860000 0,000000
45 W60222003 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU ZENTIVA 95 mg/ml SOL. INJ. 95mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE X 10 ML SOL. INJ. P-RF 5 2,232000 2,232000 1,302000
46 W00868001 A16AA01 LEVOCARNITINUM CARNIL (R) SOL. ORALA 100mg/ml ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 10 FLACOANE DIN STICLA BRUNA, ACOPERITE CU UN CAPAC DIN AL. X 10 ML P-6L 10 2,026000 2,026000 0,000000
Pagina 1 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 2 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 3 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 4 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Nota:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.;
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.
Pagina 5 din 5
ANEXA 2e
SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, REPUBLICATA,
VALABILA INCEPAND CU 01 IULIE 2020
Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM
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 0,454500 0,263500 0,090900 0,627100
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 0,227250 0,025250 0,045450 0,207050
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 0,227250 0,026250 0,045450 0,208050
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 0,227250 0,025250 0,045450 0,207050
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 0,227250 0,026250 0,045450 0,208050
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 0,227250 0,026250 0,045450 0,208050
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 0,227250 0,026416 0,045450 0,208216
8 W06812001 A02BA02 RANITIDINUM ARNETIN 50 mg/2 ml SOL. INJ. 50mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE X 2 ML P-RF 5 1,916546 2,475454 0,383309 4,008691
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 0,227250 0,142416 0,045450 0,324216
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 0,227250 0,142416 0,045450 0,324216
11 W42867001 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 40 mg COMPR. FILM. 40mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,439000 0,000000 0,087800 0,351200
12 W03079002 A02BA03 FAMOTIDINUM FAMODIN 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,439000 0,000000 0,087800 0,351200
13 W54839001 A02BA03 FAMOTIDINUM QUAMATEL 20 mg 20mg
PULB+SOLV. PT. SOL. INJ./PERF. GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA CU PULBERE PENTRU SOLUTIE INJ./PERF. + 5 FIOLE DIN STICLA INCOLORA X 5ML SOLV. PENTRU UZ PARENTERAL S/P-RF 5 4,126000 0,000000 0,825200 3,300800
14 W44052002 A02BX02 SUCRALFATUM GASTROFAIT COMPR. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. P-6L 20 0,348000 0,000000 0,069600 0,278400
15 W62373001 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg BGP PRODUCTS B.V. OLANDA CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL. P-6L 30 0,829999 0,000001 0,165999 0,664001
16 W62373002 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. X 15 CAPS. ELIB. PREL. P-6L 30 0,829999 0,000001 0,165999 0,664001
17 W64562002 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 2 BLIST. X 15 CAPS. ELIB. PREL. P6L 30 0,829999 0,000001 0,165999 0,664001
18 W64562001 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 3 BLIST. X 10 CAPS. ELIB. PREL. P6L 30 0,829999 0,000001 0,165999 0,664001
19 W04080002 A03AA04 MEBEVERINUM COLOSPASMIN DRAJ. 100mg E.I.P.I.CO. MED SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 DRAJ. P-6L 20 0,414999 0,197501 0,082999 0,529501
20 W51982001 A03AA05 TRIMEBUTINUM TRIMEBUTIN 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,412333 0,000000 0,082466 0,329867
21 W52004001 A03AA05 TRIMEBUTINUM COLPERIN 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0,412333 0,000000 0,082466 0,329867
22 W42800002 A03AA05 TRIMEBUTINUM IBUTIN 300 mg COMPR. ELIB. PREL. 300mg ZENTIVA SA ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 20 1,237003 0,963997 0,247400 1,953600
23 W08438001 A03AA05 TRIMEBUTINUM DEBRIDAT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,412333 0,000000 0,082466 0,329867
24 W65034001 A03AA05 TRIMEBUTINUM DEBRIDAT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. AL/PVC X 15 COMPR. FILM.P6L 30 0,412333 0,000000 0,082466 0,329867
