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Art. 4.

Directorii generali ai caselor de asigurări de sănătate, precum şi furnizorii de servicii medicale şi


medicamente care se află în relaţii contractuale cu casele de asigurări de sănătate au obligaţia de a pune în
aplicare şi de a respecta prevederile prezentului ordin.
Art. 5. Începând cu data intrării în vigoare a prezentului ordin, ordinul preşedintelui Casei Naţionale de
Asigurări de Sănătate nr. 755 din data de 30.06.2020 pentru aprobarea preţurilor de referinţă pe unitate
terapeutică pentru medicamentele cu şi fără contribuţie personală prescrise în tratamentul ambulatoriu,
precum şi a Listei preţurilor de referinţă pe unitate terapeutică aferente medicamentelor (denumiri comerciale)
din Catalogul naţional al preţurilor medicamentelor de uz uman autorizate de punere pe piaţă (CANAMED)
pentru sublistele A, B, C (secţiunile CI şi C3) şi D din anexa la H.G. nr. 720/2008 pentru aprobarea Listei
cuprinzând denumirile comune internaţionale corespunzătoare medicamentelor de care beneficiază asiguraţii,
cu sau fără contribuţie personală, pe bază de prescripţie medicală, în sistemul de asigurări sociale de sănătate,
precum şi denumirile comune internaţionale corespunzătoare medicamentelor care se acordă în cadrul
programelor naţionale de sănătate, republicată, cu modificările şi completările ulterioare, cu modificările şi
completările ulterioare, precum şi orice alte dispoziţii contrare îşi încetează aplicabilitatea.

p. PREȘEDINTE
Adela COJAN
VICEPREȘEDINTE

3
ANEXA 2a

SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, REPUBLICATA, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILA INCEPAND CU 01 MARTIE 2022

Contributie maxima Val. maxima suportata de Contributie maxima


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

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

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


Nr crt.

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

1 W64020007 A02BC01 OMEPRAZOLUM OMEZ 10 mg CAPS. GASTROREZ. 10mg ROMANIA


DR. REDDY'S LABORATORIES CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0.242474 0.439526 0.218226 0.463774
2 W42129001 A02BC01 OMEPRAZOLUM OMEPRAZOL-RICHTER 20 mg CAPS. GASTROREZ. 20mg ROMANIA
GEDEON RICHTER ROMANIA SA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L 14 0.484949 0.261479 0.436454 0.309974
3 W51990001 A02BC01 OMEPRAZOLUM OMEPRAZOL SLAVIA 20 mg CAPS. GASTROREZ. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0.484949 0.448717 0.436454 0.497212
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 0.484949 0.374717 0.436454 0.423212
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 0.484949 0.450384 0.436454 0.498879
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 0.484949 0.450384 0.436454 0.498879
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 0.484949 0.330717 0.436454 0.379212
8 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 0.484949 0.450551 0.436454 0.499046
9 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 0.416071 0.000000 0.374463 0.041608
10 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 0.416071 0.000000 0.374463 0.041608
11 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 0.416071 0.000000 0.374463 0.041608
12 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 0.484949 0.450384 0.436454 0.498879
13 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 0.484949 0.449336 0.436454 0.497831
14 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 0.484949 0.331717 0.436454 0.380212
15 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 0.484949 0.331717 0.436454 0.380212
16 W66010005 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mg CAPS. GASTROREZ. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 0.354285 0.000000 0.318856 0.035429
17 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 0.416071 0.000000 0.374463 0.041608
18 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 0.416071 0.000000 0.374463 0.041608
19 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 0.484949 0.391384 0.436454 0.439879
20 W67667002 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE TRADING SERVICES LIMITED IRLANDA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L 28 0.484949 0.449336 0.436454 0.497831
21 W67667003 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE TRADING SERVICES LIMITED IRLANDA CUTIE CU 5 BLIST. AL/AL X 6 CAPS. GASTROREZ. P6L 30 0.484949 0.391384 0.436454 0.439879
22 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 0.860000 0.000000 0.774000 0.086000
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 0.969899 0.107767 0.872909 0.204757
24 W66011002 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mg CAPS. GASTROREZ. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 14 CAPS. GASTROREZ. P6L 14 0.587857 0.000000 0.529071 0.058786
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 16.713000 1.857000 15.041700 3.528300
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 16.713000 1.857000 15.041700 3.528300
27 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 0.242474 0.293240 0.218226 0.317488
28 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 0.484949 0.325051 0.436454 0.373546
29 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 0.484949 0.445051 0.436454 0.493546
30 W08691002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0.161750 0.000000 0.145575 0.016175
31 W04254002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0.161750 0.000000 0.145575 0.016175
32 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 0.161750 0.000000 0.145575 0.016175
33 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 0.161750 0.000000 0.145575 0.016175
34 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 11.110000 0.000000 9.999000 1.111000
35 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 5.509999 0.000001 4.958999 0.551001
36 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 1.137000 0.000000 1.023300 0.113700
37 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 1.237800 0.033600 1.114020 0.157380
38 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 2.475600 0.085800 2.228040 0.333360
39 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 61.890059 48.279941 55.701053 54.468947
40 W64011001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 8.152792 8.007208 7.337512 8.822488
41 W64559001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% MYLAN HEALTHCARE B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 8.152792 8.007208 7.337512 8.822488
42 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 11.917500 0.012500 10.725750 1.204250
43 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 3.960000 0.000000 3.564000 0.396000
44 W05695001 A07AA02 NYSTATINUM NISTATINA ATB 500000 UI COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 1.185000 0.000000 1.066500 0.118500
45 W07440001 A07EC01 SULFASALAZINUM SULFASALAZINA EN 500 mg COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0.645600 0.000000 0.581040 0.064560
46 W59162002 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L 50 0.645600 0.000000 0.581040 0.064560
47 W58461001 A07EC02 MESALAZINUM ** PENTASA 1 g COMPR. CU ELIB. PREL. 1g FERRING GMBH GERMANIA CUTIE CU 6 BLIST. AL/AL X 10 COMPR. CU ELIB. PREL. P6L 60 1.773561 1.420772 1.596204 1.598129
48 W58055001 A07EC02 MESALAZINUM ** PENTASA 500mg COMPR. ELIB. PREL. 500mg FERRING GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 100 0.886780 0.711120 0.798102 0.799798
49 W04124001 A07EC02 MESALAZINUM ** SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0.443389 0.303311 0.399050 0.347650
50 W04126001 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0.886780 0.299220 0.798102 0.387898

Pagina 1 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
51 W04126002 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 50 0.886780 0.361820 0.798102 0.450498
52 W60409003 A07EC02 MESALAZINUM ** MESALAZINA SOFARFARM 800 mg COMPR. GASTROREZISTENTE 800mg SOFARFARM S.R.L. ROMANIA CUTIE CU 8 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 120 1.418850 0.157650 1.276965 0.299535
53 W61355001 A07EC02 MESALAZINUM ** PENTASA 2 g GRAN. ELIB. PREL. 2g FERRING GMBH GERMANIA CUTIE CU 60 PLICURI PET/AL/PEJD X 2 G GRANULE CU ELIB. PREL. P6L 60 3.547126 2.929874 3.192413 3.284587
54 W58054001 A07EC02 MESALAZINUM ** PENTASA 1000mg SUPOZ. 1000mg FERRING GMBH GERMANIA CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI P-6L 28 6.007999 0.185215 5.407199 0.786015
55 W56484005 A07EC02 MESALAZINUM ** SALOFALK 1 g SUPOZ. 1g DR. FALK PHARMA GMBH GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L 30 6.007999 0.000001 5.407199 0.600801
56 W04125003 A07EC02 MESALAZINUM ** SALOFALK 250 mg SUPOZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 1.501995 2.863005 1.351795 3.013205
57 W04127003 A07EC02 MESALAZINUM ** SALOFALK 500 mg SUPOZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 3.003999 0.789001 2.703599 1.089401
58 W04128001 A07EC02 MESALAZINUM ** SALOFALK 4 g/ 60 ml SUSP. RECTALA 4g/60ml DR. FALK PHARMA GMBH GERMANIA CUTIE X 7 BLIST. AL/PE CONTINAND FIECARE CATE 1 FLACON UNIDOZA X 60 ML SUSPENSIE RECTALA + APLICA P-6L 7 20.062857 0.000000 18.056571 2.006286
59 W66550001 A09AA02 PANCREATINUM ** PANKREAL 35000 CAPS. GASTROREZ. 420mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 FLAC. DIN PEID INCHIS CU CAPAC DIN PP X 50 CAPS. GASTROREZ. P6L 50 2.646600 0.000000 2.381940 0.264660
60 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.253375 0.200625 0.228037 0.225963
61 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 0.373000 0.000000 0.335700 0.037300
62 W07616001 B01AC05 TICLOPIDINUM (1) TICLODIN 250 mg COMPR. FILM. 250mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P6L 20 0.289972 1.670028 0.260974 1.699026
63 W07968001 B01AC05 TICLOPIDINUM (1) IPATON 250 mg COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P6L 20 0.289972 1.082028 0.260974 1.111026
64 W05001002 B02BA01 PHYTOMENADIONUM FITOMENADION TERAPIA 10 mg/ml SOL. INJ. 10mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML S/P-RF 5 6.714000 0.000000 6.042600 0.671400
65 W10038010 B03AA07 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES 100 mg+60 mg COMPR. FILM. 100mg+60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, AVAND CAPAC DIN PE CU COMPENSATOR X 120 COMPR. FILM. P6L 120 0.603166 0.000000 0.542849 0.060317
66 W43097001 B03AA07 FERROSI SULFAS FERROGRADUMET 105 mg COMPR. ELIB. PREL. 105mg TEOFARMA SRL ITALIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0.310666 0.000000 0.279599 0.031067
67 W08016001 B03AA07 FERROSI SULFAS TARDYFERON 80 mg COMPR. ELIB. PREL. 80mg FRANTA
PIERRE FABRE MEDICAMENT CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0.261169 0.139831 0.235052 0.165948
68 W44026001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT MALTOFER 100 mg COMPR. MAST. 100mg VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MASTIC. P-6L 30 0.725472 0.229194 0.652924 0.301742
69 W54079001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM 50 mg/ml PICATURI ORALE, SOL. 50mg/ml BIOFARM S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, DE CLASA HIDROLITICA III, PREVAZUT CU PICURATOR DIN PE X 30 ML PICATURI ORALE, SOL. P-6L 1 12.700000 0.000000 11.430000 1.270000
70 W51228001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN 50 mg/ml PICATURI ORALE-SOL. 50mg/ml VIFOR FRANCE S.A. FRANTA CUTIE CU 1 FLAC. DE STICLA BRUNA, CU DOP PICURATOR DIN PEJD X 30 ML PIC. ORALE, SOL. P-6L 1 16.405000 1.235000 14.764500 2.875500
71 W51231001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN 10 mg/ml SIROP 10mg/ml VIFOR FRANCE S.A. FRANTA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU DOP PICURATOR DIN PE + O MASURA DOZATOARE X 150 ML SIROP P-6L 1 16.405000 8.295000 14.764500 9.935500
72 W52797001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM 50mg/5ml SIROP 50mg/5ml BIOFARM S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, DE CLASA HIDROLITICA III, CU CAPACITATEA DE 100 ML + MASURA DOZATOARE GRADATA DE LA 2,5 - 20 ML X 100 ML SIROP P-6L 1 10.936666 1.763334 9.842999 2.857001
73 W42875001 B03BB01 ACIDUM FOLICUM ACIFOL 5 mg COMPR. FILM. 5mg ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-6L 30 1.166000 0.000000 1.049400 0.116600
74 W58535002 C01AA05 DIGOXINUM DIGOXINA ZENTIVA 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0.363749 0.230251 0.327374 0.266626
75 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 0.287000 0.000000 0.258300 0.028700
76 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 6.848000 0.000000 6.163200 0.684800
77 W56891002 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.363200 0.011800 0.326880 0.048120
78 W56891003 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF 50 0.363200 0.012200 0.326880 0.048520
79 W56891004 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 0.363200 0.000000 0.326880 0.036320
80 W12499003 C01BC03 PROPAFENONUM PROPAFENONA AL 150 mg COMPR. FILM. 150mg ALIUD PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-RF 100 0.363200 0.000000 0.326880 0.036320
81 W62345001 C01BC03 PROPAFENONUM RYTMONORM 150 mg COMPR. FILM. 150mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM. PRF 50 0.363200 0.214000 0.326880 0.250320
82 W62339001 C01BC03 PROPAFENONUM RYTMONORM 70 mg/20 ml SOL. INJ. 70mg/20ml MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. PRF 5 10.076000 0.000000 9.068400 1.007600
83 W06951001 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 0.336000 0.172333 0.302400 0.205933
84 W00311002 C01BD01 AMIODARONUM AMIODARONA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.336000 0.000000 0.302400 0.033600
85 W53954002 C01BD01 AMIODARONUM AMIODARONA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.336000 0.000000 0.302400 0.033600
86 W64483001 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.336000 0.172333 0.302400 0.205933
87 W64483002 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. PRF 30 0.336000 0.172333 0.302400 0.205933
88 W04591002 C01DA02 NITROGLYCERINUM NITROMINT 2,6 mg COMPR. ELIB. PREL. 2,6mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL. P-6L 60 0.215445 0.000055 0.193900 0.021600
89 W42792002 C01DA02 NITROGLYCERINUM NITROGLICERINA 0,5 mg COMPR. SUBLING. 0,5mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE P-6L 20 0.084722 0.771778 0.076249 0.780251
90 W04587001 C01DA02 NITROGLYCERINUM NITRODERM TTS 5 mg/24 ore PLASTURE TRANSDERMIC 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC P-6L 10 2.484000 0.000000 2.235600 0.248400
91 W07257001 C01DA02 NITROGLYCERINUM NITROMINT 0,4 mg/doza SPRAY SUBLINGUAL 0,4mg/doza UNGARIA CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL
EGIS PHARMACEUTICALS P.L.C. P-6L 1 12.200000 0.000000 10.980000 1.220000
92 W07257002 C01DA02 NITROGLYCERINUM NITROMINT 0,4 mg/doza SPRAY SUBLINGUAL 0,4mg/doza UNGARIA CUTIE X 1 FLACON DIN PLASTIC X 10G (180 DOZE) SPRAY SUBLINGUAL
EGIS PHARMACEUTICALS P.L.C. P-6L 1 12.200000 0.000000 10.980000 1.220000
93 W44053001 C01DA08 ISOSORBIDI DINITRAS ISOSORBID DINITRAT EIPICO 10 mg COMPR. 10mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3, BLIST. AL/PVC X 20 COMPR. P-6L 60 0.069000 0.000000 0.062100 0.006900
94 W62347001 C01DA14 ISOSORBIDI MONONITRAS OLICARD RETARD 40 mg CAPS. ELIB. PREL. 40mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 0.414317 0.089683 0.372885 0.131115
95 W13871002 C01DA14 ISOSORBIDI MONONITRAS MONONITRON EP 60 mg COMPR. ELIB. PREL. 60mg ZENTIVA S.A ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 40 0.621476 0.592774 0.559328 0.654922
96 W53697001 C01EA01 ALPROSTADILUM ** PRIDAX 20mcg CONC. PT. SOL. PERF. 20mcg GEBRO PHARMA GMBH AUSTRIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF PR/PRF 5 49.862000 0.000000 44.875800 4.986200
97 W66688003 C01EA01 ALPROSTADILUM ** ALPROSTADIL ROMPHARM 20 micrograme PULB. PT. SOL. PERF. 20micrograme ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 15 FLAC. DE STICLA DE TIP I PR/PRF 15 50.793499 0.310501 45.714149 5.389851
98 W58530002 C01EA01 ALPROSTADILUM ** VASAPROSTAN 20 µg/ml PULB. PT. SOL. PERF. 20µg/ml UCB PHARMA GMBH GERMANIA CUTIE CU 15 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE, CU CAPACITATE DE 5 ML, CONTINÂND 48,2 MG PULB. PT. SOL. PERF. PRF 15 50.793499 11.277834 45.714149 16.357184
99 W67213002 C01EA01 ALPROSTADILUM ** VASAPROSTAN 20 µg/ml PULB. PT. SOL. PERF. 20µg/ml AMDIPHARM LIMITED IRLANDA CUTIE CU 15 FIOLE DIN STICLA INCOLORA,DE TIP I, CU PUNCT DE RUPERE, CU CAPACITATE DE 5 ML, CONTINÂND 48,2 MG PULB. PT. SOL. PERF. PRF 15 50.793499 11.277834 45.714149 16.357184
100 W04208001 C02AB01 METHYLDOPUM DOPEGYT 250 mg COMPR. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 0.633000 0.000000 0.569700 0.063300
101 W01369003 C02AC01 CLONIDINUM CLONIDINA SINTOFARM 0,15 mg COMPR. 0,15mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.253980 0.028220 0.228582 0.053618
102 W60265001 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 0.253980 0.028220 0.228582 0.053618
103 W65031002 C02CA04 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0.581999 0.421572 0.523799 0.479772
104 W67252002 C02CA04 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg UPJOHN EESV OLANDA CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. MODIF. P6L 28 0.581999 0.421572 0.523799 0.479772
105 W65031002 C02CA04 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0.581999 0.421572 0.523799 0.479772
106 W67252002 C02CA04 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg UPJOHN EESV OLANDA CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. MODIF. P6L 28 0.581999 0.421572 0.523799 0.479772
107 W43198002 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0.739600 0.000000 0.665640 0.073960
108 W62788001 C03BA11 INDAPAMIDUM INDAPAMIDA SLAVIA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 0.345599 0.039734 0.311039 0.074294

Pagina 2 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
109 W56973001 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 1,5 mg COMPR. CU ELIB. PRELUNGITA 1,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L 30 0.345599 0.039734 0.311039 0.074294
110 W61972001 C03BA11 INDAPAMIDUM INDAPAMID SR ZENTIVA 1,5 mg COMPR. ELIB. PREL 1,5 mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P6L 30 0.345599 0.039734 0.311039 0.074294
111 W03592001 C03BA11 INDAPAMIDUM TERTENSIF SR 1,5 mg COMPR. ELIB. PREL. 1,5mg LES LAB. SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-6L 30 0.345599 0.174067 0.311039 0.208627
112 W13662001 C03BA11 INDAPAMIDUM INDAPAMID LPH 1,5 mg COMPR. ELIB. PREL. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0.345599 0.039734 0.311039 0.074294
113 W52005001 C03BA11 INDAPAMIDUM INDAPAMID MCC 1,5 mg COMPR. ELIB. PREL. 1,5mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0.345599 0.039734 0.311039 0.074294
114 W53212001 C03BA11 INDAPAMIDUM IDUREN SR 1,5 mg COMPR. ELIB. PREL. 1,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0.345599 0.039734 0.311039 0.074294
115 W62164001 C03BA11 INDAPAMIDUM INDAPAMIDA ATB 1,5 mg COMPR. ELIB. PREL. 1,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0.345599 0.039734 0.311039 0.074294
116 W67387001 C03BA11 INDAPAMIDUM INDAPAMIDA SR MEDREG 1,5 mg COMPR. ELIB. PREL. 1,5mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0.345599 0.039734 0.311039 0.074294
117 W13675001 C03BA11 INDAPAMIDUM INDAPAMID LPH 2,5 mg COMPR. FILM. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0.575333 0.000000 0.517799 0.057534
118 W43065002 C03BA11 INDAPAMIDUM RAWEL SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0.293333 0.000000 0.263999 0.029334
119 W52836001 C03BA11 INDAPAMIDUM IMPAMID SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. ELIB. PREL. P-6L 30 0.345599 0.034401 0.311039 0.068961
120 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 0.321500 0.000000 0.289350 0.032150
121 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA 40 mg COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.338375 0.006125 0.304537 0.039963
122 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA 40 mg COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0.210500 0.000000 0.189450 0.021050
123 W52043001 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.338375 0.006125 0.304537 0.039963
124 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.338375 0.006125 0.304537 0.039963
125 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 0.338375 0.006291 0.304537 0.040129
126 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 0.338375 0.005625 0.304537 0.039463
127 W68090001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.338375 0.006125 0.304537 0.039963
128 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 1.390000 0.000000 1.251000 0.139000
129 W58282001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA 20 mg/2 ml SOL. INJ. 20mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1.390000 0.000000 1.251000 0.139000
130 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 0.379000 0.029400 0.341100 0.067300
131 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 0.379000 0.029333 0.341100 0.067233
132 W54823001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0.423333 0.000000 0.380999 0.042334
133 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 0.758000 0.000000 0.682200 0.075800
134 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 0.379000 0.029500 0.341100 0.067400
135 W68089001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.379000 0.029500 0.341100 0.067400
136 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 0.379000 0.029400 0.341100 0.067300
137 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 0.379000 0.029500 0.341100 0.067400
138 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 0.758000 0.000000 0.682200 0.075800
139 W58726003 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUROCARD 50 mg/20 mg CAPS. 50mg/20 mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 1.291083 0.000250 1.161974 0.129359
140 W07005001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 mg/20 mg CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-6L 20 1.291083 0.043417 1.161974 0.172526
141 W60585002 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 1.290333 0.000000 1.161299 0.129034
142 W60585001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6L 20 1.291083 0.043417 1.161974 0.172526
143 W13574002 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. CU ELIB. PREL. P-6L 40 0.365850 0.275900 0.329265 0.312485
144 W53002004 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0.365850 0.000150 0.329265 0.036735
145 W53002005 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0.365800 0.000000 0.329220 0.036580
146 W66977001 C04AD03 PENTOXIFYLLINUM ANGIOPENT RETARD 400 mg COMPR. ELIB. PREL. 400mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 20 0.365850 0.619650 0.329265 0.656235
147 W66977002 C04AD03 PENTOXIFYLLINUM ANGIOPENT RETARD 400 mg COMPR. ELIB. PREL. 400mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 40 0.365850 0.269400 0.329265 0.305985
148 W53506005 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0.519000 0.000000 0.467100 0.051900
149 W53506006 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 100 0.502100 0.000000 0.451890 0.050210
150 W54452002 C04AD03 PENTOXIFYLLINUM VASONIT RETARD 600 mg COMPR. ELIB. PREL. 600mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 50 0.548775 0.197025 0.493897 0.251903
151 W66978001 C04AD03 PENTOXIFYLLINUM ANGIOPENT RETARD 600 mg COMPR. ELIB. PREL. 600mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 20 0.548775 0.358725 0.493897 0.413603
152 W53123003 C04AD03 PENTOXIFYLLINUM OXIFLUX 400 mg COMPR. FILM. ELIB. PREL. 400mg LABORMED PHARMA S.A. ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 60 0.365850 0.255150 0.329265 0.291735
153 W56674001 C07AA05 PROPRANOLOLUM PROPRANOLOL BIOEEL 10 mg COMPR. 10 mg BIO EEL S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 25 COMPR. P6L 50 0.028450 0.061750 0.025605 0.064595
154 W08683002 C07AA05 PROPRANOLOLUM PROPRANOLOL SINTOFARM 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.028450 0.061750 0.025605 0.064595
155 W68094001 C07AA05 PROPRANOLOLUM PROPRANOLOL BIOEEL 10 mg COMPR. 10mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 25 COMPR. P6L 50 0.028450 0.061750 0.025605 0.064595
156 W12724002 C07AA05 PROPRANOLOLUM PROPRANOLOL BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.113800 0.000000 0.102420 0.011380
157 W08684002 C07AA05 PROPRANOLOLUM PROPRANOLOL SINTOFARM 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.113800 0.000000 0.102420 0.011380
158 W53681002 C07AA05 PROPRANOLOLUM PROPRANOLOL ARENA 40 mg COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.113800 0.000000 0.102420 0.011380
159 W68095001 C07AA05 PROPRANOLOLUM PROPRANOLOL BIOEEL 40 mg COMPR. 40mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 0.113800 0.000000 0.102420 0.011380
160 W41673003 C07AA07 SOTALOLUM SOTAGAMMA 80 mg COMPR. 80mg GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L
WORWAG PHARMA GMBH & CO. KG 100 0.227600 0.142500 0.204840 0.165260
161 W08420005 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.227600 0.143800 0.204840 0.166560
162 W62335001 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.227600 0.256400 0.204840 0.279160
163 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 0.281599 0.045067 0.253439 0.073227
164 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 0.281599 0.044901 0.253439 0.073061
165 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 0.281599 0.045067 0.253439 0.073227
166 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 0.281599 0.045067 0.253439 0.073227

Pagina 3 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
167 W52230001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.281599 0.045067 0.253439 0.073227
168 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 0.281599 0.044901 0.253439 0.073061
169 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 0.281599 0.045067 0.253439 0.073227
170 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 0.281599 0.037901 0.253439 0.066061
171 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 0.070399 0.093934 0.063359 0.100974
172 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 0.070399 0.093934 0.063359 0.100974
173 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 0.070399 0.093934 0.063359 0.100974
174 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 0.140799 0.127867 0.126719 0.141947
175 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 0.140799 0.048201 0.126719 0.062281
176 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 0.140799 0.127867 0.126719 0.141947
177 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 0.140799 0.127867 0.126719 0.141947
178 W52231001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.140799 0.131867 0.126719 0.145947
179 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 0.140799 0.131701 0.126719 0.145781
180 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 0.140799 0.127867 0.126719 0.141947
181 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 0.140799 0.128201 0.126719 0.142281
182 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 0.140799 0.127867 0.126719 0.141947
183 W43226010 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR. ELIB. MODIF. 47,5mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0.133759 0.104574 0.120383 0.117950
184 W43227010 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR. ELIB. MODIF. 95mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0.267519 0.128481 0.240767 0.155233
185 W66032001 C07AB02 METOPROLOLUM BETALOC ZOK 100 mg COMPR. ELIB. PREL. 100mg RECORDATI INDUSTRIA CHIMICA E FARMACEUTICA S.P.A. ITALIA CUTIE CU 1 FLAC. PEID X 30 COMPR. ELIB. PREL. P6L 30 0.281599 0.677734 0.253439 0.705894
186 W66033001 C07AB02 METOPROLOLUM BETALOC ZOK 50 mg COMPR. ELIB. PREL. 50mg RECORDATI INDUSTRIA CHIMICA E FARMACEUTICA S.P.A. ITALIA CUTIE CU 1 FLAC. PEID X 30 COMPR. ELIB. PREL. P6L 30 0.140799 0.444867 0.126719 0.458947
187 W66454003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mgCOMPR. FILM. 100mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.281599 0.043067 0.253439 0.071227
188 W67867004 C07AB02 METOPROLOLUM METOPROLOL MEDREG 100 mg COMPR. FILM. 100mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.281599 0.045067 0.253439 0.073227
189 W66453003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.140799 0.127867 0.126719 0.141947
190 W67866004 C07AB02 METOPROLOLUM METOPROLOL MEDREG 50 mg COMPR. FILM. 50mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.140799 0.122867 0.126719 0.136947
191 W43226004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0.133759 0.104574 0.120383 0.117950
192 W43227004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0.267519 0.128481 0.240767 0.155233
193 W00491003 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.403666 0.000000 0.363299 0.040367
194 W53950002 C07AB03 ATENOLOLUM ATENOLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.402000 0.000000 0.361800 0.040200
195 W61517001 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.402000 0.000000 0.361800 0.040200
196 W00492003 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.225000 0.000000 0.202500 0.022500
197 W53949002 C07AB03 ATENOLOLUM ATENOLOL ARENA 50 MG COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
P-6L 20 0.225000 0.000000 0.202500 0.022500
198 W61516001 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L 20 0.225000 0.000000 0.202500 0.022500
199 W12507001 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM. P-6L 28 0.422399 0.213672 0.380159 0.255912
200 W12507003 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 6 BLIST. PVC/AL X 14 COMPR. FILM. P6L 84 0.422399 0.447362 0.380159 0.489602
201 W64210003 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 14 COMPR. FILM. P6L 84 0.422399 0.447362 0.380159 0.489602
202 W67248003 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU 6 BLIST. PVC/AL X 14 COMPR. FILM. P6L 84 0.422399 0.447362 0.380159 0.489602
203 W67248001 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM. P6L 28 0.422399 0.213672 0.380159 0.255912
204 W00625001 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0.422399 0.424601 0.380159 0.466841
205 W13630003 C07AB07 BISOPROLOLUM BISOGAMMA 10 mg COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 100 0.294800 0.000000 0.265320 0.029480
206 W43154001 C07AB07 BISOPROLOLUM BISOTENS 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.422399 0.053601 0.380159 0.095841
207 W00625002 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM. P-6L 60 0.422399 0.396934 0.380159 0.439174
208 W60359002 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.422399 0.437267 0.380159 0.479507
209 W60569004 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0.383000 0.000000 0.344700 0.038300
210 W66286002 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK ROMANIA SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM. P6L 60 0.422399 0.396934 0.380159 0.439174
211 W66286001 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.422399 0.424601 0.380159 0.466841
212 W66289002 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.422399 0.437267 0.380159 0.479507
213 W66459003 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT 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 0.391333 0.000000 0.352199 0.039134
214 W60357002 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.105599 0.222734 0.095039 0.233294
215 W60567004 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0.105599 0.162401 0.095039 0.172961
216 W66288002 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.105599 0.222734 0.095039 0.233294
217 W00626001 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0.211199 0.334801 0.190079 0.355921
218 W43153001 C07AB07 BISOPROLOLUM BISOTENS 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.211199 0.082467 0.190079 0.103587
219 W00626002 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM. P-6L 60 0.211199 0.365801 0.190079 0.386921
220 W60358002 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.211199 0.217134 0.190079 0.238254
221 W60568004 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0.211199 0.019467 0.190079 0.040587
222 W13629005 C07AB07 BISOPROLOLUM BISOGAMMA 5 mg COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 100 0.168400 0.000000 0.151560 0.016840
223 W66285002 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK ROMANIA SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM. P6L 60 0.211199 0.365801 0.190079 0.386921
224 W66285001 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.211199 0.334801 0.190079 0.355921

Pagina 4 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
225 W66287002 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.211199 0.217134 0.190079 0.238254
226 W66458003 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0.195666 0.000000 0.176099 0.019567
227 W59931001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.242100 0.023900 0.217890 0.048110
228 W12649001 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0.242100 0.026828 0.217890 0.051038
229 W42058001 C07AG02 CARVEDILOLUM TALLITON 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.242100 0.026900 0.217890 0.051110
230 W42659001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.242100 0.356233 0.217890 0.380443
231 W53658001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.242100 0.355900 0.217890 0.380110
232 W53751001 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.242100 0.183233 0.217890 0.207443
233 W58304001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,5 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.242100 0.355900 0.217890 0.380110
234 W63454001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.242100 0.356233 0.217890 0.380443
235 W42058002 C07AG02 CARVEDILOLUM TALLITON 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. DIN OPA-AL-PVC/AL X 15 COMPR. P6L 30 0.242100 0.026900 0.217890 0.051110
236 W12648002 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 0.391785 0.000000 0.352606 0.039179
237 W42059001 C07AG02 CARVEDILOLUM TALLITON 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.484200 0.017466 0.435780 0.065886
238 W42658001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.484200 0.180466 0.435780 0.228886
239 W53752001 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.484200 0.093466 0.435780 0.141886
240 W58305001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.484200 0.180800 0.435780 0.229220
241 W59932001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.479333 0.000000 0.431399 0.047934
242 W63455001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.484200 0.180466 0.435780 0.228886
243 W42059002 C07AG02 CARVEDILOLUM TALLITON 25 mg COMPR. 25mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. DIN OPA-AL-PVC/AL X 15 COMPR. P6L 30 0.484200 0.017466 0.435780 0.065886
244 W41867002 C07AG02 CARVEDILOLUM CORYOL 6,25mg COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0.121049 0.056093 0.108944 0.068198
245 W41912001 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.121049 0.056284 0.108944 0.068389
246 W42660001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0.121049 0.157951 0.108944 0.170056
247 W53663001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.121049 0.157951 0.108944 0.170056
248 W53750001 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.121049 0.082951 0.108944 0.095056
249 W59930001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.121049 0.051951 0.108944 0.064056
250 W63453001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0.121049 0.157951 0.108944 0.170056
251 W41912002 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. DIN OPA-AL-PVC/AL X 15 COMPR. P6L 30 0.121049 0.056284 0.108944 0.068389
252 W66017007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.242100 0.153614 0.217890 0.177824
253 W66018007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.484200 0.096871 0.435780 0.145291
254 W66016007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.121049 0.157879 0.108944 0.169984
255 W41513001 C08CA01 AMLODIPINUM AMLOHEXAL 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 0.228000 0.000000 0.205200 0.022800
256 W42020001 C08CA01 AMLODIPINUM TENOX 10 mg COMPR. 10mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.291299 0.031701 0.262169 0.060831
257 W52404001 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 10 mg COMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 0.225333 0.000000 0.202799 0.022534
258 W53430001 C08CA01 AMLODIPINUM ALMACOR 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.291299 0.032367 0.262169 0.061497
259 W55742001 C08CA01 AMLODIPINUM AMLODIPINA LPH 10 mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.291299 0.032367 0.262169 0.061497
260 W57500001 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.291299 0.032367 0.262169 0.061497
261 W57500002 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0.291299 0.032367 0.262169 0.061497
262 W59686002 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.262000 0.000000 0.235800 0.026200
263 W59528001 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR.
MAREA BRITANIE P6L 30 0.291299 0.141701 0.262169 0.170831
264 W60290001 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 10 mg COMPR. 10mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.291299 0.032201 0.262169 0.061331
265 W60373002 C08CA01 AMLODIPINUM AMLODIPINA ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.291299 0.032367 0.262169 0.061497
266 W61982002 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.291299 0.032367 0.262169 0.061497
267 W64900006 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.291299 0.141701 0.262169 0.170831
268 W65894007 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.279000 0.000000 0.251100 0.027900
269 W67203006 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg UPJOHN EESV OLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.291299 0.141701 0.262169 0.170831
270 W42019001 C08CA01 AMLODIPINUM TENOX 5 mg COMPR. 5mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.145649 0.108017 0.131084 0.122582
271 W52403001 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 5 mg COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 0.145649 0.014017 0.131084 0.028582
272 W53429001 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.145649 0.132351 0.131084 0.146916
273 W55743001 C08CA01 AMLODIPINUM AMLODIPINA LPH 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.145649 0.262684 0.131084 0.277249
274 W57499001 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.145649 0.262684 0.131084 0.277249
275 W57499002 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0.145649 0.262684 0.131084 0.277249
276 W59685002 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 5 mg COMPR. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.120333 0.000000 0.108299 0.012034
277 W59527001 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR.
MAREA BRITANIE P6L 30 0.145649 0.450017 0.131084 0.464582
278 W60289001 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 5 mg COMPR. 5mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.145649 0.262851 0.131084 0.277416
279 W60372002 C08CA01 AMLODIPINUM AMLODIPINA ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.145649 0.262684 0.131084 0.277249
280 W61981002 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.145649 0.262684 0.131084 0.277249
281 W64899006 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.145649 0.450017 0.131084 0.464582
282 W65893007 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.142666 0.000000 0.128399 0.014267

Pagina 5 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
283 W67202006 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg UPJOHN EESV OLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.145649 0.450017 0.131084 0.464582
284 W03102002 C08CA02 FELODIPINUM PLENDIL 10 mg COMPR. ELIB. PREL. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 0.291299 0.467701 0.262169 0.496831
285 W03104001 C08CA02 FELODIPINUM PLENDIL 5 mg COMPR. ELIB. PREL. 5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X, 30 COMPR. ELIB. PREL. P-6L 30 0.145649 0.417351 0.131084 0.431916
286 W42170001 C08CA02 FELODIPINUM SISTAR 10 mg COMPR. FILM. ELIB. MODIF. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0.291299 0.656367 0.262169 0.685497
287 W42168001 C08CA02 FELODIPINUM SISTAR 5 mg COMPR. FILM. ELIB. MODIF. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0.145649 0.452351 0.131084 0.466916
288 W06813001 C08CA02 FELODIPINUM AURONAL 10 mg COMPR. FILM. ELIB. PREL. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0.291299 0.668034 0.262169 0.697164
289 W06814001 C08CA02 FELODIPINUM AURONAL 2,5 mg COMPR. FILM. ELIB. PREL. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0.072824 0.480176 0.065541 0.487459
290 W06815001 C08CA02 FELODIPINUM AURONAL 5 mg COMPR. FILM. ELIB. PREL. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0.145649 0.460017 0.131084 0.474582
291 W04542001 C08CA05 NIFEDIPINUM NIFEDIPIN RETARD TERAPIA 20 mg COMPR. ELIB. PREL. 20mg TERAPIA SA ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 50 0.097099 0.352501 0.087389 0.362211
292 W63872001 C08CA05 NIFEDIPINUM ADALAT 30 mg COMPR. ELIB. PREL. 30mg BAYER AG GERMANIA CUTIE CU 2 BLIST. AL/PP X 14 COMPR. ELIB. PREL. P6L 28 0.145649 0.450422 0.131084 0.464987
293 W63872002 C08CA05 NIFEDIPINUM ADALAT 30 mg COMPR. ELIB. PREL. 30mg BAYER AG GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. ELIB. PREL. P6L 28 0.145649 0.450422 0.131084 0.464987
294 W60127001 C08DA01 VERAPAMILUM VERAPAMIL ARENA 40 mg CAPS. 40mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0.109149 0.161517 0.098234 0.172432
295 W57108002 C08DA01 VERAPAMILUM VERAPAMIL ARENA 80 mg CAPS. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0.218299 0.002701 0.196469 0.024531
296 W62364001 C08DA01 VERAPAMILUM ISOPTIN RR 240 mg COMPR. ELIB. PREL. 240mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 20 0.654899 0.139601 0.589409 0.205091
297 W06068001 C08DA01 VERAPAMILUM CORDAMIL 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0.109149 0.161517 0.098234 0.172432
298 W06069001 C08DA01 VERAPAMILUM CORDAMIL 80 mg COMPR. FILM. 80mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0.218299 0.000034 0.196469 0.021864
299 W62445001 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 40 mg DRAJ. 40mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 25 DRAJ. P6L 50 0.109149 0.161451 0.098234 0.172366
300 W62446002 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 80 mg DRAJ. 80mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 25 DRAJ. P6L 50 0.218200 0.000000 0.196380 0.021820
301 W62446001 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 80 mg DRAJ. 80mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 10 DRAJ. P6L 50 0.218200 0.000000 0.196380 0.021820
302 W59964001 C08DB01 DILTIAZEMUM DILTIAZEM SR ROMPHARM 180 mg CAPS. ELIB. PREL. 180mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 0.889500 0.426500 0.800550 0.515450
303 W44079001 C08DB01 DILTIAZEMUM DILTIAZEM EIPICO 60 mg COMPR. 60mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2, BLIST. AL/PVC X 10 COMPR. P-6L 20 0.296500 0.000000 0.266850 0.029650
304 W12201003 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L 50 0.296500 0.009900 0.266850 0.039550
305 W53585001 C08DB01 DILTIAZEMUM DILTIAZEM BIOEEL 60 mg COMPR. 60mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. DIN AL/ PVC X 10 COMPR. P-6L 20 0.296500 0.000000 0.266850 0.029650
306 W41897003 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L 60 0.296500 0.012166 0.266850 0.041816
307 W00775001 C09AA01 CAPTOPRILUM CAPTOPRIL TERAPIA 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.085500 0.085166 0.076950 0.093716
308 W06860001 C09AA01 CAPTOPRILUM CAPTOPRIL EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.085500 0.081000 0.076950 0.089550
309 W00774002 C09AA01 CAPTOPRILUM CAPTOPRIL LAROPHARM 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0.085500 0.088000 0.076950 0.096550
310 W43029001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.085500 0.081000 0.076950 0.089550
311 W06857001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.085500 0.088166 0.076950 0.096716
312 W08550001 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.085500 0.085166 0.076950 0.093716
313 W41981002 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.085500 0.085166 0.076950 0.093716
314 W53677002 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.085500 0.088000 0.076950 0.096550
315 W53677003 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE CU 100 BLIST. PVC/AL X 10 COMPR. P6L 1000 0.085500 0.065570 0.076950 0.074120
316 W53678001 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.171000 0.083000 0.153900 0.100100
317 W00777001 C09AA01 CAPTOPRILUM CAPTOPRIL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.171000 0.083333 0.153900 0.100433
318 W06862001 C09AA01 CAPTOPRILUM CAPTOPRIL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.171000 0.083000 0.153900 0.100100
319 W43028001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.171000 0.083000 0.153900 0.100100
320 W42060001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.171000 0.083333 0.153900 0.100433
321 W00776003 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.171000 0.083333 0.153900 0.100433
322 W12405001 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.171000 0.049500 0.153900 0.066600
323 W02920004 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0.171000 0.049333 0.153900 0.066433
324 W02922001 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.171000 0.048500 0.153900 0.065600
325 W41447001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0.171000 0.049500 0.153900 0.066600
326 W51276001 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg CUTIE X 2 BLIST. AL/AL X 14 COMPR.
MERCK SHARP & DOHME ROMANIA P-6L 28 0.171000 0.122928 0.153900 0.140028
327 W53672002 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0.171000 0.049333 0.153900 0.066433
328 W53672003 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0.171000 0.049000 0.153900 0.066100
329 W53672004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0.171000 0.049200 0.153900 0.066300
330 W53666002 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0.171000 0.048500 0.153900 0.065600
331 W58491002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.171000 0.048500 0.153900 0.065600
332 W62035001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0.171000 0.049500 0.153900 0.066600
333 W02922002 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 30 0.171000 0.048666 0.153900 0.065766
334 W02922003 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0.171000 0.049000 0.153900 0.066100
335 W58491003 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 20 0.171000 0.048500 0.153900 0.065600
336 W12199001 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.342000 0.023000 0.307800 0.057200
337 W02921003 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0.342000 0.022666 0.307800 0.056866
338 W02923001 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.342000 0.022500 0.307800 0.056700
339 W51277001 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg CUTIE X 2 BLIST. AL/AL X 14 COMPR.
MERCK SHARP & DOHME ROMANIA P-6L 28 0.342000 0.146214 0.307800 0.180414
340 W53674001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.342000 0.022666 0.307800 0.056866

Pagina 6 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
341 W53674004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0.342000 0.022800 0.307800 0.057000
342 W56712001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.342000 0.023000 0.307800 0.057200
343 W58492001 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.342000 0.023000 0.307800 0.057200
344 W62036001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0.342000 0.023000 0.307800 0.057200
345 W02923002 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 30 0.342000 0.022666 0.307800 0.056866
346 W02923003 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0.342000 0.022666 0.307800 0.056866
347 W58492002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 20 0.342000 0.023000 0.307800 0.057200
348 W12198001 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.085500 0.017000 0.076950 0.025550
349 W02925001 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.085500 0.016000 0.076950 0.024550
350 W51275001 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0.085500 0.139142 0.076950 0.147692
351 W12811003 C09AA02 ENALAPRILUM ENALAPRIL LPH 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.085500 0.016833 0.076950 0.025383
352 W53673001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.085500 0.016833 0.076950 0.025383
353 W58490002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0.085500 0.017000 0.076950 0.025550
354 W62034001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0.085500 0.017000 0.076950 0.025550
355 W02925002 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 30 0.085500 0.016833 0.076950 0.025383
356 W02925003 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0.085500 0.016666 0.076950 0.025216
357 W58490003 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0.085500 0.017000 0.076950 0.025550
358 W58233001 C09AA02 ENALAPRILUM ENAP 1,25 mg/ml SOL. INJ./PERF. 1,25mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR/PRF 5 3.474000 0.000000 3.126600 0.347400
359 W42156001 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.171000 0.422000 0.153900 0.439100
360 W42593001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIACUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.171000 0.095000 0.153900 0.112100
361 W43054001 C09AA03 LISINOPRILUM LISINOPRIL MEDO 10 mg COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.171000 0.239000 0.153900 0.256100
362 W53916002 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.171000 0.285666 0.153900 0.302766
363 W54841001 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.171000 0.248285 0.153900 0.265385
364 W65067001 C09AA03 LISINOPRILUM RANOLIP 10 mg COMPR. 10mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.171000 0.422333 0.153900 0.439433
365 W42088001 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0.342000 0.554000 0.307800 0.588200
366 W42594001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.342000 0.032333 0.307800 0.066533
367 W53917002 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.342000 0.554333 0.307800 0.588533
368 W54840001 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.342000 0.279785 0.307800 0.313985
369 W43055002 C09AA03 LISINOPRILUM LISINOPRIL MEDO 20 mg COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 0.342000 0.356000 0.307800 0.390200
370 W65068001 C09AA03 LISINOPRILUM RANOLIP 20 mg COMPR. 20mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.342000 0.554333 0.307800 0.588533
371 W53918002 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.684000 0.816666 0.615600 0.885066
372 W43053001 C09AA03 LISINOPRILUM LISINOPRIL MEDO 5 mg COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.085500 0.116500 0.076950 0.125050
373 W54842001 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.085500 0.166642 0.076950 0.175192
374 W65066001 C09AA03 LISINOPRILUM RANOLIP 5 mg COMPR. 5mg TERAPIA S.A. ROMANIA
CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.085500 0.206166 0.076950 0.214716
375 W51933002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0.333571 0.000000 0.300213 0.033358
376 W64367002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0.333571 0.000000 0.300213 0.033358
377 W42940001 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.333333 0.000000 0.299999 0.033334
378 W42972001 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.332666 0.000000 0.299399 0.033267
379 W43524001 C09AA05 RAMIPRILUM ZENRA 10 mg COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0.333571 0.000000 0.300213 0.033358
380 W62447001 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0.579285 0.000000 0.521356 0.057929
381 W62662001 C09AA05 RAMIPRILUM RAMIPRIL ATB 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.263000 0.000000 0.236700 0.026300
382 W62447012 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 90 COMPR. P6L 90 0.601111 0.000000 0.540999 0.060112
383 W64288002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0.333571 0.000000 0.300213 0.033358
384 W51934002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 0.171000 0.019000 0.153900 0.036100
385 W64365002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0.171000 0.019000 0.153900 0.036100
386 W42939001 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.171000 0.019000 0.153900 0.036100
387 W42970001 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.171000 0.018666 0.153900 0.035766
388 W43522001 C09AA05 RAMIPRILUM ZENRA 2,5 mg COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0.171000 0.019000 0.153900 0.036100
389 W62451001 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0.171000 0.121857 0.153900 0.138957
390 W62660001 C09AA05 RAMIPRILUM RAMIPRIL ATB 2,5 mg COMPR. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.164333 0.000000 0.147899 0.016434
391 W62451011 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 60 COMPR. P6L 60 0.171000 0.413333 0.153900 0.430433
392 W51932002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0.190000 0.000000 0.171000 0.019000
393 W64366002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0.190000 0.000000 0.171000 0.019000
394 W42237001 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.272333 0.000000 0.245099 0.027234
395 W42971001 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.272666 0.000000 0.245399 0.027267
396 W43523001 C09AA05 RAMIPRILUM ZENRA 5 mg COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0.273571 0.000000 0.246213 0.027358
397 W62382001 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0.342000 0.079428 0.307800 0.113628
398 W62661001 C09AA05 RAMIPRILUM RAMIPRIL ATB 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.190000 0.000000 0.171000 0.019000

Pagina 7 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
399 W62382008 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 30 COMPR. P6L 30 0.342000 0.131000 0.307800 0.165200
400 W64287005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0.272500 0.000000 0.245250 0.027250
401 W05345001 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM. P-6L 30 0.113999 0.329334 0.102599 0.340734
402 W64842001 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0.113999 0.329334 0.102599 0.340734
403 W41466001 C09AA06 QUINAPRILUM ACCUPRO 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0.227999 0.408334 0.205199 0.431134
404 W64840001 C09AA06 QUINAPRILUM ACCUPRO 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0.227999 0.408334 0.205199 0.431134
405 W41465001 C09AA06 QUINAPRILUM ACCUPRO 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0.056999 0.155001 0.051299 0.160701
406 W64841001 C09AA06 QUINAPRILUM ACCUPRO 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0.056999 0.155001 0.051299 0.160701
407 W61581001 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0.113999 0.480286 0.102599 0.491686
408 W64284006 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 0.113999 0.305667 0.102599 0.317067
409 W66866001 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE CU 2 BLIST. AL/PVC/PVDC X 14 COMPR. P6L 28 0.113999 0.480286 0.102599 0.491686
410 W61582001 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0.227999 0.586286 0.205199 0.609086
411 W64285006 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 0.227999 0.379001 0.205199 0.401801
412 W66867001 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE CU 2 BLIST. AL/PVC/PVDC X 14 COMPR. P6L 28 0.227999 0.586286 0.205199 0.609086
413 W01855001 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP-HL 10 mg/12,5 mg COMPR. 10mg+12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.362000 0.000000 0.325800 0.036200
414 W01854001 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP H 10 mg/25 mg COMPR. 10mg+25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.462600 0.051900 0.416340 0.098160
415 W42590001 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP-HL 20 mg/12,5 mg COMPR. 20 mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0.454500 0.000000 0.409050 0.045450
416 W52320001 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 5 mg/25mg COMPR. 5mg/25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 0.412142 0.000000 0.370927 0.041215
417 W62429001 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE PLUS 5 mg/25 mg COMPR. 5mg/25mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/ AL X 28 COMPR. P6L 28 0.462600 0.074900 0.416340 0.121160
418 W58235006 C09CA01 LOSARTANUM LORISTA 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0.571785 0.000000 0.514606 0.057179
419 W53260001 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 0.352928 0.016405 0.317635 0.051698
420 W53260003 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0.352928 0.016405 0.317635 0.051698
421 W58237004 C09CA01 LOSARTANUM LORISTA 50 mg COMPR. FILM. 50mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0.331428 0.000000 0.298285 0.033143
422 W60908002 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 10 mg COMPR. FILM. 10 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0.103462 0.254395 0.093115 0.264742
423 W12477002 C10AA01 SIMVASTATINUM ZEPLAN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 0.103462 0.118680 0.093115 0.129027
424 W42158001 C10AA01 SIMVASTATINUM SINTENAL 10 mg COMPR. FILM. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.103462 0.253538 0.093115 0.263885
425 W42328001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0.103462 0.253538 0.093115 0.263885
426 W56959001 C10AA01 SIMVASTATINUM SIMVACARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0.103462 0.060109 0.093115 0.070456
427 W59878005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.103462 0.059871 0.093115 0.070218
428 W65996005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.103462 0.059871 0.093115 0.070218
429 W60907002 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 20 mg COMPR. FILM. 20 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0.206924 0.270576 0.186231 0.291269
430 W12478002 C10AA01 SIMVASTATINUM ZEPLAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 0.206924 0.264504 0.186231 0.285197
431 W51357002 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 0.206924 0.397718 0.186231 0.418411
432 W42159001 C10AA01 SIMVASTATINUM SINTENAL 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.206924 0.270742 0.186231 0.291435
433 W42327001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.206924 0.270742 0.186231 0.291435
434 W56960001 C10AA01 SIMVASTATINUM SIMVACARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0.206924 0.064861 0.186231 0.085554
435 W59879005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.206924 0.269076 0.186231 0.289769
436 W65997005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.106333 0.000000 0.095699 0.010634
437 W60906002 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 40 mg COMPR. FILM. 40 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0.413849 0.767936 0.372464 0.809321
438 W41446002 C10AA01 SIMVASTATINUM ZEPLAN 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0.413849 0.185436 0.372464 0.226821
439 W41547001 C10AA01 SIMVASTATINUM SINTENAL 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.413849 0.768151 0.372464 0.809536
440 W52431001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.413849 0.768151 0.372464 0.809536
441 W56961001 C10AA01 SIMVASTATINUM SIMVACARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0.373214 0.000000 0.335892 0.037322
442 W59880005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.405333 0.000000 0.364799 0.040534
443 W65998005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.212666 0.000000 0.191399 0.021267
444 W06752001 C10AA02 LOVASTATINUM MEDOSTATIN 20 mg COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 0.137949 1.343051 0.124154 1.356846
445 W57367004 C10AA02 LOVASTATINUM LOVASTATINA ARENA 20 mg COMPR. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.137949 0.848717 0.124154 0.862512
446 W65064001 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg TERAPIA S.A. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. P-6L 28 0.206924 0.710933 0.186231 0.731626
447 W65065001 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg TERAPIA S.A. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. P-6L 28 0.413849 1.038293 0.372464 1.079678
448 W43325002 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0.773333 0.097333 0.695999 0.174667
449 W13251001 C10AB05 FENOFIBRATUM LIPIVIM 200 mg CAPS. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0.966666 0.005667 0.869999 0.102334
450 W62362001 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg MYLAN MEDICAL SAS FRANTA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL A CATE 10 COMPR. FILM. P-6L 30 0.966666 0.216667 0.869999 0.313334
451 W62360002 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. FILM. 160mg MYLAN MEDICAL SAS FRANTA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 30 0.949666 0.000000 0.854699 0.094967
452 W13742001 D01AC02 MICONAZOLUM MICONAZOL SLAVIA 20 mg/g CREMA 20mg/g SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 6.425000 1.305000 5.782500 1.947500
453 W53471002 D07AA02 HYDROCORTISONUM HIDROCORTIZON FITERMAN 10 mg/g UNGUENT 10mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 35 G UNGUENT P-RF 1 11.358749 0.001251 10.222874 1.137126
454 W12026001 D07AA02 HYDROCORTISONUM HIDROCORTIZON ATB 10mg/g UNGUENT 10mg/g ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB DIN AL X 20 G UNGUENT P-RF 1 6.490714 1.969286 5.841642 2.618358
455 W53471001 D07AA02 HYDROCORTISONUM HIDROCORTIZON FITERMAN 10 mg/g UNGUENT 10mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 20 G UNGUENT P-RF 1 6.490000 0.000000 5.841000 0.649000
456 W53912001 D07AC01 BETAMETHASONUM EKARZIN 0,5MG/G CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 3.870000 4.590000 3.483000 4.977000

Pagina 8 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
457 W53770001 D07AC01 BETAMETHASONUM BETAMETAZONA FITERMAN 0,5 mg/g CREMA 0,5mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 20 G CREMA P-RF 1 5.160000 6.120000 4.644000 6.636000
458 W44047001 D07AC01 BETAMETHASONUM BETADERM 1 mg/g CREMA 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 10.320000 0.000000 9.288000 1.032000
459 W44048001 D07AC01 BETAMETHASONUM BETADERM 1mg/g UNGUENT 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 10.320000 0.000000 9.288000 1.032000
460 W51339001 G01AF04 MICONAZOLUM GYNOZOL 200 CAPS. VAG. 200mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI P-RF 6 1.138333 0.000000 1.024499 0.113834
461 W51340001 G01AF04 MICONAZOLUM GYNOZOL 400 CAPS. VAG. 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI P-RF 3 2.176666 0.000000 1.958999 0.217667
462 W60232003 G02AB03 ERGOMETRINUM MALEAT DE ERGOMETRINA ZENTIVA 0,2 mg/ml SOL. INJ. 0,2mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE P-RF 5 4.752000 0.000000 4.276800 0.475200
463 W63442002 G03BA03 TESTOSTERONUM * UNDESTOR TESTOCAPS 40 mg CAPS. MOI 40mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI PRF 60 0.910500 0.000000 0.819450 0.091050
464 W62752001 G03BA03 TESTOSTERONUM * ANDROGEL 16,2 mg/g GEL 16,2mg/g BESINS HEALTHCARE BELGIA CUTIE CU 1 RECIPIENT MULTIDOZA DIN PP, CARE CONTINE UN REZERVOR DIN PEJD, PREVAZUT CU UN ADAPTOR LA CARE SE CONECTEAZA O POMPA DOZATOARE CU 88 G GEL PRF 1 248.350000 0.000000 223.515000 24.835000
465 W63885002 G03BA03 TESTOSTERONUM * NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 6 ML A 4 ML SOL. INJ. PR/PRF 1 419.280000 0.000000 377.352000 41.928000
466 W62058002 G03CA03 ESTRADIOLUM * LENZETTO 1,53 mg/doza SPRAY TRANSDERMIC, SOL. 1,53mg/doza GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU UN FLAC. DIN STICLA CARE CONTINE 6,5 ML SOL., PREVAZUT CU O POMPA DOZATOARE P6L 1 49.550000 0.000000 44.595000 4.955000
467 W51724001 G04CAN1 DOXAZOSINUM DOXAZOSIN ARENA 1 mg (vezi C02CA04) COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. DIN AL/PVC X 10 COMPR. P-6L 30 0.145499 0.913167 0.130949 0.927717
468 W51724001 G04CAN1 DOXAZOSINUM DOXAZOSIN ARENA 1 mg (vezi C02CA04) COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. DIN AL/PVC X 10 COMPR. P-6L 30 0.145499 0.913167 0.130949 0.927717
469 W08648002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.290999 0.361334 0.261899 0.390434
470 W08648002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.290999 0.361334 0.261899 0.390434
471 W08649002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 0.581999 0.076334 0.523799 0.134534
472 W08649002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 0.581999 0.076334 0.523799 0.134534
473 W13893002 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. PREL. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0.581999 0.421572 0.523799 0.479772
474 W13893002 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. PREL. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0.581999 0.421572 0.523799 0.479772
475 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 1 394.634666 23.755334 355.171199 63.218801
476 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 1 394.634666 23.755334 355.171199 63.218801
477 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 1 295.976000 165.214000 266.378400 194.811600
478 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 1 686.060000 0.000000 617.454000 68.606000
479 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 1 369.970000 0.000000 332.973000 36.997000
480 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 1 739.940000 179.540000 665.946000 253.534000
481 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 1 369.970000 0.000000 332.973000 36.997000
482 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 1 686.060000 0.000000 617.454000 68.606000
483 W66036001 H01AC01 SOMATROPINUM ** SAIZEN 5,83 mg/ml SOL. INJ. IN CARTUS 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 1 444.072524 130.587476 399.665271 174.994729
484 W66037001 H01AC01 SOMATROPINUM ** SAIZEN 8 mg/ml SOL. INJ. IN CARTUS 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 1 887.928000 190.552000 799.135200 279.344800
485 W66037003 H01AC01 SOMATROPINUM ** SAIZEN 8 mg/ml SOL. INJ. IN CARTUS 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 1,479.880000 270.340000 1,331.892000 418.328000
486 W66430001 H01AC01 SOMATROPINUM ** NORDITROPIN NORDIFLEX 10 mg/1,5 ml SOL. INJ. IN STILOU INJ. PREUMPLUT 6,7mg/ml NOVO NORDISK A/S DANEMARCA CUTIE CU 1 STILOU INJ. PREUMPLUT MULTIDOZA X 1,5 ML SOL. INJ. PRF 1 739.940000 326.190000 665.946000 400.184000
487 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 19.234375 4.265625 17.310937 6.189063
488 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 71.250000 0.000000 64.125000 7.125000
489 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 0.145000 0.006000 0.130500 0.020500
490 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.145000 0.006000 0.130500 0.020500
491 W13686002 H02AB07 PREDNISONUM PREDNISON SINTOFARM 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.145000 0.006000 0.130500 0.020500
492 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 0.145000 0.000000 0.130500 0.014500
493 W68137001 H02AB09 HYDROCORTISONUM * HYDROCORTISONE ROUSSEL 10 mg COMPR. 10mg BIO EEL S.R.L. ROMANIA CUTIE CU 1 BLIST. X 25 COMPR. PRF 25 1.035600 0.000000 0.932040 0.103560
494 W44080001 H02AB09 HYDROCORTISONUM * HYDROCORTISONE SUCCINAT SODIC EIPICO 100 mg PULB+SOLV. PT. SOL. INJ./PERF. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUT IE CU 1 FLAC. DIN ST ICLA INCOLORA CU DOP DIN CAUCIUC BUT ILIC, SIGILAT CU O CAPSA DIN AL ACOPERIT A CU UN DISC DE PP DE CULOARE PORT OCALIU DESCHIS CONT INAND PULB. PENT RU SOL. INJ. + FIOLA DIN ST ICLA INCOLORA A 2 ML SOLV. PREVAZUT A CU INEL DE RUPERE PRF 1 7.810000 0.000000 7.029000 0.781000
495 W58639001 H02AB09 HYDROCORTISONUM * HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV. PR/PRF 1 30.180000 0.000000 27.162000 3.018000
496 W66429001 H02AB09 HYDROCORTISONUM * HIDROCORTIZON ROMPHARM 100 mg PULB. PT. SOL. INJ./PERF. 100mg S.C. ROMPHARM COMPANY S.R.L ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC SI SIGILAT CU CAPAC DIN PLASTIC SI CAPSA DETASABILA DIN AL X PULB. PT. SOL. INJ./PERF. PRF 1 7.810000 0.000000 7.029000 0.781000
497 W58638001 H02AB09 HYDROCORTISONUM * HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 7.810000 0.000000 7.029000 0.781000
498 W51922003 H02AB09 HYDROCORTISONUM * HIDROCORTIZON ZENTIVA 19.6mg/5mlSOL. INJ. 19,6mg/5ml ZENTIVA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 1 ML SOL. A + 5 FIOLE DIN STICLA BRUNA CU CAPACITATEA DE 5ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 4 ML SOL. B PRF 5 2.045439 2.836561 1.840895 3.041105
499 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 0.459000 0.000000 0.413100 0.045900
500 W02885004 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA 100 mg CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.459000 0.000000 0.413100 0.045900
501 W00347001 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.406000 0.000000 0.365400 0.040600
502 W00346001 J01CA04 AMOXICILLINUM AMOXICILINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.406000 0.000000 0.365400 0.040600
503 W00351001 J01CA04 AMOXICILLINUM AMOXICILINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0.469500 0.200500 0.422550 0.247450
504 W08428003 J01CA04 AMOXICILLINUM AMOXICILINA FORTE FARMEX 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0.469500 0.200500 0.422550 0.247450
505 W08428001 J01CA04 AMOXICILLINUM AMOXICILINA FORTE FARMEX 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0.469500 0.201000 0.422550 0.247950
506 W13739001 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 0.469500 0.200500 0.422550 0.247450
507 W41600001 J01CA04 AMOXICILLINUM OSPAMOX 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 12 0.916666 0.000000 0.824999 0.091667
508 W67919002 J01CA04 AMOXICILLINUM AMOXICILINA AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 10 0.921000 0.000000 0.828900 0.092100
509 W41578001 J01CA04 AMOXICILLINUM OSPAMOX 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 0.469500 0.003000 0.422550 0.049950
510 W67918002 J01CA04 AMOXICILLINUM AMOXICILINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 10 0.469500 0.200500 0.422550 0.247450
511 W41580002 J01CA04 AMOXICILLINUM OSPAMOX 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 5,1 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 2.436000 3.884000 2.192400 4.127600
512 W00388002 J01CA04 AMOXICILLINUM OSPAMOX 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 4.872000 0.548000 4.384800 1.035200
513 W41595001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0.557082 0.014584 0.501373 0.070293
514 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 0.770000 0.000000 0.693000 0.077000

Pagina 9 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
515 W41596001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0.278541 0.333959 0.250686 0.361814
516 W55413001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE P-RF 1 0.371388 9.748612 0.334249 9.785751
517 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 18.584099 24.765901 16.725689 26.624311
518 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 18.584099 14.517501 16.725689 16.375911
519 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 18.584099 13.808701 16.725689 15.667111
520 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 18.584099 20.084901 16.725689 21.943311
521 W04675002 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.417015 0.023485 0.375313 0.065187
522 W11729001 J01CF04 OXACILLINUM OXACILINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.417015 0.014485 0.375313 0.056187
523 W07274001 J01CF04 OXACILLINUM OXACILINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0.834030 0.023970 0.750627 0.107373
524 W13743001 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0.834030 0.023970 0.750627 0.107373
525 W12910001 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0.834030 0.023970 0.750627 0.107373
526 W12910003 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0.834030 0.023970 0.750627 0.107373
527 W60469002 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 50 9.839000 0.000000 8.855100 0.983900
528 W60469001 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 10.666250 1.243750 9.599625 2.310375
529 W60469003 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 9.130600 0.000000 8.217540 0.913060
530 W60469004 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 10 10.666250 0.275750 9.599625 1.342375
531 W60468002 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 50 5.333125 1.888675 4.799812 2.421988
532 W60468001 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 5.333125 2.956875 4.799812 3.490188
533 W60468003 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 5.333125 1.237175 4.799812 1.770488
534 W60468004 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 10 5.333125 2.282875 4.799812 2.816188
535 W00400003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg COMPR. FILM. 1000mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM. P-RF 14 1.060714 0.000000 0.954642 0.106072
536 W54453002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500mg/125mg COMPR. FILM. 500mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 0.606122 0.045306 0.545509 0.105919
537 W64211008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg COMPR. FILM. 500mg/125mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 0.606122 0.045306 0.545509 0.105919
538 W65088002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT PRF 14 0.606122 0.751735 0.545509 0.812348
539 W55401002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 875 mg/125 mg COMPR. FILM. 875mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1.060714 0.000000 0.954642 0.106072
540 W59497004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 875 mg/125 mg COMPR. FILM. 875mg/125mg TERAPIA S.A. ROMANIA PRF
CUTIE CU BLIST. PVC-PVDC/AL INTRODUSE IN PUNGI DE POLIESTER/AL/POLIESTER/PE X 14 COMPR. FILM. 14 1.060714 0.000000 0.954642 0.106072
541 W59497007 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 875 mg/125 mg COMPR. FILM. 875mg/125mg TERAPIA S.A. ROMANIA PRF
CUTIE CU BLIST. PVC-PVDC/AL INTRODUSE IN PUNGI DE POLIESTER/AL/POLIESTER/PE X 21 COMPR. FILM. 21 1.060714 0.000238 0.954642 0.106310
542 W64212008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM. 875mg/125mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1.060714 0.000000 0.954642 0.106072
543 W65089001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/125mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT PRF 14 1.060714 0.577143 0.954642 0.683215
544 W62046002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 625mg SANDOZ S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 0.606122 0.735306 0.545509 0.795919
545 W00399001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 156,25mg/5ml PULB. PT. SUSP. ORALA 156,25mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 MG PULB. PT. 100 ML SUSP. ORALA P-RF 1 8.340357 4.059643 7.506321 4.893679
546 W08783002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 14.780000 0.000000 13.302000 1.478000
547 W64190005 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN FP 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CARE CONTINE PULB. PT 70 ML SUSP. ORALA SI O LINGURITA PRF 1 18.682400 1.837600 16.814160 3.705840
548 W67768004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN FP 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml GLAXOSMITHKLINE TRADING SERVICES LIMITED IRLANDA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (DE CAPACITATE 147ML) CARE CONTINE PULB. PT 70 ML SUSP. ORALA SI O LINGURITA PRF 1 18.682400 1.837600 16.814160 3.705840
549 W65099003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN ES 600mg/42,9 mg/5 ml PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CONTINÂND PULB. PENTRU 100 ML SUSPENSIE SI O LINGURITA DOZATOARE DIN POLISTIREN, MARCAT CU GRADATII PT. MASURAREA VOLUMELOR 2,5 ML SI 5,0 ML PRF 1 40.033714 4.486286 36.030342 8.489658
550 W67567002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 600 mg/42,9 mg/5 ml PULB. PT. SUSP. ORALA 600mg/42,9mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 180 ML SI PREVAZUTA CU PIPETA DOZATOARE CU PISTON DIN POLISTIREN SI CORP DIN PEJD MARCATA DE LA 0,4 ML PANA LA 5 ML CU 33,10 G PULB. PT. SUSP. ORALA PRF 1 40.033714 24.496286 36.030342 28.499658
551 W00402001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 312,5mg/5ml PULB. PT.SUSP. ORALA 312,5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 15.040000 0.000000 13.536000 1.504000
552 W12083001 J01DB01 CEFALEXINUM CEFALEXINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0.601500 0.086500 0.541350 0.146650
553 W12084001 J01DB01 CEFALEXINUM CEFALEXINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 1.203000 0.000000 1.082700 0.120300
554 W06883003 J01DB01 CEFALEXINUM CEFALEXINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 1.203000 0.000000 1.082700 0.120300
555 W41666001 J01DB01 CEFALEXINUM OSPEXIN 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF 12 1.134166 0.000000 1.020749 0.113417
556 W44127002 J01DB01 CEFALEXINUM KEFLEX (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 12.000000 0.000000 10.800000 1.200000
557 W64364001 J01DB01 CEFALEXINUM KEFLEX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PRF 1 12.000000 0.000000 10.800000 1.200000
558 W55436001 J01DB05 CEFADROXILUM CEFORAN 500 mg CAPS. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 1.203000 0.336000 1.082700 0.456300
559 W53168001 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 1.084500 0.120500 0.976050 0.228950
560 W53168002 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 1.084500 0.120500 0.976050 0.228950
561 W53169001 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 2.055000 0.000000 1.849500 0.205500
562 W53169002 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 2.055000 0.000000 1.849500 0.205500
563 W65111001 J01DC02 CEFUROXIMUM ZINNAT 125 mg COMPR. FILM. 125mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 1.285000 0.000000 1.156500 0.128500
564 W12657001 J01DC02 CEFUROXIMUM ZINNAT (R) 250 mg COMPR. FILM. 250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X, 10 COMPR.FILM P-RF 10 1.084500 0.621500 0.976050 0.729950
565 W62257003 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 1.084500 0.120500 0.976050 0.228950
566 W65112001 J01DC02 CEFUROXIMUM ZINNAT 250 mg COMPR. FILM. 250mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 1.084500 0.621500 0.976050 0.729950
567 W12659001 J01DC02 CEFUROXIMUM ZINNAT (R) 500 mg COMPR. FILM. 500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR.FILM P-RF 10 2.169000 0.698000 1.952100 0.914900
568 W62258003 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 2.055000 0.000000 1.849500 0.205500
569 W65113001 J01DC02 CEFUROXIMUM ZINNAT 500 mg COMPR. FILM. 500mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 10 2.169000 0.698000 1.952100 0.914900
570 W65114001 J01DC02 CEFUROXIMUM ZINNAT 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 FLAC. DIN STICLA BRUNA CONTINAND GRANULE PT. 50 ML SUSP. ORALA + 1 MASURA DOZATOARE A 5 ML PRF 1 13.300000 9.410000 11.970000 10.740000
571 W00985003 J01DC04 CEFACLORUM CEFACLOR ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0.542250 1.192750 0.488025 1.246975
572 W56967001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250 mg CAPS. 250mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 0.542250 0.741750 0.488025 0.795975

Pagina 10 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie APP
Detinator APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
573 W55271001 J01DC04 CEFACLORUM CEFACLOR ARENA 500 mg CAPS. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1.084500 2.109500 0.976050 2.217950
574 W56966001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 500 mg CAPS. 500mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 1.084500 0.862833 0.976050 0.971283
575 W56969001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 125mg/5ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA P-RF 1 9.975000 0.025000 8.977500 1.022500
576 W56968001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250mg/5ml GRAN. PT. SUSP. ORALA 250 mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA P-RF 1 19.800000 0.000000 17.820000 1.980000
577 W44129002 J01DC04 CEFACLORUM CECLOR (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 19.950000 6.520000 17.955000 8.515000
578 W64369001 J01DC04 CEFACLORUM CECLOR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. PEID CONTINAND GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE DIN POLISTIREN PRF 1 19.950000 6.520000 17.955000 8.515000
579 W12210001 J01DC04 CEFACLORUM CEFAKLOR 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 7.980000 2.020000 7.182000 2.818000
580 W51321001 J01DC04 CEFACLORUM CEFAKLOR 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 15.960000 3.840000 14.364000 5.436000
581 W57455001 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 2.059892 0.407108 1.853902 0.613098
582 W13701001 J01DD08 CEFIXIMUM EFICEF 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3.981000 0.000000 3.582900 0.398100
583 W63367003 J01DD08 CEFIXIMUM CEFIXIMA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 3.981000 0.000000 3.582900 0.398100
584 W60256001 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE PRF 5 8.239571 2.818429 7.415613 3.642387
585 W60256003 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF 10 8.239571 2.262429 7.415613 3.086387
586 W63368003 J01DD08 CEFIXIMUM CEFIXIMA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 8.239571 0.277571 7.415613 1.101529
587 W61965002 J01DD08 CEFIXIMUM XIFIA 100 mg/5 ml GRANULE PT. SUSP. ORALA 100mg/5ml INN-FARM D.O.O. SLOVENIA CUT IE CU 1 FLAC. DIN ST ICLA BRUNA, CU CAPCIT AT EA DE 150 ML CARE CONT INE 53 G GRAN. PT . SUSP. ORALA+1 MASURA DOZAT OARE DIN PP PT . MASURAREA VOLUMULUI DE SOLVENT GRADAT A LA 66 ML+1 SERINGA DOZAT OARE DIN PLAST IC A 5 ML, GRADAT A DE LA 0,5 ML PANA LA 5 ML PRF 1 41.197855 41.152145 37.078069 45.271931
588 W05741001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.441500 0.000000 0.397350 0.044150
589 W05738001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM 400 mg/80 mg COMPR. 400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.441500 0.000000 0.397350 0.044150
590 W44046001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM 200 mg/40 mg/5 ml SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML P-RF 1 10.230000 0.000000 9.207000 1.023000
591 W05739001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM 25mg/ml+5mg/ml SUSP. ORALA 25mg/ml+5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 6.745781 4.054219 6.071202 4.728798
592 W61210001 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0.479603 0.069897 0.431642 0.117858
593 W63492001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg MYLAN PRODUCTS LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2.398017 0.517983 2.158215 0.757785
594 W65279001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2.398017 0.517983 2.158215 0.757785
595 W14043001 J01FA09 CLARITHROMYCINUM KLERIMED 250 mg COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 1.199008 0.073134 1.079107 0.193035
596 W44093001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 1.199008 0.196706 1.079107 0.316607
597 W08490001 J01FA09 CLARITHROMYCINUM FROMILID 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 1.199008 0.164563 1.079107 0.284464
598 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 1.043571 0.000000 0.939213 0.104358
599 W62390002 J01FA09 CLARITHROMYCINUM KLACID 250 mg COMPR. FILM. 250mg BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1.199008 0.685992 1.079107 0.805893
600 W65820002 J01FA09 CLARITHROMYCINUM KLACID 250 mg COMPR. FILM. 250mg MYLAN ITALIA S.R.L. ITALIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1.199008 0.685992 1.079107 0.805893
601 W14044001 J01FA09 CLARITHROMYCINUM KLERIMED 500 mg COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 2.110000 0.000000 1.899000 0.211000
602 W44087001 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 2.398017 0.202697 2.158215 0.442499
603 W08491001 J01FA09 CLARITHROMYCINUM FROMILID 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 2.120714 0.000000 1.908642 0.212072
604 W54044001 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 2.040500 0.000000 1.836450 0.204050
605 W60254003 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 1.713571 0.000000 1.542213 0.171358
606 W41838002 J01FA09 CLARITHROMYCINUM FROMILID UNO 500 mg COMPR. FILM. ELIB. PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2.398017 0.287697 2.158215 0.527499
607 W62389002 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 24.067499 2.682501 21.660749 5.089251
608 W65821002 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml MYLAN ITALIA S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 24.067499 2.682501 21.660749 5.089251
609 W66370002 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN PEID, CU CAPAC DIN PP CU 70 G GRAN. PT. 100 ML SUSP . ORALA PRF 1 21.490000 0.000000 19.341000 2.149000
610 W62389001 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 14.440499 1.599501 12.996449 3.043551
611 W65821001 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml MYLAN ITALIA S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 14.440499 1.599501 12.996449 3.043551
612 W66370001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN PEID, CU CAPAC DIN PP CU 42 G GRAN. PT. 60 ML SUSP . ORALA PRF 1 14.140000 0.000000 12.726000 1.414000
613 W66369002 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN PEID, CU CAPAC DIN PP CU 70 G GRAN. PT. 100 ML SUSP . ORALA PRF 1 48.134999 10.365001 43.321499 15.178501
614 W66369001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN PEID, CU CAPAC DIN PP CU 42 G GRAN. PT. 60 ML SUSP . ORALA PRF 1 28.880999 6.219001 25.992899 9.107101
615 W62343001 J01FA09 CLARITHROMYCINUM KLACID I.V. 500 mg PULB. PT. CONC. PT. SOL. PERF. 500mg MYLAN MEDICAL SAS FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA I, DE CAPACITATE 15 ML CONTINAND PULB. PT. CONC. PT. SOL. PERF. PRF 1 18.930500 24.719500 17.037450 26.612550
616 W53584001 J01MA01 OFLOXACINUM OFLOXACINA LAROPHARM 200 mg COMPR. FILM. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10COMPR. FILM. P-RF 10 1.395000 0.896000 1.255500 1.035500
617 W56957001 J01MA01 OFLOXACINUM OFLOXIN 200 mg COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1.395000 0.896000 1.255500 1.035500
618 W65069001 J01MA01 OFLOXACINUM ZANOCIN 200 mg COMPR. FILM. 200mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. PRF 10 1.395000 0.896000 1.255500 1.035500
619 W54037001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.279000 3.993000 0.251100 4.020900
620 W44077004 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0.697500 0.094500 0.627750 0.164250
621 W01273001 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0.697500 0.082500 0.627750 0.152250
622 W01288001 J01MA02 CIPROFLOXACINUM CIPROLEN 250 mg COMPR. FILM. 250mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.697500 0.094500 0.627750 0.164250
623 W01271002 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.697500 0.072500 0.627750 0.142250
624 W54038001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.697500 0.094500 0.627750 0.164250
625 W54038002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0.697500 0.094500 0.627750 0.164250
626 W65056001 J01MA02 CIPROFLOXACINUM CIFRAN 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. PRF 10 0.697500 0.094500 0.627750 0.164250
627 W66438003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0.542000 0.000000 0.487800 0.054200
628 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1.206000 0.000000 1.085400 0.120600
629 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 1.395000 0.118000 1.255500 0.257500
630 W01289001 J01MA02 CIPROFLOXACINUM CIPROLEN 500 mg COMPR. FILM. 500mg AC HELCOR PHARMA S.R.L.ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1.395000 0.118000 1.255500 0.257500

Pagina 11 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
631 W01272001 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1.395000 0.098000 1.255500 0.237500
632 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 1.395000 0.118000 1.255500 0.257500
633 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1.395000 0.118000 1.255500 0.257500
634 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 1.395000 0.118000 1.255500 0.257500
635 W65057001 J01MA02 CIPROFLOXACINUM CIFRAN 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. PRF 10 1.395000 0.118000 1.255500 0.257500
636 W66439003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0.795000 0.000000 0.715500 0.079500
637 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 2.092500 1.691500 1.883250 1.900750
638 W54040001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 2.092500 2.179500 1.883250 2.388750
639 W52445001 J01MA03 PEFLOXACINUM PEFLOXACIN LAROPHARM 400 mg COMPR. FILM. 400mg LAROPHARM S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 1.395000 1.781000 1.255500 1.920500
640 W60377003 J01MA06 NORFLOXACINUM NORFLOXACINA ARENA 400 mg CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE CU 2 BLIST. DIN PVC/AL X 10 CAPS. PRF 20 0.955072 0.225428 0.859564 0.320936
641 W60377004 J01MA06 NORFLOXACINUM NORFLOXACINA ARENA 400 mg CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE CU 5 BLIST DIN PVC/AL X 10 CAPS. PRF 50 0.955072 0.187128 0.859564 0.282636
642 W14009001 J01MA06 NORFLOXACINUM NORFLOXACIN LAROPHARM 400 mg COMPR. FILM. 400mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0.955072 0.224928 0.859564 0.320436
643 W41800001 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0.955072 0.225428 0.859564 0.320936
644 W07984001 J01MA06 NORFLOXACINUM NOLICIN 400 mg COMPR. FILM. 400mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0.802000 0.000000 0.721800 0.080200
645 W58303001 J01MA06 NORFLOXACINUM NORFLOXACIN HELCOR 400 mg COMPR. FILM. 400mg ROMANIA
A.C. HELCOR PHARMA S.R.L. CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0.955072 0.225428 0.859564 0.320936
646 W62811001 J01MA06 NORFLOXACINUM NORFLOXACINA ATB 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0.955072 0.016428 0.859564 0.111936
647 W63535001 J01XD01 METRONIDAZOLUM FLAGYL 250 mg (vezi P01AB01) COMPR. FILM. 250mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0.404500 0.000000 0.364050 0.040450
648 W63535001 J01XD01 METRONIDAZOLUM FLAGYL 250 mg (vezi P01AB01) COMPR. FILM. 250mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0.404500 0.000000 0.364050 0.040450
649 W64585001 J01XD01 METRONIDAZOLUM METRONIDAZOL VIOSER 500 mg/100 ml SOL. PERF. 500mg/100ml GRECIA CUTIE CU 1 FLAC. PEJD X 100 ML SOL. PERF.
VIOSER S.A. PARENTERAL SOLUTIONS INDUSTRY PRF 1 4.930375 0.559625 4.437337 1.052663
650 W64585002 J01XD01 METRONIDAZOLUM METRONIDAZOL VIOSER 500 mg/100 ml SOL. PERF. 500mg/100ml GRECIA CUTIE CU 10 FLAC. PEJD X 100 ML SOL. PERF.
VIOSER S.A. PARENTERAL SOLUTION INDUSTRY PRF 10 4.930375 0.379625 4.437337 0.872663
651 W42139002 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 9.567500 0.000000 8.610750 0.956750
652 W42138002 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 9.379166 0.000000 8.441249 0.937917
653 W08927001 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 10 4.930375 0.415625 4.437337 0.908663
654 W08927002 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 10 4.930375 0.415625 4.437337 0.908663
655 W08927003 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 20 4.930375 0.146625 4.437337 0.639663
656 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 2.977071 4.087929 2.679363 4.385637
657 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 2.977071 3.861500 2.679363 4.159208
658 W66461007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF
AUROBINDO PHARMA ROMANIA S.R.L. 7 2.977071 0.278643 2.679363 0.576351
659 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE CU 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4.465606 3.424394 4.019045 3.870955
660 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4.465606 6.734394 4.019045 7.180955
661 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 4.465606 3.424394 4.019045 3.870955
662 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4.465606 3.424394 4.019045 3.870955
663 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL SLAVIA 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4.465606 3.424394 4.019045 3.870955
664 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4.465606 3.424394 4.019045 3.870955
665 W52334001 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 4.465606 3.424394 4.019045 3.870955
666 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4.465606 26.844394 4.019045 27.290955
667 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4.465606 3.424394 4.019045 3.870955
668 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4.465606 3.424394 4.019045 3.870955
669 W65085001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4.465606 6.734394 4.019045 7.180955
670 W66462001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg ROMANIA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF
AUROBINDO PHARMA ROMANIA S.R.L. 1 4.465606 3.424394 4.019045 3.870955
671 W68087001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOEEL 150 mg CAPS. 150mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4.465606 3.424394 4.019045 3.870955
672 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 5.954142 0.485858 5.358727 1.081273
673 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1.488535 1.577179 1.339681 1.726033
674 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1.488535 2.857179 1.339681 3.006033
675 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 1.488535 1.577179 1.339681 1.726033
676 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1.488535 1.577179 1.339681 1.726033
677 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL SLAVIA 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1.488535 1.577179 1.339681 1.726033
678 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1.488535 1.577179 1.339681 1.726033
679 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1.488535 1.577179 1.339681 1.726033
680 W65084001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 1.488535 2.857179 1.339681 3.006033
681 W66460007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1.488535 0.191465 1.339681 0.340319
682 W58322002 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PEÎD, DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CE CONTINE PULB. PENTRU 35 ML SUSP. ORALA SI O SERINGA DIN PP DE 5 ML CU MARCAJ LA FIECARE 0,2 ML PRF 1 10.419749 24.560251 9.377774 25.602226
683 W65087001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. DIN PEÎD, DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CE CONTINE PULB. PENTRU 35 ML SUSP. ORALA SI O SERINGA DIN PP DE 5 ML CU MARCAJ LA FIECARE 0,2 ML PRF 1 10.419749 24.560251 9.377774 25.602226
684 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR SLAVIA 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.880605 0.344895 0.792544 0.432956
685 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.880605 0.344895 0.792544 0.432956
686 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0.880605 0.344895 0.792544 0.432956
687 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1.761211 1.281789 1.585089 1.457911
688 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.880605 0.159395 0.792544 0.247456

Pagina 12 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
689 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 0.880605 0.344895 0.792544 0.432956
690 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0.880605 0.344895 0.792544 0.432956
691 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0.880605 0.093395 0.792544 0.181456
692 W65783001 J05AB01 ACICLOVIRUM ACICLOVIR AUROBINDO 200 mg COMPR. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC/AL X 20 COMPR. PRF 20 0.685500 0.000000 0.616950 0.068550
693 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 1.761211 0.881789 1.585089 1.057911
694 W65784008 J05AB01 ACICLOVIRUM ACICLOVIR AUROBINDO 400 mg COMPR. 400mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC/AL X 10 COMPR. PRF 10 1.336000 0.000000 1.202400 0.133600
695 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 52.008000 0.000000 46.807200 5.200800
696 W67998002 J05AB01 ACICLOVIRUM VIRICIN 250 mg PULB. PT. SOL. PERF. 250mg MEDOCHEMIE LTD. CIPRU CUTIE CU 5 FLACOANE DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR/PRF 5 52.008000 0.000000 46.807200 5.200800
697 W42120001 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 0.085725 0.007275 0.077152 0.015848
698 W03600001 M01AB01 INDOMETACINUM INDOMETACIN ATB 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 0.313375 0.471625 0.282037 0.502963
699 W03609001 M01AB01 INDOMETACINUM INDOMETACIN SINTOFARM 50 mg SUPOZ. 50mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0.313375 0.472625 0.282037 0.503963
700 W12694002 M01AB01 INDOMETACINUM INDOMETACIN MCC 50 mg SUPOZ. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0.313375 0.472625 0.282037 0.503963
701 W03600003 M01AB01 INDOMETACINUM INDOMETACIN ATB 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC/PE X 6 SUPOZ. P6L 6 0.313375 0.471625 0.282037 0.502963
702 W63730001 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P6L 20 0.514350 2.216650 0.462915 2.268085
703 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 0.257175 0.302825 0.231457 0.328543
704 W67013001 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE CU 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 0.257175 0.302825 0.231457 0.328543
705 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 0.342900 0.047100 0.308610 0.081390
706 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 0.342900 0.047100 0.308610 0.081390
707 W51307002 M01AB05 DICLOFENACUM REFEN RETARD 100 mg 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 0.342900 0.047100 0.308610 0.081390
708 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 0.129500 0.000000 0.116550 0.012950
709 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 0.129500 0.000000 0.116550 0.012950
710 W54364001 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg COMPR. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P-6L 30 0.085725 0.131941 0.077152 0.140514
711 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 0.171450 0.002550 0.154305 0.019695
712 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 1.794187 0.371813 1.614768 0.551232
713 W14114001 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0.618333 0.000000 0.556499 0.061834
714 W12288001 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0.626750 0.000250 0.564075 0.062925
715 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 0.626000 0.000000 0.563400 0.062600
716 W14114003 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC/PE X 6 SUPOZ. P6L 6 0.618333 0.000000 0.556499 0.061834
717 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 0.078343 1.204990 0.070508 1.212825
718 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 0.078343 1.308657 0.070508 1.316492
719 W56142001 M01AB15 KETOROLACUM TROMETHAMIN KETOROL 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0.114299 0.465201 0.102869 0.476631
720 W44108003 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L 20 0.114299 0.465201 0.102869 0.476631
721 W44107001 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 30 mg/ml SOL. INJ. 30mg/ml TERAPIA SA ROMANIA CUTIE CU 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 2.392250 0.441750 2.153025 0.680975
722 W56143003 M01AB15 KETOROLACUM TROMETHAMIN KETOROL SOL. INJ. 30mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-RF 10 2.392250 0.441750 2.153025 0.680975
723 W61916001 M01AB15 KETOROLACUM TROMETHAMIN KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml SOL. INJ. 30mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ. PRF 5 2.244000 0.000000 2.019600 0.224400
724 W61916002 M01AB15 KETOROLACUM TROMETHAMIN KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml SOL. INJ. 30mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ. PRF 10 2.245000 0.000000 2.020500 0.224500
725 W57635001 M01AB16 ACECLOFENACUM AFLAMIL 100mg COMPR. FILM. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. P-6L 20 0.171450 0.421050 0.154305 0.438195
726 W61427001 M01AB16 ACECLOFENACUM AFLAMIL 100 mg PULB. PT.SUSP. ORALA 100mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 20 PLICURI UNIDOZA DIN MATERIAL COMPLEX DIN HARTIE DE TIP OPALINA LAMINATA PE UN STRAT DE ALUMINIU (20 ΜM) SI FILM DIN PEJD P6L 20 0.171450 1.369550 0.154305 1.386695
727 W56784001 M01AC02 TENOXICAMUM TENOXICAM ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.575100 0.232400 0.517590 0.289910
728 W12900001 M01AC02 TENOXICAMUM NEO-ENDUSIX 20 mg COMPR. FILM. 20mg ANFARM HELLAS S.A. GRECIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 0.575100 0.373900 0.517590 0.431410
729 W12899001 M01AC02 TENOXICAMUM NEO-ENDUSIX 20 mg/ml PULB+SOLV. PT. SOL. INJ. 20mg/ml ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF 1 2.170000 6.690000 1.953000 6.907000
730 W04103001 M01AC06 MELOXICAMUM MOVALIS 15 mg COMPR. 15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0.575100 0.036400 0.517590 0.093910
731 W43917001 M01AC06 MELOXICAMUM MELOXICAM MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.396000 0.000000 0.356400 0.039600
732 W53657001 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 15 mg COMPR. 15mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.396000 0.000000 0.356400 0.039600
733 W42654003 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0.396000 0.000000 0.356400 0.039600
734 W04104001 M01AC06 MELOXICAMUM MOVALIS 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0.287550 0.313950 0.258795 0.342705
735 W43916001 M01AC06 MELOXICAMUM MELOXICAM MCC 7,5 mg COMPR. 7,5mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIAT. AL/PVC X 10 COMPR. P-6L 20 0.287550 0.031950 0.258795 0.060705
736 W53656001 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 7,5 mg COMPR. 7,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.287550 0.031950 0.258795 0.060705
737 W53827001 M01AC06 MELOXICAMUM MELOXICAM LAROPHARM 7,5 mg COMPR. 7,5mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. P-6L 20 0.287550 0.031950 0.258795 0.060705
738 W42653003 M01AC06 MELOXICAMUM MELOXICAM LPH 7,5 mg COMPR. 7,5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0.287550 0.032450 0.258795 0.061205
739 W61229001 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 3 2.163333 0.000000 1.946999 0.216334
740 W61229002 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 5 2.170000 0.000000 1.953000 0.217000
741 W60600001 M01AC06 MELOXICAMUM MELOX 15 mg/1,5 ml SOL. INJ. 15mg/1,5ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC A 5 FIOLE TRANSPARENTE DIN STICLA CU CAPACITATEA DE 2 ML, CONTINAND 1,5 ML PRF 5 2.170000 0.000000 1.953000 0.217000
742 W41449001 M01AC06 MELOXICAMUM MELOXICAM MCC 15 mg SUPOZ. 15mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 1.143583 0.889750 1.029224 1.004109
743 W42896001 M01AE03 KETOPROFENUM KETONAL DUO 150 mg CAPS. ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 0.779324 0.081176 0.701391 0.159109
744 W03880001 M01AE03 KETOPROFENUM KETONAL RETARD 150 mg COMPR. ELIB. PREL. 150mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L 20 0.779324 0.155176 0.701391 0.233109
745 W43110001 M01AE03 KETOPROFENUM KETOPROXIN 100 mg COMPR. FILM. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L 20 0.309000 0.000000 0.278100 0.030900
746 W63532001 M01AE03 KETOPROFENUM PROFENID 100 mg COMPR. FILM. 100mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM. P6L 30 0.441333 0.000000 0.397199 0.044134

Pagina 13 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
747 W43111001 M01AE03 KETOPROFENUM KETOPROXIN 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L 20 0.259774 0.133726 0.233796 0.159704
748 W60385001 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 5 1.258000 0.000000 1.132200 0.125800
749 W60385002 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 10 1.253000 0.000000 1.127700 0.125300
750 W54214001 M01AE03 KETOPROFENUM KETOPROFEN TERAPIA 100MG/2ML SOL. INJ. 100mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 2.204000 0.000000 1.983600 0.220400
751 W14020001 M01AE03 KETOPROFENUM KETOMAG 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L 10 0.955000 0.000000 0.859500 0.095500
752 W00242003 M04AA01 ALLOPURINOLUM * MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 COMPR. P6L 60 0.141944 0.046222 0.127749 0.060417
753 W65236001 M04AA01 ALLOPURINOLUM * MILURIT 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P6L 30 0.278000 0.000000 0.250200 0.027800
754 W00243001 M04AA01 ALLOPURINOLUM * MILURIT 300 mg COMPR. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 0.425833 0.008833 0.383249 0.051417
755 W01429002 M04AC01 COLCHICINUM COLCHICINA 1 mg COMPR. 1mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-RF 40 0.932000 0.000000 0.838800 0.093200
756 W12691002 N02AX02 TRAMADOLUM TRAMADOL 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.360831 0.036169 0.324747 0.072253
757 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.360831 0.154669 0.324747 0.190753
758 W60291001 N02AX02 TRAMADOLUM TRAMACALM 50 mg CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0.360831 0.155169 0.324747 0.191253
759 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.360831 0.154669 0.324747 0.190753
760 W42957001 N02AX02 TRAMADOLUM CLORHIDRAT DE TRAMADOL BIOEEL 50 mg COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.360831 0.154669 0.324747 0.190753
761 W68093001 N02AX02 TRAMADOLUM CLORHIDRAT DE TRAMADOL BIOEEL 50 mg COMPR. 50mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0.360831 0.154669 0.324747 0.190753
762 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0.721666 0.000000 0.649499 0.072167
763 W61448003 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0.599000 0.000000 0.539100 0.059900
764 W61449001 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1.082500 0.045500 0.974250 0.153750
765 W61449003 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0.876666 0.000000 0.788999 0.087667
766 W61449011 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1.082500 0.045500 0.974250 0.153750
767 W63389001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 1.082500 0.182500 0.974250 0.290750
768 W63389002 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 BLIST. PP/AL X 10 COMPR. ELIB. PREL. P-RF 10 1.082500 0.182500 0.974250 0.290750
769 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg AUSTRIA
LANNACHER HEILMITTEL GES.M.B.H. CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1.166000 0.000000 1.049400 0.116600
770 W61450003 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1.091000 0.000000 0.981900 0.109100
771 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 1.082500 0.070500 0.974250 0.178750
772 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1.443332 0.093668 1.298998 0.238002
773 W64091003 N02AX02 TRAMADOLUM TRAMADOL KALCEKS 50 mg/ml SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 2 TAVITE DIN PVC CU 10 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 10 2.028000 0.000000 1.825200 0.202800
774 W05967001 N02AX02 TRAMADOLUM TRAMADOL 100 mg/2 ml SOL. INJ. 100mg/2ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 2.062500 0.939500 1.856250 1.145750
775 W05961001 N02AX02 TRAMADOLUM MABRON 100 mg/2 ml SOL. INJ. 100mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 5 2.062500 0.011500 1.856250 0.217750
776 W05966001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 1.031246 0.096754 0.928121 0.199879
777 W64948001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 100 mg COMPR. DISP. 100mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. PRF 2 7.365000 0.000000 6.628500 0.736500
778 W59299001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 50 mg COMPR. DISP. 50mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 4.415000 1.685000 3.973500 2.126500
779 W64946001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 50 mg COMPR. DISP. 50mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. PRF 2 4.415000 1.685000 3.973500 2.126500
780 W56161005 N02CC01 SUMATRIPTANUM * XIBIMER 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 8.830000 1.341666 7.947000 2.224666
781 W59112004 N02CC01 SUMATRIPTANUM * SUMACTA 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 8.830000 0.000000 7.947000 0.883000
782 W68041004 N02CC01 SUMATRIPTANUM * SUMACTA 100 mg COMPR. FILM. 100mg TEVA B.V. OLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 8.830000 0.000000 7.947000 0.883000
783 W56160005 N02CC01 SUMATRIPTANUM * XIBIMER 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 4.415000 4.700000 3.973500 5.141500
784 W66779002 N02CC01 SUMATRIPTANUM * SUMATRIPTAN SUN 3 mg/0,5 ml SOL INJ. IN STILOU INJECTOR PREUMPLUT 3mg/0,5ml SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE, FORMATE DINTR-UN CILINDRU DIN STICLA DE 1 ML, CU UN AC DE CALIBRU DE 27 G SI LUNGIME DE 1,27 CM PRF 2 124.465000 0.000000 112.018500 12.446500
785 W00806001 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0.156200 0.000000 0.140580 0.015620
786 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 0.156275 0.000225 0.140647 0.015853
787 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 0.156275 0.000225 0.140647 0.015853
788 W12403003 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA SLAVIA 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0.156200 0.000000 0.140580 0.015620
789 W62172002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA TERAPIA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0.156200 0.000000 0.140580 0.015620
790 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 0.155500 0.000000 0.139950 0.015550
791 W68153001 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN BIOEEL 200 mg COMPR. 200mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.156275 0.000225 0.140647 0.015853
792 W00807001 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0.312550 0.120450 0.281295 0.151705
793 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 0.312550 0.119450 0.281295 0.150705
794 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 0.117206 0.217994 0.105485 0.229715
795 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 0.234412 0.220788 0.210970 0.244230
796 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 0.468825 0.338175 0.421942 0.385058
797 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 0.234412 0.126988 0.210970 0.150430
798 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 0.468825 0.231775 0.421942 0.278658
799 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 47.940000 0.000000 43.146000 4.794000
800 W64281004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0.113692 0.068508 0.102322 0.079878
801 W54332002 N03AX12 GABAPENTINUM GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0.113692 0.522474 0.102322 0.533844
802 W60025001 N03AX12 GABAPENTINUM GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0.113692 0.522474 0.102322 0.533844
803 W64282004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0.341078 0.153122 0.306970 0.187230
804 W41589005 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.341078 0.493422 0.306970 0.527530

Pagina 14 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
805 W43540001 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.341078 0.136822 0.306970 0.170930
806 W54333001 N03AX12 GABAPENTINUM GRIMODIN 300 mg CAPS. 300mg UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L
EGIS PHARMACEUTICALS P.L.C. 60 0.341078 0.294088 0.306970 0.328196
807 W60026001 N03AX12 GABAPENTINUM GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0.341078 1.237422 0.306970 1.271530
808 W64360001 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0.341078 0.136822 0.306970 0.170930
809 W65059001 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0.341078 1.118922 0.306970 1.153030
810 W64283004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0.454772 0.205028 0.409294 0.250506
811 W41590005 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.454772 0.712728 0.409294 0.758206
812 W43541001 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.454772 0.182128 0.409294 0.227606
813 W54334001 N03AX12 GABAPENTINUM GRIMODIN 400 mg CAPS. 400mg UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L
EGIS PHARMACEUTICALS P.L.C. 60 0.454772 0.642228 0.409294 0.687706
814 W60027001 N03AX12 GABAPENTINUM GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0.454772 1.587728 0.409294 1.633206
815 W64361001 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg TEVA B.V. OLANDA P6L
CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. 100 0.454772 0.182128 0.409294 0.227606
816 W65060001 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0.454772 1.210828 0.409294 1.256306
817 W65061001 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P6L 30 0.682159 1.681507 0.613943 1.749723
818 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 0.158343 0.026657 0.142508 0.042492
819 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 5.950000 0.000000 5.355000 0.595000
820 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 6.333750 1.266250 5.700375 1.899625
821 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 6.333750 1.166250 5.700375 1.799625
822 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 2.553999 0.000001 2.298599 0.255401
823 W02443001 N05BA01 DIAZEPAMUM DIAZEPAM RICHTER 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0.111500 0.000000 0.100350 0.011150
824 W12717001 N05BA01 DIAZEPAMUM DIAZEPAM TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 0.153000 0.000000 0.137700 0.015300
825 W52908001 N05BA01 DIAZEPAMUM DIAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.152500 0.000000 0.137250 0.015250
826 W60414001 N05BA01 DIAZEPAMUM DIAZEPAM TERAPIA 5 mg/ml SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 4.796000 0.000000 4.316400 0.479600
827 W10514001 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN 10 mg/2,5 ml SOL. RECTALA 10mg/2,5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 5 PUNGI TUBULARE CONTINAND FIECARE CATE 1 TUB DIN PEJD X 2,5 ML SOL. RECTALA PRF 5 5.984000 0.000000 5.385600 0.598400
828 W10515001 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN 5 mg/2,5 ml SOL. RECTALA 5mg/2,5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 5 PUNGI TUBULARE CONTINAND FIECARE CATE 1 TUB DIN PEJD X 2,5 ML SOL. RECTALA PRF 5 5.112000 0.000000 4.600800 0.511200
829 W60895002 N05BA03 MEDAZEPAMUM * MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLISTERE PVC/AL X 10 COMPRIMATE P-RF 20 0.174900 0.000100 0.157410 0.017590
830 W60895003 N05BA03 MEDAZEPAMUM * MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 5 BLISTERE PVC/AL X 10 COMPRIMATE P-RF 50 0.174800 0.000000 0.157320 0.017480
831 W12943002 N05BA03 MEDAZEPAMUM * MEDAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 0.174900 0.000100 0.157410 0.017590
832 W53797002 N05BA03 MEDAZEPAMUM * MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.174900 0.000100 0.157410 0.017590
833 W41692001 N05BA06 LORAZEPAMUM * ANXIAR (R) 1 mg COMPR. 1 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0.139920 0.039480 0.125928 0.053472
834 W66829001 N05BA06 LORAZEPAMUM * TEMELOR 4 mg SOL. INJ. 4mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 5 FIOLE ASEZATE IN TAVI DIN PVC ACOPERITE CU FOLIE PROTECTOARE DIN PE X 1 ML SOL. INJ. PRF 5 5.870000 0.000000 5.283000 0.587000
835 W06824003 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 1,5 mg COMPR. 1,5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 0.052469 0.461197 0.047222 0.466444
836 W55412001 N05BA08 BROMAZEPAMUM * BROMAZEPAM ARENA 3 mg COMPR. 3mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0.104939 0.014061 0.094445 0.024555
837 W06826003 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 0.104939 0.014061 0.094445 0.024555
838 W55412004 N05BA08 BROMAZEPAMUM * BROMAZEPAM ARENA 3 mg COMPR. 3mg ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. P-RF 40 0.104939 0.014061 0.094445 0.024555
839 W00252001 N05BA12 ALPRAZOLAMUM * XANAX 0,25 mg COMPR. 0,25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.087450 0.120550 0.078705 0.129295
840 W08624003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH 0,25 mg COMPR. 0,25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0.087450 0.050216 0.078705 0.058961
841 W41469001 N05BA12 ALPRAZOLAMUM * PRAZOLEX 0,25 mg COMPR. 0,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0.087450 0.048216 0.078705 0.056961
842 W07122001 N05BA12 ALPRAZOLAMUM * FRONTIN 0,25 mg COMPR. 0,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0.087450 0.050216 0.078705 0.058961
843 W59969001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0.087450 0.049550 0.078705 0.058295
844 W59969002 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0.087450 0.050550 0.078705 0.059295
845 W59969003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.087450 0.050216 0.078705 0.058961
846 W65049001 N05BA12 ALPRAZOLAMUM * XANAX 0,25 mg COMPR. 0,25mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.087450 0.120550 0.078705 0.129295
847 W67287001 N05BA12 ALPRAZOLAMUM * XANAX 0,25 mg COMPR. 0,25mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.087450 0.120550 0.078705 0.129295
848 W00253001 N05BA12 ALPRAZOLAMUM * XANAX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.174900 0.138433 0.157410 0.155923
849 W08625003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH 0,5 mg COMPR. 0,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0.174900 0.044766 0.157410 0.062256
850 W07123001 N05BA12 ALPRAZOLAMUM * FRONTIN 0,5 mg COMPR. 0,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0.174900 0.023766 0.157410 0.041256
851 W42783001 N05BA12 ALPRAZOLAMUM * PRAZOLEX 0,5 mg COMPR. 0,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0.174900 0.041766 0.157410 0.059256
852 W59972001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0.174900 0.044100 0.157410 0.061590
853 W59972002 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0.174900 0.044600 0.157410 0.062090
854 W59972003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.174900 0.044766 0.157410 0.062256
855 W65050001 N05BA12 ALPRAZOLAMUM * XANAX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.174900 0.138433 0.157410 0.155923
856 W67288001 N05BA12 ALPRAZOLAMUM * XANAX 0,5 mg COMPR. 0,5mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.174900 0.138433 0.157410 0.155923
857 W00254001 N05BA12 ALPRAZOLAMUM * XANAX 1 mg COMPR. 1mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.349800 0.038866 0.314820 0.073846
858 W08626003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 30 0.291333 0.000000 0.262199 0.029134
859 W41470001 N05BA12 ALPRAZOLAMUM * PRAZOLEX 1 mg COMPR. 1mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0.287000 0.000000 0.258300 0.028700
860 W07126001 N05BA12 ALPRAZOLAMUM * FRONTIN 1mg COMPR. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0.291333 0.000000 0.262199 0.029134
861 W59973001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0.285000 0.000000 0.256500 0.028500
862 W59973002 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0.286000 0.000000 0.257400 0.028600

Pagina 15 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
863 W59973003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.291333 0.000000 0.262199 0.029134
864 W65051001 N05BA12 ALPRAZOLAMUM * XANAX 1 mg COMPR. 1mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.349800 0.038866 0.314820 0.073846
865 W67289001 N05BA12 ALPRAZOLAMUM * XANAX 1 mg COMPR. 1mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0.349800 0.038866 0.314820 0.073846
866 W12245003 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH 2,5 mg COMPR. 2.5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.068312 0.237688 0.061480 0.244520
867 W59781001 N05CD02 NITRAZEPAMUM NITRAZEPAM - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.135500 0.000000 0.121950 0.013550
868 W12246003 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.136625 0.000375 0.122962 0.014038
869 W64484001 N05CF01 ZOPICLONUM * IMOVANE 7,5 mg COMPR. FILM. 7,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. PRF 20 0.400500 0.000000 0.360450 0.040050
870 W13133002 N05CF02 ZOLPIDEMUM * SANVAL 10 mg COMPR. FILM. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0.246000 0.000000 0.221400 0.024600
871 W53913001 N05CF02 ZOLPIDEMUM * ZOLPIDEM ATB 10 MG COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.248000 0.000000 0.223200 0.024800
872 W62440001 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 0.297071 0.454929 0.267363 0.484637
873 W62440002 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 20 0.297071 0.148929 0.267363 0.178637
874 W62440003 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 0.297071 0.148929 0.267363 0.178637
875 W62440004 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 0.297071 0.147214 0.267363 0.176922
876 W01358001 N06AA04 CLOMIPRAMINUM * ANAFRANIL 10 mg DRAJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0.183066 0.087600 0.164759 0.105907
877 W67624001 N06AA04 CLOMIPRAMINUM * ANAFRANIL 10 mg DRAJ. 10mg ZR PHARMA& GMBH AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. PRF 30 0.183066 0.087600 0.164759 0.105907
878 W01359001 N06AA04 CLOMIPRAMINUM * ANAFRANIL 25 mg DRAJ. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0.457666 0.000000 0.411899 0.045767
879 W67625001 N06AA04 CLOMIPRAMINUM * ANAFRANIL 25 mg DRAJ. 25mg ZR PHARMA& GMBH AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. PRF 30 0.457666 0.000000 0.411899 0.045767
880 W02865001 N06AA12 DOXEPINUM * DOXEPIN 25 mg DRAJ. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0.457666 1.020000 0.411899 1.065767
881 W60729001 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0.243160 0.523840 0.218844 0.548156
882 W60729002 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0.243160 0.475840 0.218844 0.500156
883 W13241002 N06AB03 FLUOXETINUM * FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS. P-RF 28 0.486321 0.401893 0.437688 0.450526
884 W08497001 N06AB03 FLUOXETINUM * MAGRILAN 20 mg CAPS. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 0.451000 0.000000 0.405900 0.045100
885 W60730001 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0.486321 0.401679 0.437688 0.450312
886 W60730002 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0.486321 0.329379 0.437688 0.378012
887 W10228001 N06AB03 FLUOXETINUM * PROZAC 20 mg COMPR. DISP. 20mg ELI LILLY SA SPANIA CUTIE X 2 BLIST. PVC-PE-PCTFE/AL X 14 COMPR. DISP. P-RF 28 0.486321 0.931893 0.437688 0.980526
888 W43706001 N06AB04 CITALOPRAMUM ** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 0.486321 1.004345 0.437688 1.052978
889 W41796001 N06AB05 PAROXETINUM * ARKETIS 20 mg COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-RF 30 0.486321 0.087345 0.437688 0.135978
890 W57051001 N06AB05 PAROXETINUM * PAROXETINA ATB 20 mg COMPR. FILM. 20 mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 0.486321 0.194679 0.437688 0.243312
891 W43958002 N06AB05 PAROXETINUM * PAXETIN 20 mg COMPR. FILM. 20mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-RF 30 0.486321 0.071012 0.437688 0.119645
892 W64362002 N06AB05 PAROXETINUM * PAXETIN 20 mg COMPR. FILM. 20mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. OPA-AL-PVC/PVC-AL-OPA X 10 COMPR. FILM. PRF 30 0.486321 0.071012 0.437688 0.119645
893 W65203003 N06AB05 PAROXETINUM * SEROXAT 20 mg COMPR. FILM. 20mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 3 BLIST. PVC/AL-HARTIE X 10 COMPR. FILM. PRF 30 0.486321 0.194679 0.437688 0.243312
894 W44097001 N06AB06 SERTRALINUM * SERLIFT 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 0.972642 0.441643 0.875377 0.538908
895 W12874001 N06AB06 SERTRALINUM * ASENTRA 100 mg COMPR. FILM. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 0.972642 0.059143 0.875377 0.156408
896 W55563001 N06AB06 SERTRALINUM * ZOLOFT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X BLISTERE DIN AL/PVC X 28 COMPRIMATE FILMATE P-RF 28 0.972642 0.359858 0.875377 0.457123
897 W59051001 N06AB06 SERTRALINUM * ADJUVIN 100 mg COMPR. FILM. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 0.972642 0.024358 0.875377 0.121623
898 W59303002 N06AB06 SERTRALINUM * STIMULOTON 100 mg COMPR. FILM. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 0.972642 0.251286 0.875377 0.348551
899 W60444001 N06AB06 SERTRALINUM * SERTRALINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0.972642 0.442024 0.875377 0.539289
900 W61376006 N06AB06 SERTRALINUM * SERTRALINA AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0.972642 0.023358 0.875377 0.120623
901 W65116001 N06AB06 SERTRALINUM * ZOLOFT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR/PRF 28 0.972642 0.359858 0.875377 0.457123
902 W67279001 N06AB06 SERTRALINUM * ZOLOFT 100 mg COMPR. FILM. 100mg UPJOHN EESV OLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR/PRF 28 0.972642 0.359858 0.875377 0.457123
903 W44096001 N06AB06 SERTRALINUM * SERLIFT 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 0.486321 0.313321 0.437688 0.361954
904 W12873001 N06AB06 SERTRALINUM * ASENTRA 50 mg COMPR. FILM. 50mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 0.376428 0.000000 0.338785 0.037643
905 W55562001 N06AB06 SERTRALINUM * ZOLOFT 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG CUTIE X BLIST. DIN AL/PVC X 28 COMPR. FILM.
MAREA BRITANIE P-RF 28 0.486321 0.269750 0.437688 0.318383
906 W59050001 N06AB06 SERTRALINUM * ADJUVIN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 0.486321 0.012012 0.437688 0.060645
907 W59302001 N06AB06 SERTRALINUM * STIMULOTON 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-RF 30 0.486321 0.025345 0.437688 0.073978
908 W60443001 N06AB06 SERTRALINUM * SERTRALINA ARENA 50 mg COMPR. FILM. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0.486321 0.397679 0.437688 0.446312
909 W61375006 N06AB06 SERTRALINUM * SERTRALINA AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0.482666 0.000000 0.434399 0.048267
910 W65052001 N06AB06 SERTRALINUM * ZOLOFT 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR/PRF 28 0.486321 0.269750 0.437688 0.318383
911 W67278001 N06AB06 SERTRALINUM * ZOLOFT 50 mg COMPR. FILM. 50mg UPJOHN EESV OLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR/PRF 28 0.486321 0.269750 0.437688 0.318383
912 W55564001 N06AB06 SERTRALINUM * ZOLOFT 20 mg/ml CONC. PT. SOL. ORALA 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA + 1 PIPETA GRADATA P-RF 1 11.671711 53.598289 10.504539 54.765461
913 W65117001 N06AB06 SERTRALINUM * ZOLOFT 20 mg/ml CONC. PT. SOL. ORALA 20mg/ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, AVAND CAPACITATEA DE 60 ML + 1 PIPETA GRADATA CARE CONTINE CONC. PT. SOL. ORALA PR/PRF 1 11.671711 53.598289 10.504539 54.765461
914 W67280001 N06AB06 SERTRALINUM * ZOLOFT 20 mg/ml CONC. PT. SOL. ORALA 20mg/ml UPJOHN EESV OLANDA CUTIE CU 1 FLAC. DIN STICLA BRUNA, AVAND CAPACITATEA DE 60 ML + 1 PIPETA GRADATA CARE CONTINE CONC. PT. SOL. ORALA PR/PRF 1 11.671711 53.598289 10.504539 54.765461
915 W62371001 N06AB08 FLUVOXAMINUM * FEVARIN 100mg COMPR. FILM. 100mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF 30 0.486321 0.687679 0.437688 0.736312
916 W64560001 N06AB08 FLUVOXAMINUM * FEVARIN 100 COMPR. FILM. 100mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 2 BLIST. PVC/PVDC X 15 COMPR. FILM. PRF 30 0.486321 0.687679 0.437688 0.736312
917 W62372001 N06AB08 FLUVOXAMINUM * FEVARIN 50mg COMPR. FILM. 50mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF 30 0.243160 0.373173 0.218844 0.397489
918 W64561001 N06AB08 FLUVOXAMINUM * FEVARIN 50 COMPR. FILM. 50mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 2 BLIST. PVC/PVDC X 15 COMPR. FILM. PRF 30 0.243160 0.373173 0.218844 0.397489
919 W60361001 N06AX11 MIRTAZAPINUM * MIRTAZAPIN ARENA 15 mg COMPR. FILM. 15mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0.295500 0.643833 0.265950 0.673383
920 W42062001 N06AX11 MIRTAZAPINUM * MIRZATEN (R) 30 mg COMPR. FILM. 30mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0.591000 0.000000 0.531900 0.059100

Pagina 16 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
921 W44013002 N06AX11 MIRTAZAPINUM * PHARMATAZ 30 mg COMPR. FILM. 30mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL, X 10 COMPR. FILM. P-RF 30 0.591000 0.192666 0.531900 0.251766
922 W60362001 N06AX11 MIRTAZAPINUM * MIRTAZAPIN ARENA 30 mg COMPR. FILM. 30mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0.591000 0.311333 0.531900 0.370433
923 W64105002 N06AX11 MIRTAZAPINUM * VALDREN 30 mg COMPR. FILM. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU 3 BLIST. ALBE OPACE PVC/PVDC/AL X 10 COMPR. FILM. PRF 30 0.580333 0.000000 0.522299 0.058034
924 W64363002 N06AX11 MIRTAZAPINUM * PHARMATAZ 30 mg COMPR. FILM. 30mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 0.591000 0.192666 0.531900 0.251766
925 W60363001 N06AX11 MIRTAZAPINUM * MIRTAZAPIN ARENA 45 mg COMPR. FILM. 45mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0.886500 1.457166 0.797850 1.545816
926 W53476002 N06AX11 MIRTAZAPINUM * ZULIN 30 mg COMPR. ORODISPERSABILE 30mg ANTIBIOTICE S.A. ROMANIA CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE P-RF 30 0.535666 0.000000 0.482099 0.053567
927 W63233003 N06AX11 MIRTAZAPINUM * REMERON SOLTAB 30 mg COMPR. ORODISPERSABILE 30mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC-PA-POLIESTER PERFORATE PT. ELIB. UNEI UNITATI DOZATE X 6 COMPR. ORODISPERSABILE PRF 30 0.591000 1.429000 0.531900 1.488100
928 W56742002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 1.383570 0.728572 1.245213 0.866929
929 W58756003 N06AX16 VENLAFAXINUM ** ELIFY EP 150 mg CAPS. ELIB. PREL. 150 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF 30 1.130333 0.000000 1.017299 0.113034
930 W64861002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg BELGIA
PFIZER EUROPE MA EEIG CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 1.383570 0.728572 1.245213 0.866929
931 W67116002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg UPJOHN EESV OLANDA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 1.383570 0.728572 1.245213 0.866929
932 W52122001 N06AX16 VENLAFAXINUM ** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 1.383570 0.060715 1.245213 0.199072
933 W52962005 N06AX16 VENLAFAXINUM ** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0.651666 0.000000 0.586499 0.065167
934 W55396001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 1.383570 0.060763 1.245213 0.199120
935 W66465006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0.715333 0.000000 0.643799 0.071534
936 W53268003 N06AX16 VENLAFAXINUM ** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg AUSTRIA
LANNACHER HEILMITTEL GES.M.B.H. CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0.345892 0.312441 0.311302 0.347031
937 W55395001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0.345892 0.571441 0.311302 0.606031
938 W56741002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.691785 0.392857 0.622606 0.462036
939 W58755003 N06AX16 VENLAFAXINUM ** ELIFY EP 75 mg CAPS. ELIB. PREL. 75 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 0.681666 0.000000 0.613499 0.068167
940 W64860002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg BELGIA
PFIZER EUROPE MA EEIG CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.691785 0.392857 0.622606 0.462036
941 W67115002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg UPJOHN EESV OLANDA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.691785 0.392857 0.622606 0.462036
942 W52123001 N06AX16 VENLAFAXINUM ** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 0.691785 0.253572 0.622606 0.322751
943 W52961005 N06AX16 VENLAFAXINUM ** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0.413333 0.000000 0.371999 0.041334
944 W53269003 N06AX16 VENLAFAXINUM ** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg AUSTRIA
LANNACHER HEILMITTEL GES.M.B.H. CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0.691785 0.039548 0.622606 0.108727
945 W55397001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0.691785 0.285215 0.622606 0.354394
946 W66464006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0.420000 0.000000 0.378000 0.042000
947 W55398001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 37,5 mg COMPR. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0.345892 0.571441 0.311302 0.606031
948 W55399001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0.461190 0.473476 0.415071 0.519595
949 W55400001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 75 mg COMPR. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0.691785 0.278548 0.622606 0.347727
950 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 1.239166 0.000000 1.115249 0.123917
951 W65149004 N07XX07 FAMPRIDINE ** Ω FAMPYRA COMPR. ELIB. PREL. 10mg BIOGEN NETHERLANDS B.V. OLANDA CUTIE X 56 COMPRIMATE CU ELIBERARE PRELUNGITA (4 BLISTERE X 14) PR/PRF 56 14.191607 0.000000 12.772446 1.419161
952 W67601001 P01AB01 METRONIDAZOLUM METRONIDAZOL ARENA 125 mg CAPS. 125mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLISTERE DIN AL/PVC TRANSPARENT A CÂTE 10 CAPSULE PRF 30 0.899333 0.000000 0.809399 0.089934
953 W67602001 P01AB01 METRONIDAZOLUM METRONIDAZOL ARENA 500 mg CAPS. 500 mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLISTERE DIN AL/PVC TRANSPARENT A CÂTE 10 CAPSULE PRF 20 0.993499 1.695001 0.894149 1.794351
954 W42888001 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 0.993499 0.061501 0.894149 0.160851
955 W10714001 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0.993499 0.061501 0.894149 0.160851
956 W42888001 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 0.993499 0.061501 0.894149 0.160851
957 W10714001 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0.993499 0.061501 0.894149 0.160851
958 W53579001 P02CA03 ALBENDAZOLUM ALBENDAZOL VIM SPECTRUM 200 mg COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. P-RF 2 3.665000 0.000000 3.298500 0.366500
959 W00225003 P02CA03 ALBENDAZOLUM ESKAZOLE COMPR. 400mg GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 12 BLIST. PVC-PVDC/AL X 1 COMPR. P-RF 12 7.330000 26.671666 6.597000 27.404666
960 W65213003 P02CA03 ALBENDAZOLUM ESKAZOLE 400 mg COMPR. 400mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 12 BLIST. PVC-PVDC/AL X 1 COMPR. PRF 12 7.330000 26.671666 6.597000 27.404666
961 W13994001 P02CA03 ALBENDAZOLUM DUADOR 200 mg COMPR. FILM. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. X 2 COMPR. FILM. P-RF 2 3.615000 0.000000 3.253500 0.361500
962 W62163001 P02CA03 ALBENDAZOLUM VERMIGAL NOVO 200 mg COMPR. FILM. 200mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC-PVDC TRANSPARENT X 2 COMPR. FILM. PRF 2 3.665000 0.000000 3.298500 0.366500
963 W60595001 P02CA03 ALBENDAZOLUM VERMIGAL NOVO 400 mg/10 ml SUSP. ORALA 400mg/10ml BIOFARM S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA PRF 1 4.270000 0.000000 3.843000 0.427000
964 W65214001 P02CA03 ALBENDAZOLUM ZENTEL 400 mg/10 ml SUSP. ORALA 400mg/10ml GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE X 1 FLACON UNIDOZA DIN PVC X 10 ML SUSP. ORALA P-RF 1 4.317749 2.062251 3.885974 2.494026
965 W64944001 R03AC02 SALBUTAMOLUM VENTOLIN 5 mg/ml SOL. DE INHALAT PRIN NEBULIZATOR 5mg/ml GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SOL. DE INHAL. PRIN NEBULIZATOR P6L 1 5.366999 3.203001 4.830299 3.739701
966 W12650001 R03AC02 SALBUTAMOLUM VENTOLIN (R) SOL. INHAL. 5mg/ml GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FALC. DIN STICLA BRUNA X 10 ML SOL. DE INHAL. P-6L 1 5.366999 3.203001 4.830299 3.739701
967 W65178001 R03AC02 SALBUTAMOLUM VENTOLIN 100 INHALER CFC-FREE SUSP. INHAL. PRESURIZATA 100µg/doza GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE X 1 FLACON PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE X 200 DOZE + DISPOZITIV DE ADMINISTRARE P-RF 1 10.820000 0.000000 9.738000 1.082000
968 W41683001 R03BA01 BECLOMETASONUM * CLENIL JET 250 mcg/doza SOL. INHALAT PRESURIZATA 250mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON PRESURIZAT DIN AL X 200 DOZE, PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM., "SPASER JET" CU CAPAC P-RF 1 112.330000 0.000000 101.097000 11.233000
969 W43881001 R03BA02 BUDESONIDUM * FRENOLYN 200 µg PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA, X 1 INHALATOR X 100 DOZE P-RF 1 33.245000 1.785000 29.920500 5.109500
970 W43881003 R03BA02 BUDESONIDUM * FRENOLYN 200 µg PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 200 DOZE P-RF 1 66.490000 1.210000 59.841000 7.859000
971 W00680001 R03BA02 BUDESONIDUM * PULMICORT TURBUHALER 200 mcg/doza PULB. INHAL. 200mcg/doza ASTRAZENECA AB SUEDIA CUTIE X 1 FLACON MULTIDOZA DIN PEID X 100 DOZE PULB. INHAL. P-RF 1 31.430000 0.000000 28.287000 3.143000
972 W43882002 R03BA02 BUDESONIDUM * FRENOLYN 400 µg PULB. INHAL. 400 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 100 DOZE P-RF 1 66.490000 29.920000 59.841000 36.569000
973 W65226001 R03BB01 IPRATROPII BROMIDUM * IPRAVENT INHALER 20 micrograme/doza SOL. DE INHAL. PRESURIZATA 20micrograme/doza AMRING FARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. PRESURIZAT DIN AL X 200 DOZE SOL. DE INHALAT PRESURIZATA P6L 1 21.940000 0.000000 19.746000 2.194000
974 W05494001 R03CC02 SALBUTAMOLUM SALBUTAMOL MCC 4 mg COMPR. 4mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.484000 0.000000 0.435600 0.048400
975 W44064001 R03CC02 SALBUTAMOLUM SALBUTAMOL EIPICO 2mg/5ml SIROP 2mg/5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 125 ML SIROP P-6L 1 10.230000 0.000000 9.207000 1.023000
976 W65179001 R03CC02 SALBUTAMOLUM VENTOLIN 0,5 mg/ml SOL. INJ. 0,5mg/ml GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P6L 5 1.756000 0.000000 1.580400 0.175600
977 W07705001 R03DA04 THEOPHYLLINUM TEOTARD 200 mg CAPS. ELIB. PREL. 200mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-RF 40 0.241200 0.026800 0.217080 0.050920
978 W05848001 R03DA04 THEOPHYLLINUM TEOTARD 350 mg CAPS. ELIB. PREL. 350mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-RF 40 0.399500 0.000000 0.359550 0.039950

Pagina 17 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
979 W57245001 R03DX05 OMALIZUMABUM ** XOLAIR 150 mg SOL INJ. 150mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOLUTIE INJECTABILA PR/PRF 1 1,595.950000 0.000000 1,436.355000 159.595000
980 W65487001 R03DX05 OMALIZUMABUM ** XOLAIR 150 mg SOL INJ. 150mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. PR/PRF 1 1,595.950000 0.000000 1,436.355000 159.595000
981 W57244001 R03DX05 OMALIZUMABUM ** XOLAIR 75 mg SOL INJ. 75mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 0.5ML SOLUTIE INJECTABILA PR/PRF 1 797.975000 49.575000 718.177500 129.372500
982 W65486001 R03DX05 OMALIZUMABUM ** XOLAIR 75 mg SOL INJ. 75mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 SERINGA PREUMPLUTA X 0.5 ML SOL. INJ. PR/PRF 1 797.975000 49.575000 718.177500 129.372500
983 W01411002 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.221000 0.000000 0.198900 0.022100
984 W01409002 R05DA04 CODEINUM FOSFAT DE CODEINA EEL 15 mg COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0.226000 0.000000 0.203400 0.022600
985 W01407004 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 0.226000 0.000500 0.203400 0.023100
986 W54406001 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.226000 0.000500 0.203400 0.023100
987 W62739001 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0.226000 0.000500 0.203400 0.023100
988 W68091001 R05DA04 CODEINUM FOSFAT DE CODEINA BIOEEL 15 mg COMPR. 15mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 25 COMPR. PRF 25 0.226000 0.000000 0.203400 0.022600
989 W01189001 R06AB04 CHLORPHENAMINUM CLORFENIRAMIN 4 mg COMPR. 4mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.616500 0.000000 0.554850 0.061650
990 W42728001 R06AE07 CETIRIZINUM CELERG 10 mg COMPR. FILM. 10 mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 0.562874 0.648126 0.506586 0.704414
991 W43156001 R06AE07 CETIRIZINUM CETIRIZINA LAROPHARM 10 mg COMPR. FILM. 10mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0.562874 0.647626 0.506586 0.703914
992 W59369003 R06AE07 CETIRIZINUM ZYRTEC 10 mg/ml PICATURI ORALE, SOL. 10mg/ml UCB PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA + PICURATOR DIN PEJD X 20 ML PIC. ORALE, SOL. P6L 1 11.257497 3.782503 10.131747 4.908253
993 W11534001 R06AX17 KETOTIFENUM H - KETOTIFEN COMPR. 1mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.201000 0.000000 0.180900 0.020100
994 W52907001 R06AX17 KETOTIFENUM KETOTIFEN LAROPHARM 1 mg COMPR. 1mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P-6L 20 0.201000 0.000000 0.180900 0.020100
995 W58781002 R06AX17 KETOTIFENUM KETOTIFEN LPH 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR P6L 30 0.201000 0.000333 0.180900 0.020433
996 W03905001 R06AX17 KETOTIFENUM KETOF 1 mg/5 ml SIROP 1mg/5ml HEXAL AG GERMANIA CUTIE X 1 FLACON X 100 ML SIROP + MASURA DOZATOARE P-6L 1 36.880000 0.000000 33.192000 3.688000
997 W55653001 S01BC03 DICLOFENACUM DICLOFENAC ROMPHARM 1 mg/ml PIC. OFT.-SOL. 1mg/ml ROMPHARM COMPANY SRL ROMANIA FLACON PICURATOR DIN PEJD X 5 ML PIC. OFT., SOL. P-6L 1 10.620000 0.000000 9.558000 1.062000
998 W60088001 S01CA05 COMBINATII (BETHAMETASONUM+CLORAMPHENICOLUM) BETABIOPTAL 1,3 mg/g+2,5 mg/g GEL OFT. 1,3mg/g+2,5mg/g THEA FARMA S.P.A. ITALIA CUTIE CU 1 FLAC. DIN PEJD +PICURATOR DIN PE X 5 G GEL OFT. PRF 1 35.845000 21.015000 32.260500 24.599500
999 W59770001 S01CA05 COMBINATII (BETHAMETASONUM+CLORAMPHENICOLUM) BETABIOPTAL 2 mg/5 mg/ml PICATURI OFT.SUSP. 2mg/5mg/ml THEA FARMA S.P.A. ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.,SUSP. + APLICATOR PT. PICURARE P-RF 1 33.280000 0.000000 29.952000 3.328000
1,000 W59771001 S01CA05 COMBINATII (BETHAMETASONUM+CLORAMPHENICOLUM) BETABIOPTAL 2 mg/g+5 mg/g UNG. OFT. 2mg/g+5mg/g THEA FARMA S.P.A. ITALIA CUTIE X 1 TUB AL X 5 G P-RF 1 35.845000 2.565000 32.260500 6.149500

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 18 din 80
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, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILA INCEPAND CU 01 MARTIE 2022

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


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

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

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


Nr crt.