25 W65447001 A03AA05 TRIMEBUTINUM COLBUTIN 100 mg COMPR. FILM. 100mg BIOFARM S.A. ROMANIA CUTIE CU 3 BLIST. PVC TRANSPARENT/AL X 10 COMPR. FILM. P6L 30 0,412333 0,000000 0,082466 0,329867
26 W65447002 A03AA05 TRIMEBUTINUM COLBUTIN 100 mg COMPR. FILM. 100mg BIOFARM S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENT/AL X 10 COMPR. FILM. P6L 30 0,412333 0,000000 0,082466 0,329867
27 W59465001 A03AA05 TRIMEBUTINUM DEBRIDAT 200 mg COMPR. FILM. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM.P6L 30 0,824668 0,379998 0,164933 1,039733
28 W65035001 A03AA05 TRIMEBUTINUM DEBRIDAT 200 mg COMPR. FILM. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM.P6L 30 0,824668 0,379998 0,164933 1,039733
29 W07832001 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 152,5 G GRANULE PT. 250ML SUSP. + MASURA DOZATOARE P-6L 1 13,390000 0,000000 2,678000 10,712000
30 W65036001 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 152,5 G GRANULE PT. 250ML SUSP. + MASURA DOZATOARE GRADATA P6L 1 13,390000 0,000000 2,678000 10,712000
31 W07832002 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 76,25 G GRANULE PT. 125ML SUSP. + MASURA DOZATOARE P-6L 1 6,695000 4,465000 1,339000 9,821000
32 W65036002 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 76,25 G GRANULE PT. 125ML SUSP. + SERINGA DOZATOARE GRADATA P6L 1 6,695000 4,465000 1,339000 9,821000
33 W12227001 A03FA03 DOMPERIDONUM MOTILIUM 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 0,156875 0,331125 0,031375 0,456625
34 W61966003 A03FA03 DOMPERIDONUM DOMOTIL 10 mg 10mg
COMPR. ORODISPERSABILE LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE P6L 30 0,156875 0,331458 0,031375 0,456958
35 W13661001 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH 35 mg COMPR. CU ELIB. MODIF. 35mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLISTERE X 10 COMPRIMATE CU ELIBERARE MODIFICATA P-6L 60 0,429833 0,000000 0,085966 0,343867
36 W07058001 C01EB15 TRIMETAZIDINUM PREDUCTAL MR 35 mg COMPR. ELIB. MODIF. 35mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. FILM. ELIB. MODIF. P-6L 60 0,430000 0,192500 0,086000 0,536500
37 W59722004 C01EB15 TRIMETAZIDINUM MODUXIN MR 35 mg COMPR. ELIB. PREL. 35mg ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. CU ELIB. PRELUNG. P6L
GEDEON RICHTER ROMANIA SA 30 0,430000 0,000000 0,086000 0,344000
38 W41842001 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 60 0,245714 0,036452 0,049142 0,233024
39 W54945001 C01EB15 TRIMETAZIDINUM PREDUCTAL 20 mg COMPR. FILM. 20mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM.P-6L 60 0,245714 0,124786 0,049142 0,321358
40 W04516004 C04AE02 NICERGOLINUM SERMION COMPR. FILM. 30mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM P-6L 30 0,964000 0,452000 0,192800 1,223200
41 W42841001 C04AE02 NICERGOLINUM NICERGOLINA LPH 30 mg COMPR. FILM. 30mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,964000 0,000000 0,192800 0,771200
42 W63062001 C04AE02 NICERGOLINUM NICERGOLINA SLAVIA 30 mg COMPR. FILM. 30mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM.P6L 30 0,963000 0,000000 0,192600 0,770400
43 W65107002 C04AE02 NICERGOLINUM SERMION COMPR. FILM. 30mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM P6L 30 0,964000 0,452000 0,192800 1,223200
44 W52057002 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 0,964000 0,000000 0,192800 0,771200
45 W52057001 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 0,964000 0,000000 0,192800 0,771200
46 W06107003 C04AX07 VINCAMINUM VINCAMINA DRAJ. 10mg BIOFARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 DRAJ. P-6L 20 0,462000 0,000000 0,092400 0,369600
47 W11615001 C05CA53 DIOSMINUM (COMBINATII) ** DETRALEX ( R ) COMPR. FILM. 500mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,955666 0,000000 0,191133 0,764533
Pagina 1 din 3
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 3
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.
NOTĂ:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se iniţiază de către medicul de specialitate în limita competenţei şi poate fi prescris în continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.
Pagina 3 din 3