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

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 0.236785 0.000000 0.118392 0.118393 0.213106 0.023679
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 0.296000 0.000000 0.148000 0.148000 0.266400 0.029600
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 0.365333 0.000000 0.182666 0.182667 0.328799 0.036534
4 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 0.376000 0.000000 0.188000 0.188000 0.338400 0.037600
5 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 0.376000 0.000000 0.188000 0.188000 0.338400 0.037600
6 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 0.220333 0.000000 0.110166 0.110167 0.198299 0.022034
7 W67388001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL MEDREG 20 mg COMPR. GASTROREZ. 20mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0.365333 0.000000 0.182666 0.182667 0.328799 0.036534
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 0.472857 0.000000 0.236428 0.236429 0.425571 0.047286
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 0.592333 0.000000 0.296166 0.296167 0.533099 0.059234
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 0.670714 0.000000 0.335357 0.335357 0.603642 0.067072
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 0.670000 0.000000 0.335000 0.335000 0.603000 0.067000
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 0.670666 0.000000 0.335333 0.335333 0.603599 0.067067
13 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 0.711333 0.000000 0.355666 0.355667 0.640199 0.071134
14 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 0.711333 0.000000 0.355666 0.355667 0.640199 0.071134
15 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 0.440000 0.000000 0.220000 0.220000 0.396000 0.044000
16 W67390001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL MEDREG 40 mg COMPR. GASTROREZ. 40mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0.670666 0.000000 0.335333 0.335333 0.603599 0.067067
17 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 9.710000 0.000000 4.855000 4.855000 8.739000 0.971000
18 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 12.700000 0.000000 6.350000 6.350000 11.430000 1.270000
19 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 9.710000 0.000000 4.855000 4.855000 8.739000 0.971000
20 W61651003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL SUN 40 mg PULB. PT. SOL. INJ. 40mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU 10 FLAC. DIN STICLA INCOLORA DE TIP I CARE CONTIN PULB. PT. SOL. INJ. PRF 10 8.922000 0.000000 4.461000 4.461000 8.029800 0.892200
21 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 0.407857 0.000000 0.203928 0.203929 0.367071 0.040786
22 W55421016 A02BC05 ESOMEPRAZOLUM EMANERA 20 mg CAPS. GASTROREZ. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. P-6L 28 0.333928 0.000000 0.166964 0.166964 0.300535 0.033393
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 0.922857 0.000000 0.461428 0.461429 0.830571 0.092286
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 0.768214 0.000000 0.384107 0.384107 0.691392 0.076822
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 0.646598 0.459830 0.323299 0.783129 0.581938 0.524490
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 0.646598 0.441973 0.323299 0.765272 0.581938 0.506633
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 1.293198 0.263944 0.646599 0.910543 1.163878 0.393264
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 1.293198 0.234659 0.646599 0.881258 1.163878 0.363979
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 0.646598 0.441973 0.323299 0.765272 0.581938 0.506633
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 1.293198 0.234659 0.646599 0.881258 1.163878 0.363979
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 2.753214 0.000000 1.376607 1.376607 2.477892 0.275322
32 W67732001 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL ROMPHARM 40 mg PULB. PT. SOL. INJ./PERF. 40mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA DE TIP I CARE CONTINE PULB. PT. SOL. INJ./PERF. PR/PRF 1 22.283994 3.106006 11.141997 14.248003 20.055594 5.334406
33 W68187001 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SUN 40 mg PULB. PT. SOL. INJ./PERF. 40mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF. PR/PRF 1 22.283994 3.106006 11.141997 14.248003 20.055594 5.334406
34 W68187002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SUN 40 mg PULB. PT. SOL. INJ./PERF. 40mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF. PR/PRF 10 22.140000 0.000000 11.070000 11.070000 19.926000 2.214000
35 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 0.517285 0.474857 0.258642 0.733500 0.465556 0.526586
36 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 0.884333 0.000000 0.442166 0.442167 0.795899 0.088434
37 W63734001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 12 COMPR. FILM. PRF 12 2.516666 0.000000 1.258333 1.258333 2.264999 0.251667
38 W63734002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL A CATE 12 COMPR. FILM. PRF 36 2.704166 0.187500 1.352083 1.539583 2.433749 0.457917
39 W63735001 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFASIGMA S.P.A. ITALIA CUTIE CU UN FLACON DIN STICLA BRUNA CONTINÂND GRANULE PENTRU 60 ML SUSPENSIE ORALA, ÎNSOTIT DE O MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML. PRF 1 16.225012 5.634988 8.112506 13.747494 14.602510 7.257490
40 W08631001 A07EA06 BUDESONIDUM ** # BUDENOFALK 3 mg CAPS. CU PELETE GASTROREZ. 3mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ. P-RF 100 3.410400 0.000000 1.705200 1.705200 3.069360 0.341040
41 W61505003 A07EA06 BUDESONIDUM ** # CORTIMENT 9mg COMPR. ELIB. PREL. 9mg FERRING GMBH GERMANIA CUTIE CU BLIST. DIN PA-AL/PVC-AL X 30 COMPRIMATE ELIBERARE PRELUNGITA PRF 30 10.946105 4.249561 5.473052 9.722614 9.851494 5.344172
42 W58169003 A07EA06 BUDESONIDUM ** # BUDENOFALK UNO 9 mg GRANULE GASTROREZ. 9mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 30 PLICURI PET/AL/PEJD CU GRANULE GASTROREZ. PRF 30 10.946105 0.714895 5.473052 6.187948 9.851494 1.809506
43 W54445001 A07EA06 BUDESONIDUM ** # BUDENOFALK 2 mg/doza SPUMA RECTALA 2mg/doza DR. FALK PHARMA GMBH GERMANIA CUTIE X 1 FLAC. DIN AL X 14 DOZE X 1,2G SPUMA RECTALA, 14 APLICATOARE LUBREFIANTE PVC SI 14 PUNGI PL P-RF 1 335.260000 0.000000 167.630000 167.630000 301.734000 33.526000
44 W63750001 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg BIOPROJET PHARMA FRANTA CUTIE CU 2 BLIST. X 10 CAPS. PRF 20 2.994687 0.060813 1.497343 1.558157 2.695218 0.360282
45 W63748002 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. ORALA 10mg BIOPROJET PHARMA FRANTA CUTIE CU 16 PLICURI DIN HÂRTIE/AL/PEJD X 1 G PULB. ORALA PRF 16 2.935625 0.000000 1.467812 1.467813 2.642062 0.293563
46 W63749002 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. ORALA 30mg BIOPROJET PHARMA FRANTA CUTIE CU 16 PLICURI DIN HARTIE/AL/PEJD X 3 G PULB. ORALA PRF 16 2.994687 0.059063 1.497343 1.556407 2.695218 0.358532
47 W63610002 A08AB01 ORLISTATUM **1 XENICAL 120mg CAPS. 120mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC) PRF 84 1.897500 0.000000 0.948750 0.948750 1.707750 0.189750
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 0.564200 0.000000 0.282100 0.282100 0.507780 0.056420
49 W67321001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 micrograme CAPS. MOI 0,25micrograme THERAMEX IRELAND LIMITED IRLANDA CUTIE CU 1 FLAC. DIN PPID X 50 CAPS. MOI PRF 50 0.564200 0.000000 0.282100 0.282100 0.507780 0.056420
50 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 0.610174 0.234826 0.305087 0.539913 0.549156 0.295844
51 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 1.220349 0.030651 0.610174 0.640826 1.098314 0.152686
52 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 1.220349 0.030651 0.610174 0.640826 1.098314 0.152686
53 W67323001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 micrograme CAPS. MOI 0,50micrograme THERAMEX IRELAND LIMITED IRLANDA CUTIE CU 1 FLAC. DIN PPID X 30 CAPS. MOI PRF 30 1.220349 0.030651 0.610174 0.640826 1.098314 0.152686
54 W67770001 A11CC03 ALFACALCIDOLUM MEDIRAZIN 0,5 micrograme CAPS. MOI 0,50micrograme ZENIVA K.S. REPUBLICA CEHA CUTIE CU UN FLACON ALB OPAC DIN PEÎD X 30 CAPSULE MOI PRF 30 1.220349 0.030651 0.610174 0.640826 1.098314 0.152686
55 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 1.220349 0.030651 0.610174 0.640826 1.098314 0.152686
56 W60364001 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOSSEN 600 mg COMPR. FILM. 600mg AAA - PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 30 1.589000 0.168000 0.794500 0.962500 1.430100 0.326900
57 W67404001 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # ACID TIOCTIC ZENTIVA 600 mg COMPR. FILM. 600mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLISTERE OPACE DIN PVC-PVDC/AL X 30 COMPRIMATE FILMATE P-6L 30 1.533000 0.000000 0.766500 0.766500 1.379700 0.153300
58 W64296002 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # ACID TIOCTIC ROMPHARM 600 mg/24 ml SOL 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 17.252000 0.000000 8.626000 8.626000 15.526800 1.725200
59 W60368001 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOSSEN TURBO 600 mg/50ml SOL. INJ. 600mg/50ml AAA - PHARMA GMBH GERMANIA CUTIE CU 10 FLAC. DIN STICLA BRUNA X 50 ML SOL. PERF. SI 10 PUNGI PROTECTOARE DE LUMINA PR/PRF 10 17.305000 0.159000 8.652500 8.811500 15.574500 1.889500
60 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 14.016000 2.868000 7.008000 9.876000 12.614400 4.269600
61 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 14.016000 2.868000 7.008000 9.876000 12.614400 4.269600
62 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 7.008000 1.038000 3.504000 4.542000 6.307200 1.738800
63 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 14.016000 0.056000 7.008000 7.064000 12.614400 1.457600
64 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 17.243000 0.000000 8.621500 8.621500 15.518700 1.724300
65 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 22.781666 0.000000 11.390833 11.390833 20.503499 2.278167

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
66 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 9.343997 0.103003 4.671998 4.775002 8.409597 1.037403
67 W67783001 B01AB06 NADROPARINUM ** # FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml MYLAN IRE HEALTHCARE LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. PR/PRF 10 9.343997 0.103003 4.671998 4.775002 8.409597 1.037403
68 W68321001 B01AB06 NADROPARINUM ** # FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. PR/PRF 10 9.343997 0.103003 4.671998 4.775002 8.409597 1.037403
69 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 14.016000 0.000000 7.008000 7.008000 12.614400 1.401600
70 W67784001 B01AB06 NADROPARINUM ** # FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml MYLAN IRE HEALTHCARE LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. PR/PRF 10 14.016000 0.000000 7.008000 7.008000 12.614400 1.401600
71 W68323001 B01AB06 NADROPARINUM ** # FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. PR/PRF 10 14.016000 0.000000 7.008000 7.008000 12.614400 1.401600
72 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 18.687995 1.007005 9.343997 10.351003 16.819195 2.875805
73 W67785001 B01AB06 NADROPARINUM ** # FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml MYLAN IRE HEALTHCARE LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. PR/PRF 10 18.687995 1.007005 9.343997 10.351003 16.819195 2.875805
74 W68322001 B01AB06 NADROPARINUM ** # FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. PR/PRF 10 18.687995 1.007005 9.343997 10.351003 16.819195 2.875805
75 W59473001 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE LEO PHARMA A/S
10000UI anti-XA/ml DANEMARCA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT IN AURIU SI CAPSA DE SIGURANTA DIN PP DE CULOARE PORTOCALIE PR/PRF 10 40.045709 16.997291 20.022854 37.020146 36.041138 21.001862
76 W59475001 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE 20000 UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT CU LAC DE CULOARE VERDE SI CAPSA DE SIGURANTA DIN PP DE CULOARE VERDE INCHIS PR/PRF 10 80.091425 42.586575 40.045712 82.632288 72.082282 50.595718
77 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 1.822600 0.000000 0.911300 0.911300 1.640340 0.182260
78 W63737001 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVDC-PVC/AL-PVDC A CATE 25 CAPS. MOI P6L 50 2.030800 0.307000 1.015400 1.322400 1.827720 0.510080
79 W63737002 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P6L 60 2.030800 0.208200 1.015400 1.223600 1.827720 0.411280
80 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 7.108000 0.000000 3.554000 3.554000 6.397200 0.710800
81 W63736001 B01AB11 SULODEXIDUM ** VESSEL DUE F 600ULS/2ml SOL. INJ. 600ULS/2ml ALFASIGMA S.P.A. ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML PRF 10 7.576250 1.404750 3.788125 5.192875 6.818625 2.162375
82 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 0.556666 0.000000 0.278333 0.278333 0.500999 0.055667
83 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 0.538777 0.000000 0.269388 0.269389 0.484899 0.053878
84 W57177005 B01AC04 CLOPIDOGRELUM ** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0.853571 0.000000 0.426785 0.426786 0.768213 0.085358
85 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 0.556666 0.000000 0.278333 0.278333 0.500999 0.055667
86 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 0.621111 0.000000 0.310555 0.310556 0.558999 0.062112
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 1.159891 0.804751 0.579945 1.384697 1.043901 0.920741
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 1.159891 0.949442 0.579945 1.529388 1.043901 1.065432
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 1.115333 0.000000 0.557666 0.557667 1.003799 0.111534
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 0.652142 0.000000 0.326071 0.326071 0.586927 0.065215
91 W66403001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 28 1.159891 0.804751 0.579945 1.384697 1.043901 0.920741
92 W66403013 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 30 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 30 1.159891 0.949442 0.579945 1.529388 1.043901 1.065432
93 W66626001 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL EIPICO 75 mg COMPR. FILM. 75mg E.I.P.I.CO MED S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 1.159891 0.021109 0.579945 0.601055 1.043901 0.137099
94 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 0.579945 0.189855 0.289972 0.479828 0.521950 0.247850
95 W53412001 B01AC18 TRIFLUSALUM AFLEN 300 mg CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 0.579945 0.189855 0.289972 0.479828 0.521950 0.247850
96 W52943002 B01AE07 DABIGATRANUM ETEXILATUM ** # Ω PRADAXA 110mg CAPS. 110mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. (AL/AL) X 10 CAPS. (30X1 BLISTER PERFORAT UNIDOZA ) P-RF 30 5.532333 0.000000 2.766166 2.766167 4.979099 0.553234
97 W52943002 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. (AL/AL) X 10 CAPS. (30X1 BLISTER PERFORAT UNIDOZA ) P-RF 30 4.268200 1.264133 2.134100 3.398233 3.841380 1.690953
98 W57151003 B01AE07 DABIGATRANUM ETEXILATUM ** # Ω PRADAXA 150mg CAPS. 150mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 6 BLIST. (AL/AL) X 10 CAPS. (60 X1 BLISTER PERFORAT UNIDOZA ) P-RF 60 5.245666 0.000000 2.622833 2.622833 4.721099 0.524567
99 W63896002 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. PRF 10 5.774425 5.364575 2.887212 8.251788 5.196982 5.942018
100 W63896003 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. PRF 30 5.774425 4.788241 2.887212 7.675454 5.196982 5.365684
101 W63897001 B01AF01 RIVAROXABANUM ** # Ω XARELTO 15mg COMPR. FILM. 15mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 98 COMPR. FILM. PRF 98 9.239081 0.000000 4.619540 4.619541 8.315172 0.923909
102 W63898001 B01AF01 RIVAROXABANUM ** # Ω XARELTO 20mg COMPR. FILM. 20mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 98 COMPR. FILM. PRF 98 9.239081 0.000000 4.619540 4.619541 8.315172 0.923909
103 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 2.793500 2.755500 1.396750 4.152250 2.514150 3.034850
104 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 2.793500 2.755500 1.396750 4.152250 2.514150 3.034850
105 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 5.549000 0.000000 2.774500 2.774500 4.994100 0.554900
106 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 5.549000 0.000000 2.774500 2.774500 4.994100 0.554900
107 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 5.587000 0.000000 2.793500 2.793500 5.028300 0.558700
108 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 5.587000 0.000000 2.793500 2.793500 5.028300 0.558700
109 W66574001 B01AF03 EDOXABANUM ** # Ω ROTEAS 30 mg COMPR. FILM. 30mg BERLIN-CHEMIE AG GERMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PR/PRF 30 11.127666 0.000000 5.563833 5.563833 10.014899 1.112767
110 W66575001 B01AF03 EDOXABANUM ** # Ω ROTEAS 60 mg COMPR. FILM. 60mg BERLIN-CHEMIE AG GERMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PR/PRF 30 11.127666 0.000000 5.563833 5.563833 10.014899 1.112767
111 W61204003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 2,5mg/0,5ml 2,5mg/0,5ml ASPEN PHARMA TRADING LIMITED
SOL. INJ. IN SERINGA PREUMPLUTA IRLANDA CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA P-RF 10 20.647666 0.001334 10.323833 10.325167 18.582899 2.066101
112 W67494003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 2,5mg/0,5ml 2,5mg/0,5ml MYLAN IRE HEALTHCARE LIMITED
SOL. INJ. IN SERINGA PREUMPLUTA IRLANDA CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA PRF 10 20.647666 0.001334 10.323833 10.325167 18.582899 2.066101
113 W61202003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 7,5mg/0,6ml 7,5mg/0,6ml ASPEN PHARMA TRADING LIMITED
SOL. INJ. IN SERINGA PREUMPLUTA IRLANDA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE P-RF 10 61.943000 0.000000 30.971500 30.971500 55.748700 6.194300
114 W67496003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 7,5mg/0,6ml 7,5mg/0,6ml MYLAN IRE HEALTHCARE LIMITED
SOL. INJ. IN SERINGA PREUMPLUTA IRLANDA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE PRF 10 61.943000 0.000000 30.971500 30.971500 55.748700 6.194300
115 W51230001 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER 100 mg fer/5 ml SOL. INJ./PERF. 100mg/5ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 58.620000 0.000000 29.310000 29.310000 52.758000 5.862000
116 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 0.980517 0.312161 0.490258 0.802420 0.882465 0.410213
117 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 0.980517 0.805911 0.490258 1.296170 0.882465 0.903963
118 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 0.980517 0.312161 0.490258 0.802420 0.882465 0.410213
119 W62962014 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. P6L 56 0.980517 0.312161 0.490258 0.802420 0.882465 0.410213
120 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 0.980517 0.312161 0.490258 0.802420 0.882465 0.410213
121 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 0.980517 0.472697 0.490258 0.962956 0.882465 0.570749
122 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 0.980517 0.499840 0.490258 0.990099 0.882465 0.597892
123 W65679001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. PRF 56 0.980517 0.108054 0.490258 0.598313 0.882465 0.206106
124 W65845003 C01EB17 IVABRADINUM ** APREDONAV 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0.980517 0.349304 0.490258 0.839563 0.882465 0.447356
125 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 1.470776 0.315652 0.735388 1.051040 1.323698 0.462730
126 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 1.470776 0.189938 0.735388 0.925326 1.323698 0.337016
127 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 1.470776 0.189938 0.735388 0.925326 1.323698 0.337016
128 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 1.470776 0.009581 0.735388 0.744969 1.323698 0.156659
129 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 1.470776 0.167438 0.735388 0.902826 1.323698 0.314516
130 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 1.470776 0.360652 0.735388 1.096040 1.323698 0.507730
131 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 1.470776 0.009581 0.735388 0.744969 1.323698 0.156659
132 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 1.101607 0.000000 0.550803 0.550804 0.991446 0.110161
133 W65846003 C01EB17 IVABRADINUM ** APREDONAV 7,5 mg COMPR. FILM. 7,5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1.383750 0.000000 0.691875 0.691875 1.245375 0.138375
134 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 1.015920 0.175508 0.507960 0.683468 0.914328 0.277100
135 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 1.247142 0.000000 0.623571 0.623571 1.122427 0.124715
136 W05447001 C02AC06 RILMENIDINUM TENAXUM 1 mg COMPR. 1mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 1.026333 0.000000 0.513166 0.513167 0.923699 0.102634
137 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 1.803000 1.002333 0.901500 1.903833 1.622700 1.182633
138 W62960002 C03DA04 EPLERENONUM * # EPLERENONA ARENA 25 mg COMPR. FILM. 25mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 90 COMPR. FILM. PRF 90 1.803000 1.592666 0.901500 2.494166 1.622700 1.772966

Pagina 20 din 80
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
139 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 1.803000 1.002333 0.901500 1.903833 1.622700 1.182633
140 W67260004 C03DA04 EPLERENONUM * # INSPRA 25 mg COMPR. FILM. 25mg UPJOHN EESV OLANDA CUTIE X 3 BLIST. PERFORATE UNIDOZA DIN PVC/AL X 10 COMPR. FILM. PRF 30 1.803000 1.002333 0.901500 1.903833 1.622700 1.182633
141 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 3.606000 0.000000 1.803000 1.803000 3.245400 0.360600
142 W62961002 C03DA04 EPLERENONUM * # EPLERENONA ARENA 50 mg COMPR. FILM. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 90 COMPR. FILM. PRF 90 3.506444 0.000000 1.753222 1.753222 3.155799 0.350645
143 W65283004 C03DA04 EPLERENONUM * # INSPRA 50 mg COMPR. FILM. 50mg BELGIA
PFIZER EUROPE MA EEIG CUTIE X 3 BLIST. PERFORATE UNIDOZA DIN PVC/AL X 10 COMPR. FILM. PRF 30 3.606000 0.000000 1.803000 1.803000 3.245400 0.360600
144 W67261004 C03DA04 EPLERENONUM * # INSPRA 50 mg COMPR. FILM. 50mg UPJOHN EESV OLANDA CUTIE X 3 BLIST. PERFORATE UNIDOZA DIN PVC/AL X 10 COMPR. FILM. PRF 30 3.606000 0.000000 1.803000 1.803000 3.245400 0.360600
145 W04501004 C07AB12 NEBIVOLOLUM NEBILET 5 mg COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.680714 0.000000 0.340357 0.340357 0.612642 0.068072
146 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 0.460333 0.000000 0.230166 0.230167 0.414299 0.046034
147 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 0.253333 0.000000 0.126666 0.126667 0.227999 0.025334
148 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 0.448333 0.000000 0.224166 0.224167 0.403499 0.044834
149 W64800005 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVDC/AL X 10 COMPR. P6L 30 0.462666 0.000000 0.231333 0.231333 0.416399 0.046267
150 W65312001 C07AB12 NEBIVOLOLUM NOLET 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.460333 0.000000 0.230166 0.230167 0.414299 0.046034
151 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 0.460333 0.000000 0.230166 0.230167 0.414299 0.046034
152 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 0.796666 0.000000 0.398333 0.398333 0.716999 0.079667
153 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 0.796666 0.000000 0.398333 0.398333 0.716999 0.079667
154 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 0.796666 0.000000 0.398333 0.398333 0.716999 0.079667
155 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 0.796666 0.000000 0.398333 0.398333 0.716999 0.079667
156 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 0.796666 0.000000 0.398333 0.398333 0.716999 0.079667
157 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 0.796666 0.000000 0.398333 0.398333 0.716999 0.079667
158 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 0.796666 0.202334 0.398333 0.600667 0.716999 0.282001
159 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 0.796666 0.202334 0.398333 0.600667 0.716999 0.282001
160 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 0.796666 0.202334 0.398333 0.600667 0.716999 0.282001
161 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 0.796666 0.202334 0.398333 0.600667 0.716999 0.282001
162 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 0.796666 0.202334 0.398333 0.600667 0.716999 0.282001
163 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 0.796666 0.202334 0.398333 0.600667 0.716999 0.282001
164 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 4.248258 0.007277 2.124129 2.131406 3.823432 0.432103
165 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 4.248258 0.007277 2.124129 2.131406 3.823432 0.432103
166 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 4.248258 0.007277 2.124129 2.131406 3.823432 0.432103
167 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 4.226428 0.000000 2.113214 2.113214 3.803785 0.422643
168 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 0.291299 0.403701 0.145649 0.549351 0.262169 0.432831
169 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 0.291299 0.414034 0.145649 0.559684 0.262169 0.443164
170 W67383012 C08CA13 LERCANIDIPINUM LERCANIDIPINA MEDREG 10 mg COMPR. FILM. 10mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P6L 60 0.291299 0.182534 0.145649 0.328184 0.262169 0.211664
171 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 0.582598 0.530735 0.291299 0.822034 0.524338 0.588995
172 W67385012 C08CA13 LERCANIDIPINUM LERCANIDIPINA MEDREG 20 mg COMPR. FILM. 20mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P6L 60 0.582598 0.165902 0.291299 0.457201 0.524338 0.224162
173 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 0.342000 0.082333 0.171000 0.253333 0.307800 0.116533
174 W54042002 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.342000 0.082333 0.171000 0.253333 0.307800 0.116533
175 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 0.342000 0.094000 0.171000 0.265000 0.307800 0.128200
176 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 0.342000 0.644666 0.171000 0.815666 0.307800 0.678866
177 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 0.342000 0.069000 0.171000 0.240000 0.307800 0.103200
178 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 0.684000 0.055666 0.342000 0.397666 0.615600 0.124066
179 W54043002 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.684000 0.055666 0.342000 0.397666 0.615600 0.124066
180 W55291004 C09AA04 PERINDOPRILUM PRINDEX 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L 30 0.684000 0.005333 0.342000 0.347333 0.615600 0.073733
181 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 0.684000 1.191333 0.342000 1.533333 0.615600 1.259733
182 W65270004 C09AA04 PERINDOPRILUM PRENESSA 8 mg COMPR. 8mg KRKA D.D, NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 0.606000 0.000000 0.303000 0.303000 0.545400 0.060600
183 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 0.855000 0.124333 0.427500 0.551833 0.769500 0.209833
184 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 0.812000 0.000000 0.406000 0.406000 0.730800 0.081200
185 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 0.427500 0.474500 0.213750 0.688250 0.384750 0.517250
186 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 0.427500 0.247500 0.213750 0.461250 0.384750 0.290250
187 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 0.085500 0.162166 0.042750 0.204916 0.076950 0.170716
188 W62353001 C09AA10 TRANDOLAPRILUM GOPTEN 0,5 mg CAPS. 0,5mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0.085500 0.149500 0.042750 0.192250 0.076950 0.158050
189 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 0.342000 0.094666 0.171000 0.265666 0.307800 0.128866
190 W62355001 C09AA10 TRANDOLAPRILUM GOPTEN 2 mg CAPS. 2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0.342000 0.073000 0.171000 0.244000 0.307800 0.107200
191 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 0.684000 0.135666 0.342000 0.477666 0.615600 0.204066
192 W62357001 C09AA10 TRANDOLAPRILUM GOPTEN 4 mg CAPS. 4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0.684000 0.095285 0.342000 0.437285 0.615600 0.163685
193 W13178003 C09AA15 ZOFENOPRILUM ZOMEN 30 mg COMPR. FILM. 30mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0.342000 1.204071 0.171000 1.375071 0.307800 1.238271
194 W13177003 C09AA15 ZOFENOPRILUM ZOMEN 7,5 mg COMPR. FILM. 7,5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0.085500 0.720214 0.042750 0.762964 0.076950 0.728764
195 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 0.617333 0.000000 0.308666 0.308667 0.555599 0.061734
196 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 0.406333 0.000000 0.203166 0.203167 0.365699 0.040634
197 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 0.609666 0.000000 0.304833 0.304833 0.548699 0.060967
198 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 0.406333 0.000000 0.203166 0.203167 0.365699 0.040634
199 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 0.836666 0.000000 0.418333 0.418333 0.752999 0.083667
200 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 0.691666 0.000000 0.345833 0.345833 0.622499 0.069167
201 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 0.762333 0.000000 0.381166 0.381167 0.686099 0.076234
202 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 0.691666 0.000000 0.345833 0.345833 0.622499 0.069167
203 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 0.925200 0.176466 0.462600 0.639066 0.832680 0.268986
204 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 0.925200 0.176466 0.462600 0.639066 0.832680 0.268986
205 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 0.925200 0.284133 0.462600 0.746733 0.832680 0.376653
206 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 0.925200 0.178133 0.462600 0.640733 0.832680 0.270653
207 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 0.925200 0.306466 0.462600 0.769066 0.832680 0.398986
208 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 0.344666 0.000000 0.172333 0.172333 0.310199 0.034467
209 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 0.925200 0.237466 0.462600 0.700066 0.832680 0.329986
210 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 0.658333 0.000000 0.329166 0.329167 0.592499 0.065834
211 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 0.514000 0.000000 0.257000 0.257000 0.462600 0.051400

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
212 W64843001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE 10 mg/12,5 mg 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 0.514000 0.000000 0.257000 0.257000 0.462600 0.051400
213 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 0.925200 0.142133 0.462600 0.604733 0.832680 0.234653
214 W64844001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE FORTE 20 mg/12,5 mg 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 0.925200 0.142133 0.462600 0.604733 0.832680 0.234653
215 W53229003 C09BB02 COMBINATII (ENALAPRILUM+LERCANIDIPINUM) ** LERCARIL 10 mg /10 mg COMPR. FILM. 10mg/10mg RECORDATI IRELAND LIMITED IRLANDA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0.513303 0.121697 0.256651 0.378349 0.461972 0.173028
216 W53228003 C09BB02 COMBINATII (ENALAPRILUM+LERCANIDIPINUM) ** LERCARIL 20 mg /10 mg COMPR. FILM. 20mg/10mg RECORDATI IRELAND LIMITED IRLANDA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0.769954 0.012188 0.384977 0.397165 0.692958 0.089184
217 W61013003 C09BB02 COMBINATII (ENALAPRILUM+LERCANIDIPINUM) ** LERCARIL 20 mg/20 mg COMPR. FILM. 20mg/20mg RECORDATI IRELAND LIMITED IRLANDA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1.010357 0.000000 0.505178 0.505179 0.909321 0.101036
218 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 0.691666 0.000000 0.345833 0.345833 0.622499 0.069167
219 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 0.634333 0.000000 0.317166 0.317167 0.570899 0.063434
220 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 0.764049 0.043284 0.382024 0.425309 0.687644 0.119689
221 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 0.491174 0.063492 0.245587 0.309079 0.442056 0.112610
222 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 0.491174 0.063492 0.245587 0.309079 0.442056 0.112610
223 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 0.491174 0.195492 0.245587 0.441079 0.442056 0.244610
224 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 0.982349 0.138984 0.491174 0.630159 0.884114 0.237219
225 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 0.982349 0.139317 0.491174 0.630492 0.884114 0.237552
226 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 0.982349 0.143317 0.491174 0.634492 0.884114 0.241552
227 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 0.709474 0.142192 0.354737 0.496929 0.638526 0.213140
228 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 0.709474 0.142192 0.354737 0.496929 0.638526 0.213140
229 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 0.709474 0.205192 0.354737 0.559929 0.638526 0.276140
230 W53990002 C09BB06 COMBINATII (NITRENDIPINUM+ENALAPRILUM) ENEAS 10 mg/20 mg COMPR. 20mg+10mg GALENICA S.A. GRECIA CUTIE X 3 BLIST. PA-PVC-AL/AL X 10 COMPR. P-6L 30 3.143333 0.000000 1.571666 1.571667 2.828999 0.314334
231 W62349001 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 180 mg/2 mg COMPR. CU ELIB. PREL. 180mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVDC-PVC/AL X 14 COMPR. CU ELIB. PREL. P-6L 28 1.818571 0.000000 0.909285 0.909286 1.636713 0.181858
232 W62329002 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg COMPR. CU ELIB. PREL. 240mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. PREL. P6L 28 2.043035 0.224465 1.021517 1.245983 1.838731 0.428769
233 W62331002 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg COMPR. CU ELIB. PREL. 240mg/4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. PREL. P6L 28 2.043035 0.583036 1.021517 1.604554 1.838731 0.787340
234 W60513005 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) CO-AMLESSA 4mg/10mg/1,25mg COMPR. 4 mg/1,25 mg/10 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0.882333 0.000000 0.441166 0.441167 0.794099 0.088234
235 W68173001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) PRINDAL 4 mg/1,25 mg/10 mg COMPR. 4 mg/1,25 mg/10 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINÂND 30 COMPRIMATE P6L 30 0.954666 0.000000 0.477333 0.477333 0.859199 0.095467
236 W60512005 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) CO-AMLESSA 4 mg/5mg/1,25 mg COMPR. 4 mg/1,25 mg/5 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0.675000 0.153000 0.337500 0.490500 0.607500 0.220500
237 W68172001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) PRINDAL 4 mg/1,25 mg/5 mg COMPR. 4 mg/1,25 mg/5 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINÂND 30 COMPRIMATE P6L 30 0.675000 0.269666 0.337500 0.607166 0.607500 0.337166
238 W60515005 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) CO-AMLESSA 8 mg/10 mg/2,5 mg COMPR. 8 mg/2,5 mg/10 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 1.350000 0.031666 0.675000 0.706666 1.215000 0.166666
239 W68175001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) PRINDAL 8 mg/2,5 mg/10 mg COMPR. 8 mg/2,5 mg/10 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINÂND 30 COMPRIMATE P6L 30 1.101000 0.000000 0.550500 0.550500 0.990900 0.110100
240 W60514005 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) CO-AMLESSA 8 mg/5 mg/2,5 mg COMPR. 8 mg/2,5 mg/5 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0.998070 0.261930 0.499035 0.760965 0.898263 0.361737
241 W68174001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) PRINDAL 8 mg/2,5 mg/5 mg COMPR. 8 mg/2,5 mg/5 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINÂND 30 COMPRIMATE P6L 30 0.998070 0.029263 0.499035 0.528298 0.898263 0.129070
242 W61004001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM 10 mg/2,5 mg/10 mg 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 1.357742 0.772591 0.678871 1.451462 1.221967 0.908366
243 W61003001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM 10 mg/2,5 mg/5 mg 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 1.005813 0.986853 0.502906 1.489760 0.905231 1.087435
244 W61002001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM 5 mg/1,25 mg/10 mg 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 1.030800 0.546866 0.515400 1.062266 0.927720 0.649946
245 W61001001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM 5 mg/1,25 mg/5 mg 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 0.678870 0.756463 0.339435 1.095898 0.610983 0.824350
246 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 1.233928 0.000000 0.616964 0.616964 1.110535 0.123393
247 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 0.786428 0.000000 0.393214 0.393214 0.707785 0.078643
248 W58950013 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0.786428 0.000000 0.393214 0.393214 0.707785 0.078643
249 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 0.352928 0.978857 0.176464 1.155321 0.317635 1.014150
250 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 0.352928 0.631714 0.176464 0.808178 0.317635 0.667007
251 W58948013 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0.352928 0.631714 0.176464 0.808178 0.317635 0.667007
252 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 0.705856 0.328072 0.352928 0.681000 0.635270 0.398658
253 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 0.434642 0.000000 0.217321 0.217321 0.391177 0.043465
254 W58949013 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0.434642 0.000000 0.217321 0.217321 0.391177 0.043465
255 W55631001 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) P-6L 1 4.235140 21.854860 2.117570 23.972430 3.811626 22.278374
256 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 0.497500 0.000000 0.248750 0.248750 0.447750 0.049750
257 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 0.995357 0.000000 0.497678 0.497679 0.895821 0.099536
258 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 0.705856 0.007715 0.352928 0.360643 0.635270 0.078301
259 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 0.543571 0.000000 0.271785 0.271786 0.489213 0.054358
260 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 0.705856 0.582477 0.352928 0.935405 0.635270 0.653063
261 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 0.705856 0.583072 0.352928 0.936000 0.635270 0.653658
262 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 0.491428 0.000000 0.245714 0.245714 0.442285 0.049143
263 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 0.543571 0.000000 0.271785 0.271786 0.489213 0.054358
264 W66400006 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM. P6L 30 0.705856 0.582477 0.352928 0.935405 0.635270 0.653063
265 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 0.778571 0.000000 0.389285 0.389286 0.700713 0.077858
266 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 1.186428 0.000000 0.593214 0.593214 1.067785 0.118643
267 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 0.768928 0.000000 0.384464 0.384464 0.692035 0.076893
268 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 1.411713 0.250953 0.705856 0.956810 1.270541 0.392125
269 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 1.411713 0.250787 0.705856 0.956644 1.270541 0.391959
270 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 0.768928 0.000000 0.384464 0.384464 0.692035 0.076893
271 W66401007 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM. P6L 30 1.411713 0.250953 0.705856 0.956810 1.270541 0.392125
272 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 1.172142 0.000000 0.586071 0.586071 1.054927 0.117215
273 W54889004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 0.625714 0.000000 0.312857 0.312857 0.563142 0.062572
274 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 0.680000 0.000000 0.340000 0.340000 0.612000 0.068000
275 W58808002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1.242857 0.000000 0.621428 0.621429 1.118571 0.124286
276 W58874004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.504333 0.000000 0.252166 0.252167 0.453899 0.050434
277 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 1.134333 0.000000 0.567166 0.567167 1.020899 0.113434
278 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 0.793666 0.000000 0.396833 0.396833 0.714299 0.079367
279 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 0.808000 0.000000 0.404000 0.404000 0.727200 0.080800
280 W67397002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 16 mg COMPR. 16mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL CE CONTINE 28 COMPR. P6L 28 1.242857 0.000000 0.621428 0.621429 1.118571 0.124286
281 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 1.178333 0.000000 0.589166 0.589167 1.060499 0.117834
282 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 1.937857 0.000000 0.968928 0.968929 1.744071 0.193786
283 W58875004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.781666 0.000000 0.390833 0.390833 0.703499 0.078167
284 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 1.598333 0.000000 0.799166 0.799167 1.438499 0.159834

Pagina 22 din 80
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
285 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 1.542857 0.000000 0.771428 0.771429 1.388571 0.154286
286 W67398001 C09CA06 CANDESARTANUM CILEXETIL ATACAND 32 mg COMPR. 32mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL CE CONTINE 28 COMPR. P6L 28 1.937857 0.000000 0.968928 0.968929 1.744071 0.193786
287 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 0.585000 0.000000 0.292500 0.292500 0.526500 0.058500
288 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 0.503333 0.000000 0.251666 0.251667 0.452999 0.050334
289 W58807002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0.605357 0.000000 0.302678 0.302679 0.544821 0.060536
290 W58873004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA P6L
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. 30 0.531666 0.000000 0.265833 0.265833 0.478499 0.053167
291 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 0.585000 0.000000 0.292500 0.292500 0.526500 0.058500
292 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 0.585000 0.000000 0.292500 0.292500 0.526500 0.058500
293 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 0.585000 0.000000 0.292500 0.292500 0.526500 0.058500
294 W67396002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 8 mg COMPR. 8mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL CE CONTINE 28 COMPR. P6L 28 0.605357 0.000000 0.302678 0.302679 0.544821 0.060536
295 W56746002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 40mg COMPR. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0.580000 0.000000 0.290000 0.290000 0.522000 0.058000
296 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 0.603214 0.000000 0.301607 0.301607 0.542892 0.060322
297 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 0.552666 0.000000 0.276333 0.276333 0.497399 0.055267
298 W56747002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 80mg COMPR. 80 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0.783571 0.000000 0.391785 0.391786 0.705213 0.078358
299 W05785002 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 1.411713 0.023644 0.705856 0.729501 1.270541 0.164816
300 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 0.794642 0.000000 0.397321 0.397321 0.715177 0.079465
301 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 0.429000 0.000000 0.214500 0.214500 0.386100 0.042900
302 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 0.655000 0.000000 0.327500 0.327500 0.589500 0.065500
303 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 0.461785 0.000000 0.230892 0.230893 0.415606 0.046179
304 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 0.592500 0.000000 0.296250 0.296250 0.533250 0.059250
305 W43460003 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA H 50 mg/12,5 mg COMPR.FILM 50mg+ 12,50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0.501785 0.000000 0.250892 0.250893 0.451606 0.050179
306 W59584002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM 150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0.585357 0.000000 0.292678 0.292679 0.526821 0.058536
307 W65144002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5 mg COMPR. FILM 150mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P6L 28 0.585357 0.000000 0.292678 0.292679 0.526821 0.058536
308 W59585002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM 300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 0.676800 0.374985 0.338400 0.713385 0.609120 0.442665
309 W65145002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5 mg COMPR. FILM 300mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P6L 28 0.676800 0.374985 0.338400 0.713385 0.609120 0.442665
310 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 0.676800 0.591057 0.338400 0.929457 0.609120 0.658737
311 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 0.676800 0.173557 0.338400 0.511957 0.609120 0.241237
312 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 0.676800 0.173557 0.338400 0.511957 0.609120 0.241237
313 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 0.676800 0.591057 0.338400 0.929457 0.609120 0.658737
314 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 0.676800 0.892128 0.338400 1.230528 0.609120 0.959808
315 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 0.676800 0.279985 0.338400 0.618385 0.609120 0.347665
316 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 0.676800 0.279985 0.338400 0.618385 0.609120 0.347665
317 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 0.676800 0.892128 0.338400 1.230528 0.609120 0.959808
318 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 0.676800 0.926057 0.338400 1.264457 0.609120 0.993737
319 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 0.676800 0.244985 0.338400 0.583385 0.609120 0.312665
320 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 0.676800 0.244985 0.338400 0.583385 0.609120 0.312665
321 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 0.676800 0.926057 0.338400 1.264457 0.609120 0.993737
322 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 0.676800 0.075200 0.338400 0.413600 0.609120 0.142880
323 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 0.676800 0.075200 0.338400 0.413600 0.609120 0.142880
324 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 0.676800 0.149533 0.338400 0.487933 0.609120 0.217213
325 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 0.676800 0.139866 0.338400 0.478266 0.609120 0.207546
326 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 0.511666 0.000000 0.255833 0.255833 0.460499 0.051167
327 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 0.511666 0.000000 0.255833 0.255833 0.460499 0.051167
328 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 0.511666 0.000000 0.255833 0.255833 0.460499 0.051167
329 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 0.491000 0.000000 0.245500 0.245500 0.441900 0.049100
330 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 0.676800 0.421057 0.338400 0.759457 0.609120 0.488737
331 W59819005 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/12,5mg COMPR. 80 mg/12,5mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0.676800 0.149200 0.338400 0.487600 0.609120 0.216880
332 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 0.676800 0.149200 0.338400 0.487600 0.609120 0.216880
333 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 0.676800 0.433200 0.338400 0.771600 0.609120 0.500880
334 W12033002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/12,5mg COMPR. 80/12,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 0.676800 1.017128 0.338400 1.355528 0.609120 1.084808
335 W53178002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/25mg COMPR. 80/25mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL) P-6L 28 0.676800 1.045342 0.338400 1.383742 0.609120 1.113022
336 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 0.676800 0.149533 0.338400 0.487933 0.609120 0.217213
337 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 0.676800 0.085533 0.338400 0.423933 0.609120 0.153213
338 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 0.676800 0.399628 0.338400 0.738028 0.609120 0.467308
339 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 0.676800 0.194200 0.338400 0.532600 0.609120 0.261880
340 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 0.676800 0.429271 0.338400 0.767671 0.609120 0.496951
341 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 1.828471 0.268136 0.914235 1.182372 1.645623 0.450984
342 W62738003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 10 mg/160 mg COMPR. FILM. 10mg/160mg ZENTIVA, K.S. P6L
REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 COMPR. FILM. 28 1.828471 0.631171 0.914235 1.545407 1.645623 0.814019
343 W62738005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 10 mg/160 mg COMPR. FILM. 10mg/160mg ZENTIVA, K.S. P6L
REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 56 COMPR. FILM. 56 1.828471 0.504564 0.914235 1.418800 1.645623 0.687412
344 W62875006 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN STADA 10 mg/160 mg COMPR. FILM. 10mg/160mg STADA M&D S.R.L. ROMANIA P6L
CUTIE CU BLIST. PVC-TE-PVDC/AL X 56 COMPR. FILM. 56 0.979285 0.000000 0.489642 0.489643 0.881356 0.097929
345 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 1.828471 0.268136 0.914235 1.182372 1.645623 0.450984
346 W67665003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN AUROBINDO 10 mg/160 mg COMPR. FILM. 10mg/160mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1.792333 0.000000 0.896166 0.896167 1.613099 0.179234
347 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 1.774692 0.218700 0.887346 1.106046 1.597222 0.396170
348 W62737003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/160 mg COMPR. FILM. 5mg/160mg ZENTIVA, K.S. P6L
REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 COMPR. FILM. 28 1.774692 0.538165 0.887346 1.425511 1.597222 0.715635
349 W62737005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/160 mg COMPR. FILM. 5mg/160mg ZENTIVA, K.S. P6L
REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 56 COMPR. FILM. 56 1.774692 0.419058 0.887346 1.306404 1.597222 0.596528
350 W62874006 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN STADA 5 mg/160 mg COMPR. FILM. 5mg/160mg STADA M&D S.R.L. ROMANIA P6L
CUTIE CU BLIST. PVC-TE-PVDC/AL X 56 COMPR. FILM. 56 0.979285 0.000000 0.489642 0.489643 0.881356 0.097929
351 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 1.774692 0.218700 0.887346 1.106046 1.597222 0.396170
352 W67664003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN AUROBINDO 5 mg/160 mg COMPR. FILM. 5mg/160mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1.741000 0.000000 0.870500 0.870500 1.566900 0.174100
353 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 0.914235 1.343979 0.457117 1.801097 0.822811 1.435403
354 W62736003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/80 mg COMPR. FILM. 5mg/80mg ZENTIVA, K.S. P6L
REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 COMPR. FILM. 28 0.914235 1.545050 0.457117 2.002168 0.822811 1.636474
355 W62736005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN ZENTIVA 5 mg/80 mg COMPR. FILM. 5mg/80mg ZENTIVA, K.S. P6L
REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 56 COMPR. FILM. 56 0.914235 1.418265 0.457117 1.875383 0.822811 1.509689
356 W62873006 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN STADA 5 mg/80 mg COMPR. FILM. 5mg/80mg STADA M&D S.R.L. ROMANIA P6L
CUTIE CU BLIST. PVC-TE-PVDC/AL X 56 COMPR. FILM. 56 0.914235 0.065050 0.457117 0.522168 0.822811 0.156474
357 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 0.914235 1.343979 0.457117 1.801097 0.822811 1.435403

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
358 W67663003 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) AMLODIPINA/VALSARTAN AUROBINDO 5 mg/80 mg COMPR. FILM. 5mg/80mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0.914235 0.775765 0.457117 1.232883 0.822811 0.867189
359 W53445002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 20 mg/5 mg COMPR. FILM. 20mg/5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 0.914235 0.869693 0.457117 1.326811 0.822811 0.961117
360 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 0.914235 1.213265 0.457117 1.670383 0.822811 1.304689
361 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 0.914235 0.488979 0.457117 0.946097 0.822811 0.580403
362 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 CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0.914235 0.488979 0.457117 0.946097 0.822811 0.580403
363 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 0.914235 0.769693 0.457117 1.226811 0.822811 0.861117
364 W66702002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-PVC/AL X 28 COMPR. FILM. P6L 28 0.914235 0.770050 0.457117 1.227168 0.822811 0.861474
365 W66702011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU UN PACHET CALENDAR DIN OPA-PVC/AL X 28 COMPR. FILM. P6L 28 0.914235 0.770050 0.457117 1.227168 0.822811 0.861474
366 W68064002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 20 mg/5 mg COMPR. FILM. 20mg/5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0.914235 1.213265 0.457117 1.670383 0.822811 1.304689
367 W53447002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/10 mg COMPR. FILM. 40mg/10mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 1.828471 0.139743 0.914235 1.053979 1.645623 0.322591
368 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 1.828471 0.458314 0.914235 1.372550 1.645623 0.641162
369 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 1.345357 0.000000 0.672678 0.672679 1.210821 0.134536
370 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 CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1.345357 0.000000 0.672678 0.672679 1.210821 0.134536
371 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 1.814285 0.000000 0.907142 0.907143 1.632856 0.181429
372 W67078002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-PVC/AL X 28 COMPR. FILM. P6L 28 1.814285 0.000000 0.907142 0.907143 1.632856 0.181429
373 W67078011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU UN PACHET CALENDAR DIN OPA-PVC/AL X 28 COMPR. FILM. P6L 28 1.814285 0.000000 0.907142 0.907143 1.632856 0.181429
374 W68066002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/10 mg COMPR. FILM. 40mg/10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1.828471 0.458314 0.914235 1.372550 1.645623 0.641162
375 W53446002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/5 mg COMPR. FILM. 40mg/5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 1.645624 0.185090 0.822812 1.007902 1.481061 0.349653
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 1.645624 0.481876 0.822812 1.304688 1.481061 0.646439
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 1.436785 0.000000 0.718392 0.718393 1.293106 0.143679
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 CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1.436785 0.000000 0.718392 0.718393 1.293106 0.143679
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 1.645624 0.038304 0.822812 0.861116 1.481061 0.202867
380 W67077002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-PVC/AL X 28 COMPR. FILM. P6L 28 1.645624 0.038661 0.822812 0.861473 1.481061 0.203224
381 W67077011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU UN PACHET CALENDAR DIN OPA-PVC/AL X 28 COMPR. FILM. P6L 28 1.645624 0.038661 0.822812 0.861473 1.481061 0.203224
382 W68065002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/5 mg COMPR. FILM. 40mg/5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1.645624 0.481876 0.822812 1.304688 1.481061 0.646439
383 W66857003 C09DB05 COMBINATII (IRBERSARTANUM+AMLODIPINUM) ** APREXEVO 150 mg/10 mg COMPR. FILM. 150mg/10mg SANOFI ROMANIA SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0.584370 0.208630 0.292185 0.500815 0.525933 0.267067
384 W66856003 C09DB05 COMBINATII (IRBERSARTANUM+AMLODIPINUM) ** APREXEVO 150 mg/5 mg COMPR. FILM. 150mg/5mg SANOFI ROMANIA SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0.566109 0.041891 0.283054 0.324946 0.509498 0.098502
385 W66859003 C09DB05 COMBINATII (IRBERSARTANUM+AMLODIPINUM) ** APREXEVO 300 mg/10 mg COMPR. FILM. 300mg/10mg SANOFI ROMANIA SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 1.132218 0.042448 0.566109 0.608557 1.018996 0.155670
386 W66858003 C09DB05 COMBINATII (IRBERSARTANUM+AMLODIPINUM) ** APREXEVO 300 mg/5 mg COMPR. FILM. 300mg/5mg SANOFI ROMANIA SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0.988666 0.000000 0.494333 0.494333 0.889799 0.098867
387 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
388 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
389 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
390 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
391 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
392 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
393 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
394 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
395 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 0.692857 0.000000 0.346428 0.346429 0.623571 0.069286
396 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 0.693000 0.000000 0.346500 0.346500 0.623700 0.069300
397 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 0.310387 0.602279 0.155193 0.757473 0.279348 0.633318
398 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 0.310387 0.089613 0.155193 0.244807 0.279348 0.120652
399 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 0.310387 0.072613 0.155193 0.227807 0.279348 0.103652
400 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 0.175666 0.000000 0.087833 0.087833 0.158099 0.017567
401 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 0.310387 0.602279 0.155193 0.757473 0.279348 0.633318
402 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 0.310387 0.072613 0.155193 0.227807 0.279348 0.103652
403 W65547003 C10AA05 ATORVASTATINUM ATORVASTATINA ARENA 10 mg COMPR. FILM. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL A CATE 10 COMPRIMATE FILMATE P6L 30 0.310387 0.469946 0.155193 0.625140 0.279348 0.500985
404 W66304007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 10 mg COMPR. FILM. 10mg POLONIA
ACCORD HEALTHCARE POLSKA SP. Z O.O. CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0.142666 0.000000 0.071333 0.071333 0.128399 0.014267
405 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 0.142666 0.000000 0.071333 0.071333 0.128399 0.014267
406 W66444016 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0.142666 0.000000 0.071333 0.071333 0.128399 0.014267
407 W67270001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg UPJOHN EESV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0.310387 0.602279 0.155193 0.757473 0.279348 0.633318
408 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 0.620775 0.488225 0.310387 0.798613 0.558697 0.550303
409 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 0.382857 0.000000 0.191428 0.191429 0.344571 0.038286
410 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 0.607666 0.000000 0.303833 0.303833 0.546899 0.060767
411 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 0.351666 0.000000 0.175833 0.175833 0.316499 0.035167
412 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 0.620775 0.488225 0.310387 0.798613 0.558697 0.550303
413 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 0.530000 0.000000 0.265000 0.265000 0.477000 0.053000
414 W65548003 C10AA05 ATORVASTATINUM ATORVASTATINA ARENA 20 mg COMPR. FILM. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL A CATE 10 COMPRIMATE FILMATE P6L 30 0.620775 0.392225 0.310387 0.702613 0.558697 0.454303
415 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 0.278000 0.000000 0.139000 0.139000 0.250200 0.027800
416 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 0.281333 0.000000 0.140666 0.140667 0.253199 0.028134
417 W66445016 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 0.281333 0.000000 0.140666 0.140667 0.253199 0.028134
418 W67271001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg UPJOHN EESV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0.620775 0.488225 0.310387 0.798613 0.558697 0.550303
419 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 1.241550 0.079164 0.620775 0.699939 1.117395 0.203319
420 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 0.712857 0.000000 0.356428 0.356429 0.641571 0.071286
421 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 0.713333 0.000000 0.356666 0.356667 0.641999 0.071334
422 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 1.177000 0.000000 0.588500 0.588500 1.059300 0.117700
423 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 0.699000 0.000000 0.349500 0.349500 0.629100 0.069900
424 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 1.241550 0.079164 0.620775 0.699939 1.117395 0.203319
425 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 1.124333 0.000000 0.562166 0.562167 1.011899 0.112434
426 W65549003 C10AA05 ATORVASTATINUM ATORVASTATINA ARENA 40 mg COMPR. FILM. 40mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30(3X10) COMPR. FILM. P6L 30 0.714333 0.000000 0.357166 0.357167 0.642899 0.071434
427 W66306007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 40 mg COMPR. FILM. 40mg POLONIA
ACCORD HEALTHCARE POLSKA SP. Z O.O. CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0.586666 0.000000 0.293333 0.293333 0.527999 0.058667
428 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 0.526333 0.000000 0.263166 0.263167 0.473699 0.052634
429 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 0.526333 0.000000 0.263166 0.263167 0.473699 0.052634
430 W67272006 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg UPJOHN EESV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1.241550 0.079164 0.620775 0.699939 1.117395 0.203319

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
431 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 1.430714 0.000000 0.715357 0.715357 1.287642 0.143072
432 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 1.165000 0.000000 0.582500 0.582500 1.048500 0.116500
433 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 1.161666 0.000000 0.580833 0.580833 1.045499 0.116167
434 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 0.832000 0.000000 0.416000 0.416000 0.748800 0.083200
435 W64880006 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg BELGIA
PFIZER EUROPE MA EEIG CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1.430714 0.000000 0.715357 0.715357 1.287642 0.143072
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 1.165000 0.000000 0.582500 0.582500 1.048500 0.116500
437 W65550003 C10AA05 ATORVASTATINUM ATORVASTATINA ARENA 80 mg COMPR. FILM. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30(3X10) COMPR. FILM. P6L 30 1.090666 0.000000 0.545333 0.545333 0.981599 0.109067
438 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 0.770333 0.000000 0.385166 0.385167 0.693299 0.077034
439 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 0.770333 0.000000 0.385166 0.385167 0.693299 0.077034
440 W67273006 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg UPJOHN EESV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1.430714 0.000000 0.715357 0.715357 1.287642 0.143072
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 0.620775 0.068558 0.310387 0.378946 0.558697 0.130636
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 0.580000 0.000000 0.290000 0.290000 0.522000 0.058000
443 W59899004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. 28 0.620775 0.056010 0.310387 0.366398 0.558697 0.118088
444 W59899017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. 28 0.620775 0.056010 0.310387 0.366398 0.558697 0.118088
445 W60392003 C10AA07 ROSUVASTATINUM ROVASTAMED 10mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU P6L
CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. 28 0.264285 0.000000 0.132142 0.132143 0.237856 0.026429
446 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 0.620775 0.314558 0.310387 0.624946 0.558697 0.376636
447 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 0.406666 0.000000 0.203333 0.203333 0.365999 0.040667
448 W64682002 C10AA07 ROSUVASTATINUM ROSI 10 mg COMPR. FILM. 10mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.620775 0.379891 0.310387 0.690279 0.558697 0.441969
449 W65079001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 0.620775 0.584225 0.310387 0.894613 0.558697 0.646303
450 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 0.401000 0.000000 0.200500 0.200500 0.360900 0.040100
451 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 0.849666 0.000000 0.424833 0.424833 0.764699 0.084967
452 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 0.936666 0.000000 0.468333 0.468333 0.842999 0.093667
453 W59900004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. 28 1.175714 0.000000 0.587857 0.587857 1.058142 0.117572
454 W59900017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. 28 1.175714 0.000000 0.587857 0.587857 1.058142 0.117572
455 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 0.496428 0.000000 0.248214 0.248214 0.446785 0.049643
456 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 1.105333 0.000000 0.552666 0.552667 0.994799 0.110534
457 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 0.879333 0.000000 0.439666 0.439667 0.791399 0.087934
458 W64684002 C10AA07 ROSUVASTATINUM ROSI 20 mg COMPR. FILM. 20mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1.241550 0.263450 0.620775 0.884225 1.117395 0.387605
459 W65078001 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 1.200357 0.000000 0.600178 0.600179 1.080321 0.120036
460 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 0.426333 0.000000 0.213166 0.213167 0.383699 0.042634
461 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 1.361000 0.000000 0.680500 0.680500 1.224900 0.136100
462 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 1.161666 0.000000 0.580833 0.580833 1.045499 0.116167
463 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 1.610357 0.000000 0.805178 0.805179 1.449321 0.161036
464 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 1.610357 0.000000 0.805178 0.805179 1.449321 0.161036
465 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 1.173928 0.000000 0.586964 0.586964 1.056535 0.117393
466 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 2.483100 0.274233 1.241550 1.515783 2.234790 0.522543
467 W64686002 C10AA07 ROSUVASTATINUM ROSI 40 mg COMPR. FILM. 40mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1.858333 0.000000 0.929166 0.929167 1.672499 0.185834
468 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
469 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 0.297000 0.000000 0.148500 0.148500 0.267300 0.029700
470 W59898004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. 28 0.310387 0.034255 0.155193 0.189449 0.279348 0.065294
471 W59898017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA P6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. 28 0.310387 0.034255 0.155193 0.189449 0.279348 0.065294
472 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 0.310387 0.591398 0.155193 0.746592 0.279348 0.622437
473 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 0.310387 0.540279 0.155193 0.695473 0.279348 0.571318
474 W65077001 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 0.310387 0.884255 0.155193 1.039449 0.279348 0.915294
475 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 0.208000 0.000000 0.104000 0.104000 0.187200 0.020800
476 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 1.124666 0.801405 0.562333 1.363738 1.012199 0.913872
477 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 1.124666 0.775667 0.562333 1.338000 1.012199 0.888134
478 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 1.124666 0.439000 0.562333 1.001333 1.012199 0.551467
479 W66959003 C10AX09 EZETIMIBUM CEXADO 10 mg COMPR. 10mg ZENTIVA K.S. REP. CEHA CUTIE CU BLISTERE DIN PVC/ACLAR/PVC/AL X 30 COMPRIMATE PRF 30 1.124666 0.000000 0.562333 0.562333 1.012199 0.112467
480 W66959021 C10AX09 EZETIMIBUM CEXADO 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. PRF 30 1.124666 0.000000 0.562333 0.562333 1.012199 0.112467
481 W66280001 C10BA05 COMBINATII (EZETIMIBUM+ATORVASTATINUM) ** TORVAZIN PLUS 10 mg/10 mg CAPS. 10mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-PVC/AL X 30 CAPS. P6L 30 0.797333 2.356333 0.398666 2.755000 0.717599 2.436067
482 W66281001 C10BA05 COMBINATII (EZETIMIBUM+ATORVASTATINUM) ** TORVAZIN PLUS 20 mg/10 mg CAPS. 10mg/20mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-PVC/AL X 30 CAPS. P6L 30 1.594666 1.357334 0.797333 2.154667 1.435199 1.516801
483 W66282001 C10BA05 COMBINATII (EZETIMIBUM+ATORVASTATINUM) ** TORVAZIN PLUS 40 mg/10 mg CAPS. 10mg/40mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-PVC/AL X 30 CAPS. P6L 30 3.189333 0.216333 1.594666 1.811000 2.870399 0.535267
484 W66253002 C10BA05 COMBINATII (EZETIMIBUM+ATORVASTATINUM) ** ZETOVAR 10 mg/10 mg COMPR. 10mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE DE CARTON CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 0.797333 1.490333 0.398666 1.889000 0.717599 1.570067
485 W66254002 C10BA05 COMBINATII (EZETIMIBUM+ATORVASTATINUM) ** ZETOVAR 10 mg/20 mg COMPR. 10mg/20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE DE CARTON CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.594666 0.938334 0.797333 1.735667 1.435199 1.097801
486 W66255002 C10BA05 COMBINATII (EZETIMIBUM+ATORVASTATINUM) ** ZETOVAR 10 mg/40 mg COMPR. 10mg/40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE DE CARTON CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2.973000 0.000000 1.486500 1.486500 2.675700 0.297300
487 W66256002 C10BA05 COMBINATII (EZETIMIBUM+ATORVASTATINUM) ** ZETOVAR 10 mg/80 mg COMPR. 10mg/80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE DE CARTON CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 3.603666 0.000000 1.801833 1.801833 3.243299 0.360367
488 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 2.319666 1.454000 1.159833 2.613833 2.087699 1.685967
489 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 2.319666 1.692667 1.159833 2.852500 2.087699 1.924634
490 W67505003 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** ROZETIN 10 mg/10 mg COMPR. FILM. 10 mg/10 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE P6L 30 2.319666 1.454000 1.159833 2.613833 2.087699 1.685967
491 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 2.319666 0.556334 1.159833 1.716167 2.087699 0.788301
492 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 2.162000 0.000000 1.081000 1.081000 1.945800 0.216200
493 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 2.319666 0.939000 1.159833 2.098833 2.087699 1.170967
494 W67506001 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** ROZETIN 20 mg/10 mg COMPR. FILM. 20 mg/10 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE P6L 30 2.319666 1.692667 1.159833 2.852500 2.087699 1.924634
495 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 2.319666 0.729334 1.159833 1.889167 2.087699 0.961301
496 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 2.222666 0.000000 1.111333 1.111333 2.000399 0.222267
497 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 2.319666 1.125334 1.159833 2.285167 2.087699 1.357301
498 W67507001 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** ROZETIN 40 mg/10 mg COMPR. FILM. 40 mg/10 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE P6L 30 2.319666 0.000000 1.159833 1.159833 2.087699 0.231967
499 W65829001 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** SUVEZEN 40 mg/10 mg COMPR. FILM. 40mg/10mg SANOFI ROMANIA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 2.319666 0.000000 1.159833 1.159833 2.087699 0.231967
500 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 0.870666 0.053667 0.435333 0.489000 0.783599 0.140734
501 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 0.743333 0.000000 0.371666 0.371667 0.668999 0.074334
502 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 0.870666 0.053667 0.435333 0.489000 0.783599 0.140734
503 W67263001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/10mg COMPR. FILM. 10mg/10mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P6L 30 0.870666 0.053667 0.435333 0.489000 0.783599 0.140734

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
504 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 0.870666 0.028000 0.435333 0.463333 0.783599 0.115067
505 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 0.605000 0.000000 0.302500 0.302500 0.544500 0.060500
506 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 0.870666 0.028000 0.435333 0.463333 0.783599 0.115067
507 W67262001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/5mg COMPR. FILM. 10mg/5mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P6L 30 0.870666 0.028000 0.435333 0.463333 0.783599 0.115067
508 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 0.870666 0.248334 0.435333 0.683667 0.783599 0.335401
509 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 0.861333 0.000000 0.430666 0.430667 0.775199 0.086134
510 W65527003 C10BX13 ROSUVASTATINUM+PERINDOPRILUM+INDAPAMIDUM ** ROXIPER 10 mg/4 mg/1,25 mg COMPR. FILM. 10mg/4mg/1,25mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0.861798 0.170202 0.430899 0.601101 0.775618 0.256382
511 W65529003 C10BX13 ROSUVASTATINUM+PERINDOPRILUM+INDAPAMIDUM ** ROXIPER 10 mg/8 mg/2,5 mg COMPR. FILM. 10mg/8mg/2,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1.158483 0.347183 0.579241 0.926425 1.042634 0.463032
512 W65528003 C10BX13 ROSUVASTATINUM+PERINDOPRILUM+INDAPAMIDUM ** ROXIPER 20 mg/4 mg/1,25 mg COMPR. FILM. 20mg/4mg/1,25mg KRKA D.D., NOVO MESTOSLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1.311666 0.000000 0.655833 0.655833 1.180499 0.131167
513 W65530003 C10BX13 ROSUVASTATINUM+PERINDOPRILUM+INDAPAMIDUM ** ROXIPER 20 mg/8 mg/2,5 mg COMPR. FILM. 20mg/8mg/2,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1.723596 0.046404 0.861798 0.908202 1.551236 0.218764
514 W05806001 D01BA02 TERBINAFINUM LAMISIL 250 mg COMPR. 250mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. X 14 COMPR. P-RF 14 1.778035 0.029107 0.889017 0.918125 1.600231 0.206911
515 W53418001 D01BA02 TERBINAFINUM TERBINAFINA SLAVIA 250mg COMPR. 250mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR. P-RF 14 1.778035 0.029107 0.889017 0.918125 1.600231 0.206911
516 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 1.748928 0.000000 0.874464 0.874464 1.574035 0.174893
517 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 51.640000 0.000000 25.820000 25.820000 46.476000 5.164000
518 W62934001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * ENSTILUM 50 micrograme/0,5 mg/g SPUMA CUT. 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA CUT IE CU 1 RECIPIENT PRESURIZAT DIN AL, CU UN ST RAT INT ERIOR DIN LAC POLIAMID-IMIDIC PREVAZUT CU VALVA DOZAT OARE SI SIST EM DE ACT IONARE CARE CONT INE 60 G SPUMA CUT ANAT A PRF 1 207.180000 9.320000 103.590000 112.910000 186.462000 30.038000
519 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 51.795000 0.155000 25.897500 26.052500 46.615500 5.334500
520 W66142001 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml KARO PHARMA AB SUEDIA CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE P-RF 1 42.380000 0.000000 21.190000 21.190000 38.142000 4.238000
521 W07761001 D06BB10 IMIQUIMODUM * ALDARA 5% CREMA 5% MEDA AB SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA P-RF 12 22.330000 0.000000 11.165000 11.165000 20.097000 2.233000
522 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 13.280000 0.000000 6.640000 6.640000 11.952000 1.328000
523 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 13.280000 1.000000 6.640000 7.640000 11.952000 2.328000
524 W67758001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID 1 mg/g CREMA 1mg/g CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU 1 FLAC. DIN AL X 30 G CREMA PRF 1 13.280000 0.000000 6.640000 6.640000 11.952000 1.328000
525 W67759001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID LIPOCREAM 1mg/g CREMA 1mg/g CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU 1 FLAC. DIN AL X 30 G CREMA PRF 1 13.280000 1.000000 6.640000 7.640000 11.952000 2.328000
526 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 3.880000 2.140000 1.940000 4.080000 3.492000 2.528000
527 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 3.880000 0.000000 1.940000 1.940000 3.492000 0.388000
528 W57222001 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3.880000 2.140000 1.940000 4.080000 3.492000 2.528000
529 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 3.880000 0.000000 1.940000 1.940000 3.492000 0.388000
530 W66063005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g INTENDIS GMBH GERMANIA CUTIE CU 1 TUB DIN AL SIGILAT CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G CREMA PRF 1 37.292500 1.957500 18.646250 20.603750 33.563250 5.686750
531 W66594005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL SIGILAT CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G CREMA PRF 1 37.292500 1.957500 18.646250 20.603750 33.563250 5.686750
532 W66062002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g INTENDIS GMBH GERMANIA CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA PRF 1 36.640000 0.000000 18.320000 18.320000 32.976000 3.664000
533 W66593002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA PRF 1 36.640000 0.000000 18.320000 18.320000 32.976000 3.664000
534 W66064005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g INTENDIS GMBH GERMANIA CUTIE CU 1 TUB DIN AL CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G UNGUENT PRF 1 37.292500 1.957500 18.646250 20.603750 33.563250 5.686750
535 W66595005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL CU MEMBRANA DIN AL SI INCHIS CU CAPAC CU FILET DIN PEID X 50 G UNGUENT PRF 1 37.292500 1.957500 18.646250 20.603750 33.563250 5.686750
536 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 11.280000 0.000000 5.640000 5.640000 10.152000 1.128000
537 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 11.770000 1.470000 5.885000 7.355000 10.593000 2.647000
538 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 6.626250 2.203750 3.313125 5.516875 5.963625 2.866375
539 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 6.626250 6.113750 3.313125 9.426875 5.963625 6.776375
540 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 6.240000 0.000000 3.120000 3.120000 5.616000 0.624000
541 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 6.626250 0.003750 3.313125 3.316875 5.963625 0.666375
542 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 6.626250 3.593750 3.313125 6.906875 5.963625 4.256375
543 W52924001 D07AD01 CLOBETASOLUM * CLOBETASOL MK 0,5 mg/g UNGUENT 0,5mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 20 G P-RF 1 5.300000 0.000000 2.650000 2.650000 4.770000 0.530000
544 W60525001 D07CA01 COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H CREMA 20mg/g+10mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 23.200000 0.000000 11.600000 11.600000 20.880000 2.320000
545 W59984002 D07CC01 COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg pe gram LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL X 20 G CREMA PRF 1 30.287500 0.142500 15.143750 15.286250 27.258750 3.171250
546 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 33.540000 0.000000 16.770000 16.770000 30.186000 3.354000
547 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 33.540000 0.000000 16.770000 16.770000 30.186000 3.354000
548 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 41.925000 11.535000 20.962500 32.497500 37.732500 15.727500
549 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 41.925000 11.535000 20.962500 32.497500 37.732500 15.727500
550 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 1.162249 0.748417 0.581124 1.329542 1.046024 0.864642
551 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 1.138666 0.000000 0.569333 0.569333 1.024799 0.113867
552 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 2.324499 0.047167 1.162249 1.209417 2.092049 0.279617
553 W51716002 G01AA51 COMBINATII MACMIROR COMPLEX 500 mg/200000 UI CAPS. MOI VAG. 500mg/200000UI POLICHEM SA LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG. P-RF 12 2.283416 1.270750 1.141708 2.412458 2.055074 1.499092
554 W64599001 G01AA51 COMBINATII POLYGYNAX VIRGO CAPS. MOI VAG. FARA LABORATOIRE INNOTECH INTERNATIONAL FRANTA CUTIE CU 1 BLIST. PVC/PVDC TRANSPARENT/AL X 6 CAPS. VAG. MOI PRF 6 2.283416 0.313250 1.141708 1.454958 2.055074 0.541592
555 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 2.283416 0.456584 1.141708 1.598292 2.055074 0.684926
556 W51914001 G01AA51 COMBINATII MACMIROR COMPLEX 100 mg+40000 UI/g CREMA VAG. 10g+4000000UI/100g POLICHEM SA LUXEMBURG CUTIE CU 1 TUB DIN AL X 30 G CREMA VAG. SI UN APLICATOR VAGINAL P-RF 1 40.310000 0.000000 20.155000 20.155000 36.279000 4.031000
557 W03126002 G01AF12 FENTICONAZOLUM LOMEXIN 1000 mg 1000mg
CAPS. MOI VAG. RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 2 CAPS. VAG. MOI P-RF 2 18.596247 15.563753 9.298123 24.861877 16.736622 17.423378
558 W03125002 G01AF12 FENTICONAZOLUM LOMEXIN 600 mg 600mg
CAPS. MOI VAG. RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE P-RF 1 11.157748 5.512252 5.578874 11.091126 10.041973 6.628027
559 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 29.010146 8.819854 14.505073 23.324927 26.109131 11.720869
560 W54844001 G01AF15 BUTOCONAZOLUM GYNOFORT 20 mg/g CREMA VAG. 20mg/g ROMANIA GEDEON RICHTER ROMANIA SA CUTIE X 1 APLICATOR PREUMPLUT UNIDOZA DIN PP CU 5 G CREMA VAG. P-RF 1 1.859624 31.790376 0.929812 32.720188 1.673661 31.976339
561 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 1.700892 0.017108 0.850446 0.867554 1.530802 0.187198
562 W63731001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON 40 mg/g + 200 mg/g CREMA VAG. 200mg/g+40mg/g ALFASIGMA S.P.A. ITALIA CUTIE CU 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN PP PRF 1 10.205353 4.504647 5.102676 9.607324 9.184817 5.525183
563 W63733001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON 500 mg/100 mg OVULE 500mg/100mg ALFASIGMA S.P.A. ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULE PRF 10 1.700892 2.531108 0.850446 3.381554 1.530802 2.701198
564 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 1.700892 0.000536 0.850446 0.850982 1.530802 0.170626
565 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 1.700892 0.000536 0.850446 0.850982 1.530802 0.170626
566 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 1.699285 0.000000 0.849642 0.849643 1.529356 0.169929
567 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 1.699285 0.000000 0.849642 0.849643 1.529356 0.169929
568 W63732001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE ALFASIGMA S.P.A. ITALIA CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE P-RF 5 1.700381 3.337619 0.850190 4.187810 1.530342 3.507658
569 W64655001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore SISTEM CU CEDARE INTRAUTERINA 20micrograme/24ore BAYER AG GERMANIA CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR PRF 1 539.560000 0.000000 269.780000 269.780000 485.604000 53.956000
570 W00716002 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 9.133750 0.826250 4.566875 5.393125 8.220375 1.739625
571 W00716001 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 9.133750 0.000000 4.566875 4.566875 8.220375 0.913375
572 W65037001 G02CB03 CABERGOLINUM * DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 2 COMPR. P6L 2 9.133750 0.826250 4.566875 5.393125 8.220375 1.739625
573 W65037002 G02CB03 CABERGOLINUM * DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 8 COMPR. P6L 8 9.133750 0.000000 4.566875 4.566875 8.220375 0.913375
574 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 9.133750 0.826250 4.566875 5.393125 8.220375 1.739625
575 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 9.133750 0.000000 4.566875 4.566875 8.220375 0.913375
576 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 1.574000 0.000000 0.787000 0.787000 1.416600 0.157400

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
577 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 1.750357 0.000000 0.875178 0.875179 1.575321 0.175036
578 W12320001 G03DA04 PROGESTERONUM * UTROGESTAN 100 mg CAPS. MOI 100mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI P-6L 30 0.677666 0.446000 0.338833 0.784833 0.609899 0.513767
579 W42276001 G03DA04 PROGESTERONUM * UTROGESTAN 200 mg CAPS. MOI 200mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. AL/PVC X 7 CAPS. MOI P-6L 14 1.355333 1.793238 0.677666 2.470905 1.219799 1.928772
580 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 1.355333 0.000000 0.677666 0.677667 1.219799 0.135534
581 W67480001 G03DA04 PROGESTERONUM * AREFAM 200 mg CAPS. MOI 200mg EFFIK FRANTA CUTIE CU 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI PRF 30 1.355333 0.000000 0.677666 0.677667 1.219799 0.135534
582 W60214001 G03DA04 PROGESTERONUM * MASTOPROFEN 10 mg/g GEL 10mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GEL P6L 1 7.870000 0.000000 3.935000 3.935000 7.083000 0.787000
583 W61888001 G03DA04 PROGESTERONUM * CRINONE 80 mg/g GEL VAGINAL 80mg/g MERCK ROMANIA SRL ROMANIA P6LCUT IE CU 6 APLICAT OARE DOZA UNICA DIN PE, CONT INÂND GEL VAGINAL, PREVAZUT E CU VÂRF CARE SE DESFACE PRIN RASUCIRE, AMBALAT E SEPARAT ÎNT R-O FOLIE DIN HÂRT IE/AL/RASINA IONOMERICA 6 13.021666 0.000000 6.510833 6.510833 11.719499 1.302167
584 W67640002 G03DA04 PROGESTERONUM * PROLUTEX 25 mg SOL INJ. 25mg IBSA FARMACEUTICI ITALIA S.R.L. ITALIA CUTIE CU 7 FLAC. DIN STICLA INCOLORA CARE CONTINE SOL. INJ. PRF 7 23.395714 0.000000 11.697857 11.697857 21.056142 2.339572
585 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 1.266500 0.000000 0.633250 0.633250 1.139850 0.126650
586 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 1.266500 0.000000 0.633250 0.633250 1.139850 0.126650
587 W04045001 G03DC03 LYNESTRENOLUM * ORGAMETRIL 5 mg COMPR. 5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 30 COMPR. P-6L 30 0.348333 0.000000 0.174166 0.174167 0.313499 0.034834
588 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 0.348333 0.000000 0.174166 0.174167 0.313499 0.034834
589 W64044001 G03FB01 COMBINATII ** CYCLO-PROGYNOVA DRAJ. FARA CONCENTRATIE BAYER AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P6L 21 0.393809 0.000000 0.196904 0.196905 0.354428 0.039381
590 W61928001 G03FB08 COMBINATII (ESTRADIOLUM + DIDROGESTERONUM) ** FEMOSTON 2/10, comprimate filmate COMPR. FILM. 2 mg/10 mg BGP PRODUCTS B.V. OLANDA CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) P-RF 28 0.728690 0.334881 0.364345 0.699226 0.655821 0.407750
591 W64557001 G03FB08 COMBINATII (ESTRADIOLUM + DIDROGESTERONUM) ** FEMOSTON 2/10 COMPR. FILM. FARA MYLAN HEALTHCARE B.V. OLANDA CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) P-RF 28 0.728690 0.334881 0.364345 0.699226 0.655821 0.407750
592 W60481002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. P-RF/R 1 95.928750 28.481250 47.964375 76.445625 86.335875 38.074125
593 W65133002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK EUROPE B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. PR/PRF 1 95.928750 28.481250 47.964375 76.445625 86.335875 38.074125
594 W65720001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 300 UI/0,5 ml SOL INJ. 300UI/0,5ml THERAMEX IRELAND LIMITED IRLANDA CUTIE X 1 CARTUS (STICLA TIP I) X 0.5 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE PR/PRF 1 380.620000 0.000000 190.310000 190.310000 342.558000 38.062000
595 W65721001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 450 UI/0,75 ml SOL INJ. 450UI/0,75ml THERAMEX IRELAND LIMITED IRLANDA CUTIE X 1 CARTUS (STICLA TIP I) X 0.75 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE PR/PRF 1 544.970000 0.000000 272.485000 272.485000 490.473000 54.497000
596 W65722001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 900 UI/ 1,5ml SOL INJ. 900UI/1,5ml THERAMEX IRELAND LIMITED IRLANDA CUTIE X 1 CARTUS (STICLA TIP I) X 1.5ML SOLUTIE INJECTABILA + 20 ACE PENTRU INJECTIE PR/PRF 1 992.740000 0.000000 496.370000 496.370000 893.466000 99.274000
597 W63834001 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 150 UI/0,25 ml 150UI/0,25ml
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT GEDEON RICHTER PLC UNGARIA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 191.857500 9.122500 95.928750 105.051250 172.671750 28.308250
598 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 1 287.786250 6.413750 143.893125 150.306875 259.007625 35.192375
599 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 1 383.715000 3.095000 191.857500 194.952500 345.343500 41.466500
600 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 95.928750 11.751250 47.964375 59.715625 86.335875 21.344125
601 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 1 383.715000 71.035000 191.857500 262.892500 345.343500 109.406500
602 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 1 383.715000 71.035000 191.857500 262.892500 345.343500 109.406500
603 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 1 575.572500 82.357500 287.786250 370.143750 518.015250 139.914750
604 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 1 575.572500 82.357500 287.786250 370.143750 518.015250 139.914750
605 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 1,151.145000 79.495000 575.572500 655.067500 1,036.030500 194.609500
606 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 1,151.145000 79.495000 575.572500 655.067500 1,036.030500 194.609500
607 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 1 383.561514 27.888486 191.780757 219.669243 345.205362 66.244638
608 W67765001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml N.V . ORGANON OLANDA CUTIE CU 1 CARTUS + 6 ACE PR/PRF 1 383.561514 27.888486 191.780757 219.669243 345.205362 66.244638
609 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 1,092.650000 0.000000 546.325000 546.325000 983.385000 109.265000
610 W67766001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml N.V . ORGANON OLANDA CUTIE CU 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1,092.650000 0.000000 546.325000 546.325000 983.385000 109.265000
611 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 1 126.240000 0.000000 63.120000 63.120000 113.616000 12.624000
612 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 1 126.240000 0.000000 63.120000 63.120000 113.616000 12.624000
613 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 1.668035 0.130536 0.834017 0.964554 1.501231 0.297340
614 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 1.668035 0.072322 0.834017 0.906340 1.501231 0.239126
615 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 1.595714 0.000000 0.797857 0.797857 1.436142 0.159572
616 W62337001 G04BD04 OXYBUTYNINUM DRIPTANE 5 mg COMPR. 5mg MYLAN MEDICAL SAS FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. PRF 60 0.257333 0.137167 0.128666 0.265834 0.231599 0.162901
617 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 0.193000 0.856285 0.096500 0.952785 0.173700 0.875585
618 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 0.386000 0.409000 0.193000 0.602000 0.347400 0.447600
619 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 1.494666 0.000000 0.747333 0.747333 1.345199 0.149467
620 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 1.544000 1.647333 0.772000 2.419333 1.389600 1.801733
621 W63709008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 1.544000 2.191000 0.772000 2.963000 1.389600 2.345400
622 W63709010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 1.544000 0.887333 0.772000 1.659333 1.389600 1.041733
623 W63709013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 1.544000 1.087444 0.772000 1.859444 1.389600 1.241844
624 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 1.544000 2.191000 0.772000 2.963000 1.389600 2.345400
625 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 1.544000 0.887333 0.772000 1.659333 1.389600 1.041733
626 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 1.544000 1.087444 0.772000 1.859444 1.389600 1.241844
627 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 1.494666 0.000000 0.747333 0.747333 1.345199 0.149467
628 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 1.494666 0.000000 0.747333 0.747333 1.345199 0.149467
629 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 1.494666 0.000000 0.747333 0.747333 1.345199 0.149467
630 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 1.544000 2.004000 0.772000 2.776000 1.389600 2.158400
631 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 1.445000 0.000000 0.722500 0.722500 1.300500 0.144500
632 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 0.772000 0.000000 0.386000 0.386000 0.694800 0.077200
633 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 0.772000 1.721666 0.386000 2.107666 0.694800 1.798866
634 W63708008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 0.772000 2.872000 0.386000 3.258000 0.694800 2.949200
635 W63708010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 0.772000 1.191666 0.386000 1.577666 0.694800 1.268866
636 W63708013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 0.772000 0.722777 0.386000 1.108777 0.694800 0.799977
637 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 0.772000 2.872000 0.386000 3.258000 0.694800 2.949200
638 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 0.772000 1.191666 0.386000 1.577666 0.694800 1.268866
639 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 0.772000 0.722777 0.386000 1.108777 0.694800 0.799977
640 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 0.772000 0.000000 0.386000 0.386000 0.694800 0.077200
641 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 0.772000 0.000000 0.386000 0.386000 0.694800 0.077200
642 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 0.772000 0.000000 0.386000 0.386000 0.694800 0.077200
643 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 0.772000 1.710000 0.386000 2.096000 0.694800 1.787200
644 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 0.772000 0.260333 0.386000 0.646333 0.694800 0.337533
645 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 23.160000 67.130000 11.580000 78.710000 20.844000 69.446000
646 W43786001 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.289500 0.864500 0.144750 1.009250 0.260550 0.893450
647 W43789001 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0.579000 1.341666 0.289500 1.631166 0.521100 1.399566
648 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 0.780333 0.000000 0.390166 0.390167 0.702299 0.078034
649 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 1.430000 0.000000 0.715000 0.715000 1.287000 0.143000

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
650 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 1.430000 0.000000 0.715000 0.715000 1.287000 0.143000
651 W56791001 G04CA02 TAMSULOSINUM FOKUSIN 0,4 mg CAPS. ELIB. MODIF. 0,4mg ZENTIVA KS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF. P-6L 30 0.646666 0.000000 0.323333 0.323333 0.581999 0.064667
652 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 0.646666 0.000000 0.323333 0.323333 0.581999 0.064667
653 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 1.121666 0.000000 0.560833 0.560833 1.009499 0.112167
654 W42715001 G04CA02 TAMSULOSINUM TAMSOL 0,4 mg CAPS. ELIB. PREL. 0,4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-6L 30 0.924000 0.000000 0.462000 0.462000 0.831600 0.092400
655 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 1.121666 0.000000 0.560833 0.560833 1.009499 0.112167
656 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 0.646666 0.000000 0.323333 0.323333 0.581999 0.064667
657 W67739002 G04CA02 TAMSULOSINUM TAMSULOSIN AUROBINDO 0,4 mg COMPR. CU ELIB. PREL. 0,4mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. ELIB. PREL. P6L 30 0.640333 0.000000 0.320166 0.320167 0.576299 0.064034
658 W43106001 G04CA02 TAMSULOSINUM OMNIC TOCAS 0,4 mg COMPR. FILM. ELIB. PREL. 0,4mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 FOLII AL/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0.992666 0.000000 0.496333 0.496333 0.893399 0.099267
659 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 1.068892 0.102179 0.534446 0.636625 0.962002 0.209069
660 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 0.966785 0.000000 0.483392 0.483393 0.870106 0.096679
661 W51273003 G04CB01 FINASTERIDUM * PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PE/PVD-AL X 15 COMPR. FILM. P6L 30 1.068892 0.102108 0.534446 0.636554 0.962002 0.208998
662 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 1.183916 0.389750 0.591958 0.981708 1.065524 0.508142
663 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 1.183916 1.123750 0.591958 1.715708 1.065524 1.242142
664 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 1.183916 0.047417 0.591958 0.639375 1.065524 0.165809
665 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 1.041666 0.000000 0.520833 0.520833 0.937499 0.104167
666 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 1.183916 1.123750 0.591958 1.715708 1.065524 1.242142
667 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 1.183916 0.047417 0.591958 0.639375 1.065524 0.165809
668 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 0.838666 0.000000 0.419333 0.419333 0.754799 0.083867
669 W67626002 G04CB02 DUTASTERIDUM * AVODART 0,5 mg CAPS. MOI 0,5mg GLAXOSMITHKLINE TRADING SERVICES LIMITED IRLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI P6L 30 1.183916 0.389750 0.591958 0.981708 1.065524 0.508142
670 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 1 114.410000 0.000000 57.205000 57.205000 102.969000 11.441000
671 W67695001 H01CC01 GANIRELIXUM ** # ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml N.V. ORGANON OLANDA CUTIE CU 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT PR/PRF 1 114.410000 0.000000 57.205000 57.205000 102.969000 11.441000
672 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 7 114.410000 6.522857 57.205000 63.727857 102.969000 17.963857
673 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 7 114.410000 6.522857 57.205000 63.727857 102.969000 17.963857
674 W03165001 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 0.386400 0.000000 0.193200 0.193200 0.347760 0.038640
675 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 0.386400 0.000000 0.193200 0.193200 0.347760 0.038640
676 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 21.250000 0.000000 10.625000 10.625000 19.125000 2.125000
677 W54546003 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0.305595 0.175405 0.152797 0.328203 0.275035 0.205965
678 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 0.305595 0.175405 0.152797 0.328203 0.275035 0.205965
679 W54545003 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0.584800 0.000000 0.292400 0.292400 0.526320 0.058480
680 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 0.584800 0.000000 0.292400 0.292400 0.526320 0.058480
681 W54547004 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 0.152797 0.194903 0.076398 0.271302 0.137517 0.210183
682 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 0.152797 0.194903 0.076398 0.271302 0.137517 0.210183
683 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. PRF 1 19.323800 4.486200 9.661900 14.148100 17.391420 6.418580
684 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. PRF 50 18.261200 0.000000 9.130600 9.130600 16.435080 1.826120
685 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. PRF 25 19.323800 0.354200 9.661900 10.016100 17.391420 2.286580
686 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. PRF 10 19.323800 1.428200 9.661900 11.090100 17.391420 3.360580
687 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 2.987500 0.000000 1.493750 1.493750 2.688750 0.298750
688 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 2.987500 0.000000 1.493750 1.493750 2.688750 0.298750
689 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 23.900000 2.880000 11.950000 14.830000 21.510000 5.270000
690 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 23.900000 2.880000 11.950000 14.830000 21.510000 5.270000
691 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 0.799336 0.323789 0.399668 0.723457 0.719402 0.403723
692 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 1.598676 1.003324 0.799338 1.802662 1.438808 1.163192
693 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 1.598676 1.003324 0.799338 1.802662 1.438808 1.163192
694 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 3.996694 0.438306 1.998347 2.436653 3.597024 0.837976
695 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 3.996694 0.438306 1.998347 2.436653 3.597024 0.837976
696 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 1.998344 2.563322 0.999172 3.562494 1.798509 2.763157
697 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 1.998344 2.563322 0.999172 3.562494 1.798509 2.763157
698 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 2.755000 0.000000 1.377500 1.377500 2.479500 0.275500
699 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 3.631666 0.000000 1.815833 1.815833 3.268499 0.363167
700 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 3.573333 0.000000 1.786666 1.786667 3.215999 0.357334
701 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 6.156666 0.000000 3.078333 3.078333 5.540999 0.615667
702 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 6.156666 0.000000 3.078333 3.078333 5.540999 0.615667
703 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. P-RF 3 6.156666 0.000000 3.078333 3.078333 5.540999 0.615667
704 W57032001 J01FA10 AZITHROMYCINUM AZITROX 500 mg COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 5.233333 0.000000 2.616666 2.616667 4.709999 0.523334
705 W60406001 J01FA10 AZITHROMYCINUM AZITROMICINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF 3 6.156666 0.000000 3.078333 3.078333 5.540999 0.615667
706 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 6.156666 0.000000 3.078333 3.078333 5.540999 0.615667
707 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 7.993388 0.876612 3.996694 4.873306 7.194049 1.675951
708 W53281001 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA CUT IE X 1 FLACON DIN PE CU PULBERE PENT RU 15ML SUSPENSIE ORALA RECONST IT UIT A + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENT RU ADMINIST RAREA ORALA + O LINGURIT A DOZAT OARE P-RF 1 15.950000 0.000000 7.975000 7.975000 14.355000 1.595000
709 W42901001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA 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 P-RF 1 12.835996 8.504004 6.417998 14.922002 11.552396 9.787604
710 W42877002 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA 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 P-RF 1 20.650000 0.000000 10.325000 10.325000 18.585000 2.065000
711 W00520001 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 37.100000 0.000000 18.550000 18.550000 33.390000 3.710000
712 W64358002 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA 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 PRF 1 37.100000 0.000000 18.550000 18.550000 33.390000 3.710000
713 W00520003 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 46.090000 0.000000 23.045000 23.045000 41.481000 4.609000
714 W64358003 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA 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 PRF 1 46.090000 0.000000 23.045000 23.045000 41.481000 4.609000
715 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 0.518442 0.140933 0.259221 0.400154 0.466597 0.192778
716 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 0.518442 0.140933 0.259221 0.400154 0.466597 0.192778
717 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 0.975625 0.000000 0.487812 0.487813 0.878062 0.097563
718 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 0.975625 0.000000 0.487812 0.487813 0.878062 0.097563
719 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 2.073770 0.599980 1.036885 1.636865 1.866393 0.807357
720 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 2.073770 0.367563 1.036885 1.404448 1.866393 0.574940
721 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 2.764285 0.000000 1.382142 1.382143 2.487856 0.276429
722 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 2.740000 0.000000 1.370000 1.370000 2.466000 0.274000

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
723 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. 5 PRF 2.740000 0.000000 1.370000 1.370000 2.466000 0.274000
724 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. 10 PRF 2.741000 0.000000 1.370500 1.370500 2.466900 0.274100
725 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. 7 PRF 2.764285 0.000000 1.382142 1.382143 2.487856 0.276429
726 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 2.744000 0.000000 1.372000 1.372000 2.469600 0.274400
727 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 4.724285 0.000000 2.362142 2.362143 4.251856 0.472429
728 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 4.140000 0.000000 2.070000 2.070000 3.726000 0.414000
729 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 5.580000 0.101428 2.790000 2.891428 5.022000 0.659428
730 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 4.882000 0.000000 2.441000 2.441000 4.393800 0.488200
731 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 4.725000 0.000000 2.362500 2.362500 4.252500 0.472500
732 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 4.095714 0.000000 2.047857 2.047857 3.686142 0.409572
733 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 4.687000 0.000000 2.343500 2.343500 4.218300 0.468700
734 W60943001 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINÂND 5 COMPRIMATE FILMATE PRF 5 5.580000 1.330000 2.790000 4.120000 5.022000 1.888000
735 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 5.580000 2.538000 2.790000 5.328000 5.022000 3.096000
736 W65324001 J01MA14 MOXIFLOXACINUM KIMOKS 400 mg COMPR. FILM. 400mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM. PRF 5 5.580000 1.560000 2.790000 4.350000 5.022000 2.118000
737 W65543001 J01MA14 MOXIFLOXACINUM ERELAN 400 mg COMPR. FILM. 400mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 5 COMPR. FILM. PRF 5 5.580000 1.694000 2.790000 4.484000 5.022000 2.252000
738 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 5.580000 2.538000 2.790000 5.328000 5.022000 3.096000
739 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 5.580000 2.136000 2.790000 4.926000 5.022000 2.694000
740 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 2.459333 0.000000 1.229666 1.229667 2.213399 0.245934
741 W43051001 J02AC02 ITRACONAZOLUM * ITRACONAZOL SLAVIA 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 2.291333 0.000000 1.145666 1.145667 2.062199 0.229134
742 W53958001 J02AC02 ITRACONAZOLUM * MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 2.291333 0.000000 1.145666 1.145667 2.062199 0.229134
743 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 2.291333 0.000000 1.145666 1.145667 2.062199 0.229134
744 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 2.291333 0.000000 1.145666 1.145667 2.062199 0.229134
745 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 2.291333 0.000000 1.145666 1.145667 2.062199 0.229134
746 W67015006 J02AC02 ITRACONAZOLUM * OMICRAL 100 mg CAPS. 100mg BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 2.291333 0.000000 1.145666 1.145667 2.062199 0.229134
747 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 5.085000 0.000000 2.542500 2.542500 4.576500 0.508500
748 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 3.306000 0.000000 1.653000 1.653000 2.975400 0.330600
749 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 47.465714 0.000000 23.732857 23.732857 42.719142 4.746572
750 W12490001 L01AA01 CYCLOPHOSPHAMIDUM * ENDOXAN 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 1.223000 0.000000 0.611500 0.611500 1.100700 0.122300
751 W65081001 L02AE03 GOSERELINUM ** # ZOLADEX 3,6 mg IMPLANT 3,6mg ASTRAZENECA AB SUEDIA CUTIE CU 1 PUNGA X 1 SERINGA PREUMPLUTA MONODOZA A 3,6 MG GASORELINA PR/PRF 1 200.425832 6.064168 100.212916 106.277084 180.383248 26.106752
752 W62378001 L02AE03 GOSERELINUM ** # RESELIGO 3,6 mg IMPLANT IN SERINGA PREUMPLUTA 3,6mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 PUNGA CU UN IMPLANT IN SERINGA PREUMPLUTA PR/PRF 1 200.425832 1.454168 100.212916 101.667084 180.383248 21.496752
753 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 15.095714 0.000000 7.547857 7.547857 13.586142 1.509572
754 W55726002 L02AE04 TRIPTORELINUM ** # DIPHERELINE PR 11,25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 11,25mg IPSEN PHARMA FRANTA S/P-RF 1
CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA CU 2 ML SOLV. + 1 BLIST. CU 1 SERINGA DIN PP A 3 ML + 1 BLIST. CU 3 ACE STERILE 677.140000 0.000000 338.570000 338.570000 609.426000 67.714000
755 W55727001 L02AE04 TRIPTORELINUM ** # DIPHERELINE 3,75 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 3,75mg 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 360.500000 0.000000 180.250000 180.250000 324.450000 36.050000
756 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 2.374132 25.158725 1.187066 26.345791 2.136718 25.396139
757 W60846001 L04AX01 AZATHIOPRINUM * IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.000000 0.319400 0.319400 0.574920 0.063880
758 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 0.766799 0.364201 0.383399 0.747601 0.690119 0.440881
759 W66689001 M01AC05 LORNOXICAMUM LORNOXICAM ROMPHARM 8 mg PULB+SOLV. PT. SOL. INJ 8mg ROMPHARM COMPANY S.R.L. ROMANIA PRF 1
CUTIE CU 1 SET CARE CONTINE 1 FLAC. DIN STICLA BRUNA CU 8 MG PULB. PT. SOL. INJ. SI O FIOLA CU CAPACITATEA DE 2 ML CU SOLV. PT. SOL. INJ. 2.893330 8.046670 1.446665 9.493335 2.603997 8.336003
760 W66689004 M01AC05 LORNOXICAMUM LORNOXICAM ROMPHARM 8 mg PULB+SOLV. PT. SOL. INJ 8mg ROMPHARM COMPANY S.R.L. ROMANIA PRF 10
CUTIE CU 10 SETURI CARE CONTIN CÂTE 1 FLAC. DIN STICLA BRUNA CU 8 MG PULB. PT. SOL. INJ. SI O FIOLA CU CAPACITATEA DE 2 ML CU SOLV. PT. SOL. INJ. 2.893330 7.149670 1.446665 8.596335 2.603997 7.439003
761 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 0.519549 0.417451 0.259774 0.677226 0.467594 0.469406
762 W67023001 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg MENARINI INTERNATIONAL OPERATIONS LUXEMBOURG S.A. LUXEMBURG CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 0.519549 0.417451 0.259774 0.677226 0.467594 0.469406
763 W67369002 M01AE17 DEXKETOPROFENUM DEKENOR 25 mg COMPR. FILM. 25mg KRKA D.D, NOVO MESTO SLOVENIA P6L 20
CUTIE CU BLISTERE DIN PVC-PVDC-FILM ALB PVC/HÂRTIE-FOLIE AL CU 20X1 COMPRIMATE FILMATE 0.519549 0.262451 0.259774 0.522226 0.467594 0.314406
764 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 2.762000 0.000000 1.381000 1.381000 2.485800 0.276200
765 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. 2.912000 0.000000 1.456000 1.456000 2.620800 0.291200
766 W64522003 M01AE17 DEXKETOPROFENUM DEKENOR 50 mg/2 ml SOL INJ./PERF. 50mg/2ml KRKA, D.D., NOVO MESTO SLOVENIA PRF 10
CUTIE CU 10 FIOLE DIN STICLA BRUNA, CU PUNCT DE CULOARE ALBA SI INEL DE CULOARE ALBASTRA X 2 ML SOL. INJ./PERF. 2.912000 0.000000 1.456000 1.456000 2.620800 0.291200
767 W43063001 M01AE17 DEXKETOPROFENUM TADOR INJECT 50 mg/2ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml MENARINI INTERNATIONAL OPERATIONS LUXEMBOURG S.A. LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF. P-RF 5 4.096000 0.000000 2.048000 2.048000 3.686400 0.409600
768 W61199001 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA PRF 5
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. 2.912000 0.000000 1.456000 1.456000 2.620800 0.291200
769 W61199002 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA PRF 10
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. 2.911000 0.000000 1.455500 1.455500 2.619900 0.291100
770 W57029003 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA PRF 30
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 30 COMPR. ELIB. MODIF. 1.866416 0.124250 0.933208 1.057458 1.679774 0.310892
771 W57029004 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA PRF 60
CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 60 COMPR. ELIB. MODIF. 1.825000 0.000000 0.912500 0.912500 1.642500 0.182500
772 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 0.650208 0.431458 0.325104 0.756562 0.585187 0.496479
773 W60458003 M01AH01 CELECOXIBUM ALGOXIB 100 mg CAPS. 100mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 0.644666 0.000000 0.322333 0.322333 0.580199 0.064467
774 W60519003 M01AH01 CELECOXIBUM ACLEXA 100 mg CAPS. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0.644666 0.000000 0.322333 0.322333 0.580199 0.064467
775 W60596003 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0.644666 0.000000 0.322333 0.322333 0.580199 0.064467
776 W61088003 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 0.644666 0.000000 0.322333 0.322333 0.580199 0.064467
777 W65173006 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 0.650208 0.431458 0.325104 0.756562 0.585187 0.496479
778 W67264006 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 0.650208 0.431458 0.325104 0.756562 0.585187 0.496479
779 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 1.300416 0.043250 0.650208 0.693458 1.170374 0.173292
780 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 1.300416 0.089584 0.650208 0.739792 1.170374 0.219626
781 W60459003 M01AH01 CELECOXIBUM ALGOXIB 200 mg CAPS. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 1.300416 0.000250 0.650208 0.650458 1.170374 0.130292
782 W60520003 M01AH01 CELECOXIBUM ACLEXA 200 mg CAPS. 200mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1.299666 0.000000 0.649833 0.649833 1.169699 0.129967
783 W60597003 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 200 mg CAPS. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1.300416 0.000250 0.650208 0.650458 1.170374 0.130292
784 W61089003 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 200 mg CAPS. 200mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 1.300416 0.000250 0.650208 0.650458 1.170374 0.130292
785 W65174004 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 1.300416 0.089584 0.650208 0.739792 1.170374 0.219626
786 W65174006 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 1.300416 0.043250 0.650208 0.693458 1.170374 0.173292
787 W67265004 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg UPJOHN EESV OLANDA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 1.300416 0.089584 0.650208 0.739792 1.170374 0.219626
788 W67265006 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 1.300416 0.043250 0.650208 0.693458 1.170374 0.173292
789 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 2.600832 0.667739 1.300416 1.968155 2.340748 0.927823
790 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 2.600832 0.563453 1.300416 1.863869 2.340748 0.823537
791 W62615001 M01AH05 ETORICOXIBUM IMESOL 120 mg COMPR. FILM. 120mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 7 COMPR. FILM. PRF 7 2.600832 0.634882 1.300416 1.935298 2.340748 0.894966
792 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 2.600832 0.634882 1.300416 1.935298 2.340748 0.894966
793 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 1.994285 0.000000 0.997142 0.997143 1.794856 0.199429
794 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 1.930357 0.000000 0.965178 0.965179 1.737321 0.193036
795 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 2.415714 0.000000 1.207857 1.207857 2.174142 0.241572

Pagina 29 din 80
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
796 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 2.600832 0.667739 1.300416 1.968155 2.340748 0.927823
797 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 2.495714 0.000000 1.247857 1.247857 2.246142 0.249572
798 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 2.567142 0.000000 1.283571 1.283571 2.310427 0.256715
799 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 2.289285 0.000000 1.144642 1.144643 2.060356 0.228929
800 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 2.397142 0.000000 1.198571 1.198571 2.157427 0.239715
801 W62612001 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. PRF 28 0.650208 1.035863 0.325104 1.360967 0.585187 1.100884
802 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 0.650208 1.035863 0.325104 1.360967 0.585187 1.100884
803 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 0.650208 0.273363 0.325104 0.598467 0.585187 0.338384
804 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 0.650208 1.480506 0.325104 1.805610 0.585187 1.545527
805 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 0.650208 0.939434 0.325104 1.264538 0.585187 1.004455
806 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 0.650208 0.575506 0.325104 0.900610 0.585187 0.640527
807 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 0.650208 0.912292 0.325104 1.237396 0.585187 0.977313
808 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 1.300416 0.546726 0.650208 1.196934 1.170374 0.676768
809 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 1.300416 0.546726 0.650208 1.196934 1.170374 0.676768
810 W62613001 M01AH05 ETORICOXIBUM IMESOL 60 mg COMPR. FILM. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1.300416 1.046012 0.650208 1.696220 1.170374 1.176054
811 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 1.300416 1.046012 0.650208 1.696220 1.170374 1.176054
812 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 1.300416 0.546726 0.650208 1.196934 1.170374 0.676768
813 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 1.300416 0.419584 0.650208 1.069792 1.170374 0.549626
814 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 1.300416 0.417441 0.650208 1.067649 1.170374 0.547483
815 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 1.300416 0.546726 0.650208 1.196934 1.170374 0.676768
816 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 1.300416 0.486726 0.650208 1.136934 1.170374 0.616768
817 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 1.300416 0.546726 0.650208 1.196934 1.170374 0.676768
818 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 1.300416 0.428869 0.650208 1.079077 1.170374 0.558911
819 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 1.300416 0.436012 0.650208 1.086220 1.170374 0.566054
820 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 1.950624 0.570090 0.975312 1.545402 1.755561 0.765153
821 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 1.950624 0.570090 0.975312 1.545402 1.755561 0.765153
822 W62614001 M01AH05 ETORICOXIBUM IMESOL 90 mg COMPR. FILM. 90mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1.950624 0.545804 0.975312 1.521116 1.755561 0.740867
823 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 1.950624 0.545804 0.975312 1.521116 1.755561 0.740867
824 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 1.950624 0.233661 0.975312 1.208973 1.755561 0.428724
825 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 1.950624 0.162947 0.975312 1.138259 1.755561 0.358010
826 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 1.950624 0.543661 0.975312 1.518973 1.755561 0.738724
827 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 1.950624 0.139376 0.975312 1.114688 1.755561 0.334439
828 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 1.950624 0.071876 0.975312 1.047188 1.755561 0.266939
829 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 1.800714 0.000000 0.900357 0.900357 1.620642 0.180072
830 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 1.740000 0.000000 0.870000 0.870000 1.566000 0.174000
831 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 1.911428 0.000000 0.955714 0.955714 1.720285 0.191143
832 W10193001 M03BX01 BACLOFENUM LIORESAL 10 mg COMPR. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.246546 0.133654 0.123273 0.256927 0.221891 0.158309
833 W10194001 M03BX01 BACLOFENUM LIORESAL 25 mg COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0.616365 0.043435 0.308182 0.351618 0.554728 0.105072
834 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 3.290000 0.000000 1.645000 1.645000 2.961000 0.329000
835 W60296004 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 5.093850 7.181150 2.546925 9.728075 4.584465 7.690535
836 W60296002 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 4 COMPR. P6L 4 5.093850 6.543650 2.546925 9.090575 4.584465 7.053035
837 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 3.410000 0.000000 1.705000 1.705000 3.069000 0.341000
838 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 3.195000 0.000000 1.597500 1.597500 2.875500 0.319500
839 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 5.093850 3.876983 2.546925 6.423908 4.584465 4.386368
840 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 5.093850 4.666150 2.546925 7.213075 4.584465 5.175535
841 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 5.093850 4.353650 2.546925 6.900575 4.584465 4.863035
842 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 4.095000 0.000000 2.047500 2.047500 3.685500 0.409500
843 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 5.093850 7.218650 2.546925 9.765575 4.584465 7.728035
844 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 4.660000 0.000000 2.330000 2.330000 4.194000 0.466000
845 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 5.093850 7.218650 2.546925 9.765575 4.584465 7.728035
846 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 10.915392 13.719608 5.457696 19.177304 9.823852 14.811148
847 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 10.915392 13.719608 5.457696 19.177304 9.823852 14.811148
848 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 10.915392 3.699608 5.457696 9.157304 9.823852 4.791148
849 W66935003 M05BA07 ACIDUM RISEDRONICUM * ACTONEL 35 mg COMPR. GASTROREZ. 35mg THERAMEX IRELAND LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 4 COMPR. P6L 4 5.093850 16.236150 2.546925 18.783075 4.584465 16.745535
850 W63914002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/2800 UI COMPR. 70mg/2800UI AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.093850 1.453650 2.546925 4.000575 4.584465 1.963035
851 W63922002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/2800 UI COMPR. 70mg/2800UI ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.093850 7.283650 2.546925 9.830575 4.584465 7.793035
852 W64728002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME OLANDA CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P6L 4 5.093850 3.961150 2.546925 6.508075 4.584465 4.470535
853 W67694002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI N.V. ORGANON OLANDA CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P6L 4 5.093850 3.961150 2.546925 6.508075 4.584465 4.470535
854 W62143003 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR., AMBALAJ TIP CALENDAR P6L 4 5.093850 0.481150 2.546925 3.028075 4.584465 0.990535
855 W62143001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. P6L 4 5.093850 0.481150 2.546925 3.028075 4.584465 0.990535
856 W62143002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4X1 COMPR. P6L 4 5.093850 0.481150 2.546925 3.028075 4.584465 0.990535
857 W63915002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/5600 UI COMPR. 70mg/5600UI AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.093850 1.838650 2.546925 4.385575 4.584465 2.348035
858 W63923002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/5600 UI COMPR. 70mg/5600UI ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.093850 7.581150 2.546925 10.128075 4.584465 8.090535
859 W64729001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME OLANDA CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P6L 2 5.093850 4.266150 2.546925 6.813075 4.584465 4.775535
860 W65841001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ACCORD 70 mg/5600 UI COMPR. 70mg/5600UI ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.093850 7.581150 2.546925 10.128075 4.584465 8.090535
861 W67697001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI N.V. ORGANON OLANDA CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P6L 2 5.093850 4.266150 2.546925 6.813075 4.584465 4.775535
862 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 0.979810 0.344023 0.489905 0.833928 0.881829 0.442004
863 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 1.959625 0.111375 0.979812 1.091188 1.763662 0.307338
864 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 1.959625 0.298875 0.979812 1.278688 1.763662 0.494838
865 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 2.939439 3.123561 1.469719 4.593281 2.645495 3.417505
866 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 3.646166 0.000000 1.823083 1.823083 3.281549 0.364617
867 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 3.845000 0.000000 1.922500 1.922500 3.460500 0.384500
868 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 1.699047 0.510417 0.849523 1.359941 1.529142 0.680322

Pagina 30 din 80
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
869 W44119001 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GESELLSCHAFT M.B.H. AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 0.832857 0.000000 0.416428 0.416429 0.749571 0.083286
870 W44120001 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GESELLSCHAFT M.B.H. AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1.274285 0.025000 0.637142 0.662143 1.146856 0.152429
871 W62536002 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA EP 75 mg/650 mg COMPR. ELIB. PREL. 75mg/650mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. ELIB. PREL. PRF 20 0.559833 0.273167 0.279916 0.553084 0.503849 0.329151
872 W62536003 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA EP 75 mg/650 mg COMPR. ELIB. PREL. 75mg/650mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. PRF 30 0.559833 0.273167 0.279916 0.553084 0.503849 0.329151
873 W62536009 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA EP 75 mg/650 mg COMPR. ELIB. PREL. 75mg/650mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. ALBE PVC-PVDC-HARTIE/AL X 20 COMPR. ELIB. PREL. PRF 20 0.559833 0.273167 0.279916 0.553084 0.503849 0.329151
874 W62536010 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA EP 75 mg/650 mg COMPR. ELIB. PREL. 75mg/650mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. ALBE PVC-PVDC-HARTIE/AL X 30 COMPR. ELIB. PREL. PRF 30 0.559833 0.273167 0.279916 0.553084 0.503849 0.329151
875 W61518001 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR 37,5 mg/325 mg 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 0.279916 0.589084 0.139958 0.729042 0.251924 0.617076
876 W61518002 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR 37,5 mg/325 mg 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 0.279916 0.577584 0.139958 0.717542 0.251924 0.605576
877 W61518003 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR 37,5 mg/325 mg 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 0.279916 0.577417 0.139958 0.717375 0.251924 0.605409
878 W61518004 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR 37,5 mg/325 mg 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 0.279916 0.547084 0.139958 0.687042 0.251924 0.575076
879 W54375003 N02AJ13 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 0.276000 0.000000 0.138000 0.138000 0.248400 0.027600
880 W54375004 N02AJ13 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 0.275333 0.000000 0.137666 0.137667 0.247799 0.027534
881 W66473002 N02AJ13 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 0.279916 0.298084 0.139958 0.438042 0.251924 0.326076
882 W67798003 N02AJ13 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAMADOL/PARACETAMOL MEDREG 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL X 30 COMPR. FILM. PRF 30 0.279916 0.011750 0.139958 0.151708 0.251924 0.039742
883 W58620002 N02AJ13 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 0.551000 0.000000 0.275500 0.275500 0.495900 0.055100
884 W58620003 N02AJ13 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 0.551000 0.000000 0.275500 0.275500 0.495900 0.055100
885 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 1.705397 1.129603 0.852698 1.982302 1.534857 1.300143
886 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 1.153750 0.000000 0.576875 0.576875 1.038375 0.115375
887 W63613008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1.705397 1.129603 0.852698 1.982302 1.534857 1.300143
888 W63613010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.153750 0.000000 0.576875 0.576875 1.038375 0.115375
889 W41745001 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 2.012857 0.000000 1.006428 1.006429 1.811571 0.201286
890 W41745002 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 1.353214 0.000000 0.676607 0.676607 1.217892 0.135322
891 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 0.663571 0.000000 0.331785 0.331786 0.597213 0.066358
892 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 0.641785 0.000000 0.320892 0.320893 0.577606 0.064179
893 W62053001 N03AX16 PREGABALINUM ** # PREGABALIN ZENTIVA 150 mg CAPS. 150mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.653392 0.000000 0.326696 0.326696 0.588052 0.065340
894 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 2.046480 1.095662 1.023240 2.118902 1.841832 1.300310
895 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 1.145357 0.000000 0.572678 0.572679 1.030821 0.114536
896 W62572008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2.046480 1.095662 1.023240 2.118902 1.841832 1.300310
897 W62572011 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.145357 0.000000 0.572678 0.572679 1.030821 0.114536
898 W63186001 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2.046480 0.753520 1.023240 1.776760 1.841832 0.958168
899 W63186004 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.653392 0.000000 0.326696 0.326696 0.588052 0.065340
900 W63186008 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 2.046480 0.753520 1.023240 1.776760 1.841832 0.958168
901 W63186011 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0.653392 0.000000 0.326696 0.326696 0.588052 0.065340
902 W64907002 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 1.353214 0.000000 0.676607 0.676607 1.217892 0.135322
903 W64907001 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 2.012857 0.000000 1.006428 1.006429 1.811571 0.201286
904 W65243001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0.618214 0.000000 0.309107 0.309107 0.556392 0.061822
905 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 1.595000 0.000000 0.797500 0.797500 1.435500 0.159500
906 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 0.776785 0.000000 0.388392 0.388393 0.699106 0.077679
907 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 1.130535 0.000000 0.565267 0.565268 1.017481 0.113054
908 W66013005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 0.646166 0.000000 0.323083 0.323083 0.581549 0.064617
909 W66797001 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg UPJOHN EESV OLANDA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 2.012857 0.000000 1.006428 1.006429 1.811571 0.201286
910 W66797002 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg UPJOHN EESV OLANDA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 1.353214 0.000000 0.676607 0.676607 1.217892 0.135322
911 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 3.410799 1.522772 1.705399 3.228172 3.069719 1.863852
912 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 1.957321 0.000000 0.978660 0.978661 1.761588 0.195733
913 W63615008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 3.410799 1.522772 1.705399 3.228172 3.069719 1.863852
914 W63615010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.957321 0.000000 0.978660 0.978661 1.761588 0.195733
915 W41747001 N03AX16 PREGABALINUM ** # LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 2.945714 0.000000 1.472857 1.472857 2.651142 0.294572
916 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 1.549285 0.000000 0.774642 0.774643 1.394356 0.154929
917 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 1.423750 0.000000 0.711875 0.711875 1.281375 0.142375
918 W63187001 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 4.092960 0.472040 2.046480 2.518520 3.683664 0.881336
919 W63187004 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.410000 0.000000 0.705000 0.705000 1.269000 0.141000
920 W63187008 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 4.092960 0.472040 2.046480 2.518520 3.683664 0.881336
921 W63187011 N03AX16 PREGABALINUM ** # SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1.410000 0.000000 0.705000 0.705000 1.269000 0.141000
922 W64908001 N03AX16 PREGABALINUM ** # LYRICA 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 2.945714 0.000000 1.472857 1.472857 2.651142 0.294572
923 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 2.483571 0.000000 1.241785 1.241786 2.235213 0.248358
924 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 2.223035 0.000000 1.111517 1.111518 2.000731 0.222304
925 W66014005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 1.416166 0.000000 0.708083 0.708083 1.274549 0.141617
926 W66798001 N03AX16 PREGABALINUM ** # LYRICA 300 mg CAPS. 300mg UPJOHN EESV OLANDA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 2.945714 0.000000 1.472857 1.472857 2.651142 0.294572
927 W41743001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 1.023240 0.109617 0.511620 0.621237 0.920916 0.211941
928 W41743002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 0.991071 0.000000 0.495535 0.495536 0.891963 0.099108
929 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 0.542857 0.000000 0.271428 0.271429 0.488571 0.054286
930 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 0.542857 0.000000 0.271428 0.271429 0.488571 0.054286
931 W62052001 N03AX16 PREGABALINUM ** # PREGABALIN ZENTIVA 75 mg CAPS. 75mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.548928 0.000000 0.274464 0.274464 0.494035 0.054893
932 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 1.023240 0.928188 0.511620 1.439808 0.920916 1.030512
933 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 0.731428 0.000000 0.365714 0.365714 0.658285 0.073143
934 W62571008 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1.023240 0.928188 0.511620 1.439808 0.920916 1.030512
935 W62571011 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.731428 0.000000 0.365714 0.365714 0.658285 0.073143
936 W63185001 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0.870714 0.000000 0.435357 0.435357 0.783642 0.087072
937 W63185004 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.548928 0.000000 0.274464 0.274464 0.494035 0.054893
938 W63185008 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0.870714 0.000000 0.435357 0.435357 0.783642 0.087072
939 W63185011 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0.548928 0.000000 0.274464 0.274464 0.494035 0.054893
940 W64906002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0.991071 0.000000 0.495535 0.495536 0.891963 0.099108
941 W64906001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 1.023240 0.109617 0.511620 0.621237 0.920916 0.211941

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
942 W65242001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0.527500 0.000000 0.263750 0.263750 0.474750 0.052750
943 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 0.869285 0.000000 0.434642 0.434643 0.782356 0.086929
944 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 0.680892 0.000000 0.340446 0.340446 0.612802 0.068090
945 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 0.578392 0.000000 0.289196 0.289196 0.520552 0.057840
946 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 0.571666 0.000000 0.285833 0.285833 0.514499 0.057167
947 W66796001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg UPJOHN EESV OLANDA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 1.023240 0.109617 0.511620 0.621237 0.920916 0.211941
948 W66796002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg UPJOHN EESV OLANDA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0.991071 0.000000 0.495535 0.495536 0.891963 0.099108
949 W64181001 N03AX16 PREGABALINUM ** # SIRANALEN 20 mg/ml SOL. ORALA 20mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 FLAC. PEID CONTINAND 473 ML SOL. ORALA, O SERINGA PT. ADMINISTRARE ORALA, UN ADAPTOR DIN PLASTIC ALB CARE SE ATASEAZA LA FLAC. PRIN IMPINGERE PRF 1 129.064689 21.605311 64.532344 86.137656 116.158220 34.511780
950 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 0.218468 0.270532 0.109234 0.379766 0.196621 0.292379
951 W53525002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0.218468 0.252532 0.109234 0.361766 0.196621 0.274379
952 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 0.218468 0.322865 0.109234 0.432099 0.196621 0.344712
953 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 0.218468 0.137532 0.109234 0.246766 0.196621 0.159379
954 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 0.849600 1.662733 0.424800 2.087533 0.764640 1.747693
955 W53527002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0.849600 1.314066 0.424800 1.738866 0.764640 1.399026
956 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 0.849600 1.313400 0.424800 1.738200 0.764640 1.398360
957 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 0.849600 1.363066 0.424800 1.787866 0.764640 1.448026
958 W60244001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0.315565 0.398435 0.157782 0.556218 0.284008 0.429992
959 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 0.315565 0.387435 0.157782 0.545218 0.284008 0.418992
960 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 0.631131 1.665869 0.315565 1.981435 0.568017 1.728983
961 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 0.631131 0.913202 0.315565 1.228768 0.568017 0.976316
962 W60803002 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,52 mg COMPR. ELIB. PREL. 0,52mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/ALC X 30 COMPR. ELIB. PREL. PRF 30 0.631131 0.913202 0.315565 1.228768 0.568017 0.976316
963 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 1.274400 2.752933 0.637200 3.390133 1.146960 2.880373
964 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 1.274400 0.620266 0.637200 1.257466 1.146960 0.747706
965 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 2.548801 1.050199 1.274400 2.324600 2.293920 1.305080
966 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 2.548801 4.296865 1.274400 5.571266 2.293920 4.551746
967 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 2.548801 1.558532 1.274400 2.832933 2.293920 1.813413
968 W62151001 N04BC05 PRAMIPEXOLUM * OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 3.823201 4.721132 1.911600 6.632733 3.440880 5.103453
969 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 0.758571 0.268095 0.379285 0.647381 0.682713 0.343953
970 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 0.527000 0.000000 0.263500 0.263500 0.474300 0.052700
971 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 0.306833 0.000000 0.153416 0.153417 0.276149 0.030684
972 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 0.161728 0.024938 0.080864 0.105802 0.145555 0.041111
973 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 0.834000 0.000000 0.417000 0.417000 0.750600 0.083400
974 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 0.972642 0.310215 0.486321 0.796536 0.875377 0.407480
975 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 0.911785 0.000000 0.455892 0.455893 0.820606 0.091179
976 W55813002 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0.566785 0.000000 0.283392 0.283393 0.510106 0.056679
977 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 0.936428 0.000000 0.468214 0.468214 0.842785 0.093643
978 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 0.543214 0.000000 0.271607 0.271607 0.488892 0.054322
979 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 0.491428 0.000000 0.245714 0.245714 0.442285 0.049143
980 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 0.679000 0.000000 0.339500 0.339500 0.611100 0.067900
981 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 0.844285 0.000000 0.422142 0.422143 0.759856 0.084429
982 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 0.537500 0.000000 0.268750 0.268750 0.483750 0.053750
983 W68274003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 10 mg COMPR. FILM. 10mg TEVA B.V. OLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0.491428 0.000000 0.245714 0.245714 0.442285 0.049143
984 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 0.912857 0.000000 0.456428 0.456429 0.821571 0.091286
985 W68276003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 20 mg COMPR. FILM. 20mg TEVA B.V. OLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0.912857 0.000000 0.456428 0.456429 0.821571 0.091286
986 W13019001 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 1.162416 0.049584 0.581208 0.630792 1.046174 0.165826
987 W13019004 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 60 1.133666 0.000000 0.566833 0.566833 1.020299 0.113367
988 W13019002 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 60 1.133666 0.000000 0.566833 0.566833 1.020299 0.113367
989 W13019003 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF 20 1.162416 0.049584 0.581208 0.630792 1.046174 0.165826
990 W66418003 N06AX05 TRAZODONUM ** TRITTICO EP 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PVDC/AL OPAC ALB X 10 COMPR. ELIB. PREL. PRF 30 1.162416 0.437917 0.581208 1.019125 1.046174 0.554159
991 W66419003 N06AX05 TRAZODONUM ** TRITTICO EP 300 mg COMPR. ELIB. PREL. 300mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PVDC/AL OPAC ALB X 10 COMPR. ELIB. PREL. PRF 30 2.324832 0.057501 1.162416 1.219917 2.092348 0.289985
992 W08616002 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-RF 30 0.581208 0.110458 0.290604 0.401062 0.523087 0.168579
993 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 2.156333 0.000000 1.078166 1.078167 1.940699 0.215634
994 W67767002 N06AX12 BUPROPIONUM ** # ELONTRIL 150 mg COMPR. ELIB. MODIF. 150mg GLAXOSMITHKLINE TRADING SERVICES LIMITED IRLANDA CUTIE CU 1 FLAC. PEID X 30 COMPR. ELIB. MODIF. PRF 30 2.156333 0.000000 1.078166 1.078167 1.940699 0.215634
995 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 0.508000 0.000000 0.254000 0.254000 0.457200 0.050800
996 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 0.491555 0.000000 0.245777 0.245778 0.442399 0.049156
997 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 0.508000 0.000000 0.254000 0.254000 0.457200 0.050800
998 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 0.508000 0.000000 0.254000 0.254000 0.457200 0.050800
999 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 0.508000 0.307000 0.254000 0.561000 0.457200 0.357800
1,000 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 0.608666 1.035976 0.304333 1.340309 0.547799 1.096843
1,001 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 0.608666 0.020667 0.304333 0.325000 0.547799 0.081534
1,002 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 0.608666 0.671691 0.304333 0.976024 0.547799 0.732558
1,003 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 0.608666 0.671691 0.304333 0.976024 0.547799 0.732558
1,004 W62006001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 30 mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 0.608666 1.610976 0.304333 1.915309 0.547799 1.671843
1,005 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 0.582142 0.000000 0.291071 0.291071 0.523927 0.058215
1,006 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 0.608666 0.368667 0.304333 0.673000 0.547799 0.429534
1,007 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 0.608666 0.073119 0.304333 0.377452 0.547799 0.133986
1,008 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 0.608666 0.515976 0.304333 0.820309 0.547799 0.576843
1,009 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 0.608666 0.515976 0.304333 0.820309 0.547799 0.576843
1,010 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 0.608666 0.703476 0.304333 1.007809 0.547799 0.764343
1,011 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 0.608666 0.470000 0.304333 0.774333 0.547799 0.530867
1,012 W62054002 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 0.582142 0.000000 0.291071 0.291071 0.523927 0.058215
1,013 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 1.217333 1.281595 0.608666 1.890262 1.095599 1.403329
1,014 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 1.217333 0.000000 0.608666 0.608667 1.095599 0.121734

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

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
1,015 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 1.217333 0.085881 0.608666 0.694548 1.095599 0.207615
1,016 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 1.217333 0.085881 0.608666 0.694548 1.095599 0.207615
1,017 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 1.164285 0.000000 0.582142 0.582143 1.047856 0.116429
1,018 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 1.133214 0.000000 0.566607 0.566607 1.019892 0.113322
1,019 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 1.098333 0.000000 0.549166 0.549167 0.988499 0.109834
1,020 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 1.217333 0.525667 0.608666 1.134334 1.095599 0.647401
1,021 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 1.217333 0.525667 0.608666 1.134334 1.095599 0.647401
1,022 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 1.217333 0.144452 0.608666 0.753119 1.095599 0.266186
1,023 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 1.217333 0.025333 0.608666 0.634000 1.095599 0.147067
1,024 W62055002 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 60 mg CAPS. GASTROREZ. 60mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1.164285 0.000000 0.582142 0.582143 1.047856 0.116429
1,025 W08060001 N06BX16 PRAMIRACETAMUM ** # PRAMISTAR 600 mg 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 4.041000 0.000000 2.020500 2.020500 3.636900 0.404100
1,026 W08060002 N06BX16 PRAMIRACETAMUM ** # PRAMISTAR 600 mg COMPR. FILM. 600mg F.I.R.M.A. S.P.A. (MENARINI GROUP) ITALIA CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P6L 20 4.041000 0.000000 2.020500 2.020500 3.636900 0.404100
1,027 W58635002 N06BX18 VINPOCETINUM VINPOCETINA VIM SPECTRUM 5 mg CAPS. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L 50 0.180200 0.000000 0.090100 0.090100 0.162180 0.018020
1,028 W54827001 N06BX18 VINPOCETINUM CAVINTON FORTE 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-6L 30 0.365550 0.015450 0.182775 0.198225 0.328995 0.052005
1,029 W57876003 N07CA01 BETAHISTINUM VERTIMED 16 mg COMPR. 16mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L 30 0.340688 0.058978 0.170344 0.229322 0.306619 0.093047
1,030 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 0.340688 0.301978 0.170344 0.472322 0.306619 0.336047
1,031 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 0.340688 0.052812 0.170344 0.223156 0.306619 0.086881
1,032 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 0.477333 0.000000 0.238666 0.238667 0.429599 0.047734
1,033 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 0.511033 0.014467 0.255516 0.269984 0.459929 0.065571
1,034 W65860004 N07CA01 BETAHISTINUM DICLORHIDRAT DE BETAHISTINA ACCORD 24 mg COMPR. 24 mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. P6L 60 0.496333 0.000000 0.248166 0.248167 0.446699 0.049634
1,035 W55890001 N07CA01 BETAHISTINUM BETAHISTINA 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 0.511033 0.014467 0.255516 0.269984 0.459929 0.065571
1,036 W55890002 N07CA01 BETAHISTINUM BETAHISTINA 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 0.511033 0.014367 0.255516 0.269884 0.459929 0.065471
1,037 W57877003 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L 30 0.496666 0.000000 0.248333 0.248333 0.446999 0.049667
1,038 W57877006 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 60 COMPR. P6L 60 0.496333 0.000000 0.248166 0.248167 0.446699 0.049634
1,039 W55890003 N07CA01 BETAHISTINUM BETAHISTINA 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 0.511033 0.014467 0.255516 0.269984 0.459929 0.065571
1,040 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 0.511033 0.321467 0.255516 0.576984 0.459929 0.372571
1,041 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 0.511033 0.347967 0.255516 0.603484 0.459929 0.399071
1,042 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 0.454500 0.000000 0.227250 0.227250 0.409050 0.045450
1,043 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 0.454500 0.000000 0.227250 0.227250 0.409050 0.045450
1,044 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 0.511033 0.347967 0.255516 0.603484 0.459929 0.399071
1,045 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 0.511033 0.321467 0.255516 0.576984 0.459929 0.372571
1,046 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 0.496333 0.000000 0.248166 0.248167 0.446699 0.049634
1,047 W55889001 N07CA01 BETAHISTINUM BETAHISTINA 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 0.170344 0.026322 0.085172 0.111494 0.153309 0.043357
1,048 W55889002 N07CA01 BETAHISTINUM BETAHISTINA 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 0.170344 0.026456 0.085172 0.111628 0.153309 0.043491
1,049 W57875009 N07CA01 BETAHISTINUM VERTIMED 8 mg COMPR. 8mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 100 COMPR. P6L 100 0.170344 0.026456 0.085172 0.111628 0.153309 0.043491
1,050 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 0.170344 0.026322 0.085172 0.111494 0.153309 0.043357
1,051 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 0.170344 0.082956 0.085172 0.168128 0.153309 0.099991
1,052 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 0.170344 0.082956 0.085172 0.168128 0.153309 0.099991
1,053 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 0.170344 0.026456 0.085172 0.111628 0.153309 0.043491
1,054 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 0.511033 0.441800 0.255516 0.697317 0.459929 0.492904
1,055 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 0.511033 0.441800 0.255516 0.697317 0.459929 0.492904
1,056 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 1.130625 0.007475 0.565312 0.572788 1.017562 0.120538
1,057 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 1.130625 0.067500 0.565312 0.632813 1.017562 0.180563
1,058 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 1.108200 0.000000 0.554100 0.554100 0.997380 0.110820
1,059 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 1.130625 0.067575 0.565312 0.632888 1.017562 0.180638
1,060 W55730003 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml SOL. INJ./CONC. PT. SOL. PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 27.075499 0.910501 13.537749 14.448251 24.367949 3.618051
1,061 W55730004 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml SOL. INJ./CONC. PT. SOL. PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 20 ML SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 52.330000 0.000000 26.165000 26.165000 47.097000 5.233000
1,062 W55730002 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml SOL. INJ./CONC. PT. SOL. PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 13.537749 6.022251 6.768874 12.791126 12.183974 7.376026
1,063 W54357001 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL® COMPR. FILM. 200mg ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L
SANOFI - AVENTIS ROMANIA S.R.L. 60 0.560833 0.000000 0.280416 0.280417 0.504749 0.056084
1,064 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 0.560833 0.000000 0.280416 0.280417 0.504749 0.056084
1,065 W66244001 R01AD09 MOMETASONUM * FUROAT DE MOMETAZONA AMRING 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza AMRING FARMA S.R.L. ROMANIA PRF
CUTIE CU UN FLAC. DIN PEÎD, PREVAZUT CU POMPA DOZATOARE MANUALA DIN PP CARE CONTINE 18 G SUSPENSIE, ECHIVALENT CU 140 DOZE 1 19.485000 5.585000 9.742500 15.327500 17.536500 7.533500
1,066 W59422002 R01AD09 MOMETASONUM * FUROAT DE MOMETAZONA SANDOZ 50 micrograme/doza SPRAY NAZ.,SUSP. 50micrograme/doza SANDOZ S.R.L. ROMANIA PRF
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 1 13.900000 0.000000 6.950000 6.950000 12.510000 1.390000
1,067 W57437001 R01AD09 MOMETASONUM * NASONEX 50mcg/doza SPRAY NAZAL SUSP. 50mcg/doza MERCK SHARP & DOHME ROMANIA P-RF
CUT IE X 1 FLACON DIN PE PREVAZUT CU POMPA DOZAT OARE, DISPOZIT IV DE ACT IONARE DIN PP SI CAPAC, CU UN VOLUM DE 23,5 ML SUSPENSIE PT . 140 PULVERIZARI SPRAY NAZAL, SUSPENSIE 1 19.485000 7.205000 9.742500 16.947500 17.536500 9.153500
1,068 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
1,069 W63349002 R03AC13 FORMOTEROLUM ** ATIMOS 0,012mg/doza SOL. DE INHALAT PRESURIZATA 0,012mg/doza CHIESI PHARMACEUTICALS 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
1,070 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 2.041833 2.041833 1.020916 3.062750 1.837649 2.246017
1,071 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 2.041833 2.041833 1.020916 3.062750 1.837649 2.246017
1,072 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 4.083666 0.000000 2.041833 2.041833 3.675299 0.408367
1,073 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 4.083666 0.000000 2.041833 2.041833 3.675299 0.408367
1,074 W66773001 R03AK06 SALMETEROLUM+FLUTICASONUM * EVERIO AIRMASTER 50 micrograme/100 micrograme PULB. DE INHAL. UNIDOZA 50micrograme/100micrograme ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 INHALATOR A 60 DOZE PULBERE DE INHALAT PRF 1 25.735000 43.625000 12.867500 56.492500 23.161500 46.198500
1,075 W66774001 R03AK06 SALMETEROLUM+FLUTICASONUM * EVERIO AIRMASTER 50 micrograme/250 micrograme PULB. DE INHAL. UNIDOZA 50micrograme/250micrograme ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 INHALATOR A 60 DOZE PULBERE DE INHALAT PRF 1 64.337500 38.572500 32.168750 70.741250 57.903750 45.006250
1,076 W66775001 R03AK06 SALMETEROLUM+FLUTICASONUM * EVERIO AIRMASTER 50 micrograme/500 micrograme PULB. DE INHAL. UNIDOZA 50micrograme/500micrograme ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 INHALATOR A 60 DOZE PULBERE DE INHALAT PRF 1 128.675000 4.335000 64.337500 68.672500 115.807500 17.202500
1,077 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 25.735000 43.625000 12.867500 56.492500 23.161500 46.198500
1,078 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 1 106.800000 0.000000 53.400000 53.400000 96.120000 10.680000
1,079 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 64.337500 18.012500 32.168750 50.181250 57.903750 24.446250
1,080 W68287001 R03AK06 SALMETEROLUM+FLUTICASONUM * EVERIO 25 micrograme/125 micrograme/doza SUSP. DE INHALAT PRESURIZATA 25micrograme/125micrograme/doz ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 INHALATOR SUB PRESIUNE CU 120 DE DOZE MASURATE PRF 1 64.337500 22.912500 32.168750 55.081250 57.903750 29.346250
1,081 W68288001 R03AK06 SALMETEROLUM+FLUTICASONUM * EVERIO 25 micrograme/250 micrograme/doza SUSP. DE INHALAT PRESURIZATA 25micrograme/250micrograme/doz ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 INHALATOR SUB PRESIUNE CU 120 DE DOZE MASURATE PRF 1 110.400000 0.000000 55.200000 55.200000 99.360000 11.040000
1,082 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 64.337500 33.952500 32.168750 66.121250 57.903750 40.386250
1,083 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 1 124.340000 0.000000 62.170000 62.170000 111.906000 12.434000
1,084 W65218001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE INHALER CFC FREE 25 µg/50 µg SUSP. INHAL. PRESURIZATA 25µg/50µg IRLANDA CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L
GLAXOSMITHKLINE (IRELAND) LIMITED 1 25.735000 71.465000 12.867500 84.332500 23.161500 74.038500
1,085 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 1 123.880000 0.000000 61.940000 61.940000 111.492000 12.388000
1,086 W56427001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 160micrograme/4,5micrograme/in ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. P6L 1 64.806666 5.953334 32.403333 38.356667 58.325999 12.434001
1,087 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 1 123.880000 0.000000 61.940000 61.940000 111.492000 12.388000

Pagina 33 din 80
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
1,088 W56428001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie PULB. DE INHAL. 320micrograme/9micrograme/inha ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. P6L 1 129.613333 15.026667 64.806666 79.833334 116.651999 27.988001
1,089 W56426001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 80micrograme/4,5micrograme/inh ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. P6L 1 64.806666 18.363334 32.403333 50.766667 58.325999 24.844001
1,090 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 64.806666 1.133334 32.403333 33.536667 58.325999 7.614001
1,091 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 1 129.613333 4.636667 64.806666 69.443334 116.651999 17.598001
1,092 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 1 194.420000 8.840000 97.210000 106.050000 174.978000 28.282000
1,093 W57995002 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER 100/6 micrograme pe doza SOL. DE INHALAT PRESURIZATA 100/6micrograme pe doza CHIESI PHARMACEUTICALS GMBH AUSTRIA CUT IE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZAT OARE, INT RODUS IN DISPOZIT IVUL DE ADMINIST RARE DIN PE CU CAPAC PROT ECT OR DIN PLAST IC A 180 DOZE SOL. DE INHALAT PRF 1 194.420000 0.000000 97.210000 97.210000 174.978000 19.442000
1,094 W62575003 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER 200 micrograme/6 micrograme SOL. DE INHALAT PRESURIZATA 200micrograme/6micrograme CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS INTR-UN DISPOZITIV DE ADMINISTRARE DIN PP CU CAPAC PROTECTOR CE ASIGURA 180 DE DOZE SOL. DE INHALAT PRESURIZATA PRF 1 194.420000 0.000000 97.210000 97.210000 174.978000 19.442000
1,095 W59645001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 125 micrograme/5 micrograme SUSP. INHAL. PRESURIZATA 125micrograme/5micrograme MUNDIPHARMA GESELLSCHAFT 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 1 134.590000 32.790000 67.295000 100.085000 121.131000 46.249000
1,096 W59644001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 50 micrograme/5 micrograme SUSP. INHAL. PRESURIZATA 50micrograme/5micrograme MUNDIPHARMA GESELLSCHAFT 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 1 123.660000 0.000000 61.830000 61.830000 111.294000 12.366000
1,097 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
1,098 W64767001 R03AL04 COMBINATII (INDACATEROLUM+GLICOPIRONIUM) ** ULTIBRO BREEZHALER 85 micrograme/43 micrograme CAPS. CU PULB. DE INHAL. 85micrograme/43micrograme NOVARTIS EUROPHARM LTD. IRLANDA 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
1,099 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 1 238.290000 1.230000 119.145000 120.375000 214.461000 25.059000
1,100 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 1 237.880000 0.000000 118.940000 118.940000 214.092000 23.788000
1,101 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 1 204.400000 0.000000 102.200000 102.200000 183.960000 20.440000
1,102 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 1 206.395000 5.985000 103.197500 109.182500 185.755500 26.624500
1,103 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 17.557200 16.112800 8.778600 24.891400 15.801480 17.868520
1,104 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 43.893000 16.487000 21.946500 38.433500 39.503700 20.876300
1,105 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 87.786000 9.754000 43.893000 53.647000 79.007400 18.532600
1,106 W63693001 R03BA05 FLUTICASONUM PROPIONAT * ARQUIST 125 micrograme SUSP. INHAL. PRESURIZATA 125micrograme AMRING FARMA SRL ROMANIA 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 43.893000 4.407000 21.946500 26.353500 39.503700 8.796300
1,107 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 21.946500 15.583500 10.973250 26.556750 19.751850 17.778150
1,108 W63695001 R03BA05 FLUTICASONUM PROPIONAT * ARQUIST 250 micrograme SUSP. INHAL. PRESURIZATA 250micrograme AMRING FARMA SRL ROMANIA 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 82.970000 0.000000 41.485000 41.485000 74.673000 8.297000
1,109 W65209001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE 50 µg/doza 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 17.557200 17.652800 8.778600 26.431400 15.801480 19.408520
1,110 W65204003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 0,5 mg/2 ml SUSP. INHAL. PRIN NEBULIZATOR 0,5mg/2ml 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 0.585239 3.450761 0.292619 3.743381 0.526715 3.509285
1,111 W65205003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 2 mg/2 ml SUSP. INHAL. PRIN NEBULIZATOR 2mg/2ml 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 2.340959 6.971041 1.170479 8.141521 2.106863 7.205137
1,112 W64226001 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER SOL. DE INHALAT PRESURIZATA 160micrograme/doza ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA PRF 1 86.680000 0.000000 43.340000 43.340000 78.012000 8.668000
1,113 W67523001 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER SOL. DE INHALAT PRESURIZATA 160micrograme/doza COVIS PHARMA EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA PRF 1 86.680000 0.000000 43.340000 43.340000 78.012000 8.668000
1,114 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 4.585333 0.005000 2.292666 2.297667 4.126799 0.463534
1,115 W63214002 R03BB04 TIOTROPIUM * GREGAL 10 micrograme PULB. DE INHAL. CAPSULA 10micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUT IE CU 1 FLAC. DIN PEÎD CU CAPAC CU FILET DIN PP, FOLIE PROT ECT OARE DIN PE, INEL DE SIGILARE SI CU REZERVOR DIN PEÎD CARE CONT INE SILICAGEL CU 30 CAPSULE SI UN INHALAT OR ZONDA PRF 30 3.834333 0.000000 1.917166 1.917167 3.450899 0.383434
1,116 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 1 137.559990 0.150010 68.779995 68.930005 123.803991 13.906009
1,117 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 1 137.559990 6.490010 68.779995 75.270005 123.803991 20.246009
1,118 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 4.585333 0.000000 2.292666 2.292667 4.126799 0.458534
1,119 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 4.585333 0.000000 2.292666 2.292667 4.126799 0.458534
1,120 W42796002 R03DA05 AMINOPHYLLINUM MIOFILIN 100 mg CAPS. 100mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.160799 0.540201 0.080399 0.620601 0.144719 0.556281
1,121 W42330001 R03DA05 AMINOPHYLLINUM AMINOFILINA BIOEEL 100 mg COMPR. 100mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0.160799 0.037601 0.080399 0.118001 0.144719 0.053681
1,122 W68096001 R03DA05 AMINOPHYLLINUM AMINOFILINA BIOEEL 100 mg COMPR. 100mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 25 COMPR. PRF 50 0.160799 0.037601 0.080399 0.118001 0.144719 0.053681
1,123 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 10.164000 0.000000 5.082000 5.082000 9.147600 1.016400
1,124 W51362004 R03DC03 MONTELUKASTUM * SINGULAIR 10 mg COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L 28 0.894303 1.579268 0.447151 2.026420 0.804872 1.668699
1,125 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
1,126 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 0.894303 0.063911 0.447151 0.511063 0.804872 0.153342
1,127 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 0.894303 0.114982 0.447151 0.562134 0.804872 0.204413
1,128 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 0.894303 0.114982 0.447151 0.562134 0.804872 0.204413
1,129 W67985003 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 10 mg COMPR. FILM. 10mg TEVA B.V. OLANDA 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
1,130 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 0.662571 0.157095 0.331285 0.488381 0.596313 0.223353
1,131 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 0.600000 0.000000 0.300000 0.300000 0.540000 0.060000
1,132 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 0.662571 0.107786 0.331285 0.439072 0.596313 0.174044
1,133 W58747005 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0.662571 1.811000 0.331285 2.142286 0.596313 1.877258
1,134 W66475005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 4 mg COMPR. MAST. 4mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0.662571 0.107786 0.331285 0.439072 0.596313 0.174044
1,135 W67728005 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 4 mg COMPR. MAST. 4mg TEVA B.V. OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L 30 0.662571 0.157095 0.331285 0.488381 0.596313 0.223353
1,136 W51361004 R03DC03 MONTELUKASTUM * SINGULAIR 5 mg COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 28 0.828214 1.645357 0.414107 2.059464 0.745392 1.728179
1,137 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 0.750714 0.000000 0.375357 0.375357 0.675642 0.075072
1,138 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 0.828214 0.000000 0.414107 0.414107 0.745392 0.082822
1,139 W66474005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 5 mg COMPR. MAST. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0.828214 0.000000 0.414107 0.414107 0.745392 0.082822
1,140 W58090003 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg GRANULE 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 0.662571 1.898143 0.331285 2.229429 0.596313 1.964401
1,141 W61978001 R05DA09 DEXTROMETHORPHANUM ROFEDEX 10 mg COMPR. 10mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0.194250 0.202750 0.097125 0.299875 0.174825 0.222175
1,142 W59312001 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE 20 mg COMPR. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.388500 0.000000 0.194250 0.194250 0.349650 0.038850
1,143 W61979001 R05DA09 DEXTROMETHORPHANUM ROFEDEX 20 mg COMPR. 20mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0.259000 0.000000 0.129500 0.129500 0.233100 0.025900
1,144 W67666001 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE 20 mg COMPR. 20mg GLAXOSMITHKLINE TRADING SERVICES LIMITED IRLANDA CUTIE CU 2 BLIST. PVC/AL/HÂRTIE X 10 COMPR. P6L 20 0.388500 0.000000 0.194250 0.194250 0.349650 0.038850
1,145 W06856002 R05DA09 DEXTROMETHORPHANUM ROFEDEX 15mg/5ml SIROP 15mg/5ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOARE P-RF 1 5.827505 3.692495 2.913752 6.606248 5.244754 4.275246
1,146 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 2.904040 13.245960 1.452020 14.697980 2.613636 13.536364
1,147 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. 2,5 ML; 5 ML; 7,5 ML; 10 ML P-RF 1 9.550000 0.000000 4.775000 4.775000 8.595000 0.955000
1,148 W66946001 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN JUNIOR 3,75 mg/5 ml SOL. ORALA 3,75mg/5ml GLAXOSMITHKLINE CONSUMER HEALTHCARE ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SOL. ORALA + MASURA DOZATOARE DIN PP PT. 2,5ML;5ML;7,5ML;10ML PRF 1 9.550000 0.000000 4.775000 4.775000 8.595000 0.955000
1,149 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. 2,5 ML; 5 ML; 7,5 ML; 10 ML P-RF 1 2.913751 6.636249 1.456875 8.093125 2.622375 6.927625
1,150 W66944001 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN ANTITUSSICUM 7,5 mg/5 ml SOL. ORALA 7,5mg/5ml GLAXOSMITHKLINE CONSUMER HEALTHCARE ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SOL. ORALA + MASURA DOZATOARE DIN PP PT. 2,5ML;5ML;7,5ML;10ML PRF 1 2.913751 6.636249 1.456875 8.093125 2.622375 6.927625
1,151 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 0.619500 0.000000 0.309750 0.309750 0.557550 0.061950
1,152 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 0.619500 0.000000 0.309750 0.309750 0.557550 0.061950
1,153 W65372011 R06AE09 LEVOCETIRIZINUM XYZAL 5 mg COMPR. FILM. 5mg UCB PHARMA GMBH GERMANIA CUTIE CU 3 BLIST. PVC-AL-OPA/AL X 10 COMPR. FILM. P6L 30 0.631333 0.000000 0.315666 0.315667 0.568199 0.063134
1,154 W58148003 R06AE09 LEVOCETIRIZINUM XYZAL 5 mg/ml PIC. ORALE, SOL. 5mg/ml UCB PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR P-6L 1 22.514994 5.575006 11.257497 16.832503 20.263494 7.826506
1,155 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 0.401000 0.000000 0.200500 0.200500 0.360900 0.040100
1,156 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 0.492000 0.118333 0.246000 0.364333 0.442800 0.167533
1,157 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 0.492000 0.000000 0.246000 0.246000 0.442800 0.049200
1,158 W63751004 R06AX27 DESLORATADINUM DESLORATADINA AMRING 5 mg COMPR. FILM. 5mg AMRING FARMA SRL ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 COMPR. FILM. P6L 30 0.492000 0.118333 0.246000 0.364333 0.442800 0.167533
1,159 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 0.386333 0.000000 0.193166 0.193167 0.347699 0.038634
1,160 W64699011 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME OLANDA CUTIE CU 30 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 30 0.492000 0.269666 0.246000 0.515666 0.442800 0.318866

Pagina 34 din 80
Contributie maxima a Val. maxima suportata de Val. maxima suportata de
asiguratului / UT (pt. sistemul de asigurari Contributie maxima a sistemul de asigurari Contributie maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

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

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


Nr crt.

Tara det. ambal referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
1,161 W64699006 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME OLANDA CUTIE CU 10 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 10 0.492000 0.448000 0.246000 0.694000 0.442800 0.497200
1,162 W67690011 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg N.V. ORGANON OLANDA CUTIE CU 30 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 30 0.492000 0.269666 0.246000 0.515666 0.442800 0.318866
1,163 W67690006 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg N.V. ORGANON OLANDA CUTIE CU 10 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 10 0.492000 0.448000 0.246000 0.694000 0.442800 0.497200
1,164 W58720004 R06AX27 DESLORATADINUM DESLORATADINA SANDOZ 0.5 mg/ml SOL. ORALA 0,5 mg/ml SANDOZ S.R.L. ROMANIA CUT IE CU 1 FLAC. DIN ST ICLA BRUNA CU CAPACIT AT EA DE 125 ML X 120 ML, SOL. ORALA + LINGURIT A DOZAT OARE DE 2,5 ML SI 5 ML SAU CU SERINGA DOZAT OARE DE 5 ML, MARCAT A LA FIECARE 0,5ML P6L 1 11.725500 0.004500 5.862750 5.867250 10.552950 1.177050
1,165 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 11.590000 0.000000 5.795000 5.795000 10.431000 1.159000
1,166 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 11.725500 2.094500 5.862750 7.957250 10.552950 3.267050
1,167 W67693005 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SOL. ORALA 0,5mg/ml N.V. ORGANON OLANDA CUTIE CU 1 FLAC. DIN STICLA X 120 ML SOL. ORALA + LINGURITA DOZATOARE DE 2,5 ML SI 5 ML PRF 1 11.725500 2.094500 5.862750 7.957250 10.552950 3.267050
1,168 W66903001 R06AX27 DESLORATADINUM DESLORATADINA FITERMAN 0,5 mg/ml SOL. ORALA 0,5mg/ml FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 FLAC. DIN STICLA DE CULOARE BRUNA SI O LINGURITA DOZATOARE DIN POLISTIREN SI CONTINE 60 ML SOL. ORALA 1 5.862750 0.007250 2.931375 2.938625 5.276475 0.593525
1,169 W66903002 R06AX27 DESLORATADINUM DESLORATADINA FITERMAN 0,5 mg/ml SOL. ORALA 0,5mg/ml FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 FLAC. DIN STICLA DE CULOARE BRUNA SI O LINGURITA DOZATOARE DIN POLISTIREN SI CONTINE 100 ML SOL. ORALA 1 9.770000 0.000000 4.885000 4.885000 8.793000 0.977000
1,170 W66903003 R06AX27 DESLORATADINUM DESLORATADINA FITERMAN 0,5 mg/ml SOL. ORALA 0,5mg/ml FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 FLAC. DIN STICLA DE CULOARE BRUNA SI O LINGURITA DOZATOARE DIN POLISTIREN SI CONTINE 150 ML SOL. ORALA 1 14.650000 0.000000 7.325000 7.325000 13.185000 1.465000
1,171 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 10.230000 0.000000 5.115000 5.115000 9.207000 1.023000
1,172 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 4.510000 0.000000 2.255000 2.255000 4.059000 0.451000
1,173 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 8.671249 0.048751 4.335624 4.384376 7.804124 0.915876
1,174 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 8.671249 0.048751 4.335624 4.384376 7.804124 0.915876
1,175 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 8.671249 13.128751 4.335624 17.464376 7.804124 13.995876
1,176 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 8.671249 13.128751 4.335624 17.464376 7.804124 13.995876
1,177 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 6.503437 2.956563 3.251718 6.208282 5.853093 3.606907
1,178 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 6.503437 2.956563 3.251718 6.208282 5.853093 3.606907
1,179 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 21.260000 0.000000 10.630000 10.630000 19.134000 2.126000
1,180 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 1.545480 0.663186 0.772740 1.435926 1.390932 0.817734
1,181 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 25.758000 10.222000 12.879000 23.101000 23.182200 12.797800
1,182 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 9.709999 0.970001 4.854999 5.825001 8.738999 1.941001
1,183 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 14.080000 0.000000 7.040000 7.040000 12.672000 1.408000
1,184 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 6.020000 0.000000 3.010000 3.010000 5.418000 0.602000
1,185 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 6.380000 0.120000 3.190000 3.310000 5.742000 0.758000
1,186 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 6.380000 0.120000 3.190000 3.310000 5.742000 0.758000
1,187 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 11.340000 0.000000 5.670000 5.670000 10.206000 1.134000
1,188 W43768002 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) Netildex 3 mg/1 mg/ml PIC. OFT., SOL IN FLAC. 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 0.462779 2.474221 0.231389 2.705611 0.416501 2.520499
1,189 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 7.713000 27.077000 3.856500 30.933500 6.941700 27.848300
1,190 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 7.713000 6.587000 3.856500 10.443500 6.941700 7.358300
1,191 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 5.580000 0.000000 2.790000 2.790000 5.022000 0.558000
1,192 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 7.713000 0.857000 3.856500 4.713500 6.941700 1.628300
1,193 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 7.713000 0.857000 3.856500 4.713500 6.941700 1.628300
1,194 W02225001 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX 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 5.399100 8.620900 2.699550 11.320450 4.859190 9.160810
1,195 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 5.399100 8.620900 2.699550 11.320450 4.859190 9.160810
1,196 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 19.880000 0.200000 9.940000 10.140000 17.892000 2.188000
1,197 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 19.880000 0.000000 9.940000 9.940000 17.892000 1.988000
1,198 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 19.880000 0.200000 9.940000 10.140000 17.892000 2.188000
1,199 W64476001 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. X 5 ML PRF 1 19.880000 0.200000 9.940000 10.140000 17.892000 2.188000
1,200 W67299002 S01GX09 OLOPATADINUM OLOPATADINA UNIMED PHARMA 1 mg/ml PIC. OFT., SOL. 1mg/ml UNIMED PHARMA SPOL. S.R.O. SLOVACIA CUTIE CU 1 FLAC. DIN PE CU PICURATOR NOVELIA X 10 ML PIC. OFT., SOL. PRF 1 38.860000 0.000000 19.430000 19.430000 34.974000 3.886000

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 (2) se prescrie numai în etapa pregătitoare pentru colonoscopie.
- Pentru medicamentele corespunzătoare DCI-urilor notate cu # regulile de prescriere sunt stabilite prin contractul-cadru.
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu **1 se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii şi pot fi administrate şi în
regim de spitalizare de zi.
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu Ω se efectuează în baza contractelor cost-volum încheiate.

Pagina 35 din 80
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, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE
VALABILĂ ÎNCEPÂND CU 01 MARTIE 2022

Val. maxima suportata de Contributie maxima


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

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


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

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

1 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.454000 0.454000 0.000000
2 W62461001 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg MERUS LABS LUXCO II S.A.R.L. CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
LUXEMBURG P-RF 20 0.373000 0.373000 0.000000
3 W58535002 C01AA05 DIGOXINUM DIGOXINA ZENTIVA 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0.344400 0.344400 0.249600
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 0.287000 0.287000 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 6.848000 6.848000 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 0.739600 0.739600 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 0.252600 0.252600 0.068900
8 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA 40 mg COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.252600 0.252600 0.091900
9 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA 40 mg COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0.210500 0.210500 0.000000
10 W52043001 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.252600 0.252600 0.091900
11 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.252600 0.252600 0.091900
12 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 0.252600 0.252600 0.092066
13 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 0.252600 0.252600 0.091400
14 W68090001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.252600 0.252600 0.091900
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 1.390000 1.390000 0.000000
16 W58282001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA 20 mg/2 ml SOL. INJ. 20mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1.390000 1.390000 0.000000
17 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 0.408400 0.408400 0.000000
18 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 0.408333 0.408333 0.000000
19 W54823001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0.423333 0.423333 0.000000
20 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 0.507999 0.507999 0.250001
21 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 0.408500 0.408500 0.000000
22 W68089001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.408500 0.408500 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 0.408400 0.408400 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 0.408500 0.408500 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 0.507999 0.507999 0.250001
26 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 0.326666 0.326666 0.000000
27 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 0.326500 0.326500 0.000000
28 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 0.326666 0.326666 0.000000
29 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 0.326666 0.326666 0.000000
30 W52230001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.326666 0.326666 0.000000
31 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 0.326500 0.326500 0.000000
32 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 0.326666 0.326666 0.000000
33 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 0.319500 0.319500 0.000000
34 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 0.164333 0.164333 0.000000
35 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 0.164333 0.164333 0.000000
36 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 0.164333 0.164333 0.000000
37 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 0.226800 0.226800 0.041866
38 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 0.189000 0.189000 0.000000
39 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 0.226800 0.226800 0.041866
40 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 0.226800 0.226800 0.041866
41 W52231001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.226800 0.226800 0.045866
42 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 0.226800 0.226800 0.045700
43 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 0.226800 0.226800 0.041866
44 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 0.226800 0.226800 0.042200
45 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 0.226800 0.226800 0.041866
46 W43226010 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR. ELIB. MODIF. 47,5mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0.238333 0.238333 0.000000
47 W43227010 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR. ELIB. MODIF. 95mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0.396000 0.396000 0.000000
48 W66032001 C07AB02 METOPROLOLUM BETALOC ZOK 100 mg COMPR. ELIB. PREL. 100mg ITALIA CUTIE CU 1 FLAC. PEID X 30 COMPR. ELIB. PREL.
RECORDATI INDUSTRIA CHIMICA E FARMACEUTICA S.P.A. P6L 30 0.383400 0.383400 0.575933
49 W66033001 C07AB02 METOPROLOLUM BETALOC ZOK 50 mg COMPR. ELIB. PREL. 50mg ITALIA CUTIE CU 1 FLAC. PEID X 30 COMPR. ELIB. PREL.
RECORDATI INDUSTRIA CHIMICA E FARMACEUTICA S.P.A. P6L 30 0.226800 0.226800 0.358866
50 W66454003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.324666 0.324666 0.000000

Pagina 36 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
51 W67867004 C07AB02 METOPROLOLUM METOPROLOL MEDREG 100 mg COMPR. FILM. 100mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.326666 0.326666 0.000000
52 W66453003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.226800 0.226800 0.041866
53 W67866004 C07AB02 METOPROLOLUM METOPROLOL MEDREG 50 mg COMPR. FILM. 50mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.226800 0.226800 0.036866
54 W43226004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0.238333 0.238333 0.000000
55 W43227004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0.396000 0.396000 0.000000
56 W66031001 C07AB02 METOPROLOLUM BETALOC 5 mg/5 ml SOL. INJ. I.V/PERF. 5mg/5ml RECORDATI INDUSTRIA CHIMICA E FARMACEUTICA S.P.A. ITALIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 5 ML SOL. INJ. I.V./PERF. PR 5 3.544000 3.544000 0.000000
57 W60359002 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.353760 0.353760 0.505906
58 W60569004 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0.353760 0.353760 0.029240
59 W66289002 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.353760 0.353760 0.505906
60 W60357002 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.321600 0.321600 0.006733
61 W60567004 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0.268000 0.268000 0.000000
62 W66288002 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.321600 0.321600 0.006733
63 W60358002 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.202080 0.202080 0.226253
64 W60568004 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0.202080 0.202080 0.028586
65 W66287002 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK ROMANIA SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.202080 0.202080 0.226253
66 W04501004 C07AB12 NEBIVOLOLUM ** NEBILET 5 mg COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.303999 0.303999 0.376715
67 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 0.303999 0.303999 0.156334
68 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 0.253333 0.253333 0.000000
69 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 0.303999 0.303999 0.144334
70 W64800005 C07AB12 NEBIVOLOLUM ** NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVDC/AL X 10 COMPR. P6L 30 0.303999 0.303999 0.158667
71 W65312001 C07AB12 NEBIVOLOLUM ** NOLET 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.303999 0.303999 0.156334
72 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 0.303999 0.303999 0.156334
73 W59931001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.266000 0.266000 0.000000
74 W12649001 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0.268928 0.268928 0.000000
75 W42058001 C07AG02 CARVEDILOLUM TALLITON 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.269000 0.269000 0.000000
76 W42659001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.319200 0.319200 0.279133
77 W53658001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.319200 0.319200 0.278800
78 W53751001 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.319200 0.319200 0.106133
79 W58304001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,5 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.319200 0.319200 0.278800
80 W63454001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.319200 0.319200 0.279133
81 W42058002 C07AG02 CARVEDILOLUM TALLITON 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. DIN OPA-AL-PVC/AL X 15 COMPR. P6L 30 0.269000 0.269000 0.000000
82 W12648002 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 0.391785 0.391785 0.000000
83 W42059001 C07AG02 CARVEDILOLUM TALLITON 25 mg COMPR. 25mg UNGARIA
EGIS PHARMACEUTICALS P.L.C. CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.470142 0.470142 0.031524
84 W42658001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.470142 0.470142 0.194524
85 W53752001 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.470142 0.470142 0.107524
86 W58305001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.470142 0.470142 0.194858
87 W59932001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.470142 0.470142 0.009191
88 W63455001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.470142 0.470142 0.194524
89 W42059002 C07AG02 CARVEDILOLUM TALLITON 25 mg COMPR. 25mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. DIN OPA-AL-PVC/AL X 15 COMPR. P6L 30 0.470142 0.470142 0.031524
90 W41867002 C07AG02 CARVEDILOLUM CORYOL 6,25mg COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0.177142 0.177142 0.000000
91 W41912001 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg UNGARIA
EGIS PHARMACEUTICALS P.L.C. CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0.177333 0.177333 0.000000
92 W42660001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0.207600 0.207600 0.071400
93 W53663001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.207600 0.207600 0.071400
94 W53750001 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.204000 0.204000 0.000000
95 W59930001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.173000 0.173000 0.000000
96 W63453001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0.207600 0.207600 0.071400
97 W41912002 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU 2 BLIST. DIN OPA-AL-PVC/AL X 15 COMPR. P6L 30 0.177333 0.177333 0.000000
98 W66017007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.319200 0.319200 0.076514
99 W66018007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.470142 0.470142 0.110929
100 W66016007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0.207600 0.207600 0.071328
101 W00775001 C09AA01 CAPTOPRILUM CAPTOPRIL TERAPIA 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.170666 0.170666 0.000000
102 W06860001 C09AA01 CAPTOPRILUM CAPTOPRIL EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.166500 0.166500 0.000000
103 W00774002 C09AA01 CAPTOPRILUM CAPTOPRIL LAROPHARM 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0.173500 0.173500 0.000000
104 W43029001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.166500 0.166500 0.000000
105 W06857001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.173666 0.173666 0.000000
106 W08550001 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.170666 0.170666 0.000000
107 W41981002 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.170666 0.170666 0.000000
108 W53677002 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.173500 0.173500 0.000000
109 W53677003 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE CU 100 BLIST. PVC/AL X 10 COMPR. P6L 1000 0.151070 0.151070 0.000000
110 W53678001 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.254000 0.254000 0.000000

Pagina 37 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
111 W00777001 C09AA01 CAPTOPRILUM CAPTOPRIL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.254333 0.254333 0.000000
112 W06862001 C09AA01 CAPTOPRILUM CAPTOPRIL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.254000 0.254000 0.000000
113 W43028001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.254000 0.254000 0.000000
114 W42060001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.254333 0.254333 0.000000
115 W00776003 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.254333 0.254333 0.000000
116 W12405001 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.220500 0.220500 0.000000
117 W02920004 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0.220333 0.220333 0.000000
118 W02922001 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.219500 0.219500 0.000000
119 W41447001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0.220500 0.220500 0.000000
120 W51276001 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0.263400 0.263400 0.030528
121 W53672002 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0.220333 0.220333 0.000000
122 W53672003 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0.220000 0.220000 0.000000
123 W53672004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0.220200 0.220200 0.000000
124 W53666002 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0.219500 0.219500 0.000000
125 W58491002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.219500 0.219500 0.000000
126 W62035001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0.220500 0.220500 0.000000
127 W02922002 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 30 0.219666 0.219666 0.000000
128 W02922003 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0.220000 0.220000 0.000000
129 W58491003 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 20 0.219500 0.219500 0.000000
130 W12199001 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.365000 0.365000 0.000000
131 W02921003 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0.364666 0.364666 0.000000
132 W02923001 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.364500 0.364500 0.000000
133 W51277001 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0.437400 0.437400 0.050814
134 W53674001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.364666 0.364666 0.000000
135 W53674004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0.364800 0.364800 0.000000
136 W56712001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.365000 0.365000 0.000000
137 W58492001 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.365000 0.365000 0.000000
138 W62036001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0.365000 0.365000 0.000000
139 W02923002 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 30 0.364666 0.364666 0.000000
140 W02923003 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0.364666 0.364666 0.000000
141 W58492002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 20 0.365000 0.365000 0.000000
142 W12198001 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.102500 0.102500 0.000000
143 W02925001 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0.101500 0.101500 0.000000
144 W51275001 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0.121800 0.121800 0.102842
145 W12811003 C09AA02 ENALAPRILUM ENALAPRIL LPH 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.102333 0.102333 0.000000
146 W53673001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.102333 0.102333 0.000000
147 W58490002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0.102500 0.102500 0.000000
148 W62034001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0.102500 0.102500 0.000000
149 W02925002 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 30 0.102333 0.102333 0.000000
150 W02925003 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P6L 60 0.102166 0.102166 0.000000
151 W58490003 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0.102500 0.102500 0.000000
152 W58233001 C09AA02 ENALAPRILUM ENAP 1,25 mg/ml SOL. INJ./PERF. 1,25mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR/PRF 5 3.474000 3.474000 0.000000
153 W42156001 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.319200 0.319200 0.273800
154 W42593001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.266000 0.266000 0.000000
155 W43054001 C09AA03 LISINOPRILUM LISINOPRIL MEDO 10 mg COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.319200 0.319200 0.090800
156 W53916002 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.319200 0.319200 0.137466
157 W54841001 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.319200 0.319200 0.100085
158 W65067001 C09AA03 LISINOPRILUM RANOLIP 10 mg COMPR. 10mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.319200 0.319200 0.274133
159 W42088001 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0.449199 0.449199 0.446801
160 W42594001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0.374333 0.374333 0.000000
161 W53917002 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.449199 0.449199 0.447134
162 W54840001 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.449199 0.449199 0.172586
163 W43055002 C09AA03 LISINOPRILUM LISINOPRIL MEDO 20 mg COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 0.449199 0.449199 0.248801
164 W65068001 C09AA03 LISINOPRILUM RANOLIP 20 mg COMPR. 20mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.449199 0.449199 0.447134
165 W53918002 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1.500666 1.500666 0.000000
166 W43053001 C09AA03 LISINOPRILUM LISINOPRIL MEDO 5 mg COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.202000 0.202000 0.000000
167 W54842001 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0.242400 0.242400 0.009742
168 W65066001 C09AA03 LISINOPRILUM RANOLIP 5 mg COMPR. 5mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0.242400 0.242400 0.049266
169 W51933002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0.315600 0.315600 0.017971
170 W64367002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0.315600 0.315600 0.017971

Pagina 38 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
171 W42940001 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.315600 0.315600 0.017733
172 W42972001 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.315600 0.315600 0.017066
173 W43524001 C09AA05 RAMIPRILUM ZENRA 10 mg COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0.315600 0.315600 0.017971
174 W62447001 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0.315600 0.315600 0.263685
175 W62662001 C09AA05 RAMIPRILUM RAMIPRIL ATB 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.263000 0.263000 0.000000
176 W62447012 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 90 COMPR. P6L 90 0.315600 0.315600 0.285511
177 W64288002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg ROMANIA
AUROBINDO PHARMA ROMANIA S.R.L. CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0.315600 0.315600 0.017971
178 W51934002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 0.190000 0.190000 0.000000
179 W64365002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0.190000 0.190000 0.000000
180 W42939001 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.190000 0.190000 0.000000
181 W42970001 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.189666 0.189666 0.000000
182 W43522001 C09AA05 RAMIPRILUM ZENRA 2,5 mg COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0.190000 0.190000 0.000000
183 W62451001 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0.197199 0.197199 0.095658
184 W62660001 C09AA05 RAMIPRILUM RAMIPRIL ATB 2,5 mg COMPR. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.164333 0.164333 0.000000
185 W62451011 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 60 COMPR. P6L 60 0.197199 0.197199 0.387134
186 W51932002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0.190000 0.190000 0.000000
187 W64366002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0.190000 0.190000 0.000000
188 W42237001 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.228000 0.228000 0.044333
189 W42971001 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0.228000 0.228000 0.044666
190 W43523001 C09AA05 RAMIPRILUM ZENRA 5 mg COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0.228000 0.228000 0.045571
191 W62382001 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0.228000 0.228000 0.193428
192 W62661001 C09AA05 RAMIPRILUM RAMIPRIL ATB 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0.190000 0.190000 0.000000
193 W62382008 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 30 COMPR. P6L 30 0.228000 0.228000 0.245000
194 W64287005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0.228000 0.228000 0.044500
195 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 0.943713 0.943713 0.290215
196 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 0.786428 0.786428 0.000000
197 W58950013 C09CA03 VALSARTANUM ** VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0.786428 0.786428 0.000000
198 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 1.181570 1.181570 0.150215
199 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 0.984642 0.984642 0.000000
200 W58948013 C09CA03 VALSARTANUM ** VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0.984642 0.984642 0.000000
201 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 0.521570 0.521570 0.512358
202 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 0.434642 0.434642 0.000000
203 W58949013 C09CA03 VALSARTANUM ** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0.434642 0.434642 0.000000
204 W55631001 C09CA03 VALSARTANUM ** DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) P-6L 1 26.090000 26.090000 0.000000
205 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 0.605199 0.605199 0.566943
206 W54889004 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 0.605199 0.605199 0.020515
207 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 0.605199 0.605199 0.074801
208 W58808002 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0.605199 0.605199 0.637658
209 W58874004 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.504333 0.504333 0.000000
210 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 0.605199 0.605199 0.529134
211 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 0.605199 0.605199 0.188467
212 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 0.605199 0.605199 0.202801
213 W67397002 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 16 mg COMPR. 16mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL CE CONTINE 28 COMPR. P6L 28 0.605199 0.605199 0.637658
214 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 0.937999 0.937999 0.240334
215 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 0.937999 0.937999 0.999858
216 W58875004 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.781666 0.781666 0.000000
217 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 0.937999 0.937999 0.660334
218 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 0.937999 0.937999 0.604858
219 W67398001 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 32 mg COMPR. 32mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL CE CONTINE 28 COMPR. P6L 28 0.937999 0.937999 0.999858
220 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 0.585000 0.585000 0.000000
221 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 0.503333 0.503333 0.000000
222 W58807002 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0.603999 0.603999 0.001358
223 W58873004 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0.531666 0.531666 0.000000
224 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 0.585000 0.585000 0.000000
225 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 0.585000 0.585000 0.000000
226 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 0.585000 0.585000 0.000000
227 W67396002 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 8 mg COMPR. 8mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL CE CONTINE 28 COMPR. P6L 28 0.603999 0.603999 0.001358
228 W62448001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 24 mg/26 mg COMPR. FILM. 24mg/26mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 28 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 28 11.942857 11.942857 0.000000
229 W64479001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 24 mg/26 mg COMPR. FILM. 24mg/26mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 28 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 28 11.942857 11.942857 0.000000
230 W62449001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 49 mg/51 mg COMPR. FILM. 49mg/51mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.960178 10.960178 0.000000

Pagina 39 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
231 W64480001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 49 mg/51 mg COMPR. FILM. 49mg/51mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.960178 10.960178 0.000000
232 W62450001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 97 mg/103 mg COMPR. FILM. 97mg/103mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.960178 10.960178 0.000000
233 W64481001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 97 mg/103 mg COMPR. FILM. 97mg/103mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.960178 10.960178 0.000000

2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

1 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.454000 0.454000 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 0.373000 0.373000 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 0.556666 0.556666 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 0.538777 0.538777 0.000000
3 W57177005 B01AC04 CLOPIDOGRELUM ** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0.646532 0.646532 0.207039
4 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 0.556666 0.556666 0.000000
5 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 0.621111 0.621111 0.000000
6 W61520001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 0.646532 0.646532 1.318110
7 W61520013 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 30 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 30 0.646532 0.646532 1.462801
8 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 0.646532 0.646532 0.468801
9 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 0.646532 0.646532 0.005610
10 W66403001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 28 0.646532 0.646532 1.318110
11 W66403013 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 30 COMPR. FILM. ( BLIST. PVC-PVDC/AL) PRF 30 0.646532 0.646532 1.462801
12 W66626001 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL EIPICO 75 mg COMPR. FILM. 75mg E.I.P.I.CO MED S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0.646532 0.646532 0.534468
13 W62794001 B01AC24 TICAGRELOR ** Ω BRILIQUE COMPR. FILM. 60 mg ASTRA ZENECA AB SUEDIA BLISTER CALENDAR TRANSPARENT DIN PVC-PVDC/AL (CU SIMBOLURILE SOARE/LUNA) X 56 COMPR. FILM. PRF 56 4.913571 4.913571 0.000000
14 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 5.562678 5.562678 0.000000

Tratamentul se iniţiază de către medicul în specialitatea cardiologie, chirurgie cardiovasculară şi chirurgie vasculară.

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

1 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 3.645666 3.645666 0.000000
2 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 4.374799 4.374799 0.201272
3 W60828015 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA 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. PR 30 15.516799 15.516799 4.735534
4 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 15.516799 15.516799 0.523534
5 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 15.516799 15.516799 0.523867
6 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 15.516799 15.516799 9.791534
7 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 12.930666 12.930666 0.000000
8 W65812001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL ACCORD 245 mg COMPR. FILM. 245mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 15.516799 15.516799 4.719534
9 W65970001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR STADA 245 mg COMPR. FILM. 245mg STADA M&D SRL ROMANIA CUTIE CU 1 FLAC. PEID CU CAPAC DIN PP, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 30 (1X30) COMPR. FILM. PR 30 15.516799 15.516799 10.770867
10 W65970002 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR STADA 245 mg COMPR. FILM. 245mg STADA M&D SRL ROMANIA AMBALAJ MULTIPLU CU 3 FLAC. PEID CU CAPAC DIN PP, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 90 (3X30) COMPR. FILM. PR 90 15.516799 15.516799 7.448089
11 W65737001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL ACCORDPHARMA 245 mg COMPR. FILM. 245mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU 1 BLIST. PERFORAT PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 15.516799 15.516799 4.719534
12 W68144001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL MYLAN COMPR. FILM. 245mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. PR 30 15.516799 15.516799 0.523867
13 W68200001 J05AF07 TENOFOVIRUM DISOPROXIL **1 VIROFOB 245 mg COMPR. FILM. 245mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 FLAC. PEID CU CAPAC DIN PP X 30 COMPR. FILM. PR 30 15.516799 15.516799 0.523534
14 W64757001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. DIN PEID X 30 COMPR. PR 30 36.109666 36.109666 0.000000
15 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 0.000134
16 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 16.067134
17 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 0.000134
18 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 0.000134
19 W63803001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 0,5 mg COMPR. FILM. 0,5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5.463199 5.463199 17.625467
20 W63755002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 5.463199 5.463199 0.000134
21 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
22 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 5.257333 5.257333 0.000000
23 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 5.257333 5.257333 0.000000
24 W65716001 J05AF10 ENTECAVIRUM **1 ENTECAVIR KRKA 0,5 mg COMPR. FILM. 0,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 5.463199 5.463199 0.165134
25 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 12.857134

Pagina 40 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
26 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 0.000134
27 W65511001 J05AF10 ENTECAVIRUM **1 ENTECAVIR TERAPIA 0,5 mg COMPR. FILM. 0,5mg S.C. TERAPIA S.A. ROMANIA CUTIE CU BLIST. UNIDOZA PENTRU ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL CONTINAND 30X1 COMPR. FILM. PR 30 5.463199 5.463199 0.000134
28 W68145001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 5.463199 5.463199 0.000134
29 W68145002 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE DIN (OPA/AL/PVC-AL) X 30X1 COMPR. PR 30 5.463199 5.463199 0.000134
30 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
31 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 24.141800
32 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
33 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 10.927000 10.927000 0.000000
34 W63814001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 1 mg COMPR. FILM. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 10.927200 10.927200 37.016800
35 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 17.578133
36 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 17.578133
37 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
38 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 13.852800
39 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 0.330466
40 W65512001 J05AF10 ENTECAVIRUM **1 ENTECAVIR TERAPIA 1 mg COMPR. FILM. 1mg S.C. TERAPIA S.A. ROMANIA CUTIE CU BLIST. UNIDOZA PENTRU ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL CONTINAND 30X1 COMPR. FILM. PR 30 10.927200 10.927200 10.769466
41 W68146001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 1 mg COMPR. FILM. 1mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 10.927000 10.927000 0.000000
42 W66449009 J05AP01 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2.085059 2.085059 0.000000
43 W64676001 J05AP09 DASABUVIRUM **1 β EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA PR
CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE ) 56 18.082321 18.082321 0.000000
44 W64756001 J05AP51 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2,191.503571 2,191.503571 0.000000
45 W64675001 J05AP53 OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 β VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA PR
CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPR. FIECARE ) 56 194.662321 194.662321 0.000000
46 W64754001 J05AP55 COMBINATII (SOFOSBUVIRUM+VELPATASVIRUM) **1 β EPCLUSA 400mg/100mg COMPR. FILM. 400mg/100mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU SISTEM SECURIZAT PENTRU COPII X 28 COMPR. FILM. PR 28 1,477.164642 1,477.164642 0.000000
47 W64760001 J05AP56 SOFOSBUVIRUM +VELPATASVIRUM + VOXILAPREVIRUM **1 β VOSEVI 400 mg/100 mg/100 mg COMPR. FILM. 400mg/100mg/100mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID X 28 COMPR. FILM. PR 28 2,155.894285 2,155.894285 0.000000
48 W65905001 J05AP57 COMBINATII (GLECAPREVIRUM + PIBRENTASVIRUM) **1 β MAVIRET 100 mg/40 mg COMPR. FILM. 100mg/40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 4 BLIST. PVC/PE/PCTFE/AL X 21 COMPR. FILM PR 84 749.654523 749.654523 0.000000
49 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 92.030400 92.030400 83.669600
50 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 148.274400 148.274400 129.275600
51 W67882001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 12 MU/0,2 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 12 MU/0,2 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,2 ML SOL. INJ. CU DISPOZITIV DE SIGURANTA PENTRU AC PR 1 59.910000 59.910000 0.000000
52 W61793001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 92.030400 92.030400 134.819600
53 W65658001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,5 ML SOL. INJ. PR 1 92.030400 92.030400 134.819600
54 W65659001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,5 ML SOL. INJ. PR 1 148.274400 148.274400 209.375600
55 W67883001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 70 MU/0,73 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 70 MU/0,73 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,73 ML SOL. INJ. CU DISPOZITIV DE SIGURANTA PENTRU AC PR 1 282.840000 282.840000 0.000000
56 W55757002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 76.692000 76.692000 0.000000
57 W64857002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 76.692000 76.692000 0.000000
58 W55758002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 123.562000 123.562000 0.000000
59 W64858002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 123.562000 123.562000 0.000000
60 W64393001 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 micrograme/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180µg/0,5ml ROCHE REGISTRATION GMBH GERMANIACUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC PR 1 766.960000 766.960000 0.000000
61 W68070001 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 microrgrame/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180µg/0,5ml ZR PHARMA& GMBH AUSTRIA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC PR 1 766.960000 766.960000 0.000000
62 W00264001 N04BB01 AMANTADINUM ** VIREGYT-K 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 0.414400 0.414400 0.000000

Tratamentul se iniţiază de către medicul în specialitatea gastroenterologie, boli infecţioase, nefrologie (doar pentru pacienţii cu afectare renală consecutivă infecţiei cu virusuri hepatitice), gastroenterologie pediatrică şi pediatrie cu
supraspecializare/competenţă/atestat în gastroenterologie pediatrică.

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 0.654800 0.654800 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 0.654800 0.654800 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 2.298500 2.298500 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 2.298500 2.298500 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 23.500000 23.500000 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 71.250000 71.250000 0.000000
7 W60846001 L04AX01 AZATHIOPRINUM IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.638800 0.000000

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

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. P6L 100 1.137000 1.137000 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. P-6L 50 1.271400 1.271400 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 2.561400 2.561400 0.000000

Pagina 41 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
4 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 1 110.170000 110.170000 0.000000

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

7. CIROZA HEPATICA - G7

1 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 P6L 1 16.160000 16.160000 0.000000
2 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 16.160000 16.160000 0.000000
3 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 11.930000 11.930000 0.000000
4 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 3.960000 3.960000 0.000000
5 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 2.516666 2.516666 0.000000
6 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 2.891666 2.891666 0.000000
7 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 21.860000 21.860000 0.000000
8 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 0.252600 0.252600 0.068900
9 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA 40 mg COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.252600 0.252600 0.091900
10 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA 40 mg COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0.210500 0.210500 0.000000
11 W52043001 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.252600 0.252600 0.091900
12 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0.252600 0.252600 0.091900
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 0.252600 0.252600 0.092066
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 0.252600 0.252600 0.091400
15 W68090001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.252600 0.252600 0.091900
16 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 1.390000 1.390000 0.000000
17 W58282001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA 20 mg/2 ml SOL. INJ. 20mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1.390000 1.390000 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 0.408400 0.408400 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 0.408333 0.408333 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 0.423333 0.423333 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 0.507999 0.507999 0.250001
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 0.408500 0.408500 0.000000
23 W68089001 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.408500 0.408500 0.000000
24 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 0.408400 0.408400 0.000000
25 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 0.408500 0.408500 0.000000
26 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 0.507999 0.507999 0.250001
27 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 3.645666 3.645666 0.000000
28 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 4.374799 4.374799 0.201272
29 W64757001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. DIN PEID X 30 COMPR. PR 30 36.109666 36.109666 0.000000
30 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 0.000134
31 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 16.067134
32 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 0.000134
33 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 0.000134
34 W63803001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 0,5 mg COMPR. FILM. 0,5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 5.463199 5.463199 17.625467
35 W63755002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 5.463199 5.463199 0.000134
36 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
37 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 5.257333 5.257333 0.000000
38 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 5.257333 5.257333 0.000000
39 W65716001 J05AF10 ENTECAVIRUM **1 ENTECAVIR KRKA 0,5 mg COMPR. FILM. 0,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 5.463199 5.463199 0.165134
40 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 12.857134
41 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 0.000134
42 W65511001 J05AF10 ENTECAVIRUM **1 ENTECAVIR TERAPIA 0,5 mg COMPR. FILM. 0,5mg S.C. TERAPIA S.A. ROMANIA CUTIE CU BLIST. UNIDOZA PENTRU ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL CONTINAND 30X1 COMPR. FILM. PR 30 5.463199 5.463199 0.000134
43 W68145001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 5.463199 5.463199 0.000134
44 W68145002 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE DIN (OPA/AL/PVC-AL) X 30X1 COMPR. PR 30 5.463199 5.463199 0.000134
45 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
46 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 24.141800
47 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
48 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 10.927000 10.927000 0.000000
49 W63814001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 1 mg COMPR. FILM. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 10.927200 10.927200 37.016800
50 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 17.578133
51 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 17.578133
52 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
53 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 13.852800

Pagina 42 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
54 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 0.330466
55 W65512001 J05AF10 ENTECAVIRUM **1 ENTECAVIR TERAPIA 1 mg COMPR. FILM. 1mg S.C. TERAPIA S.A. ROMANIA CUTIE CU BLIST. UNIDOZA PENTRU ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL CONTINAND 30X1 COMPR. FILM. PR 30 10.927200 10.927200 10.769466
56 W68146001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 1 mg COMPR. FILM. 1mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 10.927000 10.927000 0.000000
57 W66449009 J05AP01 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2.085059 2.085059 0.000000
58 W64676001 J05AP09 DASABUVIRUM **1 β EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE ) PR 56 18.082321 18.082321 0.000000
59 W64756001 J05AP51 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2,191.503571 2,191.503571 0.000000
60 W64675001 J05AP53 OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 β VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPR. FILM. (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPR. FIECARE ) PR 56 194.662321 194.662321 0.000000
61 W64754001 J05AP55 COMBINATII (SOFOSBUVIRUM+VELPATASVIRUM) **1 β EPCLUSA 400mg/100mg COMPR. FILM. 400mg/100mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU SISTEM SECURIZAT PENTRU COPII X 28 COMPR. FILM. PR 28 1,477.164642 1,477.164642 0.000000
62 W64760001 J05AP56 SOFOSBUVIRUM +VELPATASVIRUM + VOXILAPREVIRUM **1 β VOSEVI 400 mg/100 mg/100 mg COMPR. FILM. 400mg/100mg/100mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID X 28 COMPR. FILM. PR 28 2,155.894285 2,155.894285 0.000000
63 W65905001 J05AP57 COMBINATII (GLECAPREVIRUM + PIBRENTASVIRUM) **1 β MAVIRET 100 mg/40 mg COMPR. FILM. 100mg/40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 4 BLIST. PVC/PE/PCTFE/AL X 21 COMPR. FILM PR 84 749.654523 749.654523 0.000000
64 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 92.030400 92.030400 83.669600
65 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 148.274400 148.274400 129.275600
66 W67882001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 12 MU/0,2 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 12 MU/0,2 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,2 ML SOL. INJ. CU DISPOZITIV DE SIGURANTA PENTRU AC PR 1 59.910000 59.910000 0.000000
67 W61793001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 92.030400 92.030400 134.819600
68 W65658001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,5 ML SOL. INJ. PR 1 92.030400 92.030400 134.819600
69 W65659001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,5 ML SOL. INJ. PR 1 148.274400 148.274400 209.375600
70 W67883001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 70 MU/0,73 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 70 MU/0,73 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,73 ML SOL. INJ. CU DISPOZITIV DE SIGURANTA PENTRU AC PR 1 282.840000 282.840000 0.000000
71 W55757002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 76.692000 76.692000 0.000000
72 W64857002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 76.692000 76.692000 0.000000
73 W55758002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 123.562000 123.562000 0.000000
74 W64858002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 123.562000 123.562000 0.000000
75 W64393001 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 micrograme/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180µg/0,5ml ROCHE REGISTRATION GMBH GERMANIACUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC PR 1 766.960000 766.960000 0.000000
76 W68070001 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 microrgrame/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180µg/0,5ml ZR PHARMA& GMBH AUSTRIA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC PR 1 766.960000 766.960000 0.000000
77 W00264001 N04BB01 AMANTADINUM ** VIREGYT-K 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 0.414400 0.414400 0.000000

Tratamentul se iniţiază de către medicul în specialitatea gastroenterologie, boli infecţioase, nefrologie (doar pentru pacienţii cu afectare renală consecutivă infecţiei cu virusuri hepatitice), gastroenterologie pediatrică şi pediatrie cu
supraspecializare/competenţă/atestat în gastroenterologie pediatrică.

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 CU 1 BLIST. AL-PVDC/PVC X 10 COMPR. FILM. P-RF 10 2.539000 2.539000 0.000000
2 W56154001 A04AA01 ONDANSETRONUM ** OSETRON 8 mg COMPR. FILM. 8mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 BLIST. AL-PVDC/PVC X 10 COMPR. FILM. P-RF 10 4.297000 4.297000 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 5.448000 5.448000 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 10.018000 10.018000 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 6.468000 6.468000 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 11.896000 11.896000 0.000000
7 W54347002 A04AA02 GRANISETRONUM ** GRANISETRON ACTAVIS 1 mg COMPR. FILM. 1mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 11.260000 11.260000 0.000000
8 W57716002 A04AA02 GRANISETRONUM ** GRANORED 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 13.512000 13.512000 6.911000
9 W66610002 A04AA02 GRANISETRONUM ** GRANISETRON ALVOGEN 1 mg COMPR. FILM. 1mg ALVOGEN PHARMA TRADING EUROPE EOOD BULGARIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. PRF 10 13.512000 13.512000 6.911000
10 W68168002 A04AA02 GRANISETRONUM ** GRANISETRON LABORMED 1 mg COMPR. FILM. 1mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. PRF 10 13.512000 13.512000 6.911000
11 W54348002 A04AA02 GRANISETRONUM ** GRANISETRON ACTAVIS 2 mg COMPR. FILM. 2mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 23.754000 23.754000 0.000000
12 W66612002 A04AA02 GRANISETRONUM ** GRANISETRON ALVOGEN 2 mg COMPR. FILM. 2mg ALVOGEN PHARMA TRADING EUROPE EOOD BULGARIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. PRF 10 28.504800 28.504800 2.616200
13 W68169002 A04AA02 GRANISETRONUM ** GRANISETRON LABORMED 2 mg COMPR. FILM. 2mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. PRF 10 28.504800 28.504800 2.616200
14 W53853003 A04AA02 GRANISETRONUM ** GRANISETRON KABI 1 mg/ml SOL. INJ. 1mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ. PR 5 30.816000 30.816000 0.000000
15 W56568002 A04AA05 PALONOSETRONUM ** ALOXI 500mcg CAPS. MOI 500mcg IRLANDA CUTIE X BLISTER DIN POLIAMIDA/AL/PVC X 1 CAPSULA MOALE PRF
HELSINN BIREX PHARMACEUTICALS LTD. 1 276.160000 276.160000 0.000000
16 W62987001 A04AA05 PALONOSETRONUM ** FERANT 250 micrograme SOL INJ. 250micrograme MEDOCHEMIE LTD. CIPRU CUTIE CU 1 FIOLA DIN STICLA INCOLORA CARE CONTINE 5 ML SOL. INJ. PR 1 106.310000 106.310000 0.000000
17 W65704001 A04AA05 PALONOSETRONUM ** PALONOSETRON ACCORD 250 micrograme SOL INJ. 250micrograme ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 FLAC. CARE CONTINE 5 ML SOLUTIE PALONOSETRON PRF 1 122.480000 122.480000 0.000000
18 W43177001 A04AA05 PALONOSETRONUM ** ALOXI SOL. INJ. 250 mcg/5ml HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA CUTIE X 1 FLAC. DIN STICLA X 5 ML SOL. INJ. P-RF 1 127.572000 127.572000 31.158000
19 W63032001 A04AA05 PALONOSETRONUM ** PALONOSETRON FRESENIUS KABI 250 micrograme SOL. INJ. 250micrograme FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA TIP I CARE CONTINE 5 ML SOL. INJ. PRF 1 127.572000 127.572000 31.158000
20 W63231001 A04AA05 PALONOSETRONUM ** PALONOSETRON DR. REDDY'S 250 micrograme SOL. INJ. 250micrograme DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. TUBULAR DIN STICLA CONTINAND 5 ML SOL. INJ. PRF 1 127.572000 127.572000 108.948000
21 W63033002 A04AA05 PALONOSETRONUM ** PALONOSETRON FRESENIUS KABI 250 micrograme SOL. INJ. IN SERINGA PREUMPLUTA 250micrograme FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE CARE CONTIN 5 ML SOL. INJ. PRF 10 127.572000 127.572000 8.350000
22 W62207001 A04AA55 COMBINATII (NETUPITANTUM+PALONOSETRONUM) ** AKYNZEO 300 mg/0,5 mg CAPS. 300mg/0,5mg HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA BLISTER DIN AL/AL X 1 CAPS. PRF 1 315.070000 315.070000 0.000000
23 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 57.723333 57.723333 0.000000
24 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 1 554.590000 554.590000 0.000000
25 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 1 866.388000 866.388000 401.662000
26 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 1 721.990000 721.990000 0.000000
27 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 6 105.675000 105.675000 0.000000
28 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 6 295.070000 295.070000 0.000000
29 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 59.321666 59.321666 0.000000

Pagina 43 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
30 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 1,074.000000 1,074.000000 0.000000
31 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 6 107.033333 107.033333 0.000000
32 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 6 143.961666 143.961666 0.000000
33 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 1 242.590000 242.590000 0.000000
34 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 1 242.590000 242.590000 0.000000
35 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 56.080000 56.080000 0.000000
36 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 56.080000 56.080000 0.000000
37 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 1 527.400000 527.400000 0.000000
38 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 1 527.400000 527.400000 0.000000
39 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 79.880000 79.880000 0.000000
40 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 79.880000 79.880000 0.000000
41 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 1 499.370000 499.370000 0.000000
42 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 1 499.370000 499.370000 0.000000
43 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 1 106.520000 106.520000 0.000000
44 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 1 106.520000 106.520000 0.000000
45 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 1 128.580000 128.580000 0.000000
46 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 1 128.580000 128.580000 0.000000
47 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 1 151.520000 151.520000 0.000000
48 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 1 151.520000 151.520000 0.000000
49 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 1 216.320000 216.320000 0.000000
50 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 1 216.320000 216.320000 0.000000
51 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 4 753.142500 753.142500 0.000000
52 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 99.940000 99.940000 0.000000
53 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 4 162.120000 162.120000 0.000000
54 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 1,867.670000 1,867.670000 0.000000
55 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 4 235.445000 235.445000 0.000000
56 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 4 307.427500 307.427500 0.000000
57 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 3,011.950000 3,011.950000 0.000000
58 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 4 381.300000 381.300000 0.000000
59 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 4 455.387500 455.387500 0.000000
60 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 4 604.010000 604.010000 0.000000
61 W64041001 G03HA01 CYPROTERONUM ** ANDROCUR 50 mg COMPR. 50mg BAYER AG GERMANIA CUTIE CU 5 BLIST. AL/PVC X 10 COMPR. PRF 50 2.105600 2.105600 0.000000
62 W63171002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 7.061500 7.061500 0.000000
63 W63169002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 4 mg COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 1.620000 1.620000 0.000000
64 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 0.917000 0.917000 0.000000
65 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 0.901600 0.901600 0.000000
66 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 0.812700 0.812700 0.000000
67 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 1.530000 1.530000 0.000000
68 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 1.464400 1.464400 0.000000
69 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 1.327900 1.327900 0.000000
70 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 1.370900 1.370900 0.000000
71 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 1.572000 1.572000 0.000000
72 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 1.573000 1.573000 0.000000
73 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 2.459333 2.459333 0.000000
74 W43051001 J02AC02 ITRACONAZOLUM ITRACONAZOL SLAVIA 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 2.291333 2.291333 0.000000
75 W53958001 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 2.291333 2.291333 0.000000
76 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 2.291333 2.291333 0.000000
77 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 2.291333 2.291333 0.000000
78 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 2.291333 2.291333 0.000000
79 W67015006 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 2.291333 2.291333 0.000000
80 W08947008 J02AC03 VORICONAZOLUM ** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 19.905199 19.905199 47.911586
81 W61017005 J02AC03 VORICONAZOLUM ** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 19.905199 19.905199 44.228372
82 W61628005 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 16.755714 16.755714 0.000000
83 W61628006 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 16.587666 16.587666 0.000000
84 W61817001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM PRF 28 19.905199 19.905199 20.413729
85 W64073003 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 19.905199 19.905199 9.843372
86 W64073005 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 19.905199 19.905199 7.311943
87 W64073008 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 19.905199 19.905199 6.050872
88 W64931001 J02AC03 VORICONAZOLUM ** VFEND 200 mg COMPR. FILM. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 19.905199 19.905199 47.911586
89 W65715001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 19.905199 19.905199 20.413729

Pagina 44 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
90 W64072003 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 28.455000 28.455000 0.000000
91 W64072005 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 25.906071 25.906071 0.000000
92 W64072008 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 24.660714 24.660714 0.000000
93 W68026001 J02AC03 VORICONAZOLUM ** VORICONAZOL ROMPHARM 200 mg PULB. PT. CONC. PT. SOL. PERF. FARA CONCENTRATIE ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, INCOLORA CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PRF 1 386.990000 386.990000 0.000000
94 W10489001 J02AC03 VORICONAZOLUM ** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 424.380000 424.380000 0.000000
95 W62122001 J02AC03 VORICONAZOLUM ** VORICONAZOL FRESENIUS KABI 200 mg PULB. PT. SOL. PERF. 200mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA TIP I, CU CAPACITATEA DE 25 ML, CU PULBERE PT. SOL. PERF. PRF 1 459.696000 459.696000 28.084000
96 W62815001 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg PULB. PT. SOL. PERF. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA CU CAPCITATEA DE 25 ML CU PULB. PT. SOL. PERF. PRF 1 459.696000 459.696000 357.694000
97 W64929001 J02AC03 VORICONAZOLUM ** VFEND 200 mg PULB. PT. SOL. PERF. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. UNIDOZA X 30 ML PRF 1 424.380000 424.380000 0.000000
98 W66540001 J02AC03 VORICONAZOLUM ** VORICONAZOL ACCORDPHARMA 200 mg PULB. PT. SOL. PERF. 200mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. PERF. PRF 1 383.080000 383.080000 0.000000
99 W41889001 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 1,827.390000 1,827.390000 0.000000
100 W64930001 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER EUROPE MA EEIG BELGIA PRF
CUTIE CU 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR 1 1,827.390000 1,827.390000 0.000000
101 W64693001 J02AC04 POSACONAZOLUM ** NOXAFIL 100mg COMPR. GASTROREZ. 100mg MERCK SHARP & DOHME OLANDA CUTIE CU BLIST. PVC/PCTFE/AL X 24 COMPR. GASTROREZ. PR 24 40.512999 40.512999 106.648667
102 W66225001 J02AC04 POSACONAZOLUM ** POSACONAZOLE ACCORD 100 mg COMPR. GASTROREZ. 100mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 24 COMPR. GASTROREZ PR 24 33.760833 33.760833 0.000000
103 W66364009 J02AC04 POSACONAZOLUM ** POSACONAZOL ZENTIVA 100 mg COMPR. GASTROREZ. 100mg ZENTIVA K.S. REP. CEHA CUTIE CU BLIST. OPAC NEPERFORAT DIN PVC-PE-PVDC/AL X 24 COMPR. GASTROREZ. PR 24 40.512999 40.512999 49.952001
104 W66421009 J02AC04 POSACONAZOLUM ** POSACONAZOL MYLAN 100 mg COMPR. GASTROREZ. 100mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 24 COMPR. GASTROREZ. PR 24 40.512999 40.512999 40.438667
105 W66491011 J02AC04 POSACONAZOLUM ** POSACONAZOL ALVOGEN 100 mg COMPR. GASTROREZ. 100mg ALVOGEN PHARMA TRADING EUROPE EOOD BULGARIA CUTIE CU BLIST. PVC-PE-PVDC/AL PERFORAT PENTRU ELIBERAREA UNEI UNITATI DOZATE X 24 COMPR. GASTROREZ. PR 24 40.512999 40.512999 59.008251
106 W66832009 J02AC04 POSACONAZOLUM ** POSACONAZOL STADA 100 mg COMPR. GASTROREZ. 100mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PE-PVDC/AL X 24 COMPR. GASTROREZ. PR 24 33.760833 33.760833 0.000000
107 W68234009 J02AC04 POSACONAZOLUM ** POSACONAZOL MYLAN 100 mg COMPR. GASTROREZ. 100mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 24 COMPR. GASTROREZ. PR 24 40.512999 40.512999 40.438667
108 W64694001 J02AC04 POSACONAZOLUM ** NOXAFIL 300mg CONC. PT. SOL. PERF. 300mg MERCK SHARP & DOHME OLANDA CUTIE CU 1 FLAC. X 16,7ML CONC. PT SOL. PERF. (18MG POSACONAZOL/ML) PR 1 1,584.900000 1,584.900000 0.000000
109 W64692001 J02AC04 POSACONAZOLUM ** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME OLANDA CUTIE CU 1 FLAC. X 105 ML SUSP. ORALA PR 1 927.744000 927.744000 1,914.756000
110 W65835001 J02AC04 POSACONAZOLUM ** POSACONAZOL MYLAN 40 mg/ml SUSP. ORALA 40mg/ml MYLAN IRELAND LIIMTED IRLANDA PR
CUTIE CU 1 FLAC. DIN STICLA, CU CAPAC DIN PE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII SI O LINGURITA DE MASURARE A DOZELOR X 105 ML SUSP. ORALA 1 773.120000 773.120000 0.000000
111 W66224001 J02AC04 POSACONAZOLUM ** POSACONAZOLE AHCL 40 mg/ml SUSP. ORALA 40mg/ml ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA INCHIS CU CAPAC DIN PP + 1 LINGURITA DOZATOARE X 105 ML SUSP. ORALA PR 1 773.120000 773.120000 0.000000
112 W63845001 J02AC05 ISAVUCONAZOLUM ** CRESEMBA 100 mg CAPS. 100mg BASILEA MEDICAL LTD MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 CAPS. PRF 14 197.005000 197.005000 0.000000
113 W65622001 J02AC05 ISAVUCONAZOLUM ** CRESEMBA 100 mg CAPS. 100mg GERMANIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS.
BASILEA PHARMACEUTICA DEUTSCHLAND GMBH PRF 14 197.005000 197.005000 0.000000
114 W63457001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ZENTIVA 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1,022.020000 1,022.020000 0.000000
115 W63403001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA MYLAN 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONCENTRAT PT. SOL. PERF. PR 1 1,022.020000 1,022.020000 0.000000
116 W63505001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ATB 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TIP I CU CAPACITATEA DE 10 ML, CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1,012.370000 1,012.370000 0.000000
117 W63508001 J02AX04 CASPOFUNGINUM ** DALVOCANS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 969.470000 969.470000 0.000000
118 W64793001 J02AX04 CASPOFUNGINUM ** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME OLANDA CUTIE X 1 FLAC. X 50 MG PULB. PTR. CONC. PTR. SOL. PERF. PR 1 1,022.020000 1,022.020000 0.000000
119 W65379001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA SANDOZ 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (TIP I) CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1,022.020000 1,022.020000 0.000000
120 W68225001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA MYLAN 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONCENTRAT PT. SOL. PERF. PR 1 1,022.020000 1,022.020000 0.000000
121 W63458001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ZENTIVA 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1,312.260000 1,312.260000 0.000000
122 W63404001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA MYLAN 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONCENTRAT PT. SOL. PERF. PR 1 1,312.260000 1,312.260000 0.000000
123 W63506001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ATB 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TIP I CU CAPACITATEA DE 10 ML, CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1,299.670000 1,299.670000 0.000000
124 W63509001 J02AX04 CASPOFUNGINUM ** DALVOCANS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1,214.050000 1,214.050000 0.000000
125 W64792001 J02AX04 CASPOFUNGINUM ** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME OLANDA CUTIE X 1 FLAC. X 70 MG PULB. PTR. CONC. PTR. SOL. PERF. PR 1 1,312.260000 1,312.260000 0.000000
126 W65380001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA SANDOZ 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (TIP I) CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1,312.260000 1,312.260000 0.000000
127 W68226001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA MYLAN 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MYLAN PHARMACEUTICALS LIMITED IRLANDA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONCENTRAT PT. SOL. PERF. PR 1 1,312.260000 1,312.260000 0.000000
128 W62968001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA STADA 50 mg PULB. PT.CONC. PT. SOL. PERF. 50mg STADA M&D SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1,022.020000 1,022.020000 0.000000
129 W62969001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA STADA 70 mg PULB. PT.CONC. PT. SOL. PERF. 70mg STADA M&D SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1,312.260000 1,312.260000 0.000000
130 W61708002 L01XX35 ANAGRELIDUM ** THROMBOREDUCTIN 0,5 mg CAPS. 0,5mg AOP ORPHAN PHARMACEUTICALS AG AUSTRIA CUTIE CU 1 FLAC. DIN PE X 100 CAPS. PRF 100 3.142800 3.142800 2.548000
131 W64277002 L01XX35 ANAGRELIDUM ** ANAGRELIDA ZENTIVA 0,5 mg CAPS. 0,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 4.646900
132 W64221001 L01XX35 ANAGRELIDUM ** CAPS.
ANAGRELIDA DR. REDDY'S 0,5 mg 0,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 7.020300
133 W64564002 L01XX35 ANAGRELIDUM ** GRENALVON 0,5 mg CAPS. 0,5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 7.347700
134 W64656002 L01XX35 ANAGRELIDUM ** ANAGRELIDA TEVA 0,5 mg CAPS. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 0.628800
135 W64540001 L01XX35 ANAGRELIDUM ** ANAGRELIDA TERAPIA 0,5 mg CAPS. 0,5mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 1.383100
136 W64672001 L01XX35 ANAGRELIDUM ** ANAGRELIDA GLENMARK 0,5 mg CAPS. 0,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 2.619000 2.619000 0.000000
137 W64671001 L01XX35 ANAGRELIDUM ** ANAGRELIDA SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 2.984200
138 W65794001 L01XX35 ANAGRELIDUM ** ANAGRELIDA ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 6.344000
139 W65474004 L01XX35 ANAGRELIDUM ** ANAGRELIDA AUROBINDO 0,5 mg CAPS. 0,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 3.109100
140 W68277002 L01XX35 ANAGRELIDUM ** GRENALVON 0,5 mg CAPS. 0,5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 3.142800 3.142800 7.347700
141 W64565001 L01XX35 ANAGRELIDUM ** GRENALVON 1 mg CAPS. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. PEID X 42 CAPS. PR 42 20.484523 20.484523 0.000000
142 W64565002 L01XX35 ANAGRELIDUM ** GRENALVON 1 mg CAPS. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 19.523000 19.523000 0.000000
143 W65795001 L01XX35 ANAGRELIDUM ** ANAGRELIDA ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 18.265100 18.265100 0.000000
144 W68278001 L01XX35 ANAGRELIDUM ** GRENALVON 1 mg CAPS. 1mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 FLAC. PEID X 42 CAPS. PR 42 20.484523 20.484523 0.000000
145 W68278002 L01XX35 ANAGRELIDUM ** GRENALVON 1 mg CAPS. 1mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 19.523000 19.523000 0.000000
146 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 25 mg CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 1.832400 1.832400 0.000000
147 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 50 mg CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 3.351800 3.351800 0.000000
148 W59252003 N02AA01 MORPHYNUM SEVREDOL 10 mg COMPR. FILM. 10mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. PS 60 1.087833 1.087833 0.000000
149 W59251003 N02AA01 MORPHYNUM SEVREDOL 20 mg COMPR. FILM. 20mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. PS 60 1.377000 1.377000 0.000000

Pagina 45 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
150 W12686002 N02AA01 MORPHYNUM VENDAL RETARD 100 mg 100mg
COMPR. FILM. ELIB. PREL. LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 3.051333 3.051333 0.000000
151 W12682002 N02AA01 MORPHYNUM VENDAL RETARD 30 mg COMPR. FILM. ELIB. PREL. 30mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 1.238000 1.238000 0.000000
152 W12684002 N02AA01 MORPHYNUM VENDAL RETARD 60 mg COMPR. FILM. ELIB. PREL. 60mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 1.819666 1.819666 0.000000
153 W64720001 N02AA01 MORPHYNUM MARACEX 20 mg/ml SOL INJ./PERF. 20mg/ml AS KALCEKS LETONIA CUTIE CU 10 FIOLE DIN STICLA INCOLORA CU CAPACITATEA DE 1 ML SOL. INJ./PERF. PS 10 3.513000 3.513000 0.000000
154 W59797001 N02AA01 MORPHYNUM MORFINA ZENTIVA 20 mg/ml SOL. INJ. 20mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML P-TS 5 3.680000 3.680000 0.000000
155 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 1.323833 1.323833 0.000000
156 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 2.071000 2.071000 0.000000
157 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 2.258500 2.258500 0.000000
158 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 6.063000 6.063000 0.000000
159 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 3.646166 3.646166 0.000000
160 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 3.845000 3.845000 0.000000
161 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 2.209464 2.209464 0.000000
162 W44119001 N02AA08 DIHYDROCODEINUM DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GESELLSCHAFT M.B.H. AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 0.832857 0.832857 0.000000
163 W44120001 N02AA08 DIHYDROCODEINUM DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GESELLSCHAFT M.B.H. AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1.299285 1.299285 0.000000
164 W42905002 N02AB02 PETHIDINUM MIALGIN 100 mg/2 ml SOL. INJ. 50mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA X 2 ML PS 5 6.232000 6.232000 0.000000
165 W58214001 N02AB03 FENTANYLUM ** LUNALDIN 100 micrograme COMPR. SUBLING. 100micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 31.708000 31.708000 0.000000
166 W58215001 N02AB03 FENTANYLUM ** LUNALDIN 200 micrograme COMPR. SUBLING. 200micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 31.708000 31.708000 0.000000
167 W58216001 N02AB03 FENTANYLUM ** LUNALDIN 300 micrograme COMPR. SUBLING. 300micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 31.120000 31.120000 0.000000
168 W58217001 N02AB03 FENTANYLUM ** LUNALDIN 400 micrograme COMPR. SUBLING. 400micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 30.937000 30.937000 0.000000
169 W58218001 N02AB03 FENTANYLUM ** LUNALDIN 600 micrograme COMPR. SUBLING. 600micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 30.782000 30.782000 0.000000
170 W58219001 N02AB03 FENTANYLUM ** LUNALDIN 800 micrograme COMPR. SUBLING. 800micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 32.338000 32.338000 0.000000
171 W53503005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 100 mcg/h PLASTURE TRANSDERMIC 100mcg/h SANDOZ S.R.L. ROMANIA CUTIE CU 5 PLICURI DIN PET/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 31.934000 31.934000 0.000000
172 W53251003 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 100micrograme/h PLASTURE TRANSDERMIC 100micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC PS 5 31.972000 31.972000 0.000000
173 W53500005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 25 mcg/h PLASTURE TRANSDERMIC 25mcg/h SANDOZ S.R.L. ROMANIA CUTIE CU 5 PLICURI DIN PET/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 11.720000 11.720000 0.000000
174 W53248003 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 25micrograme/h PLASTURE TRANSDERMIC 25micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC PS 5 10.238000 10.238000 0.000000
175 W53501005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 50 mcg/h PLASTURE TRANSDERMIC 50mcg/h SANDOZ S.R.L. ROMANIA CUTIE CU 5 PLICURI DIN PET/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 20.230000 20.230000 0.000000
176 W53249003 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 50micrograme/h PLASTURE TRANSDERMIC 50micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC PS 5 18.452000 18.452000 0.000000
177 W53502005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 75 mcg/h PLASTURE TRANSDERMIC 75mcg/h SANDOZ S.R.L. ROMANIA CUTIE CU 5 PLICURI DIN PET/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 30.226000 30.226000 0.000000
178 W12691002 N02AX02 TRAMADOLUM TRAMADOL 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.397000 0.397000 0.000000
179 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.476400 0.476400 0.039100
180 W60291001 N02AX02 TRAMADOLUM TRAMACALM 50 mg CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0.476400 0.476400 0.039600
181 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.476400 0.476400 0.039100
182 W42957001 N02AX02 TRAMADOLUM CLORHIDRAT DE TRAMADOL BIOEEL 50 mg COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.476400 0.476400 0.039100
183 W68093001 N02AX02 TRAMADOLUM CLORHIDRAT DE TRAMADOL BIOEEL 50 mg COMPR. 50mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0.476400 0.476400 0.039100
184 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0.718800 0.718800 0.002866
185 W61448003 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0.599000 0.599000 0.000000
186 W61449001 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1.051999 1.051999 0.076001
187 W61449003 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0.876666 0.876666 0.000000
188 W61449011 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1.051999 1.051999 0.076001
189 W63389001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 1.051999 1.051999 0.213001
190 W63389002 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 BLIST. PP/AL X 10 COMPR. ELIB. PREL. P-RF 10 1.051999 1.051999 0.213001
191 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1.166000 1.166000 0.000000
192 W61450003 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1.091000 1.091000 0.000000
193 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 1.051999 1.051999 0.101001
194 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1.309200 1.309200 0.227800
195 W64091003 N02AX02 TRAMADOLUM TRAMADOL KALCEKS 50 mg/ml SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 2 TAVITE DIN PVC CU 10 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 10 2.028000 2.028000 0.000000
196 W05967001 N02AX02 TRAMADOLUM TRAMADOL 100 mg/2 ml SOL. INJ. 100mg/2ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 2.433600 2.433600 0.568400
197 W05961001 N02AX02 TRAMADOLUM MABRON 100 mg/2 ml SOL. INJ. 100mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 5 2.074000 2.074000 0.000000
198 W05966001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 1.128000 1.128000 0.000000
199 W66267001 N07BC02 METHADONUM METADONA BIOEEL 10 mg COMPR. 10mg S.C. BIO EEL S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC-PVDC X 10 COMPR. PS 20 1.113000 1.113000 0.000000
200 W66267002 N07BC02 METHADONUM METADONA BIOEEL 10 mg COMPR. 10mg S.C. BIO EEL S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC-PVDC X 10 COMPR. PS 50 1.077800 1.077800 0.000000
201 W51921003 N07BC02 METHADONUM SINTALGON 2,5 mg COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-TS 50 0.558800 0.558800 0.000000
202 W66268001 N07BC02 METHADONUM METADONA BIOEEL 40 mg COMPR. 40mg S.C. BIO EEL S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC-PVDC X 10 COMPR. PS 20 3.908500 3.908500 0.000000
203 W66268002 N07BC02 METHADONUM METADONA BIOEEL 40 mg COMPR. 40mg S.C. BIO EEL S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC-PVDC X 10 COMPR. PS 50 3.706000 3.706000 0.000000
204 W55533002 N07BC02 METHADONUM METADON BIOEEL 5 mg COMPR. 5mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 50 0.556800 0.556800 0.000000
205 W63213001 N07BC02 METHADONUM METHASAN 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CARE CONTINE 100 ML CONC. PT. SOL. ORALA, SERINGA GRADATA PT. ADMINISTRARE ORALA SI UN ADAPTOR PT. FLAC. PS 1 52.070000 52.070000 0.000000
206 W60166003 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 CU SIGILIU DIN PE A 1000 ML CONC. PT. SOL. ORAL PS 1 372.610000 372.610000 0.000000
207 W60166004 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII, A 1000 ML CONC. PT. SOL. ORALA PS 1 372.610000 372.610000 0.000000
208 W01411002 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.221000 0.221000 0.000000
209 W01409002 R05DA04 CODEINUM FOSFAT DE CODEINA EEL 15 mg COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0.226000 0.226000 0.000000

Pagina 46 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
210 W01407004 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 0.226500 0.226500 0.000000
211 W54406001 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.226500 0.226500 0.000000
212 W62739001 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0.226500 0.226500 0.000000
213 W68091001 R05DA04 CODEINUM FOSFAT DE CODEINA BIOEEL 15 mg COMPR. 15mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 25 COMPR. PRF 25 0.226000 0.226000 0.000000
214 W02408001 V03AC01 DEFEROXAMINUM ** (3) DESFERAL 500 mg PULB. PT. SOL. INJ./PERF. 500mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF. PR 10 14.691000 14.691000 0.000000
215 W64443001 V03AC03 DEFERASIROXUM ** EXJADE 180 mg COMPR. FILM. 180mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. PVC/PVDC/ALU X 30 COMPR. FILM. PR 30 42.462399 42.462399 4.645601
216 W66803001 V03AC03 DEFERASIROXUM ** REDITENS 180 mg COMPR. FILM. 180mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 35.385333 35.385333 0.000000
217 W66841001 V03AC03 DEFERASIROXUM ** DEFERASIROX STADA 180 mg COMPR. FILM. 180mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 35.385333 35.385333 0.000000
218 W68074001 V03AC03 DEFERASIROXUM ** DEFERASIROX ACCORD 180 mg COMPR. FILM. 180mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. (PVC/PE/PVDC/ALU) X 30X1 (UNIT DOSE) PR 30 35.385333 35.385333 0.000000
219 W68284001 V03AC03 DEFERASIROXUM ** ZEOKS 180 mg COMPR. FILM. 180mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE X 30X1 COMPR. FILM. PR 30 35.385333 35.385333 0.000000
220 W68284003 V03AC03 DEFERASIROXUM ** ZEOKS 180 mg COMPR. FILM. 180mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL NEPERFORATE X 30 COMPR. FILM. PR 30 35.385333 35.385333 0.000000
221 W68284005 V03AC03 DEFERASIROXUM ** ZEOKS 180 mg COMPR. FILM. 180mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE X 30X1 COMPR. FILM. PR 30 35.385333 35.385333 0.000000
222 W68284007 V03AC03 DEFERASIROXUM ** ZEOKS 180 mg COMPR. FILM. 180mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL NEPERFORATE X 30 COMPR. FILM. PR 30 35.385333 35.385333 0.000000
223 W64444001 V03AC03 DEFERASIROXUM ** EXJADE 360 mg COMPR. FILM. 360mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. PVC/PVDC/ALU X 30 COMPR. FILM. PR 30 82.091199 82.091199 9.763467
224 W66804001 V03AC03 DEFERASIROXUM ** REDITENS 360 mg COMPR. FILM. 360mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 68.411000 68.411000 0.000000
225 W66842001 V03AC03 DEFERASIROXUM ** DEFERASIROX STADA 360 mg COMPR. FILM. 360mg STADA M&D S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 68.409333 68.409333 0.000000
226 W68075001 V03AC03 DEFERASIROXUM ** DEFERASIROX ACCORD 360 mg COMPR. FILM. 360mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. (PVC/PE/PVDC/ALU) X 30X1 (UNIT DOSE) PR 30 68.409333 68.409333 0.000000
227 W68283001 V03AC03 DEFERASIROXUM ** ZEOKS 360 mg COMPR. FILM. 360mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE X 30X1 COMPR. FILM. PR 30 68.409333 68.409333 0.000000
228 W68283003 V03AC03 DEFERASIROXUM ** ZEOKS 360 mg COMPR. FILM. 360mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL NEPERFORATE X 30 COMPR. FILM. PR 30 68.409333 68.409333 0.000000
229 W68283005 V03AC03 DEFERASIROXUM ** ZEOKS 360 mg COMPR. FILM. 360mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE X 30X1 COMPR. FILM. PR 30 68.409333 68.409333 0.000000
230 W68283007 V03AC03 DEFERASIROXUM ** ZEOKS 360 mg COMPR. FILM. 360mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL NEPERFORATE X 30 COMPR. FILM. PR 30 68.409333 68.409333 0.000000
231 W66802001 V03AC03 DEFERASIROXUM ** REDITENS 90 mg COMPR. FILM. 90mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 19.898000 19.898000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea oncologie, hematologie, oncologie şi hematologie pediatrică sau pediatrie cu supraspecializarea în hematooncologie pediatrică/oncologie pediatrică sau competenţă în oncopediatrie sau atestat de studii complementare în oncologie şi hematologie pediatrică.

9. EPILEPSIE - G11

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 0.247599 0.247599 0.241201
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 0.206333 0.206333 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 7.068000 7.068000 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 0.385000 0.385000 0.000000
5 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 24.518000 24.518000 0.000000
6 W00806001 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0.156200 0.156200 0.000000
7 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 0.156500 0.156500 0.000000
8 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 0.156500 0.156500 0.000000
9 W12403003 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA SLAVIA 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0.156200 0.156200 0.000000
10 W62172002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA TERAPIA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0.156200 0.156200 0.000000
11 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 0.155500 0.155500 0.000000
12 W68153001 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN BIOEEL 200 mg COMPR. 200mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.156500 0.156500 0.000000
13 W00807001 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0.433000 0.433000 0.000000
14 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 0.432000 0.432000 0.000000
15 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 0.335200 0.335200 0.000000
16 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 0.433680 0.433680 0.021520
17 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 0.807000 0.807000 0.000000
18 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 0.361400 0.361400 0.000000
19 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 0.700600 0.700600 0.000000
20 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 47.940000 47.940000 0.000000
21 W51417002 N03AF02 OXCARBAZEPINUM TRILEPTAL 300 mg COMPR. FILM. 300mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 0.978800 0.978800 0.000000
22 W51416002 N03AF02 OXCARBAZEPINUM TRILEPTAL 600 mg COMPR. FILM. 600mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 1.487800 1.487800 0.000000
23 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 0.287160 0.287160 0.252040
24 W63234001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ.
LANNACHER HEILMITTEL GES.M.B.H. P6L 100 0.239300 0.239300 0.000000
25 W63235001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ.
LANNACHER HEILMITTEL GES.M.B.H. P6L 100 0.336400 0.336400 0.000000
26 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 0.403680 0.403680 0.011920
27 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 0.577666 0.577666 0.000000
28 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 0.418250 0.418250 0.000000
29 W08325005 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 100 MINIPLICURI. DIN HARTIE/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 100 1.888600 1.888600 0.000000
30 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 1.747000 1.747000 0.000000
31 W43170001 N03AG01 ACIDUM VALPROICUM + SARURI VALEPIL 200 mg/5 ml SIROP 200mg/5ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 100 ML SI O LINGURITA DOZATOARE DUBLA (2,5/5 ML) P-6L 1 23.110000 23.110000 0.000000
32 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 20.140000 20.140000 0.000000
33 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 20.140000 20.140000 0.000000

Pagina 47 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
34 W42997002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.949666 0.949666 0.000000
35 W65105001 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 1.139599 1.139599 0.289329
36 W42996002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.033000 2.033000 0.000000
37 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 0.311071 0.311071 0.000000
38 W65103003 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0.311428 0.311428 0.000000
39 W42995002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.632666 0.632666 0.000000
40 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 0.260000 0.260000 0.000000
41 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 0.150333 0.150333 0.000000
42 W65101010 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. MAST./DISP. 5mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU FLAC. DIN PEID X 30 COMPR. MAST./DISP. P6L 30 0.150333 0.150333 0.000000
43 W53160001 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 100 mg COMPR. FILM. 100mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 1.083833 1.083833 0.000000
44 W59849002 N03AX11 TOPIRAMATUM ** TOPILEX 100 mg COMPR. FILM. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 1.119666 1.119666 0.000000
45 W64806001 N03AX11 TOPIRAMATUM ** TOPIRAMAT TEVA 100 mg COMPR. FILM. 100mg TEVA B.V. OLANDA CUTIE CU 6 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. PRF 60 1.083833 1.083833 0.000000
46 W53158001 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 25 mg COMPR. FILM. 25mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 0.439666 0.439666 0.000000
47 W59847002 N03AX11 TOPIRAMATUM ** TOPILEX 25 mg COMPR. FILM. 25mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.430333 0.430333 0.000000
48 W64802001 N03AX11 TOPIRAMATUM ** TOPIRAMAT TEVA 25 mg COMPR. FILM. 25mg TEVA B.V. OLANDA CUTIE CU 6 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. PRF 60 0.439666 0.439666 0.000000
49 W53159001 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 50 mg COMPR. FILM. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 0.691166 0.691166 0.000000
50 W59848002 N03AX11 TOPIRAMATUM ** TOPILEX 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0.684000 0.684000 0.000000
51 W64804001 N03AX11 TOPIRAMATUM ** TOPIRAMAT TEVA 50 mg COMPR. FILM. 50mg TEVA B.V. OLANDA CUTIE CU 6 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. PRF 60 0.691166 0.691166 0.000000
52 W64281004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0.182200 0.182200 0.000000
53 W54332002 N03AX12 GABAPENTINUM ** GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0.218640 0.218640 0.417526
54 W60025001 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0.218640 0.218640 0.417526
55 W64282004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0.494200 0.494200 0.000000
56 W41589005 N03AX12 GABAPENTINUM ** GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.573480 0.573480 0.261020
57 W43540001 N03AX12 GABAPENTINUM ** GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.477900 0.477900 0.000000
58 W54333001 N03AX12 GABAPENTINUM ** GRIMODIN 300 mg CAPS. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0.573480 0.573480 0.061686
59 W60026001 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0.573480 0.573480 1.005020
60 W64360001 N03AX12 GABAPENTINUM ** GABALEPT 300 mg CAPS. 300mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0.477900 0.477900 0.000000
61 W65059001 N03AX12 GABAPENTINUM ** GABARAN 300 mg CAPS. 300mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0.573480 0.573480 0.886520
62 W64283004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0.659800 0.659800 0.000000
63 W41590005 N03AX12 GABAPENTINUM ** GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.764280 0.764280 0.403220
64 W43541001 N03AX12 GABAPENTINUM ** GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0.636900 0.636900 0.000000
65 W54334001 N03AX12 GABAPENTINUM ** GRIMODIN 400 mg CAPS. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0.764280 0.764280 0.332720
66 W60027001 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0.764280 0.764280 1.278220
67 W64361001 N03AX12 GABAPENTINUM ** GABALEPT 400 mg CAPS. 400mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0.636900 0.636900 0.000000
68 W65060001 N03AX12 GABAPENTINUM ** GABARAN 400 mg CAPS. 400mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0.764280 0.764280 0.901320
69 W65061001 N03AX12 GABAPENTINUM ** GABARAN 600 mg COMPR. FILM. 600mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P6L 30 2.363666 2.363666 0.000000
70 W58650001 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TERAPIA 1000 mg COMPR. FILM. 1000 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMP.FILM. PRF 30 1.396333 1.396333 0.000000
71 W58295002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. PRF 30 1.163666 1.163666 0.000000
72 W66007002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. FILM. PRF 30 1.163666 1.163666 0.000000
73 W58649003 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF 30 0.721000 0.721000 0.000000
74 W66006002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0.601000 0.601000 0.000000
75 W57149002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 1000 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 1.396399 1.396399 1.806267
76 W57147002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 500 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 500mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 0.721200 0.721200 0.840466
77 W57148004 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 750 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 750mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 60 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 60 2.134166 2.134166 0.000000
78 W57146002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 250 mg GRANULE DRAJEFIATE IN PLIC 250mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI DIN HARTIE/AL/PE CONTINAND GRANULE DRAJEFIATE PRF 30 0.709666 0.709666 0.000000
79 W57146003 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 250 mg GRANULE DRAJEFIATE IN PLIC 250mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 50 PLICURI DIN HARTIE/AL/PE CONTINAND GRANULE DRAJEFIATE PRF 50 0.722800 0.722800 0.000000
80 W57146005 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 250 mg GRANULE DRAJEFIATE IN PLIC 250mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 100 PLICURI DIN HARTIE/AL/PE CONTINAND GRANULE DRAJEFIATE PRF 100 0.670800 0.670800 0.000000
81 W57148003 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 750 mg GRANULE DRAJEFIATE IN PLIC 750mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 50 PLICURI DIN HARTIE/AL/PE CONTINAND GRANULE DRAJEFIATE PRF 50 2.326600 2.326600 0.000000
82 W57729001 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACTAVIS GROUP 100mg/ml SOL. ORALA 100 mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLACON DIN STICLA BRUNA A 300ML PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 SERINGA PENTRU ADMINISTRARE ORALA A 10ML PRF 1 65.370000 65.370000 0.000000
83 W66333001 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACCORD 100 mg/ml SOL. ORALA 100mg/ml ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, O SERINGA DOZATOARE DE 10 ML CU UN ADAPTOR PT. SERINGA X 300 ML SOL. ORALA PR 1 65.370000 65.370000 0.000000
84 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 1.384500 1.384500 1.450500
85 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 1.153750 1.153750 0.000000
86 W63613008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1.384500 1.384500 1.450500
87 W63613010 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.153750 1.153750 0.000000
88 W41745001 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 0.741856 0.741856 1.271001
89 W41745002 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 0.741856 0.741856 0.611358
90 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 0.663571 0.663571 0.000000
91 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 0.641785 0.641785 0.000000
92 W62053001 N03AX16 PREGABALINUM ** PREGABALIN ZENTIVA 150 mg CAPS. 150mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.653392 0.653392 0.000000
93 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 0.741856 0.741856 2.400286

Pagina 48 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
94 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 0.741856 0.741856 0.403501
95 W62572008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0.741856 0.741856 2.400286
96 W62572011 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.741856 0.741856 0.403501
97 W63186001 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0.741856 0.741856 2.058144
98 W63186004 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.653392 0.653392 0.000000
99 W63186008 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0.741856 0.741856 2.058144
100 W63186011 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0.653392 0.653392 0.000000
101 W64907002 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0.741856 0.741856 0.611358
102 W64907001 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0.741856 0.741856 1.271001
103 W65243001 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0.618214 0.618214 0.000000
104 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 0.741856 0.741856 0.853144
105 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 0.741856 0.741856 0.034929
106 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 0.741856 0.741856 0.388679
107 W66013005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 0.646166 0.646166 0.000000
108 W66797001 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg UPJOHN EESV OLANDA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0.741856 0.741856 1.271001
109 W66797002 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg UPJOHN EESV OLANDA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0.741856 0.741856 0.611358
110 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 2.348785 2.348785 2.584786
111 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 1.957321 1.957321 0.000000
112 W63615008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2.348785 2.348785 2.584786
113 W63615010 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.957321 1.957321 0.000000
114 W41747001 N03AX16 PREGABALINUM ** LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 1.692000 1.692000 1.253714
115 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 1.549285 1.549285 0.000000
116 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 1.423750 1.423750 0.000000
117 W63187001 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1.692000 1.692000 2.873000
118 W63187004 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1.410000 1.410000 0.000000
119 W63187008 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 1.692000 1.692000 2.873000
120 W63187011 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1.410000 1.410000 0.000000
121 W64908001 N03AX16 PREGABALINUM ** LYRICA 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 1.692000 1.692000 1.253714
122 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 1.692000 1.692000 0.791571
123 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 1.692000 1.692000 0.531035
124 W66014005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 CAPS. PRF 60 1.416166 1.416166 0.000000
125 W66798001 N03AX16 PREGABALINUM ** LYRICA 300 mg CAPS. 300mg UPJOHN EESV OLANDA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 1.692000 1.692000 1.253714
126 W41743001 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 0.633000 0.633000 0.499857
127 W41743002 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 0.633000 0.633000 0.358071
128 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 0.542857 0.542857 0.000000
129 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 0.542857 0.542857 0.000000
130 W62052001 N03AX16 PREGABALINUM ** PREGABALIN ZENTIVA 75 mg CAPS. 75mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.548928 0.548928 0.000000
131 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 0.633000 0.633000 1.318428
132 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 0.633000 0.633000 0.098428
133 W62571008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0.633000 0.633000 1.318428
134 W62571011 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.633000 0.633000 0.098428
135 W63185001 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0.633000 0.633000 0.237714
136 W63185004 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0.548928 0.548928 0.000000
137 W63185008 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0.633000 0.633000 0.237714
138 W63185011 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0.548928 0.548928 0.000000
139 W64906002 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0.633000 0.633000 0.358071
140 W64906001 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0.633000 0.633000 0.499857
141 W65242001 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0.527500 0.527500 0.000000
142 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 0.633000 0.633000 0.236285
143 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 0.633000 0.633000 0.047892
144 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 0.578392 0.578392 0.000000
145 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 0.571666 0.571666 0.000000
146 W66796001 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg UPJOHN EESV OLANDA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0.633000 0.633000 0.499857
147 W66796002 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg UPJOHN EESV OLANDA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0.633000 0.633000 0.358071
148 W64181001 N03AX16 PREGABALINUM ** SIRANALEN 20 mg/ml SOL. ORALA 20mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 FLAC. PEID CONTINAND 473 ML SOL. ORALA, O SERINGA PT. ADMINISTRARE ORALA, UN ADAPTOR DIN PLASTIC ALB CARE SE ATASEAZA LA FLAC. PRIN IMPINGERE PRF 1 150.670000 150.670000 0.000000
149 W51468002 N03AX17 STIRIPENTOLUM ** DIACOMIT 250mg CAPS. 250mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 13.373000 13.373000 0.000000
150 W58592002 N03AX17 STIRIPENTOLUM ** DIACOMIT 500mg CAPS. 500mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 25.565000 25.565000 0.000000
151 W51470002 N03AX17 STIRIPENTOLUM ** DIACOMIT 250mg PULB. PT. SUSP. ORALA 250mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 13.373000 13.373000 0.000000
152 W51471002 N03AX17 STIRIPENTOLUM ** DIACOMIT 500mg PULB. PT. SUSP. ORALA 500mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 25.565000 25.565000 0.000000
153 W63827001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 100mg COMPR. FILM. 100mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 7.949107 7.949107 0.000000

Pagina 49 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
154 W63823001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 10mg COMPR. FILM. 10mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 14COMPRIMATE FILMATE PRF 14 7.812142 7.812142 0.000000
155 W63824001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 25mg COMPR. FILM. 25mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 7.949107 7.949107 0.000000
156 W63825001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 50mg COMPR. FILM. 50mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 7.294642 7.294642 0.000000
157 W63826001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 75mg COMPR. FILM. 75mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 8.320000 8.320000 0.000000
158 W63829001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 10mg/ml SOL. ORALA 10mg/ml U.C.B. PHARMA S.A. BELGIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, 300 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII (PE) + 1 SERINGA PT. ADMINISTRARE ORALA (PP, PE), GRADATA, A 5 ML SI 10 ML + 1 ADAPTOR PT. SERINGA (PE) PRF 1 492.000000 492.000000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea neurologie şi neurologie pediatrică.

10. BOALA PARKINSON ŞI ALTE AFECŢIUNI NEUROLOGICE - G12

1 W06002001 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 1.092600 1.092600 0.000000
2 MADOPAR 200mg/50mg
W58811002 N04BA02 COMBINATII (LEVODOPUM+BENSERAZIDUM) ** COMPR. 200mg+50mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 1.389333 1.389333 0.000000
3 W03950004 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM) ** ISICOM 250 mg/25 mg COMPR. 250mg/25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 10 BLIST. PP/AL X 10 COMPR. P-6L 100 1.247100 1.247100 0.000000
4 W60962001 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM) ** DUODOPA 20 mg/ml+5 mg/ml GEL INT. 20mg/ml+5mg/ml ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC PR 7 438.391428 438.391428 0.000000
5 W61590003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1.341840 1.341840 0.162160
6 W61362008 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1.341840 1.341840 0.202160
7 W62567004 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1.118200 1.118200 0.000000
8 W61363008 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1.967500 1.967500 0.000000
9 W61591003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1.430000 1.430000 0.000000
10 W61364008 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1.542000 1.542000 0.000000
11 W62568004 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1.291700 1.291700 0.000000
12 W61366008 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1.264500 1.264500 0.000000
13 W62569004 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1.211800 1.211800 0.000000
14 W61360008 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1.544800 1.544800 0.000000
15 W62566004 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TRIGELAN 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1.406900 1.406900 0.000000
16 W61361008 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF 100 1.253400 1.253400 0.000000
17 W67558001 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** LECIGON 20 mg/5 mg/20 mg/ml GEL INTESTINAL 20mg/5mg/20mg/ml LABSOR PHARMACEUTICALS AB SUEDIA CUTIE CU 7 CARTUSE DIN PP CU PISTON A CATE 47 ML GEL INTESTINAL PR 7 607.414285 607.414285 0.000000
18 W00264001 N04BB01 AMANTADINUM ** VIREGYT-K 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 0.414400 0.414400 0.000000
19 W11164002 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 0.694500 0.694500 0.000000
20 W65198006 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 2 mg COMPR. CU ELIB. PREL. 2mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL-HÂRTIE X 28 COMPR. CU ELIB. PREL. P-RF 28 1.213713 1.213713 0.220572
21 W65199003 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 4 mg COMPR. CU ELIB. PREL. 4mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL-HÂRTIE X 28 COMPR. CU ELIB. PREL. P-RF 28 2.347713 2.347713 0.245144
22 W65200003 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 8 mg COMPR. CU ELIB. PREL. 8mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL-HÂRTIE X 28 COMPR. CU ELIB. PREL. PRF 28 4.032428 4.032428 0.457572
23 W56606002 N04BC04 ROPINIROLUM ** ROLPRYNA EP 2 mg COMPR. CU ELIBERARE PRELUNGITA 2 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF 28 1.011428 1.011428 0.000000
24 W56607002 N04BC04 ROPINIROLUM ** ROLPRYNA EP 4 mg COMPR. CU ELIBERARE PRELUNGITA 4 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF 28 1.956428 1.956428 0.000000
25 W56608002 N04BC04 ROPINIROLUM ** ROLPRYNA EP 8 mg COMPR. CU ELIBERARE PRELUNGITA 8 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF 28 3.360357 3.360357 0.000000
26 W58902002 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 2 mg COMPR. ELIB. PREL. 2mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 1.011428 1.011428 0.000000
27 W68051002 N04BC04 ROPINIROLUM ** ROPINIROL TEVA 2 mg COMPR. ELIB. PREL. 2mg TEVA B.V. OLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 1.011428 1.011428 0.000000
28 W58903002 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 4 mg COMPR. ELIB. PREL. 4mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 1.956428 1.956428 0.000000
29 W68053002 N04BC04 ROPINIROLUM ** ROPINIROL TEVA 4 mg COMPR. ELIB. PREL. 4mg TEVA B.V. OLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 1.956428 1.956428 0.000000
30 W58904002 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 8 mg COMPR. ELIB. PREL. 8mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 3.360357 3.360357 0.000000
31 W68055002 N04BC04 ROPINIROLUM ** ROPINIROL TEVA 8 mg COMPR. ELIB. PREL. 8mg TEVA B.V. OLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 3.360357 3.360357 0.000000
32 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 0.427200 0.427200 0.061800
33 W53525002 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0.427200 0.427200 0.043800
34 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 0.427200 0.427200 0.114133
35 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 0.356000 0.356000 0.000000
36 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 2.512333 2.512333 0.000000
37 W53527002 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 2.163666 2.163666 0.000000
38 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 2.163000 2.163000 0.000000
39 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 2.212666 2.212666 0.000000
40 W60244001 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0.714000 0.714000 0.000000
41 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 0.703000 0.703000 0.000000
42 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 1.853199 1.853199 0.443801
43 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 1.544333 1.544333 0.000000
44 W60803002 N04BC05 PRAMIPEXOLUM ** CALMOLAN 0,52 mg COMPR. ELIB. PREL. 0,52mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/ALC X 30 COMPR. ELIB. PREL. PRF 30 1.544333 1.544333 0.000000
45 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 2.273599 2.273599 1.753734
46 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 1.894666 1.894666 0.000000
47 W60243001 N04BC05 PRAMIPEXOLUM ** OPRYMEA 2,10mg COMPR. ELIB. PREL. 2,10mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 3.599000 3.599000 0.000000
48 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 4.318800 4.318800 2.526866

Pagina 50 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
49 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 4.107333 4.107333 0.000000
50 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 8.544333 8.544333 0.000000
51 W66228002 N04BC07 APOMORFINUM ** Ω APO-GO 10 mg/ml SOL. INJ. IN PEN MULTIDOZA 10mg/ml STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 5 STILOURI INJECTOARE TIP "PEN" MULTIDOZA X 3 ML SOL. INJ. PRF 5 169.676000 169.676000 0.000000
52 W64036003 N04BC09 ROTIGOTINUM ** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 7.645000 7.645000 0.000000
53 W64037003 N04BC09 ROTIGOTINUM ** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 10.956785 10.956785 0.000000
54 W64038003 N04BC09 ROTIGOTINUM ** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 14.103214 14.103214 0.000000
55 W64039003 N04BC09 ROTIGOTINUM ** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 16.760357 16.760357 0.000000
56 W08952005 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 BLIST. DIN AL/PVC X 10 COMPR. P-6L 50 0.786200 0.786200 0.000000
57 W08952003 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L 100 0.943440 0.943440 0.001960
58 W62180001 N04BD02 RASAGILINUM ** RASAGILINA RATIOPHARM 1 mg COMPR. 1mg TEVA B.V. OLANDA CUTIE CU BLIST AL/AL X 30 COMPR. PRF 30 2.087599 2.087599 0.799067
59 W62556004 N04BD02 RASAGILINUM ** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 2.087599 2.087599 0.799067
60 W62556010 N04BD02 RASAGILINUM ** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 2.087599 2.087599 0.799067
61 W62766004 N04BD02 RASAGILINUM ** HIPERAVIA 1 mg COMPR. 1mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2.087599 2.087599 0.000067
62 W62759004 N04BD02 RASAGILINUM ** RASIGEROLAN 1 mg COMPR. 1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.873333 1.873333 0.000000
63 W62764004 N04BD02 RASAGILINUM ** RASAGILINA ZENTIVA 1 mg COMPR. 1mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2.087599 2.087599 1.060401
64 W62982004 N04BD02 RASAGILINUM ** AZILECT 1mg COMPR. 1mg TEVA BV OLANDA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 2.087599 2.087599 2.052734
65 W66562012 N04BD02 RASAGILINUM ** RASAGILINA AUROBINDO 1 mg COMPR. 1mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 1.739666 1.739666 0.000000
66 W59891001 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 1.963333 1.963333 0.000000
67 W59891002 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PRF 60 1.864333 1.864333 0.000000
68 W59891003 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 100 COMPR. FILM. PRF 100 1.767900 1.767900 0.000000
69 W63027003 N04BX02 ENTACAPONUM ** ENTACAPONE TEVA COMPR. FILM. 200mg TEVA B.V. OLANDA CUTIE CU 1 FLAC. DIN PEID X 100 COMPR. FILM PRF 100 1.767900 1.767900 0.000000
70 W63177002 N05AH02 CLOZAPINUM ** LEPONEX 100 mg COMPR. 100mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 1.267600 1.267600 0.000000
71 W63176002 N05AH02 CLOZAPINUM ** LEPONEX 25 mg COMPR. 25mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 0.419400 0.419400 0.000000
72 W60126001 N07XX06 TETRABENAZINUM ** TETMODIS 25 mg COMPR. 25mg AOP ORPHAN PHARMACEUTICALS AG AUSTRIA CUTIE CU 1 FLAC. PEID X 112 COMPR. PRF 112 4.800000 4.800000 0.000000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

11. MIASTENIA GRAVIS - G13

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 0.151000 0.151000 0.000000
2 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
3 W13686002 H02AB07 PREDNISONUM PREDNISON SINTOFARM 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
4 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 0.145000 0.145000 0.000000
5 W60846001 L04AX01 AZATHIOPRINUM IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.638800 0.000000
6 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 1.239166 1.239166 0.000000
7 W57190001 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg MEDA AB SUEDIA CUTIE X 1 FLAC. X 20 DRAJ. P-RF 20 0.706500 0.706500 0.000000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

12. SCLEROZA MULTIPLA - G14

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 0.654800 0.654800 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 0.654800 0.654800 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 2.298500 2.298500 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 2.298500 2.298500 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 23.500000 23.500000 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 71.250000 71.250000 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 0.151000 0.151000 0.000000
8 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
9 W13686002 H02AB07 PREDNISONUM PREDNISON SINTOFARM 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
10 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 0.145000 0.145000 0.000000
11 W42735002 L01DB07 MITOXANTRONUM ** ONKOTRONE 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. PR 1 630.540000 630.540000 0.000000
12 W60846001 L04AX01 AZATHIOPRINUM IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.638800 0.000000

Tratamentul se iniţiază de către medicul din specialitatea neurologie.

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

Pagina 51 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


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

1 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 0.287160 0.287160 0.252040
2 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 0.239300 0.239300 0.000000
3 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 0.336400 0.336400 0.000000
4 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 0.403680 0.403680 0.011920
5 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 0.577666 0.577666 0.000000
6 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 0.418250 0.418250 0.000000
7 W08325005 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 100 MINIPLICURI. DIN HARTIE/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 100 1.888600 1.888600 0.000000
8 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 1.747000 1.747000 0.000000
9 W43170001 N03AG01 ACIDUM VALPROICUM + SARURI VALEPIL 200 mg/5 ml SIROP 200mg/5ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 100 ML SI O LINGURITA DOZATOARE DUBLA (2,5/5 ML) P-6L 1 23.110000 23.110000 0.000000
10 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 20.140000 20.140000 0.000000
11 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 20.140000 20.140000 0.000000
12 W42997002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.949666 0.949666 0.000000
13 W65105001 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 1.139599 1.139599 0.289329
14 W42996002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2.033000 2.033000 0.000000
15 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 0.311071 0.311071 0.000000
16 W65103003 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0.311428 0.311428 0.000000
17 W42995002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.632666 0.632666 0.000000
18 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 0.260000 0.260000 0.000000
19 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 0.150333 0.150333 0.000000
20 W65101010 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. MAST./DISP. 5mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU FLAC. DIN PEID X 30 COMPR. MAST./DISP. P6L 30 0.150333 0.150333 0.000000
21 W06002001 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 1.092600 1.092600 0.000000
22 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 0.185000 0.185000 0.000000
23 W56620001 N05AD01 HALOPERIDOLUM PIC. ORALE, SOL.
HALOPERIDOL ROMPHARM 2 mg/ml 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 5.950000 5.950000 0.000000
24 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 7.140000 7.140000 0.460000
25 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 7.140000 7.140000 0.360000
26 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 2.554000 2.554000 0.000000
27 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 14.798928 14.798928 0.000000
28 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 3.775000 3.775000 0.000000
29 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 3.076166 3.076166 0.000000
30 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 4.648666 4.648666 0.000000
31 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 4.403000 4.403000 0.000000
32 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 7.010000 7.010000 0.000000
33 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 0.366800 0.366800 0.000000
34 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 31.260000 31.260000 0.000000
35 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 13.501000 13.501000 0.000000
36 W13182005 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL ACUPHASE 50 mg/ml SOL. INJ. 50mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 5 FIOLE X 1 ML P-RF 5 9.996000 9.996000 0.000000
37 W63177002 N05AH02 CLOZAPINUM ** LEPONEX 100 mg COMPR. 100mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 1.267600 1.267600 0.000000
38 W63176002 N05AH02 CLOZAPINUM ** LEPONEX 25 mg COMPR. 25mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 0.419400 0.419400 0.000000
39 W52357003 N05AH03 OLANZAPINUM ** ZALASTA 10mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL) P-RF 28 0.617500 0.617500 0.000000
40 W52354002 N05AH03 OLANZAPINUM ** ZALASTA 5mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL) P-RF 28 0.484642 0.484642 0.000000
41 W08727002 N05AH03 OLANZAPINUM ** ZYPREXA 10 mg COMPR. FILM. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 0.740799 0.740799 1.938129
42 W55022004 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0.740799 0.740799 2.663843
43 W55022005 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0.740799 0.740799 2.664201
44 W55124004 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0.617333 0.617333 0.000000
45 W62411002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0.740714 0.740714 0.000000
46 W64075002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. FILM. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0.740714 0.740714 0.000000
47 W68186004 N05AH03 OLANZAPINUM ** OLANZAPINA TEVA 10 mg COMPR. FILM. 10mg TEVA B.V. OLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 0.617333 0.617333 0.000000
48 W55023004 N05AH03 OLANZAPINUM ** LAPOZAN 15 mg COMPR. FILM. 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 3.144000 3.144000 4.340285
49 W08557001 N05AH03 OLANZAPINUM ** ZYPREXA 5 mg COMPR. FILM. 5mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 0.493200 0.493200 1.838942
50 W55021004 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0.493200 0.493200 0.932871
51 W55021005 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0.493200 0.493200 0.932800
52 W55122004 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0.411000 0.411000 0.000000
53 W62412002 N05AH03 OLANZAPINUM ** BLOONIS 5 mg COMPR. FILM. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0.490357 0.490357 0.000000
54 W64076002 N05AH03 OLANZAPINUM ** BLOONIS 5 mg COMPR. FILM. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0.490357 0.490357 0.000000
55 W68184004 N05AH03 OLANZAPINUM ** OLANZAPINA TEVA 5 mg COMPR. FILM. 5mg TEVA B.V. OLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 0.411000 0.411000 0.000000
56 W54601004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0.733571 0.733571 0.000000
57 W62413002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. ORODISPERSABILE 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0.617500 0.617500 0.000000
58 W64077002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. ORODISPERSABILE 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0.617500 0.617500 0.000000
59 W66001004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 10 mg COMPR. ORODISPERSABILE 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0.712500 0.712500 0.000000

Pagina 52 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
60 W54602004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2.620000 2.620000 0.000000
61 W56902001 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 15 mg COMPR. ORODISPERSABILE 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 3.144000 3.144000 0.026714
62 W62414002 N05AH03 OLANZAPINUM ** BLOONIS 15 mg COMPR. ORODISPERSABILE 15mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 3.144000 3.144000 0.054928
63 W64078002 N05AH03 OLANZAPINUM ** BLOONIS 15 mg COMPR. ORODISPERSABILE 15mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 3.144000 3.144000 0.054928
64 W66002004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 3.034642 3.034642 0.000000
65 W67794001 N05AH03 OLANZAPINUM ** OLANZAPINA TEVA 15 mg COMPR. ORODISPERSABILE 15mg TEVA B.V. OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE PRF 28 3.144000 3.144000 0.026714
66 W54603004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 20 mg COMPR. ORODISPERSABILE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2.064856 2.064856 0.955501
67 W56903001 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 20 mg COMPR. ORODISPERSABILE 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2.064642 2.064642 0.000000
68 W62415002 N05AH03 OLANZAPINUM ** BLOONIS 20 mg COMPR. ORODISPERSABILE 20mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2.064856 2.064856 0.057286
69 W64079002 N05AH03 OLANZAPINUM ** BLOONIS 20 mg COMPR. ORODISPERSABILE 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2.064856 2.064856 0.057286
70 W66003004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 20 mg COMPR. ORODISPERSABILE 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 1.720714 1.720714 0.000000
71 W67796001 N05AH03 OLANZAPINUM ** OLANZAPINA TEVA 20 mg COMPR. ORODISPERSABILE 20mg TEVA B.V. OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE PRF 28 2.064642 2.064642 0.000000
72 W54599004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 5 mg COMPR. ORODISPERSABILE 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0.488214 0.488214 0.000000
73 W66000004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 5 mg COMPR. ORODISPERSABILE 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PE-DESICANT-PE/AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0.473214 0.473214 0.000000
74 W53870001 N05AH03 OLANZAPINUM ** ZYPADHERA 210mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 210mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 210MG PULB. + 1 FLAC. X 3ML SOLVENT PR 1 559.400000 559.400000 0.000000
75 W53871001 N05AH03 OLANZAPINUM ** ZYPADHERA 300mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 300mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 300MG PULB. + 1 FLAC. X 3ML SOLVENT PR 1 784.370000 784.370000 0.000000
76 W53872001 N05AH03 OLANZAPINUM ** ZYPADHERA 405mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 405mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 405MG PULB. + 1 FLAC. X 3ML SOLVENT PR 1 1,048.060000 1,048.060000 0.000000
77 W63282004 N05AH04 QUETIAPINUM ** UNIQUET 200 mg COMPR. CU ELIB. PREL. 200mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 0.900600 0.900600 0.000066
78 W65804004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 200 mg COMPR. CU ELIB. PREL. 200mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. PREL. PRF 60 0.750500 0.750500 0.000000
79 W63284004 N05AH04 QUETIAPINUM ** UNIQUET 300 mg COMPR. CU ELIB. PREL. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 1.638999 1.638999 0.000001
80 W65805004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 300 mg COMPR. CU ELIB. PREL. 300mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. PREL. PRF 60 1.365833 1.365833 0.000000
81 W63286004 N05AH04 QUETIAPINUM ** UNIQUET 400 mg COMPR. CU ELIB. PREL. 400mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 2.445333 2.445333 0.000000
82 W65806004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 400 mg COMPR. CU ELIB. PREL. 400mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. PREL. PRF 60 2.037833 2.037833 0.000000
83 W63280009 N05AH04 QUETIAPINUM ** UNIQUET 50 mg COMPR. CU ELIB. PREL. 50mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ELIB. PREL. PRF 60 0.481833 0.481833 0.000000
84 W63280004 N05AH04 QUETIAPINUM ** UNIQUET 50 mg COMPR. CU ELIB. PREL. 50mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 0.481833 0.481833 0.000000
85 W59533007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 150 mg COMPR. ELIB. PREL. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1.245399 1.245399 0.083101
86 W63039004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1.245399 1.245399 0.328934
87 W63631004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 150 mg COMPR. ELIB. PREL. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 1.037833 1.037833 0.000000
88 W65168001 N05AH04 QUETIAPINUM ** SEROQUEL XR 150 mg COMPR. ELIB. PREL. 150mg ASTRAZENECA AB SUEDIA CUTIE CU 6 BLIST. DIN PVC-PCTFE/AL X 10 COMPR. ELIB. PREL. PRF 60 1.245399 1.245399 2.154267
89 W66340004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 150 mg COMPR. ELIB. PREL. 150mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 1.037833 1.037833 0.000000
90 W58674007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 200 mg COMPR. ELIB. PREL. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0.896833 0.896833 0.000000
91 W63040004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 200 mg COMPR. ELIB. PREL. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 0.900600 0.900600 0.023066
92 W58675007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 300 mg COMPR. ELIB. PREL. 300mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1.590833 1.590833 0.000000
93 W63041004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 300 mg COMPR. ELIB. PREL. 300mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1.638666 1.638666 0.000000
94 W58676007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 400 mg COMPR. ELIB. PREL. 400mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 2.340833 2.340833 0.000000
95 W63042004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 2.445399 2.445399 0.359601
96 W58673007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 50 mg COMPR. ELIB. PREL. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0.467666 0.467666 0.000000
97 W63038004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 50 mg COMPR. ELIB. PREL. 50mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 0.486166 0.486166 0.000000
98 W66339007 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 50 mg COMPR. ELIB. PREL. 50mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 0.468333 0.468333 0.000000
99 W63528001 N05AL01 SULPIRIDUM EGLONYL 50 mg CAPS. 50mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. PRF 30 0.369666 0.369666 0.000000
100 W63528002 N05AL01 SULPIRIDUM EGLONYL 50 mg CAPS. 50mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 30 CAPS. PRF 30 0.369666 0.369666 0.000000
101 W63529001 N05AL01 SULPIRIDUM EGLONYL 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 12 COMPR. PRF 12 1.723333 1.723333 0.000000
102 W55404001 N05AL05 AMISULPRIDUM ** AMISULPRIDA LPH 200 mg COMPR. 200mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 1.679333 1.679333 0.000000
103 W55435001 N05AL05 AMISULPRIDUM ** MIDORA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 1.679333 1.679333 0.000000
104 W64420001 N05AL05 AMISULPRIDUM ** SOLIAN 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 2.015199 2.015199 0.255134
105 W67577002 N05AL05 AMISULPRIDUM ** MASULTAB 200 mg COMPR. 200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 1.679333 1.679333 0.000000
106 W67577007 N05AL05 AMISULPRIDUM ** MASULTAB 200 mg COMPR. 200mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 1.679333 1.679333 0.000000
107 W62189001 N05AL05 AMISULPRIDUM ** AKTIPROL 400 mg COMPR. 400mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 2.261666 2.261666 0.000000
108 W62189004 N05AL05 AMISULPRIDUM ** AKTIPROL 400 mg COMPR. 400mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 2.261666 2.261666 0.000000
109 W67578002 N05AL05 AMISULPRIDUM ** MASULTAB 400 mg COMPR. 400mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 2.633666 2.633666 0.000000
110 W67578007 N05AL05 AMISULPRIDUM ** MASULTAB 400 mg COMPR. 400mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 2.633666 2.633666 0.000000
111 W61038001 N05AL05 AMISULPRIDUM ** MIDORA 400 mg COMPR. FILM. 400mg TERAPIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 2.633666 2.633666 0.000000
112 W64419001 N05AL05 AMISULPRIDUM ** SOLIAN 400 mg COMPR. FILM. 400mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 2.713999 2.713999 0.543667
113 W56212003 N05AX08 RISPERIDONUM ** RISPEN 1 COMPR. FILM. 1mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0.544000 0.544000 0.000000
114 W58413001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 1 mg COMPR. FILM. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0.568000 0.568000 0.000000
115 W56213003 N05AX08 RISPERIDONUM ** RISPEN 2 COMPR. FILM. 2 mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0.744400 0.744400 0.000000
116 W58414001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 2 mg COMPR. FILM. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0.893280 0.893280 0.159720
117 W56214003 N05AX08 RISPERIDONUM ** RISPEN 3 COMPR. FILM. 3mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0.755200 0.755200 0.000000
118 W58415001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 3 mg COMPR. FILM. 3mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0.906240 0.906240 0.751760
119 W56215003 N05AX08 RISPERIDONUM ** RISPEN 4 COMPR. FILM. 4 mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 1.286800 1.286800 0.000000

Pagina 53 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
120 W57800001 N05AX08 RISPERIDONUM ** COMPR. FILM.
RISPERIDONA MEDOCHEMIE 4 mg 4mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. PRF 20 1.544160 1.544160 0.467340
121 W58416001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 4 mg COMPR. FILM. 4mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 1.544160 1.544160 0.684340
122 W13666002 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 25mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 394.250000 394.250000 0.000000
123 W13667002 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 37,5 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 37,5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 525.050000 525.050000 0.000000
124 W13833002 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 50 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE PRF 1 610.160000 610.160000 0.000000
125 W08728005 N05AX08 RISPERIDONUM ** RISPOLEPT 1 mg/ml SOL. ORALA 1mg/ml JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SOL. ORALA SI O PIPETA DOZATOARE PRF 1 54.780000 54.780000 0.000000
126 W08728003 N05AX08 RISPERIDONUM ** RISPOLEPT 1 mg/ml SOL. ORALA 1mg/ml JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 30 ML SOL. ORALA + 1 PIPETA P-RF 1 17.010000 17.010000 0.000000
127 W61492003 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 10mg COMPR. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.284856 1.284856 0.351810
128 W61847007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.284856 1.284856 0.415477
129 W62245006 N05AX12 ARIPIPRAZOLUM ** ARICOGAN 10 mg COMPR. 10mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.284856 1.284856 0.385810
130 W62048001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 10 mg COMPR. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. PRF 28 1.070714 1.070714 0.000000
131 W62250002 N05AX12 ARIPIPRAZOLUM ** ZYKALOR 10 mg COMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.284856 1.284856 1.878810
132 W62259003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL STADA 10 mg COMPR. 10mg STADA M&D SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. PRF 28 1.284856 1.284856 1.424072
133 W65661001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR. PRF 28 1.127500 1.127500 0.000000
134 W66436003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 1.284856 1.284856 0.703144
135 W61493003 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 15mg COMPR. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.714666 1.714666 0.000000
136 W61848007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 15 mg COMPR. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.795713 1.795713 0.253620
137 W62251002 N05AX12 ARIPIPRAZOLUM ** ZYKALOR 15 mg COMPR. 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.795713 1.795713 1.656287
138 W62260003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL STADA 15 mg COMPR. 15mg STADA M&D SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. PRF 28 1.795713 1.795713 0.733572
139 W62049001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 15 mg COMPR. 15mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. PRF 28 1.592142 1.592142 0.000000
140 W62246006 N05AX12 ARIPIPRAZOLUM ** ARICOGAN 15 mg COMPR. 15mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1.795713 1.795713 0.002953
141 W65662002 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 15 mg COMPR. 15mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR. PRF 28 1.496428 1.496428 0.000000
142 W66437003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL AUROBINDO 15 mg COMPR. 15mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 1.640333 1.640333 0.000000
143 W61849007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 20 mg COMPR. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 11.559000 11.559000 0.000000
144 W61850007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 30 mg COMPR. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 4.838000 4.838000 0.000000
145 W61718002 N05AX12 ARIPIPRAZOLUM ** ASTORET 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE PRF 28 1.284856 1.284856 0.000144
146 W61719002 N05AX12 ARIPIPRAZOLUM ** ASTORET 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE PRF 28 1.795713 1.795713 0.000001
147 W65091001 N05AX12 ARIPIPRAZOLUM ** ABILIFY MAINTENA 400mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 400mg OLANDA
OTSUKA PHARMACEUTICAL NETHERLANDS B.V. CUTIE CU 1 FL. CU PULB.,1 FL. DE 2 ML CU SOLV., 1SERINGA LUER-LOCK DE 3 ML CU AC HYPODERMIC SECURIZAT DE CALIBRU 21,DE 38 MM PREATASAT,1SERINGA JETABILA DE 3 ML CU VÂRF LUER-LOCK,1ADAPTOR PT. FLAC. SI 3 ACE HIPODERMICE SECURIZATE PRF 1 966.060000 966.060000 0.000000
148 W52104015 N05AX13 PALIPERIDONUM ** INVEGA 3mg COMPR. ELIB. PREL. 3mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1FLAC. DIN PEID X 30 COMPR.ELIB.PREL. P-RF 30 5.050399 5.050399 3.424601
149 W65237002 N05AX13 PALIPERIDONUM ** PARNIDO 3 mg COMPR. ELIB. PREL. 3mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINAND 30 COMPRIMATE CU ELIBERARE PRELUNGITA PRF 30 4.208666 4.208666 0.000000
150 W52105015 N05AX13 PALIPERIDONUM ** INVEGA 6mg COMPR. ELIB. PREL. 6mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1FLAC. DIN PEID X 30 COMPR.ELIB.PREL. P-RF 30 8.141199 8.141199 0.908467
151 W65238002 N05AX13 PALIPERIDONUM ** PARNIDO 6 mg COMPR. ELIB. PREL. 6mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINAND 30 COMPRIMATE CU ELIBERARE PRELUNGITA PRF 30 6.784333 6.784333 0.000000
152 W52106015 N05AX13 PALIPERIDONUM ** INVEGA 9mg COMPR. ELIB. PREL. 9mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1FLAC. DIN PEID X 30 COMPR.ELIB.PREL. P-RF 30 9.165000 9.165000 0.000000
153 W65239002 N05AX13 PALIPERIDONUM ** PARNIDO 9 mg COMPR. ELIB. PREL. 9mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINAND 30 COMPRIMATE CU ELIBERARE PRELUNGITA PRF 30 8.454666 8.454666 0.000000
154 W57259001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 100mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1,072.410000 1,072.410000 0.000000
155 W57260001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 150mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1,530.270000 1,530.270000 0.000000
156 W62903001 N05AX13 PALIPERIDONUM ** TREVICTA 175 mg SUSP. INJ. CU ELIB. PREL. 175mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 1,924.330000 1,924.330000 0.000000
157 W62904001 N05AX13 PALIPERIDONUM ** TREVICTA 263 mg SUSP. INJ. CU ELIB. PREL. 263mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 2,528.430000 2,528.430000 0.000000
158 W62905001 N05AX13 PALIPERIDONUM ** TREVICTA 350 mg SUSP. INJ. CU ELIB. PREL. 350mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 3,029.470000 3,029.470000 0.000000
159 W57257001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 698.290000 698.290000 0.000000
160 W62906001 N05AX13 PALIPERIDONUM ** TREVICTA 525 mg SUSP. INJ. CU ELIB. PREL. 525mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 4,382.020000 4,382.020000 0.000000
161 W57258001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 75mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 902.780000 902.780000 0.000000
162 W43706001 N06AB04 CITALOPRAMUM ** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 1.490666 1.490666 0.000000
163 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 0.589713 0.589713 0.244287
164 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 0.589713 0.589713 0.693144
165 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 0.589713 0.589713 0.322072
166 W55813002 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0.566785 0.566785 0.000000
167 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 0.589713 0.589713 0.346715
168 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 0.543214 0.543214 0.000000
169 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 0.491428 0.491428 0.000000
170 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 0.589713 0.589713 0.089287
171 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 0.589713 0.589713 0.254572
172 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 0.537500 0.537500 0.000000
173 W68274003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 10 mg COMPR. FILM. 10mg TEVA B.V. OLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0.491428 0.491428 0.000000
174 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 0.912857 0.912857 0.000000
175 W68276003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TEVA 20 mg COMPR. FILM. 20mg TEVA B.V. OLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0.912857 0.912857 0.000000
176 W13019001 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 1.212000 1.212000 0.000000
177 W13019004 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 60 1.133666 1.133666 0.000000
178 W13019002 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 60 1.133666 1.133666 0.000000
179 W13019003 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF 20 1.212000 1.212000 0.000000

Pagina 54 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
180 W66418003 N06AX05 TRAZODONUM ** TRITTICO EP 150 mg COMPR. ELIB. PREL. 150mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PVDC/AL OPAC ALB X 10 COMPR. ELIB. PREL. PRF 30 1.360399 1.360399 0.239934
181 W66419003 N06AX05 TRAZODONUM ** TRITTICO EP 300 mg COMPR. ELIB. PREL. 300mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PVDC/AL OPAC ALB X 10 COMPR. ELIB. PREL. PRF 30 2.382333 2.382333 0.000000
182 W08616002 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ACR ANGELINI FRANCESCO S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-RF 30 0.691666 0.691666 0.000000
183 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 0.508000 0.508000 0.000000
184 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 0.491555 0.491555 0.000000
185 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 0.508000 0.508000 0.000000
186 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 0.508000 0.508000 0.000000
187 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 0.589866 0.589866 0.225134
188 W56742002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.781999 0.781999 1.330143
189 W58756003 N06AX16 VENLAFAXINUM ** ELIFY EP 150 mg CAPS. ELIB. PREL. 150 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF 30 0.781999 0.781999 0.348334
190 W64861002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.781999 0.781999 1.330143
191 W67116002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg UPJOHN EESV OLANDA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.781999 0.781999 1.330143
192 W52122001 N06AX16 VENLAFAXINUM ** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0.781999 0.781999 0.662286
193 W52962005 N06AX16 VENLAFAXINUM ** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0.651666 0.651666 0.000000
194 W55396001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0.781999 0.781999 0.662334
195 W66465006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0.715333 0.715333 0.000000
196 W53268003 N06AX16 VENLAFAXINUM ** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0.658333 0.658333 0.000000
197 W55395001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0.789999 0.789999 0.127334
198 W56741002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.495999 0.495999 0.588643
199 W58755003 N06AX16 VENLAFAXINUM ** ELIFY EP 75 mg CAPS. ELIB. PREL. 75 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 0.495999 0.495999 0.185667
200 W64860002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.495999 0.495999 0.588643
201 W67115002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg UPJOHN EESV OLANDA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0.495999 0.495999 0.588643
202 W52123001 N06AX16 VENLAFAXINUM ** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 0.495999 0.495999 0.449358
203 W52961005 N06AX16 VENLAFAXINUM ** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0.413333 0.413333 0.000000
204 W53269003 N06AX16 VENLAFAXINUM ** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0.495999 0.495999 0.235334
205 W55397001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0.495999 0.495999 0.481001
206 W66464006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0.420000 0.420000 0.000000
207 W55398001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 37,5 mg COMPR. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0.789999 0.789999 0.127334
208 W55399001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0.934666 0.934666 0.000000
209 W55400001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 75 mg COMPR. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0.495999 0.495999 0.474334
210 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 0.698570 0.698570 0.946072
211 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 0.629333 0.629333 0.000000
212 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 0.698570 0.698570 0.581787
213 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 0.698570 0.698570 0.581787
214 W62006001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 30 mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 0.698570 0.698570 1.521072
215 W62054001 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ.
REPUBLICA CEHA PRF 28 0.582142 0.582142 0.000000
216 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 0.698570 0.698570 0.278763
217 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 0.681785 0.681785 0.000000
218 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 0.698570 0.698570 0.426072
219 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 0.698570 0.698570 0.426072
220 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 0.698570 0.698570 0.613572
221 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 0.698570 0.698570 0.380096
222 W62054002 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. CUTIE CU BLIST. PVC/PVDC/AL X 28 CAPS. GASTROREZ.
REPUBLICA CEHA PRF 28 0.582142 0.582142 0.000000
223 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 1.317999 1.317999 1.180929
224 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 1.217333 1.217333 0.000000
225 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 1.303214 1.303214 0.000000
226 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 1.303214 1.303214 0.000000
227 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 1.164285 1.164285 0.000000
228 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 1.133214 1.133214 0.000000
229 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 1.098333 1.098333 0.000000
230 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 1.317999 1.317999 0.425001
231 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 1.317999 1.317999 0.425001
232 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 1.317999 1.317999 0.043786
233 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 1.242666 1.242666 0.000000
234 W62055002 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 60 mg CAPS. GASTROREZ. 60mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 1.164285 1.164285 0.000000
235 W61181001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 10 mg CAPS. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 7 CAPS. PRF 7 4.004570 4.004570 1.162572
236 W62698001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACTAVIS 10 mg CAPS. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC-PVC/AL X 7 CAPS. PR 7 4.004570 4.004570 4.495430
237 W63559001 N06BA09 ATOMOXETINUM ** BITINEX 10 mg CAPS. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 3.337142 3.337142 0.000000
238 W65181001 N06BA09 ATOMOXETINUM ** STRATTERA 10 mg CAPS. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 4.004570 4.004570 5.291144
239 W65385002 N06BA09 ATOMOXETINUM ** ATOFAB 10 mg CAPS. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 10 CAPS. PRF 10 4.004570 4.004570 0.301430

Pagina 55 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
240 W65742001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACCORD 10 mg CAPS. 10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE/PCTFE-AL X 7 CAPS. PRF 7 4.004570 4.004570 4.754001
241 W61182001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 18 mg CAPS. 18mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 7 CAPS. PRF 7 2.758285 2.758285 2.501715
242 W62699001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACTAVIS 18 mg CAPS. 18mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC-PVC/AL X 7 CAPS. PR 7 2.758285 2.758285 5.781715
243 W63560001 N06BA09 ATOMOXETINUM ** BITINEX 18 mg CAPS. 18mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 2.758285 2.758285 2.568857
244 W65186001 N06BA09 ATOMOXETINUM ** STRATTERA 18 mg CAPS. 18mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 7 CAPS. PRF 7 2.758285 2.758285 6.926000
245 W65386002 N06BA09 ATOMOXETINUM ** ATOFAB 18 mg CAPS. 18mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 10 CAPS. PRF 10 2.758285 2.758285 1.625715
246 W65462001 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 18 mg CAPS. 18mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 7 CAPS. PRF 7 2.298571 2.298571 0.000000
247 W65743001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACCORD 18 mg CAPS. 18mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE/PCTFE-AL X 7 CAPS. PRF 7 2.758285 2.758285 5.097429
248 W61183003 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 25 mg CAPS. 25mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 CAPS. PRF 28 5.329285 5.329285 0.000000
249 W62700002 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACTAVIS 25 mg CAPS. 25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC-PVC/AL X 28 CAPS. PR 28 5.330400 5.330400 2.406385
250 W63561003 N06BA09 ATOMOXETINUM ** BITINEX 25 mg CAPS. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.173928 5.173928 0.000000
251 W65185003 N06BA09 ATOMOXETINUM ** STRATTERA 25 mg CAPS. 25mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.330400 5.330400 3.594600
252 W65387005 N06BA09 ATOMOXETINUM ** ATOFAB 25 mg CAPS. 25mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 30 CAPS. PRF 30 4.442000 4.442000 0.000000
253 W65463005 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 25 mg CAPS. 25mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. PRF 28 4.883214 4.883214 0.000000
254 W65744002 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACCORD 25 mg CAPS. 25mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE/PCTFE-AL X 28 CAPS. PRF 28 5.330400 5.330400 3.066385
255 W61184003 N06BA09 ATOMOXETINUM ** ATOMOXETINA ZENTIVA 40 mg CAPS. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 28 CAPS. PRF 28 5.337000 5.337000 0.251214
256 W62701002 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACTAVIS 40 mg CAPS. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC-PVC/AL X 28 CAPS. PR 28 5.337000 5.337000 2.402285
257 W63562003 N06BA09 ATOMOXETINUM ** BITINEX 40 mg CAPS. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.337000 5.337000 0.000142
258 W65184003 N06BA09 ATOMOXETINUM ** STRATTERA 40 mg CAPS. 40mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.337000 5.337000 3.588000
259 W65388005 N06BA09 ATOMOXETINUM ** ATOFAB 40 mg CAPS. 40mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 30 CAPS. PRF 30 4.574666 4.574666 0.000000
260 W65464005 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 40 mg CAPS. 40mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. PRF 28 4.447500 4.447500 0.000000
261 W65745002 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACCORD 40 mg CAPS. 40mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE/PCTFE-AL X 28 CAPS. PRF 28 5.337000 5.337000 3.059785
262 W62702001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACTAVIS 60 mg CAPS. 60mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC-PVC/AL X 28 CAPS. PR 28 5.502000 5.502000 2.255857
263 W63563003 N06BA09 ATOMOXETINUM ** BITINEX 60 mg CAPS. 60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.502000 5.502000 0.295857
264 W65183003 N06BA09 ATOMOXETINUM ** STRATTERA 60 mg CAPS. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 5.502000 5.502000 3.423000
265 W65389005 N06BA09 ATOMOXETINUM ** ATOFAB 60 mg CAPS. 60mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 30 CAPS. PRF 30 4.585000 4.585000 0.000000
266 W65465005 N06BA09 ATOMOXETINUM ** ATOMOXETINA AUROBINDO 60 mg CAPS. 60mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. PRF 28 5.502000 5.502000 1.051214
267 W65746002 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACCORD 60 mg CAPS. 60mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE/PCTFE-AL X 28 CAPS. PRF 28 5.502000 5.502000 2.894785
268 W62703001 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACTAVIS 80 mg CAPS. 80mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC-PVC/AL X 28 CAPS. PR 28 11.826071 11.826071 0.000000
269 W65180003 N06BA09 ATOMOXETINUM ** STRATTERA 80 mg CAPS. 80mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. PRF 28 11.826071 11.826071 0.000000
270 W65747002 N06BA09 ATOMOXETINUM ** ATOMOXETINA ACCORD 80 mg CAPS. 80mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE/PCTFE-AL X 28 CAPS. PRF 28 11.826071 11.826071 0.000000
271 W65182001 N06BA09 ATOMOXETINUM ** STRATTERA 4 mg/ml SOL. ORALA 4mg/ml ELI LILLY NEDERLAND BV OLANDA CUTIE CU 1 FLAC. DIN STICLA DE CULOARE BRUNA CU 100 ML SOL. ORALA+1 DISPOZITIV CARE CONTINE O SERINGA PT. ADMINISTRARE ORALA DE 10 ML GRADATA PT. FIECARE MILILITRU SI UN ADAPTOR PT. STICLA DIN PEJD PRF 1 194.070000 194.070000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea psihiatrie şi psihiatrie pediatrică/neuropsihiatrie infantilă.

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

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 1.191785 1.191785 0.000000
2 W53425001 N06DA02 DONEPEZILUM ** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1.372666 1.372666 0.000000
3 W53425002 N06DA02 DONEPEZILUM ** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 1.372666 1.372666 0.000000
4 W53618001 N06DA02 DONEPEZILUM ** TUADIN 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 1.366333 1.366333 0.000000
5 W54141002 N06DA02 DONEPEZILUM ** DONECEPT 10 MG COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1.207142 1.207142 0.000000
6 W55613001 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1.430142 1.430142 2.055929
7 W55613002 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 1.430142 1.430142 1.875858
8 W55613003 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 1.430142 1.430142 1.875750
9 W55613004 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1.430142 1.430142 2.431524
10 W55613005 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 1.430142 1.430142 2.407102
11 W55613006 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 1.430142 1.430142 2.399358
12 W68085002 N06DA02 DONEPEZILUM ** DONECEPT 10 mg COMPR. FILM. 10mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 1.207142 1.207142 0.000000
13 W52397001 N06DA02 DONEPEZILUM ** YASNAL 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 0.974570 0.974570 0.112215
14 W53424001 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0.974570 0.974570 0.000096
15 W53424002 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 0.974570 0.974570 0.000096
16 W54140002 N06DA02 DONEPEZILUM ** DONECEPT 5 MG COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 0.812142 0.812142 0.000000
17 W55612001 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 0.974570 0.974570 0.832215
18 W55612002 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 0.974570 0.974570 1.369030
19 W55612003 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 0.974570 0.974570 1.288465
20 W55612004 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 0.974570 0.974570 1.814430
21 W55612005 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 0.974570 0.974570 1.814409
22 W55612006 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 0.974570 0.974570 1.814330

Pagina 56 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
23 W68084002 N06DA02 DONEPEZILUM ** DONECEPT 5 mg COMPR. FILM. 5mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 0.812142 0.812142 0.000000
24 W56596002 N06DA02 DONEPEZILUM ** YASNAL 10 mg COMPR. ORODISPERSABILE 10 mg KRKA D.D. SLOVENIA CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL TIP "PEEL-OPEN" A CATE 28 COMPR. ORODISP. PRF 28 1.430142 1.430142 0.142358
25 W61217007 N06DA02 DONEPEZILUM ** DARIZOL 10 mg COMPR. ORODISPERSABILE 10mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE PRF 28 1.386785 1.386785 0.000000
26 W43353002 N06DA02 DONEPEZILUM ** ARICEPT EVESS COMPR. ORODISPERSABILE 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. ORODISPERSABILE PRF 28 1.430142 1.430142 2.642358
27 W64847002 N06DA02 DONEPEZILUM ** ARICEPT EVESS COMPR. ORODISPERSABILE 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. ORODISPERSABILE PRF 28 1.430142 1.430142 2.642358
28 W56594002 N06DA02 DONEPEZILUM ** YASNAL 5 mg COMPR. ORODISPERSABILE 5 mg KRKA D.D. SLOVENIA CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL "PEEL-OPEN" A CATE 28 COMPR. ORODISP. PRF 28 0.974570 0.974570 0.124358
29 W61218007 N06DA02 DONEPEZILUM ** DARIZOL 5 mg COMPR. ORODISPERSABILE 5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE PRF 28 0.974570 0.974570 0.854715
30 W60990002 N06DA03 RIVASTIGMINUM ** RIDAXIN 1,5 mg CAPS. 1,5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 0.851142 0.851142 0.432965
31 W54536002 N06DA03 RIVASTIGMINUM ** NIMVASTID 1.5mg CAPS. 1.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE P-RF/R 28 0.709285 0.709285 0.000000
32 W54537001 N06DA03 RIVASTIGMINUM ** NIMVASTID 3mg CAPS. 3mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE P-RF/R 28 1.152142 1.152142 0.000000
33 W60991002 N06DA03 RIVASTIGMINUM ** RIDAXIN 3 mg CAPS. 3mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 1.343571 1.343571 0.000000
34 W60992002 N06DA03 RIVASTIGMINUM ** RIDAXIN 4,5 mg CAPS. 4,5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 2.007428 2.007428 0.376322
35 W60993002 N06DA03 RIVASTIGMINUM ** RIDAXIN 6 mg CAPS. 6mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 2.676428 2.676428 0.471607
36 W54541001 N06DA03 RIVASTIGMINUM ** NIMVASTID 4.5 mg COMPR. ORODISPERSABILE 4.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 1.672857 1.672857 0.000000
37 W54542001 N06DA03 RIVASTIGMINUM ** NIMVASTID 6mg COMPR. ORODISPERSABILE 6mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 2.230357 2.230357 0.000000
38 W59938005 N06DA03 RIVASTIGMINUM ** EXELON 13,3mg/24h PLASTURE TRANSDERMIC 13,3/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 5.953333 5.953333 0.000000
39 W64475005 N06DA03 RIVASTIGMINUM ** EXELON 13,3 mg/24h PLASTURE TRANSDERMIC 13,3mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 5.953333 5.953333 0.000000
40 W64475008 N06DA03 RIVASTIGMINUM ** EXELON 13,3 mg/24h PLASTURE TRANSDERMIC 13,3mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI DIN HÂRTIE/PET/PE/AL/PA X 1 PLASTURE TRANSDERMIC PR 30 5.953333 5.953333 0.000000
41 W52347002 N06DA03 RIVASTIGMINUM ** EXELON 4,6mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 3.520399 3.520399 0.592934
42 W60439002 N06DA03 RIVASTIGMINUM ** EVERTAS 4,6 mg/24 h PLASTURE TRANSDERMIC 4,6mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 2.933666 2.933666 0.000000
43 W64473002 N06DA03 RIVASTIGMINUM ** EXELON 4,6 mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 3.520399 3.520399 0.592934
44 W64473005 N06DA03 RIVASTIGMINUM ** EXELON 4,6 mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI DIN HÂRTIE/PET/PE/AL/PA X 1 PLASTURE TRANSDERMIC PR 30 3.520399 3.520399 0.592934
45 W52348002 N06DA03 RIVASTIGMINUM ** EXELON 9,5mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 5.081333 5.081333 0.000000
46 W60440002 N06DA03 RIVASTIGMINUM ** EVERTAS 9,5 mg/24 h PLASTURE TRANSDERMIC 9,5mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 4.246333 4.246333 0.000000
47 W64474002 N06DA03 RIVASTIGMINUM ** EXELON 9,5 mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 5.081333 5.081333 0.000000
48 W64474005 N06DA03 RIVASTIGMINUM ** EXELON 9,5 mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI DIN HÂRTIE/PET/PE/AL/PA X 1 PLASTURE TRANSDERMIC PR 30 5.081333 5.081333 0.000000
49 W55333001 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA TEVA 2 mg/ml SOL. ORALA 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPACIT. 125ML X 120ML SOLUTIE ORALA, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII, CU O SERINGA DOZATOARE GRADATA DIN PP SI UN ADAPTOR DIN PE P-RF 1 332.448000 332.448000 126.772000
50 W62196002 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA SANDOZ 2mg/ml SOL. ORALA 2mg/ml SANDOZ GMBH AUSTRIA CUTIE CU FLAC. DIN STICLA BRUNA A 120 ML SOL.ORALA + SERINGA DOZATOARE PR 1 277.040000 277.040000 0.000000
51 W57106004 N06DA04 GALANTAMINUM ** GALSYA 16 mg CAPS. ELIB. PREL. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 2.003666 2.003666 0.000000
52 W57106013 N06DA04 GALANTAMINUM ** GALSYA 16 mg CAPS. ELIB. PREL. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 2.003666 2.003666 0.000000
53 W57107004 N06DA04 GALANTAMINUM ** GALSYA 24 mg CAPS. ELIB. PREL. 24mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 2.003666 2.003666 0.000000
54 W57107013 N06DA04 GALANTAMINUM ** GALSYA 24 mg CAPS. ELIB. PREL. 24mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 2.003666 2.003666 0.000000
55 W57105004 N06DA04 GALANTAMINUM ** GALSYA 8 mg CAPS. ELIB. PREL. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 2.003666 2.003666 0.000000
56 W57105013 N06DA04 GALANTAMINUM ** GALSYA 8 mg CAPS. ELIB. PREL. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 2.003666 2.003666 0.000000
57 W41503001 N06DA04 GALANTAMINUM ** REMINYL 4 mg/ml SOL. ORALA 4mg/ml JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 1 FLACON X 100 ML + 1 PIPETA DOZATOARE P-RF 1 133.070000 133.070000 0.000000
58 W12136004 N06DX01 MEMANTINUM ** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R 56 0.624000 0.624000 1.612428
59 W59817001 N06DX01 MEMANTINUM ** NEMDATINE 10mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 0.605714 0.605714 0.000000
60 W60024003 N06DX01 MEMANTINUM ** MIRVEDOL 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0.624000 0.624000 0.084750
61 W60183005 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0.624000 0.624000 0.000107
62 W60183015 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR 56 0.624000 0.624000 0.000107
63 W60192007 N06DX01 MEMANTINUM ** MEMANTINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0.624000 0.624000 0.099928
64 W60672010 N06DX01 MEMANTINUM ** MEMANTINA LANNACHER HEILMITTEL 10 mg COMPR. FILM. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 70 COMPR. FILM. PR 70 0.624000 0.624000 0.069428
65 W61445005 N06DX01 MEMANTINUM ** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 0.624000 0.624000 0.721892
66 W61445014 N06DX01 MEMANTINUM ** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 0.624000 0.624000 0.721892
67 W64525001 N06DX01 MEMANTINUM ** MARIXINO 10mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE PR 56 0.624000 0.624000 0.134928
68 W65675002 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 0.520000 0.520000 0.000000
69 W66008004 N06DX01 MEMANTINUM ** MEMANTINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0.580892 0.580892 0.000000
70 W59818001 N06DX01 MEMANTINUM ** NEMDATINE 20mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 1.907828 1.907828 0.007172
71 W60184001 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PR 28 1.907500 1.907500 0.000000
72 W60184009 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. PR 28 1.907500 1.907500 0.000000
73 W60193002 N06DX01 MEMANTINUM ** MEMANTINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR 28 1.907828 1.907828 0.012529
74 W60671010 N06DX01 MEMANTINUM ** MEMANTINA LANNACHER HEILMITTEL 20 mg COMPR. FILM. 20mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 70 COMPR. FILM. PR 70 1.589857 1.589857 0.000000
75 W61446005 N06DX01 MEMANTINUM ** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 1.907828 1.907828 0.291636
76 W61446014 N06DX01 MEMANTINUM ** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 1.907828 1.907828 0.291636
77 W65676002 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 1.644642 1.644642 0.000000
78 W56770002 N06DX01 MEMANTINUM ** EBIXA 5mg/doza PICATURI ORALE - SOL. 5mg/doza H LUNDBECK A/S DANEMARCA CUTIE X 1 FLACON DIN STICLA BRUNA CU POMPA DOZATOARE X 50 ML SOLUTIE P-RF/R 1 127.980000 127.980000 43.380000
79 W60646004 N06DX01 MEMANTINUM ** MEMANTINA TEVA 10 mg/ml SOL. ORALA 10 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA + SERINGA DOZATOARE A 50 ML SOL. ORALA PR 1 106.650000 106.650000 0.000000

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

Pagina 57 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


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

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 CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR.
MAREA BRITANIE P-RF 50 0.654800 0.654800 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 0.654800 0.654800 0.000000
3 W04222001 H02AB04 METHYLPREDNISOLONUM (5) MEDROL 32 mg COMPR. 32mg PFIZER EUROPE MA EEIG CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR.
MAREA BRITANIE P-RF 20 2.298500 2.298500 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 2.298500 2.298500 0.000000
5 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 1.223000 1.223000 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 32.970000 32.970000 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 32.970000 32.970000 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 2 687.135000 687.135000 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 2 656.350000 656.350000 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 3 644.540000 644.540000 0.000000
11 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 2 773.448000 773.448000 73.192000
12 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 3,415.660000 3,415.660000 0.000000
13 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 3,823.470000 3,823.470000 311.700000
14 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 3,221.650000 3,221.650000 0.000000
15 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 3,186.225000 3,186.225000 0.000000
16 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 1 738.210000 738.210000 0.000000
17 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 1 738.210000 738.210000 0.000000
18 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 2,309.460000 2,309.460000 0.000000
19 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 2,309.460000 2,309.460000 0.000000
20 W60846001 L04AX01 AZATHIOPRINUM IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.638800 0.000000
21 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 0.560833 0.560833 0.000000
22 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 0.560833 0.560833 0.000000

Tratamentul se iniţiază şi se monitorizează de către medicul în specialitatea reumatologie, nefrologie, boli infecţioase, pediatrie sau medicină internă, iar pentru medicamentul prevăzut la poziţia 6 şi de către medicul în specialitatea pneumologie.

16. POLIARTRITA REUMATOIDĂ, ARTROPATIA PSORIAZICĂ, PSORIAZIS CRONIC SEVER ŞI ARTRITA JUVENILĂ - G 18

1 W07440001 A07EC01 SULFASALAZINUM SULFASALAZINA EN 500 mg COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0.645600 0.645600 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 0.645600 0.645600 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 21.250000 21.250000 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 0.654800 0.654800 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 0.654800 0.654800 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 2.298500 2.298500 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 2.298500 2.298500 0.000000
8 W65904001 L01BA01 METHOTREXATUM JYLAMVO 2 mg/ml SOL. ORALA 2mg/ml THERAKIND (EUROPE) LIMITED IRLANDA CUTIE CU 1 FLAC. DIN STICLA, CU ADAPTOR DIN PEJD PENTRU FLACON SI O SERINGA DOZATOARE DIN PP X 60 ML SOL. ORALA PR 1 859.740000 859.740000 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 14.156666 14.156666 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 2.054666 2.054666 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 2.096666 2.096666 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 2.054666 2.054666 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 2.551333 2.551333 0.000000
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 3.061599 3.061599 0.841401
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 3.061599 3.061599 0.920401
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 3.061599 3.061599 0.920401
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 3.061599 3.061599 0.841401
18 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 25 mg CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 1.832400 1.832400 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 3.351800 3.351800 0.000000
20 W60846001 L04AX01 AZATHIOPRINUM IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.638800 0.000000
21 W68112002 L04AX03 METHOTREXATUM METHOTREXAAT PCH 2,5 mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 3 BLIST. X 10 COMPR. PR 30 1.036080 1.036080 0.061920
22 W68338004 L04AX03 METHOTREXATUM METOTREXAT SANDOZ 2,5 mg (vezi L01BA01) COMPR. 2,5mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PP X 50 COMPR. PR 50 0.863400 0.863400 0.000000
23 W62233002 L04AX03 METHOTREXATUM NAMAXIR 10 mg SOL INJ. IN SERINGA PREUMPLUTA 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. PR 4 35.495000 35.495000 0.000000
24 W68057002 L04AX03 METHOTREXATUM NAMAXIR 10 mg SOL INJ. IN SERINGA PREUMPLUTA 10mg TEVA B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. PR 4 35.495000 35.495000 0.000000
25 W63589007 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA 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 PR 1 52.026000 52.026000 35.034000
26 W63589001 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA 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 PR 1 32.493000 32.493000 32.857000
27 W63589004 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA 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 PR 1 42.594000 42.594000 8.446000
28 W63589010 L04AX03 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA 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 PR 1 75.939000 75.939000 60.431000
29 W66270001 L04AX03 METHOTREXATUM NORDIMET 12,5 mg SOL INJ. IN SERINGA PREUMPLUTA 12,5mg NORDIC GROUP BV OLANDA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA X 0,5 ML SOL. INJ. + 2 TAMPOANE DE ALCOOL PRF 1 89.900000 89.900000 0.000000

Pagina 58 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
30 W66270002 L04AX03 METHOTREXATUM NORDIMET 12,5 mg SOL INJ. IN SERINGA PREUMPLUTA 12,5mg NORDIC GROUP BV OLANDA CUTIE CU (4X1) SERINGI PREUMPLUTE + 8 (4X2) TAMPOANE (AMBALAJ MULTIPLU) PR 4 79.330000 79.330000 0.000000
31 W62235002 L04AX03 METHOTREXATUM NAMAXIR 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. PR 4 43.355000 43.355000 0.000000
32 W64738001 L04AX03 METHOTREXATUM NORDIMET 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 52.026000 52.026000 42.864000
33 W64738002 L04AX03 METHOTREXATUM NORDIMET 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg NORDIC GROUP BV OLANDA 4 (4X1) SERINGI PREUMPLUTE+8 (4X2) TAMPOANE CU ALCOOL (AMBALAJ MULTIPLU) PR 4 52.026000 52.026000 37.954000
34 W68058002 L04AX03 METHOTREXATUM NAMAXIR 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg TEVA B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. PR 4 43.355000 43.355000 0.000000
35 W64739001 L04AX03 METHOTREXATUM NORDIMET 17,5 mg SOL INJ. IN SERINGA PREUMPLUTA 17,5mg NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 108.550000 108.550000 0.000000
36 W62237002 L04AX03 METHOTREXATUM NAMAXIR 20 mg SOL INJ. IN SERINGA PREUMPLUTA 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,50 ML SOL. INJ. PR 4 63.282500 63.282500 0.000000
37 W64740001 L04AX03 METHOTREXATUM NORDIMET 20 mg SOL INJ. IN SERINGA PREUMPLUTA 20mg NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 75.939000 75.939000 40.381000
38 W64740002 L04AX03 METHOTREXATUM NORDIMET 20 mg SOL INJ. IN SERINGA PREUMPLUTA 20mg NORDIC GROUP BV OLANDA 4 (4X1) SERINGI PREUMPLUTE+8 (4X2) TAMPOANE CU ALCOOL (AMBALAJ MULTIPLU) PR 4 75.939000 75.939000 31.308500
39 W68059002 L04AX03 METHOTREXATUM NAMAXIR 20 mg SOL INJ. IN SERINGA PREUMPLUTA 20mg TEVA B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,50 ML SOL. INJ. PR 4 63.282500 63.282500 0.000000
40 W64741001 L04AX03 METHOTREXATUM NORDIMET 22,5 mg SOL INJ. IN SERINGA PREUMPLUTA 22,5mg NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 124.210000 124.210000 0.000000
41 W62239002 L04AX03 METHOTREXATUM NAMAXIR 25 mg SOL INJ. IN SERINGA PREUMPLUTA 25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. PR 4 79.110000 79.110000 0.000000
42 W64742001 L04AX03 METHOTREXATUM NORDIMET 25 mg SOL INJ. IN SERINGA PREUMPLUTA 25mg NORDIC GROUP BV OLANDA 1 SERINGA PREUMPLUTA DIN STICLA + 2 TAMPOANE CU ALCOOL PRF 1 94.932000 94.932000 30.268000
43 W68060002 L04AX03 METHOTREXATUM NAMAXIR 25 mg SOL INJ. IN SERINGA PREUMPLUTA 25mg TEVA B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. PR 4 79.110000 79.110000 0.000000
44 W62232002 L04AX03 METHOTREXATUM NAMAXIR 7,5 mg SOL INJ. IN SERINGA PREUMPLUTA 7,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. PR 4 27.077500 27.077500 0.000000
45 W68056002 L04AX03 METHOTREXATUM NAMAXIR 7,5 mg SOL INJ. IN SERINGA PREUMPLUTA 7,5mg TEVA B.V. OLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. PR 4 27.077500 27.077500 0.000000
46 W58316007 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 52.026000 52.026000 35.934000
47 W58316001 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 32.493000 32.493000 275.407000
48 W58316004 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 42.594000 42.594000 8.986000
49 W58316010 L04AX03 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 75.939000 75.939000 61.831000
50 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 2.731000 2.731000 0.000000
51 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 0.560000 0.560000 0.000000
52 W67013001 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE CU 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 0.560000 0.560000 0.000000
53 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 0.390000 0.390000 0.000000
54 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 0.390000 0.390000 0.000000
55 W51307002 M01AB05 DICLOFENACUM REFEN RETARD 100 mg 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 0.390000 0.390000 0.000000
56 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 0.129500 0.129500 0.000000
57 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 0.129500 0.129500 0.000000
58 W54364001 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg COMPR. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P-6L 30 0.217666 0.217666 0.000000
59 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 0.155400 0.155400 0.018600
60 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 2.166000 2.166000 0.000000
61 W14114001 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0.618333 0.618333 0.000000
62 W12288001 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0.627000 0.627000 0.000000
63 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 0.626000 0.626000 0.000000
64 W14114003 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC/PE X 6 SUPOZ. P6L 6 0.618333 0.618333 0.000000
65 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 1.283333 1.283333 0.000000
66 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 1.387000 1.387000 0.000000
67 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 0.560833 0.560833 0.000000
68 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 0.560833 0.560833 0.000000

Tratamentul se iniţiază de către medicul din specialitatea reumatologie, nefrologie, medicină internă, pediatrie, reabilitare medicală şi dermatovenerologie.

17. SPONDILITA ANKILOZANTA - G 19

1 W07440001 A07EC01 SULFASALAZINUM SULFASALAZINA EN 500 mg COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0.645600 0.645600 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 0.645600 0.645600 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 21.250000 21.250000 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 2.731000 2.731000 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 0.560000 0.560000 0.000000
6 W67013001 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE CU 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 0.560000 0.560000 0.000000
7 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 0.390000 0.390000 0.000000
8 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 0.390000 0.390000 0.000000
9 W51307002 M01AB05 DICLOFENACUM REFEN RETARD 100 mg 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 0.390000 0.390000 0.000000
10 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 0.129500 0.129500 0.000000
11 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 0.129500 0.129500 0.000000
12 W54364001 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg COMPR. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P-6L 30 0.217666 0.217666 0.000000
13 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 0.155400 0.155400 0.018600
14 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 2.166000 2.166000 0.000000

Pagina 59 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
15 W14114001 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0.618333 0.618333 0.000000
16 W12288001 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0.627000 0.627000 0.000000
17 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 0.626000 0.626000 0.000000
18 W14114003 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC/PE X 6 SUPOZ. P6L 6 0.618333 0.618333 0.000000
19 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 1.283333 1.283333 0.000000
20 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 1.387000 1.387000 0.000000

Tratamentul se iniţiază de către medicul din specialitatea reumatologie sau reabilitare medicală.

18. BOLI ENDOCRINE ŞI METABOLICE - 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 13.143320 13.143320 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 5,900.670000 5,900.670000 0.000000
3 W62419001 C10AX13 EVOLOCUMABUM ** Ω REPATHA 140 mg SOL INJ. IN PEN PREUMPLUT 140mg AMGEN EUROPE B.V. OLANDA CUTIE CU 2 PENURI SURECLICK PREUMPLUTE PRF 2 979.625000 979.625000 0.000000
4 W62403002 C10AX14 ALIROCUMABUM ** Ω PRALUENT 150 mg 150mg
SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT SANOFI - AVENTIS GROUPE FRANTA CUTIE X 2 STILOURI INJECTOARE (PEN) PREUMPLUT X 1ML PRF 2 989.285000 989.285000 0.000000
5 W62401002 C10AX14 ALIROCUMABUM ** Ω PRALUENT 75 mg 75mg
SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE PRF 2 989.285000 989.285000 0.000000
6 W00716002 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 9.960000 9.960000 0.000000
7 W00716001 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 9.133750 9.133750 0.000000
8 W65037001 G02CB03 CABERGOLINUM ** DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 2 COMPR. P6L 2 9.960000 9.960000 0.000000
9 W65037002 G02CB03 CABERGOLINUM ** DOSTINEX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 8 COMPR. P6L 8 9.133750 9.133750 0.000000
10 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 9.960000 9.960000 0.000000
11 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 9.133750 9.133750 0.000000
12 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 30 295.864666 295.864666 0.000000
13 W64864001 H01AX01 PEGVISOMANTUM **1 SOMAVERT 10 mg PULB+SOLV. PT. SOL. INJ. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 30 FLAC. CU PULB. + 30 SERINGI PREUMPLUTE CONTINAND 1 ML PR 30 295.864666 295.864666 0.000000
14 W42029003 H01AX01 PEGVISOMANTUM **1 SOMAVERT 20 mg PULB+SOLV. PT. SOL. INJ. 20mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 30 FLAC. CU PULB. + 30 SERINGI PREUMPLUTE CONTINAND 1 ML PR 30 581.951333 581.951333 0.000000
15 W64865001 H01AX01 PEGVISOMANTUM **1 SOMAVERT 20 mg PULB+SOLV. PT. SOL. INJ. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 30 FLAC. CU PULB. + 30 SERINGI PREUMPLUTE CONTINAND 1 ML PR 30 581.951333 581.951333 0.000000
16 W53992002 H01BA02 DESMOPRESSINUM MINIRIN MELT 120 mcg LIOF. ORAL 120mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST. AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 30 6.699333 6.699333 0.000000
17 W53991002 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 30 3.539333 3.539333 0.000000
18 W42954002 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 10 mg PULB.+SOLV. PT. SOL. INJ. 10mg NOVARTIS PHARMA GMBH GERMANIA PR
CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC 1 808.890000 808.890000 0.000000
19 W42955002 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 20 mg PULB.+SOLV. PT. SOL. INJ. 20mg NOVARTIS PHARMA GMBH GERMANIA PR
CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC 1 1,546.920000 1,546.920000 0.000000
20 W42956002 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 30 mg PULB.+SOLV. PT. SOL. INJ. 30mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 2,284.930000 2,284.930000 0.000000
21 W59079001 H01CB02 OCTREOTIDUM **1 SANDOSTATIN 100 micrograme/ml SOL. INJ./PERF. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ./PERF. PR 5 8.336000 8.336000 0.000000
22 W58561001 H01CB03 LANREOTIDUM **1 SOMATULINE PR 30 mg 30mg
PULB+SOLV. PT. SUSP. INJ. CU ELIB.PREL. IPSEN PHARMA FRANTA PR
CUTIE CU 1 FLAC. DIN STICLA BRUNA CU LIOFILIZAT+1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV.+1 SERINGA DIN PP CU CAPACITATEA DE 3 ML + 2 ACE STERILE 1 1,678.570000 1,678.570000 0.000000
23 W58628001 H01CB03 LANREOTIDUM **1 SOMATULINE AUTOGEL 120 mg SOL. INJ. IN SERINGA PREUMPLUTA 120mg IPSEN PHARMA FRANTA PR
CUTIE CU 1 SERINGA PREUMPLUTA DIN PE DE 0,5 ML, CU SISTEM DE SIGURANTA AUTOMAT CU OPRITOR PENTRU PISTON SI AC DIN OTEL INOXIDABIL, ACOPERIT CU CAPAC DIN PLASTIC. FIECARE SERINGA PREUMPLUTA ESTE FIXATA IN TAVITA DIN PLASTIC SI AMBALATA IN FOLIE LAMIN. 1 4,890.270000 4,890.270000 0.000000
24 W64454001 H01CB05 PASIREOTIDUM ** SIGNIFOR 20 mg PULB+SOLV. PT. SUSP. INJ. 20mg NOVARTIS EUROPHARM LTD. IRLANDA PRF
1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA 1 11,064.810000 11,064.810000 0.000000
25 W66950001 H01CB05 PASIREOTIDUM ** SIGNIFOR 20 mg PULB+SOLV. PT. SUSP. INJ. 20mg RECORDATI RARE DISEASES FRANTA PRF
1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA 1 11,064.810000 11,064.810000 0.000000
26 W64455001 H01CB05 PASIREOTIDUM ** SIGNIFOR 40 mg PULB+SOLV. PT. SUSP. INJ. 40mg NOVARTIS EUROPHARM LTD. IRLANDA PRF
1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA 1 11,346.890000 11,346.890000 0.000000
27 W66951001 H01CB05 PASIREOTIDUM ** SIGNIFOR 40 mg PULB+SOLV. PT. SUSP. INJ. 40mg RECORDATI RARE DISEASES FRANTA PRF
1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA 1 11,346.890000 11,346.890000 0.000000
28 W64456001 H01CB05 PASIREOTIDUM ** SIGNIFOR 60 mg PULB+SOLV. PT. SUSP. INJ. 60mg NOVARTIS EUROPHARM LTD. IRLANDA PRF
1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA 1 11,845.500000 11,845.500000 0.000000
29 W66952001 H01CB05 PASIREOTIDUM ** SIGNIFOR 60 mg PULB+SOLV. PT. SUSP. INJ. 60mg RECORDATI RARE DISEASES FRANTA PRF
1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA 1 11,845.500000 11,845.500000 0.000000
30 W64451003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,3 mg SOL INJ. 0,3mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,3 MG PR 30 228.963666 228.963666 0.000000
31 W67087003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,3 mg SOL INJ. 0,3mg RECORDATI RARE DISEASES FRANTA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,3 MG PR 30 228.963666 228.963666 0.000000
32 W64452003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,6 mg SOL INJ. 0,6mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,6 MG PR 30 268.952000 268.952000 0.000000
33 W67088003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,6 mg SOL INJ. 0,6mg RECORDATI RARE DISEASES FRANTA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,6 MG PR 30 268.952000 268.952000 0.000000
34 W64453003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,9 mg SOL INJ. 0,9mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,9 MG PR 30 268.952000 268.952000 0.000000
35 W67090003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,9 mg SOL INJ. 0,9mg RECORDATI RARE DISEASES FRANTA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,9 MG PR 30 268.952000 268.952000 0.000000
36 W03165001 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 0.386400 0.386400 0.000000
37 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 0.386400 0.386400 0.000000
38 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 0.151000 0.151000 0.000000
39 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
40 W13686002 H02AB07 PREDNISONUM PREDNISON SINTOFARM 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
41 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 0.145000 0.145000 0.000000
42 W68137001 H02AB09 HYDROCORTISONUM HYDROCORTISONE ROUSSEL 10 mg COMPR. 10mg BIO EEL S.R.L. ROMANIA CUTIE CU 1 BLIST. X 25 COMPR. PRF 25 1.035600 1.035600 0.000000
43 W44080001 H02AB09 HYDROCORTISONUM HYDROCORTISONE SUCCINAT SODIC EIPICO 100 mg PULB+SOLV. PT. SOL. INJ./PERF. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BUTILIC, SIGILAT CU O CAPSA DIN AL ACOPERITA CU UN DISC DE PP DE CULOARE PORTOCALIU DESCHIS CONTINAND PULB. PENTRU SOL. INJ. + FIOLA DIN STICLA INCOLORA A 2 ML SOLV. PREVAZUTA CU INEL DE RUPERE PRF 1 7.810000 7.810000 0.000000
44 W58639001 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV. PR/PRF 1 30.180000 30.180000 0.000000
45 W66429001 H02AB09 HYDROCORTISONUM HIDROCORTIZON ROMPHARM 100 mg PULB. PT. SOL. INJ./PERF. 100mg S.C. ROMPHARM COMPANY S.R.L ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC SI SIGILAT CU CAPAC DIN PLASTIC SI CAPSA DETASABILA DIN AL X PULB. PT. SOL. INJ./PERF. PRF 1 7.810000 7.810000 0.000000
46 W58638001 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 7.810000 7.810000 0.000000
47 W51922003 H02AB09 HYDROCORTISONUM HIDROCORTIZON ZENTIVA 19.6mg/5ml SOL. INJ. 19,6mg/5ml ZENTIVA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 1 ML SOL. A + 5 FIOLE DIN STICLA BRUNA CU CAPACITATEA DE 5ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 4 ML SOL. B PRF 5 4.882000 4.882000 0.000000

Pagina 60 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
48 W67515002 H03AA01 LEVOTHYROXINUM EUTHYROX 125 µg COMPR 125 µg MERCK ROMANIA SRL ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL A CÂTE 25 COMPRIMATE P6L 100 0.184100 0.184100 0.000000
49 W57399003 H03AA01 LEVOTHYROXINUM EUTHYROX 100µg COMPR. 100µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0.149000 0.149000 0.000000
50 W66292003 H03AA01 LEVOTHYROXINUM EUTHYROX 100µg COMPR. 100µg MERCK ROMANIA SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 25 COMPR. P6L 100 0.149000 0.149000 0.000000
51 W66294002 H03AA01 LEVOTHYROXINUM EUTHYROX 150µg COMPR. 150µg MERCK ROMANIA SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 25 COMPR. P6L 100 0.202900 0.202900 0.000000
52 W57396003 H03AA01 LEVOTHYROXINUM EUTHYROX 25µg COMPR. 25µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0.098200 0.098200 0.000000
53 W66291003 H03AA01 LEVOTHYROXINUM EUTHYROX 25µg COMPR. 25µg MERCK ROMANIA SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 25 COMPR. P6L 100 0.098200 0.098200 0.000000
54 W57398002 H03AA01 LEVOTHYROXINUM EUTHYROX 50µg COMPR. 50µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0.118500 0.118500 0.000000
55 W66293002 H03AA01 LEVOTHYROXINUM EUTHYROX 50µg COMPR. 50µg MERCK ROMANIA SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 25 COMPR. P6L 100 0.118500 0.118500 0.000000
56 W67516002 H03AA01 LEVOTHYROXINUM EUTHYROX 75 µg COMPR. 75 µg MERCK ROMANIA SRL ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL A CÂTE 25 COMPRIMATE P6L 100 0.145100 0.145100 0.000000
57 W61162002 H03AA01 LEVOTHYROXINUM ACCU-THYROX 100 micrograme/5 ml SOL. ORALA 100micrograme/5ml GALENICA S.A. GRECIA CUTIE CU 2 FLAC. DIN STICLA BRUNA CONTINAND 75 ML SOL. ORALA SI 1 SERINGA DOZATOARE DE 5 ML GRADATA LA 0,1 ML SI 1 ADAPTOR PT. FLACON SAU O LINGURITA DUBLA DIN PLASTIC DE 2,5/5 ML P6L 2 21.270000 21.270000 0.000000
58 W61160002 H03AA01 LEVOTHYROXINUM ACCU-THYROX 25 micrograme/5 ml SOL. ORALA 25micrograme/5ml GALENICA S.A. GRECIA CUTIE CU 2 FLAC. DIN STICLA BRUNA CONTINAND 75 ML SOL. ORALA SI 1 SERINGA DOZATOARE DE 5 ML GRADATA LA 0,1 ML SI 1 ADAPTOR PT. FLACON SAU O LINGURITA DUBLA DIN PLASTIC DE 2,5/5 ML P6L 2 19.815000 19.815000 0.000000
59 W61161002 H03AA01 LEVOTHYROXINUM ACCU-THYROX 50 micrograme/5 ml SOL. ORALA 50micrograme/5ml GALENICA S.A. GRECIA CUTIE CU 2 FLAC. DIN STICLA BRUNA CONTINAND 75 ML SOL. ORALA SI 1 SERINGA DOZATOARE DE 5 ML GRADATA LA 0,1 ML SI 1 ADAPTOR PT. FLACON SAU O LINGURITA DUBLA DIN PLASTIC DE 2,5/5 ML P6L 2 19.815000 19.815000 0.000000
60 W03843004 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 0.176100 0.176100 0.000000
61 W66151004 H03CA01 KALII IODIDUM JODID 100 micrograme COMPR. 100micrograme MERCK ROMANIA SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. PRF 100 0.176100 0.176100 0.000000
62 W66024001 H05AA02 TERIPARATIDUM ** MOVYMIA 20 micrograme/80 microlitri SOL. INJ. 20micrograme/80microlitri STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 CARTUS DIN STICLA PREVAZUT CU OPRITOR PENTRU PISTON SI DISC DE SIGILARE, AMBALAT IN TAVITA DE PLASTIC SIGILATA X 2,4 ML SOL. INJ. PRF 1 838.060000 838.060000 0.000000
63 W66024002 H05AA02 TERIPARATIDUM ** MOVYMIA 20 micrograme/80 microlitri SOL. INJ. 20micrograme/80microlitri STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 3 CARTUSE DIN STICLA PREVAZUTE CU OPRITOR PENTRU PISTON SI DISC DE SIGILARE, AMBALATE IN TAVITE DE PLASTIC SIGILATE X 2,4 ML SOL. INJ. PRF 3 814.010000 814.010000 0.000000
64 W65771001 H05AA02 TERIPARATIDUM ** TERROSA 20 micrograme/80 microlitri SOL. INJ. 20micrograme/80microlitri GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 CARTUS PREVAZUT CU UN OPRITOR PENTRU PISTON SI DISC DE X 2,4 ML SOL. INJ PRF 1 735.510000 735.510000 0.000000
65 W55488001 H05AA02 TERIPARATIDUM ** FORSTEO 20µg/80µl SOL. INJ. 20µg/80µl ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 ΜCG/80ΜCL) P-RF 1 882.612000 882.612000 25.168000
66 W67938001 H05AA03 PARATHYROID HORMONE **1 Ω NATPAR 100 micrograme/doza PULB.+SOLV.PT.SOL.INJ. 100micrograme/doza Shire Pharmaceuticals Ireland Limited IRLANDACUTIE CU 2 CARTUSE; FIECARE CARTUS DIN SUPORTUL PENTRU CARTUS DE CULOARE ALBASTRA CONTINE 1400 MICROGRAME HORMON PARATIROIDIAN (ADNR) SUB FORMA DE PULBERE IN PRIMA CAMERA SI 1000 MICROLITRI DE SOLVENT IN A DOUA CAMERA (CEEA CE CORESPUNDE LA 14 DOZE) PR 2 14,585.945000 14,585.945000 0.000000
67 W67941001 H05AA03 PARATHYROID HORMONE **1 Ω NATPAR 25 micrograme/doza PULB.+SOLV.PT.SOL.INJ. 25micrograme/doza Shire Pharmaceuticals Ireland Limited IRLANDACUTIE CU 2 CARTUSE; FIECARE CARTUS DIN SUPORTUL PENTRU CARTUS DE CULOARE MOV CONTINE 350 MICROGRAME HORMON PARATIROIDIAN (ADNR) SUB FORMA DE PULBERE ÎN PRIMA CAMERA SI 1000 MICROLITRI DE SOLVENT ÎN A DOUA CAMERA (CEEA CE CORESPUNDE LA 14 DOZE) PR 2 14,585.945000 14,585.945000 0.000000
68 W67940001 H05AA03 PARATHYROID HORMONE **1 Ω NATPAR 50 micrograme/doza PULB.+SOLV.PT.SOL.INJ. 50micrograme/doza Shire Pharmaceuticals Ireland Limited IRLANDACUTIE CU 2 CARTUSE; FIECARE CARTUS DIN SUPORTUL PENTRU CARTUS DE CULOARE ROSIE CONTINE 700 MICROGRAME HORMON PARATIROIDIAN (ADNR) SUB FORMA DE PULBERE ÎN PRIMA CAMERA SI 1000 MICROLITRI DE SOLVENT ÎN A DOUA CAMERA (CEEA CE CORESPUNDE LA 14 DOZE) PR 2 14,585.945000 14,585.945000 0.000000
69 W67939001 H05AA03 PARATHYROID HORMONE **1 Ω NATPAR 75 micrograme/doza PULB.+SOLV.PT.SOL.INJ. 75micrograme/doza Shire Pharmaceuticals Ireland Limited IRLANDACUTIE CU 2 CARTUSE; FIECARE CARTUS DIN SUPORTUL PENTRU CARTUS DE CULOARE GRI CONTINE 1050 MICROGRAME HORMON PARATIROIDIAN (ADNR) SUB FORMA DE PULBERE ÎN PRIMA CAMERA SI 1000 MICROLITRI DE SOLVENT ÎN A DOUA CAMERA (CEEA CE CORESPUNDE LA 14 DOZE) PR 2 14,585.945000 14,585.945000 0.000000
70 W55639001 M05BX04 DENOSUMAB ** PROLIA SOL. INJ. IN SERINGA PREUMPLUTA 60mg/ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA (IN BLISTER) CU AC SI PROTECTIE AUTOMATA PT. AC P-RF 1 685.490000 685.490000 0.000000
71 W65286001 M05BX05 BUROSUMABUM **1 Ω CRYSVITA 10 mg SOL INJ. 10mg/ml KYOWA KIRIN HOLDINGS B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (CONTINE BUROSUMAB 10 MG IN 1 ML SOL.) PR 1 13,629.810000 13,629.810000 0.000000
72 W65287001 M05BX05 BUROSUMABUM **1 Ω CRYSVITA 20 mg SOL INJ. 20mg/ml KYOWA KIRIN HOLDINGS B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (CONTINE BUROSUMAB 20 MG IN 1 ML SOL.) PR 1 27,188.760000 27,188.760000 0.000000
73 W65288001 M05BX05 BUROSUMABUM **1 Ω CRYSVITA 30 mg SOL INJ. 30mg/ml KYOWA KIRIN HOLDINGS B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA (CONTINE BUROSUMAB 30 MG IN 1 ML SOL.) PR 1 40,747.720000 40,747.720000 0.000000
74 W11164002 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 0.694500 0.694500 0.000000

19. BOALA WILSON - G23

1 W61063002 M01CC01 PENICILLAMINUM ** (4) CUPRIPEN 250mg CAPS. 250mg CN UNIFARM S.A. ROMANIA CUTIE X 3 BLIST. X 10 CAPS. PRF 30 2.943666 2.943666 0.000000

Tratamentul se iniţiază de către medicul din specialitatea endocrinologie, neurologie sau neurologie pediatrică.

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

1 W51230001 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA ** VENOFER 100 mg fer/5 ml SOL. INJ./PERF. 100mg/5ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 58.620000 58.620000 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 57.723333 57.723333 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 1 554.590000 554.590000 0.000000
4 W57497004 B03XA01 EPOETINUM ALFA ** EPREX 40000 UI/ml SOL. INJ. IN SERINGA PREUMPLUTA 40 000UI/ml JOHNSON & JOHNSON D.O.O. SLOVENIACUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. PR 1 866.388000 866.388000 401.662000
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 1 721.990000 721.990000 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 6 105.675000 105.675000 0.000000
7 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 6 295.070000 295.070000 0.000000
8 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 59.321666 59.321666 0.000000
9 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 1,074.000000 1,074.000000 0.000000
10 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 6 107.033333 107.033333 0.000000
11 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 6 143.961666 143.961666 0.000000
12 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 1 242.590000 242.590000 0.000000
13 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 1 242.590000 242.590000 0.000000
14 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 56.080000 56.080000 0.000000
15 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 56.080000 56.080000 0.000000
16 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 1 527.400000 527.400000 0.000000
17 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 1 527.400000 527.400000 0.000000
18 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 79.880000 79.880000 0.000000
19 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 79.880000 79.880000 0.000000
20 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 1 499.370000 499.370000 0.000000
21 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 1 499.370000 499.370000 0.000000
22 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 1 106.520000 106.520000 0.000000

Pagina 61 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
23 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 1 106.520000 106.520000 0.000000
24 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 1 128.580000 128.580000 0.000000
25 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 1 128.580000 128.580000 0.000000
26 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 1 151.520000 151.520000 0.000000
27 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 1 151.520000 151.520000 0.000000
28 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 1 216.320000 216.320000 0.000000
29 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 1 216.320000 216.320000 0.000000
30 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 4 753.142500 753.142500 0.000000
31 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 99.940000 99.940000 0.000000
32 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 4 162.120000 162.120000 0.000000
33 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 1,867.670000 1,867.670000 0.000000
34 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 4 235.445000 235.445000 0.000000
35 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 4 307.427500 307.427500 0.000000
36 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 3,011.950000 3,011.950000 0.000000
37 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 4 381.300000 381.300000 0.000000
38 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 4 455.387500 455.387500 0.000000
39 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 4 604.010000 604.010000 0.000000
40 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 1 809.300000 809.300000 0.000000
41 W64392001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 150 micrograme/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150µg/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. PR 1 1,100.270000 1,100.270000 0.000000
42 W64389001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 50 micrograme/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 50 µg/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. PR 1 422.380000 422.380000 0.000000
43 W64390001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 75 micrograme/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 75µg/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. PR 1 624.590000 624.590000 0.000000
44 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 0.497500 0.497500 0.000000
45 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 0.922713 0.922713 0.072644
46 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 0.589713 0.589713 0.123858
47 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 0.543571 0.543571 0.000000
48 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 0.589713 0.589713 0.698620
49 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 0.589713 0.589713 0.699215
50 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 0.491428 0.491428 0.000000
51 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 0.543571 0.543571 0.000000
52 W66400006 C09CA04 IRBESARTANUM ** APROVEL 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM. P6L 30 0.589713 0.589713 0.698620
53 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 0.778571 0.778571 0.000000
54 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 0.922713 0.922713 0.263715
55 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 0.768928 0.768928 0.000000
56 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 0.922713 0.922713 0.739953
57 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 0.922713 0.922713 0.739787
58 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 0.768928 0.768928 0.000000
59 W66401007 C09CA04 IRBESARTANUM ** APROVEL 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM. P6L 30 0.922713 0.922713 0.739953
60 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 0.151000 0.151000 0.000000
61 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
62 W13686002 H02AB07 PREDNISONUM PREDNISON SINTOFARM 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
63 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 0.145000 0.145000 0.000000
64 W63199002 H05BX02 PARICALCITOLUM ** ZEMPLAR 1 microgram CAPS. MOI 1micrograme ABBVIE SPAIN S.L.U. SPANIA CUTIE CU 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI PRF 28 9.646071 9.646071 0.000000
65 W63198001 H05BX02 PARICALCITOLUM ** ZEMPLAR 5 micrograme/ml SOL. INJ. 5micrograme/ml ABBVIE SPAIN S.L.U. SPANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA TIP I X 1 ML SOL. INJ. PR 5 63.504000 63.504000 0.000000
66 W63198003 H05BX02 PARICALCITOLUM ** ZEMPLAR 5 micrograme/ml SOL. INJ. 5micrograme/ml ABBVIE SPAIN S.L.U. SPANIA CUTIE CU 5 FLAC. DIN STICLA INCOLORA TIP I X 1 ML SOL. INJ. PR 5 63.504000 63.504000 0.000000
67 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 1.223000 1.223000 0.000000
68 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 25 mg CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 1.832400 1.832400 0.000000
69 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 50 mg CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 3.351800 3.351800 0.000000
70 W60846001 L04AX01 AZATHIOPRINUM IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.638800 0.000000
71 W12240001 V06DDN1 COMBINATII (AMINOACIZI) ** KETOSTERIL COMPR. FILM. FARA CONCENTRATIE FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE X 5 BLIST. DIN PVC/AL X 20 COMPR. FILM. P-RF 100 2.177900 2.177900 0.000000

Tratamentul se initiaza de catre medicul in specialitatea nefrologie.

21. BOLI DEGENERATIVE ALE OCHIULUI (GLAUCOM ŞI BOLI MACULARE) - G 26

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 16.040000 16.040000 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 16.040000 16.040000 0.000000
3 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 19.248000 19.248000 5.332000
4 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 31.490000 31.490000 0.000000
5 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 31.490000 31.490000 0.000000

Pagina 62 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
6 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 31.490000 31.490000 0.000000
7 W55649001 S01ED01 TIMOLOLUM TIMOLOL ROMPHARM 5 mg/ml 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 5.490000 5.490000 0.000000
8 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 3.470000 3.470000 0.000000
9 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 5.840000 5.840000 0.000000
10 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 15.020000 15.020000 0.000000
11 W63541001 S01ED02 BETAXOLOLUM BETOPTIC S 2,5 mg/ml PICATURI OFT.-SUSP. 2,5mg/ml
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 15.020000 15.020000 0.000000
12 W52116001 S01ED05 CARTEOLOLUM FORTINOL EP 2% PIC. OFTALMICE CU ELIB. PREL. 20mg/ml DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFTALMICE CU ELIB. PREL. P-6L 1 12.020000 12.020000 0.000000
13 W53813001 S01ED51 COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM) ** AZARGA PIC. OFT. SUSP. 10mg/ml+5mg/ml ALCON LABORATORIES (UK) LTD. CUTIE X 1 FLAC. X 5 ML SUSP. OFT.
MAREA BRITANIE P-RF 1 56.930000 56.930000 0.000000
14 W63646001 S01ED51 COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM) ** AZARGA PIC. OFT. SUSP. 10mg/ml+5mg/ml NOVARTIS EUROPHARM LTD. CUTIE CU 1 FLAC. X 5 ML SUSP. OFT.
MAREA BRITANIE PRF 1 56.930000 56.930000 0.000000
15 W64501001 S01ED51 COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM) ** AZARGA PIC. OFT. SUSP. 10mg/ml+5mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. X 5 ML SUSP. OFT. PRF 1 56.930000 56.930000 0.000000
16 W63939001 S01ED51 COMBINATII (BIMATOPROSTUM + TIMOLOLUM) BIMATOPROST/TIMOLOL ROMPHARM 0,3 mg/5 mg/ml PIC. OFT. 0,3mg/5mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD PREVAZUT CU PICURATOR DIN PEJD X 3 ML PIC. OFT., SOL. PRF 1 50.940000 50.940000 0.000000
17 W66265001 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) SIFIOPT 20 mg/5 mg/ml PIC. OFT., SOL. 20mg/5mg/ml SIFI S.P.A. ITALIA CUTIE CU 1 FLAC. PE ALB, OPAC +PICURATOR PEJD X 5 ML PIC. OFT. SOL. PRF 1 29.170000 29.170000 0.000000
18 W65460001 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT FARA CONSERVANT 20 mg/ml+5 mg/ml PIC. OFT., SOL. 20mg/ml+5mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLAC. DIN PEJD CU CAPACITATEA DE 10 ML PREVAZUT CU PICURATOR NOVELIA DIN PEID CU PIC. OFT., SOL. P6L 1 96.510000 96.510000 0.000000
19 W62674002 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT 20 mg/l + 5 mg/ml PIC. OFT.-SOL. 20mg/ml+5mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLACON DIN PEJD X 5 ML PIC. OFT., SOL. P6L 1 35.004000 35.004000 2.836000
20 W60653001 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) GLAUTAN PLUS 50 micrograme/ml + 5 mg/ml PIC. OFT., SOL 50 micrograme/ml + 5 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE X 1 FLACON DIN PEJD CU PICURATOR DIN PEJD INCHIS CU CAPAC DIN PEID X 2.5ML PICATURI OFTALMICE- P6L 1 32.000000 32.000000 0.000000
21 W67350001 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) XALCOM 50 micrograme/ml+5 mg/ml PIC. OFT., SOL. 50 micrograme/ml+5 mg/ml UPJOHN EESV OLANDA CUTIE CU 1 FLAC. PEJD CU CAPACITATE 5 ML, PREVAZUT CU PICURATOR DIN PEJD SAU PEMD X 2,5 ML PIC. OFT. SOL. P6L 1 32.000000 32.000000 0.000000
22 W58668001 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) ARUCOM 50 micrograme/ml + 5 mg/ml PIC. OFT., SOL. 50micrograme/ml+5mg/ml DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 32.000000 32.000000 0.000000
23 W65442001 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) FIXANPOST 50 micrograme/ml+5 mg/ml PICATURI OFT.-SOL., IN RECIPIENT UNIDOZA 50micrograme/ml+5mg/ml LABORATOIRES THEA FRANTA CUTIE CU 6 PLICURI DIN PP/AL/POLIESTER A CATE 5 RECIPIENTE UNIDOZA DIN PEJD CE CONTIN FIECARE 0,2 ML PIC. OFT., SOL. P6L 30 3.327333 3.327333 0.000000
24 W65048001 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) XALCOM 50 micrograme/ml+5 mg/ml SOL. OFT. 50 micrograme/ml+5 mg/ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. PEJD CU CAPACITATE 5 ML, PREVAZUT CU PICURATOR DIN PEJD SAU PEMD X 2,5 ML PIC. OFT. SOL. P6L 1 32.000000 32.000000 0.000000
25 W52810001 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) XALCOM (R) SOL. OFT. 50mcg/ml+5mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML P-6L 1 32.000000 32.000000 0.000000
26 W64002001 S01ED51 COMBINATII (TRAVOPROSTUM+TIMOLOLUM) TRAVOPROST/TIMOLOL ZENTIVA 40 micrograme/ml+5 mg/ml PIC. OFT., SOL. 40micrograme/ml+5mg/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. PP, CU PICURATOR INCOLOR DIN PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 45.050000 45.050000 0.000000
27 W43319001 S01ED51 COMBINATII (TRAVOPROSTUM+TIMOLOLUM) DUOTRAV 40mcg/ml + 5mg/ml PIC. OFT.-SOL. 40mcg/ml + 5mg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE P-RF 1 45.050000 45.050000 0.000000
28 W63647001 S01ED51 COMBINATII (TRAVOPROSTUM+TIMOLOLUM) DUOTRAV 40µg/ml + 5mg/ml PIC. OFT.-SOL. 40µg/ml + 5mg/ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE PRF 1 45.050000 45.050000 0.000000
29 W64597001 S01ED51 COMBINATII (TRAVOPROSTUM+TIMOLOLUM) DUOTRAV 40 micrograme/ml + 5mg/ml PIC. OFT.-SOL. 40µg/ml + 5mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE PRF 1 45.050000 45.050000 0.000000
30 W59365001 S01EE01 LATANOPROSTUM SIFITAN 50 micrograme/ml PIC. OFT., SOL 50micrograme/ml NTC S.R.L. ITALIA CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 27.730000 27.730000 0.000000
31 W54876001 S01EE01 LATANOPROSTUM UNILAT 50 micrograme/ml PIC. OFT., SOL. 50micrograme/ml UNIMED PHARMA SPOL. S.R.O. REPUBLICA SLOVACA CUTIE CU 1 FLAC. PICURATOR PE X 2,5 ML PIC. OFT., SOL. P-6L 1 29.850000 29.850000 0.000000
32 W56354001 S01EE01 LATANOPROSTUM ARULATAN 50 micrograme/ml PIC. OFT., SOL. 50micrograme/ml DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE CU 1 FLAC. PEJD CU DOP PICURATOR PEID X 2,5 ML PIC. OFT., SOL. P-6L 1 32.160000 32.160000 0.000000
33 W59511003 S01EE01 LATANOPROSTUM MONOPOST 50 micrograme/ml PIC. OFT., SOL., IN RECIPIENT UNIDOZA 50micrograme/ml LABORATOIRES THEA FRANTA CUTIE CU 30 (6X5) RECIPIENTE UNIDOZA DIN PEID AMBALATE CATE 5 IN 6 PLICURI LAMINATE DIN PE-AL-COPOLIMER A CATE 0,2 MILILITRI PIC. OFT., SOL. P6L 30 1.705000 1.705000 0.000000
34 W59511010 S01EE01 LATANOPROSTUM MONOPOST 50 micrograme/ml PIC. OFT., SOL., IN RECIPIENT UNIDOZA 50micrograme/ml LABORATOIRES THEA FRANTA CUTIE CU 30 (3X10) RECIPIENTE UNIDOZA DIN PEJD AMBALATE CÂTE 10 ÎN 3 PLICURI LAMINATE DIN COPOLIMER-AL-PE-HÂRTIE A CATE 0,2 MILILITRI PIC. OFT., SOL. P6L 30 1.705000 1.705000 0.000000
35 W57240001 S01EE01 LATANOPROSTUM GLAUTAN 0,05 mg/ml PIC. OFT.,SOL. 0,05mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE CU 1 FLAC. PEJD CU CAPACITATEA DE 5 ML+PICURATOR DIN PEJD, CU CAPAC DE SIGURANTA DIN PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 27.730000 27.730000 0.000000
36 W65047001 S01EE01 LATANOPROSTUM XALATAN 50 µg/ml 50µg/ml
PICATURI OFT., SOL. PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLACON PICURATOR DIN PE CONTINÂND 2,5 ML PICATURI OFTALMICE, SOLUTIE, PREVAZUT CU CAPAC CU FILET SI CAPAC SUPLIMENTAR DE PROTECTIE DIN PE P6L 1 32.770000 32.770000 0.000000
37 W67251001 S01EE01 LATANOPROSTUM XALATAN 50 µg/ml PICATURI OFT., SOL. 50µg/ml UPJOHN EESV OLANDA CUTIE CU 1 FLAC. PICURATOR DIN PE CONTINÂND 2,5 ML PICATURI OFTALMICE, SOLUTIE, PREVAZUT CU CAPAC CU FILET SI CAPAC SUPLIMENTAR DE PROTECTIE DIN PE P6L 1 32.770000 32.770000 0.000000
38 W03937002 S01EE01 LATANOPROSTUM XALATAN (R) PICATURI OFT.-SOL. 50mcg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PICURATOR PE X 2,5 ML P-6L 1 32.770000 32.770000 0.000000
39 W60652003 S01EE03 BIMATOPROSTUM BIMAGAN 0,3 mg/ml PIC. OFT., SOL 0,3 mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLACON ALB DIN PEJD CU PICURATOR DIN PEJD SI CAPAC CU INEL DE SIGURANTA DIN PEID X 3ML PICATURI OFTALMICE , SOLUTIE PRF 1 47.220000 47.220000 0.000000
40 W61822003 S01EE03 BIMATOPROSTUM BIMAGAN 0,1 mg/ml PIC. OFT., SOL. 0,1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN FLACON DIN PEJD CU PICURATOR DIN PEJD SI CAPAC VERDE- ALBASTRUI DIN PEÎD A 3 ML PICATURI OFTALMICE, SOLUTIE PRF 1 53.256000 53.256000 3.004000
41 W55458001 S01EE03 BIMATOPROSTUM LUMIGAN 0,1mg/ml PIC. OFT.,SOL. 0,1mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFT. SOL. P-RF 1 44.380000 44.380000 0.000000
42 W60939001 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30mcg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 4ML PICATURI OFTALMICE, SOLUTIE PRF 1 78.200000 78.200000 0.000000
43 W63545001 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30micrograme/ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 FLACON A 4ML X 2,5 ML DE TRAVOPROST, PICATURI OFTALMICE, SOLUTIE PRF 1 78.200000 78.200000 0.000000
44 W64506001 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30micrograme/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. A 4 ML X 2,5 ML DE TRAVOPROST, PICATURI OFTALMICE, SOLUTIE PRF 1 78.200000 78.200000 0.000000
45 W61045001 S01EE04 TRAVOPROSTUM TRAVOPROST ZENTIVA 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. TRANSLUCID DIN PP CU CAPACITATEA DE 5 ML, CU PICURATOR TRANSPARENT DIN PEJD A 2 ,5 ML PIC. OFT. SOL. P6L 1 40.050000 40.050000 0.000000
46 W66428001 S01EE04 TRAVOPROSTUM TRAVOCOM 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml S.C. ROMPHARM COMPANY S.R.L ROMANIA CUTIE CU 1 FLAC. DIN PEID PREVAZUT CU PICURATOR DIN PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 40.050000 40.050000 0.000000
47 W62677001 S01EE05 TAFLUPROSTUM ** Ω SAFLUTAN 15 micrograme/ml PIC. OFT., SOL., FIOLA UNIDOZA 15micrograme/ml SANTEN OY FINLANDA CUTIE CU 3 PUNGI A CATE 10 FIOLE UNIDOZA DIN PEJD X 0,3 ML PIC. OFT., SOL. (30 FIOLE) PRF 30 2.272000 2.272000 0.000000
48 W59598001 S01LA05 AFLIBERCEPTUM ** Ω EYLEA 40mg/ml SOL INJ. 40mg/ml BAYER PHARMA AG GERMANIA CUTIE X 1 FLACON DIN STICLA CU SOLUTIE INJECTABILA (4MG AFIBERCEPT /100 MICROLITRI SOL.) PR 1 2,986.960000 2,986.960000 0.000000
49 W63881001 S01LA05 AFLIBERCEPTUM ** Ω EYLEA 40mg/ml SOL INJ. 40mg/ml BAYER AG GERMANIA CUTIE X 1 FLACON DIN STICLA CU SOLUTIE INJECTABILA+1 AC CU FILTRU PR 1 2,986.960000 2,986.960000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea oftalmologie.

22. PEMFIGUS - G 27

1 W63171002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 7.061500 7.061500 0.000000
2 W63169002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 4 mg COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 1.620000 1.620000 0.000000
3 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 0.917000 0.917000 0.000000
4 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 0.901600 0.901600 0.000000
5 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 0.812700 0.812700 0.000000
6 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 1.530000 1.530000 0.000000
7 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 1.464400 1.464400 0.000000
8 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 1.327900 1.327900 0.000000
9 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 1.370900 1.370900 0.000000
10 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 1.572000 1.572000 0.000000

Pagina 63 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
11 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 1.573000 1.573000 0.000000
12 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 0.654800 0.654800 0.000000
13 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 0.654800 0.654800 0.000000
14 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 2.298500 2.298500 0.000000
15 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 2.298500 2.298500 0.000000
16 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 23.500000 23.500000 0.000000
17 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 71.250000 71.250000 0.000000
18 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 0.151000 0.151000 0.000000
19 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
20 W13686002 H02AB07 PREDNISONUM PREDNISON SINTOFARM 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0.151000 0.151000 0.000000
21 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 0.145000 0.145000 0.000000
22 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 1.223000 1.223000 0.000000
23 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 32.970000 32.970000 0.000000
24 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 32.970000 32.970000 0.000000
25 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 25 mg CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 1.832400 1.832400 0.000000
26 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL 50 mg CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI PR 50 3.351800 3.351800 0.000000
27 W60846001 L04AX01 AZATHIOPRINUM IMURAN 50 mg COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0.638800 0.638800 0.000000

Tratamentul se iniţiază de către medicul în specialitatea dermatologie.

23. BOALA GAUCHER - G 29

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 6,354.120000 6,354.120000 0.000000
2 W61994001 A16AB10 VELAGLUCERASE ALFA **1 VPRIV 400 unitati PULB. PT. SOL. PERF. 400unitati IRLANDA
Shire Pharmaceuticals Ireland Limited 5 FLAC. DIN STICLA X 400 UNITATI PULBERE PT. SOL. PERF. PR 5 7,432.036000 7,432.036000 0.000000
3 W68150001 A16AB10 VELAGLUCERASE ALFA **1 VPRIV 400 unitati PULB. PT. SOL. PERF. 400unitati IRLANDA
TAKEDA PHARMACEUTICALS INTERNATIONAL AG IRELAND BR 5 FLAC. DIN STICLA X 400 UNITATI PULBERE PT. SOL. PERF. PR 5 7,432.036000 7,432.036000 0.000000
4 W65802002 A16AX06 MIGLUSTATUM **1 MIGLUSTAT ACCORD 100 mg CAPS. 100mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 84X1 PR 84 132.744523 132.744523 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 1,571.917857 1,571.917857 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.

24. BOLI VENERICE (SIFILIS, GONOREE, INFECTIA CU CHLAMIDIA) - G 30

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 0.459000 0.459000 0.000000
2 W02885004 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA 100 mg CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.459000 0.459000 0.000000
3 W12701001 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 CAPS. P-RF 20 0.370500 0.370500 0.000000
4 W56910001 J01AA07 TETRACYCLINUM TETRACICLINA ATB 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 0.444600 0.444600 0.048400
5 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 10.815000 10.815000 0.000000
6 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 12.978000 12.978000 1.302000
7 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 11.523400 11.523400 0.000000
8 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 12.978000 12.978000 1.302000
9 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 11.523400 11.523400 0.000000
10 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 10.815000 10.815000 0.000000
11 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 12.678000 12.678000 0.000000
12 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 12.678000 12.678000 0.000000
13 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 8.569000 8.569000 0.000000
14 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 10.282800 10.282800 0.827200
15 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 9.277600 9.277600 0.000000
16 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 10.213000 10.213000 0.000000
17 W41595001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0.571666 0.571666 0.000000
18 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 0.770000 0.770000 0.000000
19 W41596001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0.612500 0.612500 0.000000
20 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 10.120000 10.120000 0.000000
21 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 38.871360 38.871360 4.478640
22 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 33.101600 33.101600 0.000000
23 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 32.392800 32.392800 0.000000
24 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 38.669000 38.669000 0.000000
25 W57455001 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 2.467000 2.467000 0.000000

Pagina 64 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
26 W13701001 J01DD08 CEFIXIMUM EFICEF 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3.981000 3.981000 0.000000
27 W63367003 J01DD08 CEFIXIMUM CEFIXIMA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 3.981000 3.981000 0.000000
28 W60256001 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE PRF 5 10.220570 10.220570 0.837430
29 W60256003 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF 10 10.220570 10.220570 0.281430
30 W63368003 J01DD08 CEFIXIMUM CEFIXIMA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 8.517142 8.517142 0.000000
31 W61965002 J01DD08 CEFIXIMUM XIFIA 100 mg/5 ml GRANULE PT. SUSP. ORALA 100mg/5ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPCITATEA DE 150 ML CARE CONTINE 53 G GRAN. PT. SUSP. ORALA+1 MASURA DOZATOARE DIN PP PT. MASURAREA VOLUMULUI DE SOLVENT GRADATA LA 66 ML+1 SERINGA DOZATOARE DIN PLASTIC A 5 ML, GRADATA DE LA 0,5 ML PANA LA 5 ML PRF 1 82.350000 82.350000 0.000000
32 W61210001 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0.549500 0.549500 0.000000
33 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 3.306000 3.306000 1.129000
34 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 3.306000 3.306000 1.129000
35 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 4.561666 4.561666 0.000000
36 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 4.561666 4.561666 0.000000
37 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 2.755000 2.755000 0.000000
38 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 3.306000 3.306000 0.325666
39 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 3.573333 3.573333 0.000000
40 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 4.287999 4.287999 1.868667
41 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 4.287999 4.287999 1.868667
42 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. P-RF 3 4.287999 4.287999 1.868667
43 W57032001 J01FA10 AZITHROMYCINUM AZITROX 500 mg COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 4.287999 4.287999 0.945334
44 W60406001 J01FA10 AZITHROMYCINUM AZITROMICINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF 3 4.287999 4.287999 1.868667
45 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 4.287999 4.287999 1.868667
46 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 4.287999 4.287999 4.582001
47 W53281001 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA 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 P-RF 1 15.950000 15.950000 0.000000
48 W66687001 J01FA10 AZITHROMYCINUM AZITROMICINA ROMPHARM 500 mg PULB. PT. SOL. PERF. 500mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA PRF 1 39.840000 39.840000 0.000000
49 W66687002 J01FA10 AZITHROMYCINUM AZITROMICINA ROMPHARM 500 mg PULB. PT. SOL. PERF. 500mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FLAC. DIN STICLA TRANSPARENTA PRF 5 35.882000 35.882000 0.000000
50 W42901001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA 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 P-RF 1 21.340000 21.340000 0.000000
51 W42877002 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA 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 P-RF 1 20.650000 20.650000 0.000000
52 W00520001 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 37.100000 37.100000 0.000000
53 W64358002 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA 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 PRF 1 37.100000 37.100000 0.000000
54 W00520003 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 46.090000 46.090000 0.000000
55 W64358003 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA PRF
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 1 46.090000 46.090000 0.000000
56 W54037001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4.272000 4.272000 0.000000
57 W44077004 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0.650400 0.650400 0.141600
58 W01273001 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0.650400 0.650400 0.129600
59 W01288001 J01MA02 CIPROFLOXACINUM CIPROLEN 250 mg COMPR. FILM. 250mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.650400 0.650400 0.141600
60 W01271002 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.650400 0.650400 0.119600
61 W54038001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.650400 0.650400 0.141600
62 W54038002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0.650400 0.650400 0.141600
63 W65056001 J01MA02 CIPROFLOXACINUM CIFRAN 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. PRF 10 0.650400 0.650400 0.141600
64 W66438003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0.542000 0.542000 0.000000
65 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0.954000 0.954000 0.252000
66 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0.954000 0.954000 0.559000
67 W01289001 J01MA02 CIPROFLOXACINUM CIPROLEN 500 mg COMPR. FILM. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.954000 0.954000 0.559000
68 W01272001 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.954000 0.954000 0.539000
69 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 0.954000 0.954000 0.559000
70 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0.954000 0.954000 0.559000
71 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0.954000 0.954000 0.559000
72 W65057001 J01MA02 CIPROFLOXACINUM CIFRAN 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. PRF 10 0.954000 0.954000 0.559000
73 W66439003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0.795000 0.795000 0.000000
74 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 3.784000 3.784000 0.000000
75 W54040001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4.272000 4.272000 0.000000
76 W01275001 J01MA02 CIPROFLOXACINUM CIPRINOL 100 mg/10 ml CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML PR 5 3.836000 3.836000 0.000000
77 W60268001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF. 100mg/10ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA PREVAZUTE CU INEL DE RUPERE X 10 ML PR 5 3.846000 3.846000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea dermatologie şi obstetrică-ginecologie (pentru gonoree şi infecţia cu Chlamidia).

IMUNOSUPRESOARE SELECTIVE - G31


25. BOALA CRONICĂ INFLAMATORIE INTESTINALĂ ŞI SINDROM DE INTESTIN SCURT - G31a

1 W66585001 A16AX08 TEDUGLUTIDUM **1 REVESTIVE PULB+SOLV. PT. SOL. INJ 1,25mg Shire Pharmaceuticals Ireland Limited IRLANDA AMBALAJ CU 28 FLACOANE DE PULBERE SI 28 SERINGI PREUMPLUTE PR 28 1,535.577142 1,535.577142 0.000000

Pagina 65 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
2 W66586001 A16AX08 TEDUGLUTIDUM **1 REVESTIVE PULB+SOLV. PT. SOL. INJ 5mg Shire Pharmaceuticals Ireland Limited IRLANDA AMBALAJ CU 1 FLACON DE PULBERE SI O SERINGA PREUMPLUTA PR 1 3,321.270000 3,321.270000 0.000000
3 W66586002 A16AX08 TEDUGLUTIDUM **1 REVESTIVE PULB+SOLV. PT. SOL. INJ 5mg Shire Pharmaceuticals Ireland Limited IRLANDA AMBALAJ CU 28 FLACOANE DE PULBERE SI 28 SERINGI PREUMPLUTE PR 28 2,917.642142 2,917.642142 0.000000
4 W63432001 L04AA29 TOFACITINIB **1 Ω 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
5 W65118001 L04AA29 TOFACITINIB **1 Ω 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
6 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 6,777.480000 6,777.480000 0.000000
7 W66899001 L04AA33 VEDOLIZUMABUM **1 ENTYVIO 108 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 108mg TAKEDA PHARMA A/S DANEMARCA 1 STILOU INJECTOR (PEN) PREUMPLUT CARE CONTINE 108 MG VEDOLIZUMAB PR 1 2,069.670000 2,069.670000 0.000000
8 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 1,057.464000 1,057.464000 880.629333
9 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 1 881.220000 881.220000 0.000000
10 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 1 982.850000 982.850000 0.000000
11 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 1 909.140000 909.140000 0.000000
12 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
13 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1,888.510000 1,888.510000 0.000000
14 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
15 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 2,064.070000 2,064.070000 0.000000
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 1,075.704000 1,075.704000 38.231000
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 1,075.704000 1,075.704000 38.231000
18 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 1,075.704000 1,075.704000 40.966000
19 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 1,026.640000 1,026.640000 0.000000
20 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 2,576.430000 2,576.430000 0.000000
21 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 2,576.430000 2,576.430000 0.000000
22 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 2 572.750000 572.750000 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 1,075.704000 1,075.704000 38.231000
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 1,075.704000 1,075.704000 38.231000
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 1,075.704000 1,075.704000 40.966000
26 W67468001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
27 W67468002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
28 W67468003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
29 W67468004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE+ 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
30 W67468005 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
31 W67468006 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
32 W67468007 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
33 W67468008 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
34 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 1,034.990000 1,034.990000 0.000000
35 W67469001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
36 W67469002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 PENURI PREUMPLUTE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
37 W67469003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 PENURI PREUMPLUTE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
38 W67469004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 PENURI PREUMPLUTE + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
39 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 2 896.420000 896.420000 0.000000
40 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 2 896.420000 896.420000 0.000000
41 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 11,425.650000 11,425.650000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea gastroenterologie, gastroenterologie pediatrică şi medicină internă.

26. POLIARTITRITA REUMATOIDA - G31b

1 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 3,823.470000 3,823.470000 311.700000
2 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 3,221.650000 3,221.650000 0.000000
3 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 3,186.225000 3,186.225000 0.000000
4 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 1,377.520000 1,377.520000 0.000000
5 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 4 943.002500 943.002500 0.000000
6 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 1,131.603000 1,131.603000 3.687000
7 W66577001 L04AA29 TOFACITINIB **1 XELJANZ 11 mg COMPR. ELIB. PREL. 11mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 4 BLIST. DIN ALU/PVC/ALU X 7 COMPR. ELIB. PREL. PR 28 121.308928 121.308928 0.000000
8 W66577002 L04AA29 TOFACITINIB **1 XELJANZ 11 mg COMPR. ELIB. PREL. 11mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 13 BLIST. DIN ALU/PVC/ALU X 7 COMPR. ELIB. PREL. PR 91 119.557032 119.557032 0.000000
9 W63432001 L04AA29 TOFACITINIB **1 XELJANZ 5 mg COMPR. FILM. 5mg PFIZER LIMITED CUTIE CU 4 BLISTERE DIN AL/PVC/AL X 14 COMPR. FILM.
MAREA BRITANIE PR 56 60.654464 60.654464 0.000000
10 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
11 W65630001 L04AA37 BARICITINIBUM **1 OLUMIANT 2 mg COMPR. FILM. 2mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC/PE/PCTFE/ALU X 35 COMPR. FILM. PR 35 121.130571 121.130571 0.000000
12 W63493001 L04AA37 BARICITINIBUM **1 OLUMIANT 4 mg COMPR. FILM. 4mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC/PE/PCTFE/ALU X 35 COMPR. FILM. PR 35 120.833142 120.833142 0.000000
13 W66589001 L04AA44 UPADACITINIBUM **1 RINVOQ 15 mg COMPR. ELIB. PREL. 15mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU BLISTERE CALENDARISTICE DIN PVC/PE/PCTFE/AL X 28 COMPRIMATE CU ELIBERARE PRELUNGITA PR 28 111.413571 111.413571 0.000000
14 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 4 384.345000 384.345000 0.000000

Pagina 66 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
15 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 4 384.345000 384.345000 0.000000
16 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 530.670000 530.670000 0.000000
17 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 4 617.947500 617.947500 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 4 390.480000 390.480000 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 4 636.804000 636.804000 116.301000
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 MEDICINAL PR 4 636.804000 636.804000 116.301000
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 4 617.947500 617.947500 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 4 390.480000 390.480000 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 4 636.804000 636.804000 116.301000
24 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 4 636.804000 636.804000 116.301000
25 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 1,057.464000 1,057.464000 880.629333
26 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 1 881.220000 881.220000 0.000000
27 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 1 982.850000 982.850000 0.000000
28 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 1 909.140000 909.140000 0.000000
29 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
30 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1,888.510000 1,888.510000 0.000000
31 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
32 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 2,064.070000 2,064.070000 0.000000
33 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 1,075.704000 1,075.704000 38.231000
34 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 1,075.704000 1,075.704000 38.231000
35 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 1,075.704000 1,075.704000 40.966000
36 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 1,026.640000 1,026.640000 0.000000
37 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 1,075.704000 1,075.704000 38.231000
38 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 1,075.704000 1,075.704000 38.231000
39 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 1,075.704000 1,075.704000 40.966000
40 W67468001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
41 W67468002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
42 W67468003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
43 W67468004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE+ 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
44 W67468005 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
45 W67468006 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
46 W67468007 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
47 W67468008 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
48 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 1,034.990000 1,034.990000 0.000000
49 W67469001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
50 W67469002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 PENURI PREUMPLUTE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
51 W67469003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 PENURI PREUMPLUTE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
52 W67469004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 PENURI PREUMPLUTE + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
53 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 2 896.420000 896.420000 0.000000
54 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 2 896.420000 896.420000 0.000000
55 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 1,606.270000 1,606.270000 0.000000
56 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 3,470.690000 3,470.690000 0.000000
57 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 1,212.040000 1,212.040000 0.000000
58 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 1 527.320000 527.320000 0.000000
59 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 2,353.210000 2,353.210000 0.000000
60 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 4 816.537500 816.537500 0.000000

Tratamentul se iniţiază de către medicul în specialitatea reumatologie, medicină internă, nefrologie (pentru pacienţii cu afectare renală) şi reabilitarea medicală.

27. ARTROPATIA PSORIAZICA - G31c

1 W63432001 L04AA29 TOFACITINIB **1 Ω 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
2 W65118001 L04AA29 TOFACITINIB **1 Ω 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
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 4 384.345000 384.345000 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 4 384.345000 384.345000 0.000000
5 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 530.670000 530.670000 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 4 617.947500 617.947500 0.000000
7 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 4 390.480000 390.480000 0.000000
8 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 4 636.804000 636.804000 116.301000

Pagina 67 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
9 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 MEDICINAL PR 4 636.804000 636.804000 116.301000
10 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 4 617.947500 617.947500 0.000000
11 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 4 390.480000 390.480000 0.000000
12 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 4 636.804000 636.804000 116.301000
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 4 636.804000 636.804000 116.301000
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 1,057.464000 1,057.464000 880.629333
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 1 881.220000 881.220000 0.000000
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 1 982.850000 982.850000 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 1 909.140000 909.140000 0.000000
18 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
19 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1,888.510000 1,888.510000 0.000000
20 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
21 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 2,064.070000 2,064.070000 0.000000
22 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 1,075.704000 1,075.704000 38.231000
23 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 1,075.704000 1,075.704000 38.231000
24 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 1,075.704000 1,075.704000 40.966000
25 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 1,026.640000 1,026.640000 0.000000
26 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1,075.704000 1,075.704000 38.231000
27 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1,075.704000 1,075.704000 38.231000
28 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 1,075.704000 1,075.704000 40.966000
29 W67468001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
30 W67468002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
31 W67468003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
32 W67468004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE+ 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
33 W67468005 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
34 W67468006 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
35 W67468007 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
36 W67468008 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
37 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 1,034.990000 1,034.990000 0.000000
38 W67469001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
39 W67469002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 PENURI PREUMPLUTE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
40 W67469003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 PENURI PREUMPLUTE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
41 W67469004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 PENURI PREUMPLUTE + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
42 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 2 896.420000 896.420000 0.000000
43 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 2 896.420000 896.420000 0.000000
44 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 1,606.270000 1,606.270000 0.000000
45 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 3,470.690000 3,470.690000 0.000000
46 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 2,454.500000 2,454.500000 0.000000
47 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 2,489.930000 2,489.930000 0.000000
48 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 2,489.930000 2,489.930000 0.000000
49 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 2,454.500000 2,454.500000 0.000000
50 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 2,366.065000 2,366.065000 0.000000
51 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 2,401.500000 2,401.500000 0.000000
52 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 2,401.500000 2,401.500000 0.000000
53 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 2,366.065000 2,366.065000 0.000000
54 W67211001 L04AC10 SECUKINUMABUM **1 COSENTYX 300 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 300mg/2ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 STILOU PREUMPLUT (STILOU UNOREADY) X 2ML SOL. INJ. PR 1 4,732.130000 4,732.130000 0.000000
55 W62892001 L04AC13 IXEKIZUMABUM **1 TALTZ SOL INJ. IN STILOU PREUMPLUT 80mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU 1 STILOU INJECTOR PREUMPLUT PR 1 4,120.560000 4,120.560000 0.000000
56 W68000001 L04AC13 IXEKIZUMABUM **1 TALTZ SOL INJ. IN STILOU PREUMPLUT 80mg ELI LILLY AND COMPANY LTD. IRLANDA CUTIE CU 1 STILOU INJECTOR PREUMPLUT PR 1 4,120.560000 4,120.560000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea reumatologie şi reabilitare medicală.

28. SPONDILOARTRITA AXIALĂ - G31d

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 4 384.345000 384.345000 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 4 384.345000 384.345000 0.000000
3 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 530.670000 530.670000 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 4 617.947500 617.947500 0.000000
5 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 4 390.480000 390.480000 0.000000

Pagina 68 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
6 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 4 636.804000 636.804000 116.301000
7 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 MEDICINAL PR 4 636.804000 636.804000 116.301000
8 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 4 617.947500 617.947500 0.000000
9 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 4 390.480000 390.480000 0.000000
10 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 4 636.804000 636.804000 116.301000
11 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 4 636.804000 636.804000 116.301000
12 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 1,057.464000 1,057.464000 880.629333
13 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 1 881.220000 881.220000 0.000000
14 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 1 982.850000 982.850000 0.000000
15 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 1 909.140000 909.140000 0.000000
16 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
17 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1,888.510000 1,888.510000 0.000000
18 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
19 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 2,064.070000 2,064.070000 0.000000
20 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 1,075.704000 1,075.704000 38.231000
21 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 1,075.704000 1,075.704000 38.231000
22 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 1,075.704000 1,075.704000 40.966000
23 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 1,026.640000 1,026.640000 0.000000
24 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 1,075.704000 1,075.704000 38.231000
25 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 1,075.704000 1,075.704000 38.231000
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 1,075.704000 1,075.704000 40.966000
27 W67468001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
28 W67468002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
29 W67468003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
30 W67468004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE+ 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
31 W67468005 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
32 W67468006 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
33 W67468007 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
34 W67468008 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
35 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 1,034.990000 1,034.990000 0.000000
36 W67469001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
37 W67469002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 PENURI PREUMPLUTE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
38 W67469003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 PENURI PREUMPLUTE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
39 W67469004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 PENURI PREUMPLUTE + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 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 2 896.420000 896.420000 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 2 896.420000 896.420000 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 1,606.270000 1,606.270000 0.000000
43 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 3,470.690000 3,470.690000 0.000000
44 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 2,454.500000 2,454.500000 0.000000
45 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 2,489.930000 2,489.930000 0.000000
46 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 2,489.930000 2,489.930000 0.000000
47 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 2,454.500000 2,454.500000 0.000000
48 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 2,366.065000 2,366.065000 0.000000
49 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 2,401.500000 2,401.500000 0.000000
50 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 2,401.500000 2,401.500000 0.000000
51 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 2,366.065000 2,366.065000 0.000000
52 W67211001 L04AC10 SECUKINUMABUM **1 COSENTYX 300 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 300mg/2ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 STILOU PREUMPLUT (STILOU UNOREADY) X 2ML SOL. INJ. PR 1 4,732.130000 4,732.130000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea reumatologie, medicină internă şi reabilitare medicală.

29. ARTRITA JUVENILA - G31e

1 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 1,377.520000 1,377.520000 0.000000
2 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 4 384.345000 384.345000 0.000000
3 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 4 384.345000 384.345000 0.000000
4 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 530.670000 530.670000 0.000000
5 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 4 617.947500 617.947500 0.000000

Pagina 69 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
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 4 390.480000 390.480000 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 4 636.804000 636.804000 116.301000
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 MEDICINAL PR 4 636.804000 636.804000 116.301000
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 4 617.947500 617.947500 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 4 390.480000 390.480000 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 4 636.804000 636.804000 116.301000
12 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 4 636.804000 636.804000 116.301000
13 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 1,075.704000 1,075.704000 38.231000
14 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 1,075.704000 1,075.704000 38.231000
15 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 1,075.704000 1,075.704000 40.966000
16 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 1,026.640000 1,026.640000 0.000000
17 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 2 572.750000 572.750000 0.000000
18 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 1,075.704000 1,075.704000 38.231000
19 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 1,075.704000 1,075.704000 38.231000
20 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 1,075.704000 1,075.704000 40.966000
21 W67468001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
22 W67468002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
23 W67468003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
24 W67468004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE+ 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
25 W67468005 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
26 W67468006 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
27 W67468007 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
28 W67468008 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
29 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 1,034.990000 1,034.990000 0.000000
30 W67469001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
31 W67469002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 PENURI PREUMPLUTE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
32 W67469003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 PENURI PREUMPLUTE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
33 W67469004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 PENURI PREUMPLUTE + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
34 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 2 896.420000 896.420000 0.000000
35 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 2 896.420000 896.420000 0.000000
36 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 3,470.690000 3,470.690000 0.000000
37 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 1,212.040000 1,212.040000 0.000000
38 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 1 527.320000 527.320000 0.000000
39 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 2,353.210000 2,353.210000 0.000000
40 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 4 816.537500 816.537500 0.000000

Tratamentul se iniţiază de către medicul în specialitatea reumatologie, pediatrie şi reabilitare medicală.

30. PSORIAZIS CRONIC SEVER (PLĂCI) - G31f

1 W66653001 L04AA32 APREMILASTUM **1 Ω OTEZLA COMPR. FILM. 30mg AMGEN EUROPE B.V. OLANDA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 52.619821 52.619821 0.000000
2 W66652001 L04AA32 APREMILASTUM **1 Ω OTEZLA COMPR. FILM. FARA CONCENTRATIE AMGEN EUROPE B.V. OLANDA PACHET DE INITIERE CU BLIST. PVC/AL INCLUS INTR-UN CARD 4X10 MG+4 X 20 MG+19 X 30 MG COMPR. FILM. PR 1 1,457.420000 1,457.420000 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 4 384.345000 384.345000 0.000000
4 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA PR
CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL 4 384.345000 384.345000 0.000000
5 W63832001 L04AB01 ETANERCEPTUM **1 ERELZI 50 mg SOL INJ. 50mg SANDOZ GMBH AUSTRIA CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE PR 4 530.670000 530.670000 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 4 617.947500 617.947500 0.000000
7 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 4 390.480000 390.480000 0.000000
8 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 4 636.804000 636.804000 116.301000
9 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 MEDICINAL PR 4 636.804000 636.804000 116.301000
10 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 4 617.947500 617.947500 0.000000
11 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 4 390.480000 390.480000 0.000000
12 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 4 636.804000 636.804000 116.301000
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 4 636.804000 636.804000 116.301000
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 1,057.464000 1,057.464000 880.629333
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 1 881.220000 881.220000 0.000000
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 1 982.850000 982.850000 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 1 909.140000 909.140000 0.000000

Pagina 70 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
18 W66531005 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE CU PROTECTIE PENTRU AC+ 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
19 W66531007 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1STILOU INJECTOR PREUMPLUT + 2 TAMPOANE DE ALCOOL PR 1 1,888.510000 1,888.510000 0.000000
20 W66531008 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 STILOURI INJECTOARE PREUMPLUTE + 2 TAMPOANE DE ALCOOL PR 2 1,853.085000 1,853.085000 0.000000
21 W66531009 L04AB02 INFLIXIMABUM **1 REMSIMA 120mg SOL INJ. 120mg/ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 STILOURI INJECTOARE PREUMPLUTE + 4 TAMPOANE DE ALCOOL PR 4 2,064.070000 2,064.070000 0.000000
22 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 1,075.704000 1,075.704000 38.231000
23 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 1,075.704000 1,075.704000 38.231000
24 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 1,075.704000 1,075.704000 40.966000
25 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 1,026.640000 1,026.640000 0.000000
26 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 2,576.430000 2,576.430000 0.000000
27 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 2,576.430000 2,576.430000 0.000000
28 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 2 572.750000 572.750000 0.000000
29 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 1,075.704000 1,075.704000 38.231000
30 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 1,075.704000 1,075.704000 38.231000
31 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 1,075.704000 1,075.704000 40.966000
32 W67468001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
33 W67468002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
34 W67468003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
35 W67468004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE+ 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
36 W67468005 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
37 W67468006 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
38 W67468007 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
39 W67468008 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 SERINGI PREUMPLUTE X 0,4ML SOLUTIE CU APARATOARE PENTRU AC + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
40 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 1,034.990000 1,034.990000 0.000000
41 W67469001 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 1 PEN PREUMPLUT + 2 TAMPOANE ALCOOL PR 1 976.900000 976.900000 0.000000
42 W67469002 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 2 PENURI PREUMPLUTE + 2 TAMPOANE ALCOOL PR 2 941.480000 941.480000 0.000000
43 W67469003 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 4 PENURI PREUMPLUTE + 4 TAMPOANE ALCOOL PR 4 923.770000 923.770000 0.000000
44 W67469004 L04AB04 ADALIMUMABUM **1 YUFLYMA 40 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 40mg/0,4ml CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE CU 6 PENURI PREUMPLUTE + 6 TAMPOANE ALCOOL PR 6 917.865000 917.865000 0.000000
45 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 2 896.420000 896.420000 0.000000
46 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 2 896.420000 896.420000 0.000000
47 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 1,606.270000 1,606.270000 0.000000
48 W53884001 L04AC05 USTEKINUMAB **1 STELARA 45 SOL. INJ. 45mg/0,5ml JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. X 0,5 SOL. INJ. P-RF/R 1 10,873.020000 10,873.020000 0.000000
49 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 2,454.500000 2,454.500000 0.000000
50 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 2,489.930000 2,489.930000 0.000000
51 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 2,489.930000 2,489.930000 0.000000
52 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 2,454.500000 2,454.500000 0.000000
53 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 2,366.065000 2,366.065000 0.000000
54 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 2,401.500000 2,401.500000 0.000000
55 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 2,401.500000 2,401.500000 0.000000
56 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 2,366.065000 2,366.065000 0.000000
57 W67211001 L04AC10 SECUKINUMABUM **1 COSENTYX 300 mg SOL INJ. IN STILOU INJECTOR PREUMPLUT 300mg/2ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 STILOU PREUMPLUT (STILOU UNOREADY) X 2ML SOL. INJ. PR 1 4,732.130000 4,732.130000 0.000000
58 W62892001 L04AC13 IXEKIZUMABUM **1 TALTZ SOL INJ. IN STILOU PREUMPLUT 80mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU 1 STILOU INJECTOR PREUMPLUT PR 1 4,120.560000 4,120.560000 0.000000
59 W68000001 L04AC13 IXEKIZUMABUM **1 TALTZ SOL INJ. IN STILOU PREUMPLUT 80mg ELI LILLY AND COMPANY LTD. IRLANDA CUTIE CU 1 STILOU INJECTOR PREUMPLUT PR 1 4,120.560000 4,120.560000 0.000000
60 W65090001 L04AC16 GUSELKUMABUM **1 TREMFYA 100 mg SOL INJ. 100mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA PR 1 8,806.370000 8,806.370000 0.000000
61 W65090002 L04AC16 GUSELKUMABUM **1 TREMFYA 100 mg SOL INJ. 100mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 STILOU INJECTOR (PEN ) PREUMPLUT PR 1 9,936.230000 9,936.230000 0.000000
62 W66238001 L04AC17 TILDRAKIZUMABUM **1 ILUMETRI 100 mg SOL. INJ. IN SERINGA PREUMPLUTA 100mg/ml ALMIRALL, S.A. SPANIA CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. PR 1 13,682.980000 13,682.980000 0.000000
63 W66053001 L04AC18 RISANKIZUMABUM **1 SKYRIZI 75 mg SOL. INJ. IN SERINGA PREUMPLUTA 75mg/0,83ml ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA PR
CUTIE CU 2 SERINGI PREUMPLUTE DIN STICLA, CU AC FIXAT INTR-UN SISTEM DE PROTECTIE AUTOMATA A ACULUI X 0,83 ML SOL. INJ. (75 MG RISANKIZUMAB) + 2 TAMPOANE CU ALCOOL 2 6,829.700000 6,829.700000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea dermatologie.

31 DERMATITA ATOPICĂ - G31g

1 W66535001 D11AH05 DUPILUMABUM **1 Ω DUPIXENT 300 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 150mg/ml SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 2 ML SOL. INJ. IN PEN PREUMPLUT PR 2 2,912.830000 2,912.830000 0.000000
2 W66695001 D11AH05 DUPILUMABUM **1 Ω DUPIXENT 200 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 175mg/ml SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 1,14 ML SOL. INJ. IN PEN PREUMPLUT PR 2 2,912.830000 2,912.830000 0.000000
3 W66694001 D11AH05 DUPILUMABUM **1 Ω DUPIXENT 200 mg SOL. INJ. IN SERINGA PREUMPLUTA 175mg/ml SANOFI-AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE CU SCUT PT. AC X 1,14 ML SOL. PR 2 2,912.830000 2,912.830000 0.000000
4 W65623001 D11AH05 DUPILUMABUM **1 Ω DUPIXENT 300 mg SOL. INJ. IN SERINGA PREUMPLUTA 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE DIN STICLA TRANSPARENTA DE TIP 1 SILICONATA, CU UN AC FIX DIN OTEL INOXIDABIL CU PERETE SUBTIRE X 2 ML SOL. INJ. IN SERINGA PREUMPLUTA PR 2 2,912.830000 2,912.830000 0.000000
5 W65623002 D11AH05 DUPILUMABUM **1 Ω DUPIXENT 300 mg SOL. INJ. IN SERINGA PREUMPLUTA 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE DIN STICLA TRANSPARENTA DE TIP 1 SILICONATA, CU UN AC FIX DIN OTEL INOXIDABIL, CU SCUT PENTRU AC, CU PERETE SUBTIRE X 2 ML SOL. INJ. IN SERINGA PREUMPLUTA PR 2 2,912.830000 2,912.830000 0.000000

32. AFECȚIUNI PULMONARE CRONICE - G31h

Pagina 71 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


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

1 W63059001 B02AB02 INHIBITOR ALFA1 PROTEINAZA UMANA **1 RESPREEZA 1000 mg PULB+SOLV. PT. SOL. PERF. 1000mg CSL BEHRING GMBH GERMANIA FLAC. DIN STICLA (TIP I) CU 1000 MG PULB. SI 1 FLAC. DIN STICLA (TIP I) CU 20 ML APA PT. PREPARATE INJ. PR 1 1,478.880000 1,478.880000 0.000000
2 W66535001 D11AH05 DUPILUMABUM ** DUPIXENT 300 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 150mg/ml SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 2 ML SOL. INJ. IN PEN PREUMPLUT PR 2 2,912.830000 2,912.830000 0.000000
3 W66695001 D11AH05 DUPILUMABUM ** DUPIXENT 200 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 175mg/ml SANOFI - AVENTIS GROUPE FRANTA CUTIE CU 2 STILOURI INJECTOARE (PEN) PREUMPLUTE X 1,14 ML SOL. INJ. IN PEN PREUMPLUT PR 2 2,912.830000 2,912.830000 0.000000
4 W66694001 D11AH05 DUPILUMABUM ** DUPIXENT 200 mg SOL. INJ. IN SERINGA PREUMPLUTA 175mg/ml SANOFI-AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE CU SCUT PT. AC X 1,14 ML SOL. PR 2 2,912.830000 2,912.830000 0.000000
5 W65623001 D11AH05 DUPILUMABUM ** DUPIXENT 300 mg SOL. INJ. IN SERINGA PREUMPLUTA 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE DIN STICLA TRANSPARENTA DE TIP 1 SILICONATA, CU UN AC FIX DIN OTEL INOXIDABIL CU PERETE SUBTIRE X 2 ML SOL. INJ. IN SERINGA PREUMPLUTA PR 2 2,912.830000 2,912.830000 0.000000
6 W65623002 D11AH05 DUPILUMABUM ** DUPIXENT 300 mg SOL. INJ. IN SERINGA PREUMPLUTA 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU 2 SERINGI PREUMPLUTE DIN STICLA TRANSPARENTA DE TIP 1 SILICONATA, CU UN AC FIX DIN OTEL INOXIDABIL, CU SCUT PENTRU AC, CU PERETE SUBTIRE X 2 ML SOL. INJ. IN SERINGA PREUMPLUTA PR 2 2,912.830000 2,912.830000 0.000000
7 W61689002 L01XE31 NINTEDANIBUM ** OFEV 100 mg CAPS. MOI 100mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA AMBALAJ CU 60X1 CAPSULE MOI ÎN BLISTERE PERFORATE DIN ALUMINIU PENTRU ELIBERAREA UNUI UNITATII DOZATE PR 60 90.842833 90.842833 0.000000
8 W61690002 L01XE31 NINTEDANIBUM ** OFEV 150 mg CAPS. MOI 150mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA AMBALAJ CU 60X1 CAPSULE MOI ÎN BLISTERE PERFORATE DIN ALUMINIU PENTRU ELIBERAREA UNUI UNITATII DOZATE PR 60 168.944166 168.944166 0.000000
9 W66202001 R03DX10 BENRALIZUMABUM ** FASENRA 30 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 30mg ASTRA ZENECA AB SUEDIA CUTIE CU 1 STILOU INJECTOR (PEN) PREUMPLUT DE UNICA FOLOSINTA X 1 ML SOL. INJ. PR/PRF 1 9,799.340000 9,799.340000 0.000000

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.
- Medicamentul corespunzător DCI-ului notat cu (3) se livrează împreună cu solventul.
- Medicamentele corespunzătoare DCI-urilor notate cu (4) se importă cu avizul Agenţiei Naţionale a Medicamentului şi a Dispozitivelor Medicale din România.
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (5) se utilizează numai pentru cazurile fără răspuns terapeutic la prednisonum.
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu β se efectuează în baza contractelor cost-volum-rezultat încheiate.
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu Ω se efectuează în baza contractelor cost-volum încheiate.
- 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.

Pagina 72 din 80
ANEXA 2d

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREȚUL DE REFERINȚĂ - CONFORM DCI-URILOR, ALTELE DECÂT CELE DIN
SUBLISTELE A, B, SUBLISTA C SECŢIUNEA C1 ŞI SUBLISTA D, CORESPUNZĂTOARE MEDICAMENTELOR, DE CARE BENEFICIAZĂ COPIII PÂNĂ LA 18 ANI, TINERII DE LA 18
LA 26 DE ANI DACĂ SUNT ELEVI, UCENICI SAU STUDENŢI, DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LEHUZE, ÎN TRATAMENTUL AMBULATORIU,
DIN HG NR. 720/2008, REPUBLICATA, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILĂ ÎNCEPÂND CU 01 MARTIE 2022

Val. maxima suportata de Contributie maxima


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

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


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

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 1.082400 1.082400 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 1.082400 1.082400 0.000000
3 W67971002 A03AD02 DROTAVERINUM NO-SPA 40 mg/2 ml SOL. INJ. 40mg/2ml OPELLA HEALTHCARE ROMANIA SRL ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 2 ML SOL. INJ. PRF 25 1.082400 1.082400 0.000000
4 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 1.768000 1.768000 0.000000
5 W43286001 A03DA02 COMBINATII ALGIFEN 500 mg/5 mg/0,1 mg COMPR. 500mg/5mg/0,1mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.413500 0.413500 0.000000
6 W01509001 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0.413500 0.413500 0.000000
7 W43285003 A03DA02 COMBINATII ALGIFEN 500 mg/2 mg/0,02 mg/ml 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 6.118000 6.118000 0.000000
8 W43285004 A03DA02 COMBINATII ALGIFEN 500 mg/2 mg/0,02 mg/ml 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 5.923000 5.923000 0.000000
9 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 6.118000 6.118000 0.000000
10 W01529001 A05BAN3 COMBINATII ASPATOFORT SOL. INJ. FARA CONCENTRATIE TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 10 ML P-RF 10 6.322000 6.322000 0.000000
11 W64179002 A06AD65 COMBINATII PLENVU PULB. PT. SOL. ORALA FARA CONCENTRATIE NORGINE B.V. OLANDA PACHETE A CÂTE 40 AMBALAJE PENTRU UN SINGUR TRATAMENT CARE CONTIN PLICURI CU PULBERE PENTRU SOL. ORALA (DOZA 1 - UN PLIC, DOZA 2 - UN PLIC A SI UN PLIC B) PRF 40 51.408000 51.408000 19.789250
12 W64179003 A06AD65 COMBINATII PLENVU PULB. PT. SOL. ORALA FARA CONCENTRATIE NORGINE B.V. OLANDA PACHETE A CÂTE 80 AMBALAJE PENTRU UN SINGUR TRATAMENT CARE CONTIN PLICURI CU PULBERE PENTRU SOL. ORALA (DOZA 1 - UN PLIC, DOZA 2 - UN PLIC A SI UN PLIC B) PRF 80 51.408000 51.408000 17.632625
13 W64179001 A06AD65 COMBINATII PLENVU PULB. PT. SOL. ORALA FARA CONCENTRATIE NORGINE B.V. OLANDA CUTIE CU 1 SINGUR TRATAMENT CARE CONTINE PLICURI CU PULBERE PENTRU SOL. ORALA (DOZA 1 - UN PLIC, DOZA 2 - UN PLIC A SI UN PLIC B) PRF 1 51.408000 51.408000 34.952000
14 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 1 42.840000 42.840000 0.000000
15 W66223001 A06AD65 COMBINATII CLENSIA PULB. PT. SUSP. ORALA FARA CONCENTRATIE ADDENDA PHARMACEUTICALS S.R.L. ROMANIA 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 PRF 1 51.408000 51.408000 9.192000
16 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 0.485357 0.485357 0.000000
17 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. MOI P-6L 24 0.210000 0.210000 0.000000
18 W60620001 A11CA01 RETINOLUM VITAMINA A FORTE BIOFARM 50000 UI CAPS. MOI 50000ui BIOFARM SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. MOI P6L 30 0.252000 0.252000 0.159000
19 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 9.520000 9.520000 0.000000
20 W01433001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0.290333 0.290333 0.000000
21 W01433003 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE CU 2 BLIST. AL/PVC X 15 COMPR. P6L 30 0.290333 0.290333 0.000000
22 W66949001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI P&G HEALTH GERMANY GMBH GERMANIA CUTIE CU 1 BLIST. AL/PVC X 30 COMPR. P6L 30 0.290333 0.290333 0.000000
23 W66949003 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI P&G HEALTH GERMANY GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 15 COMPR. P6L 30 0.290333 0.290333 0.000000
24 W01434001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 500 COMPR. 500UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0.277000 0.277000 0.000000
25 W66948001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 500 COMPR. 500UI P&G HEALTH GERMANY GMBH GERMANIA CUTIE CU 1 BLIST. AL/PVC X 30 COMPR. P6L 30 0.277000 0.277000 0.000000
26 W01432001 A11CC05 COLECALCIFEROLUM VIGANTOL OIL 0,5 mg/ml PIC. ORALE, SOL. 0,5mg/ml MERCK KGAA GERMANIA CUTIE CU UN FLACON DIN STICA BRUNA A 10 ML PICATURI ORALE SOLUTIE, PREVAZUT CU PICURATOR DIN PE P-6L 1 16.830000 16.830000 0.000000
27 W66947001 A11CC05 COLECALCIFEROLUM VIGANTOL OIL 0,5 mg/ml PIC. ORALE, SOL. 0,5mg/ml P&G HEALTH GERMANY GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICA BRUNA A 10 ML PICATURI ORALE SOLUTIE, PREVAZUT CU PICURATOR DIN PE P6L 1 16.830000 16.830000 0.000000
28 W53793001 A11CC05 COLECALCIFEROLUM VITAMINA D3 BIOFARM 18000UI/ml PIC. ORALE, SOL. 18000UI/ml
BIOFARM S.A. ROMANIA CUTIE CU 1 FLAC. PICURATOR DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-6L 1 7.940000 7.940000 0.000000
29 W67598001 A11CC05 COLECALCIFEROLUM DIBASE 100.000 UI/ml SOL INJ. 100.000UI/ml IMECO S.A. ROMANIA CUTIE CU 6 FIOLE A CATE 1 ML SOL. INJ. PRF 6 9.780000 9.780000 0.000000
30 W67599001 A11CC05 COLECALCIFEROLUM DIBASE 300.000 UI/ml SOL INJ. 300.000UI/ml IMECO S.A. ROMANIA CUTIE CU 2 FIOLE A CATE 1 ML SOL. INJ. PRF 2 25.610000 25.610000 0.000000
31 W56759001 A11DA01 THIAMINUM VITAMINA B1 ZENTIVA 100 mg/2 ml SOL. 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 4.640000 4.640000 0.000000
32 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 2.974000 2.974000 0.000000
33 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 2.878666 2.878666 0.000000
34 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 1.073400 1.073400 0.000000
35 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 0.488880 0.488880 0.011120
36 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 0.407400 0.407400 0.000000
37 W42092002 A11DBN1 COMBINATII MILGAMMA 100+100mg DRAJ. 100mg+100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 DRAJ. P-6L 60 1.716666 1.716666 0.000000
38 W01731002 A11DBN1 COMBINATII MILGAMMA (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 1.138000 1.138000 0.000000
39 W01731002 A11DBN1 COMBINATII MILGAMMA (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 1.138000 1.138000 0.000000
40 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 4.382000 4.382000 0.000000
41 W68013001 A11GA01 ACIDUM ASCORBICUM VITAMINA C ARENA 100 mg/ml SOL INJ. 100mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE A CATE 5 ML SOL. INJ. PRF 5 5.318000 5.318000 0.000000
42 W68014001 A11GA01 ACIDUM ASCORBICUM VITAMINA C ARENA 200 mg/ml SOL INJ. 200mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE A CATE 5 ML SOL. INJ. PRF 5 10.292000 10.292000 0.000000
43 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 5.794000 5.794000 0.000000
44 W65755001 A11GA01 ACIDUM ASCORBICUM VITAMINA C MESFARMA 100 mg/ml SOL INJ./PERF. 100mg/ml MESFARMA SRL ROMANIA CUTIE CU 5 BLIST. PVC A CATE 10 FIOLE X 5 ML SOL. INJ./PERF. PR 50 4.498600 4.498600 0.000000
45 W67594002 A11GA01 ACIDUM ASCORBICUM VITAMINA C ZENTIVA 100 mg/ml SOL INJ./PERF. 100mg/ml ZENTIVA S.A. ROMANIA CUTIE CU 1 BLIST. PVC CARE CONTINE 10 FIOLE DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML CARE CONTIN SOL. INJ./PERF. PRF 10 5.146000 5.146000 0.000000
46 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 5.794000 5.794000 0.000000

Pagina 73 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
47 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 0.624960 0.624960 0.386040
48 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 0.521000 0.521000 0.000000
49 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 0.520800 0.520800 0.000000
50 W56758001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg/5 ml SOL. 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 6.674000 6.674000 0.000000
51 W56757001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 50 mg/2ml SOL. INJ. 50mg/2ml ZENTIVA SA ROMANIA 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. P-RF 5 4.640000 4.640000 0.000000
52 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 0.445416 0.445416 0.000000
53 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 3.255500 3.255500 0.000000
54 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 3.642000 3.642000 0.000000
55 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 2.442000 2.442000 0.000000
56 W61534002 A16AXN1 DIVERSE ACTOVEGIN 200 mg DRAJ. 200mg TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P6L 50 3.202600 3.202600 0.000000
57 W61535001 A16AXN1 DIVERSE ACTOVEGIN 200 mg/5 ml SOL. INJ. 200mg/5ml TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE X 5 ML SOL. INJ. PR 5 24.000000 24.000000 0.000000
58 W57392002 B02BX01 ETAMSYLATUM ETAMSILAT ZENTIVA 250mg SOL. INJ. 250mg/2ml ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. P-RF 5 5.966000 5.966000 0.000000
59 W00831001 B02BX02 CARBAZOCHROMI SALICYLAS ADRENOSTAZIN 1,5 mg/5 ml SOL. INJ./PERF. 1,5mg/5ml TERAPIA SA ROMANIA CUTIE CU 5 FIOLE X 5 ML SOL. INJ./PERF. P-RF 5 5.294000 5.294000 0.000000
60 W01714003 B03AD02 COMBINATII FERRETAB 50 mg+0,5 mg CAPS. ELIB. PREL. 50mg+0,5mg AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L
LANNACHER HEILMITTEL GES.M.B.H. 30 0.378840 0.378840 0.021826
61 W01714005 B03AD02 COMBINATII FERRETAB 50 mg+0,5 mg CAPS. ELIB. PREL. 50mg+0,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P6L 100 0.315700 0.315700 0.000000
62 W01713001 B03AD03 COMBINATII (FERROSI SULFAS+ACIDUM FOLICUM) TARDYFERON FOL 80 mg+0,350 mg COMPR. ELIB. PREL. 80mg+0,350mg PIERRE FABRE MEDICAMENT FRANTA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0.506000 0.506000 0.000000
63 W51229001 B03AD04 COMBINATII MALTOFER FOL 100 mg/0,35 mg COMPR. MAST. 100mg/0,35mg VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MAST. P-6L 30 0.853666 0.853666 0.000000
64 W60902001 B03AE10 COMBINATII TOT'HEMA SOL. ORALA FARA CONCENTRATIE LABORATOIRE INNOTECH INTERNATIONAL FRANTA CUTIE X 20 FIOLE X 10 ML P-6L 20 1.014500 1.014500 0.000000
65 W56756001 B03BA01 CYANOCOBALAMINUM VITAMINA B12 ZENTIVA 1000µg/ml SOL. INJ. 1000µg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL INJ. P-RF 5 4.352000 4.352000 0.000000
66 W56761001 B03BA01 CYANOCOBALAMINUM VITAMINA B12 ZENTIVA 50µg/ml SOL. INJ. 50µg/ml ZENTIVA SA ROMANIA P-RF
CUTIE CU 5 FIOLE DIN STICLA INCOLORA, CU 1 INEL DE RUPERE SAU CU PUNCT DE RUPERE SI 2 INELE COLORATE (ALBASTRU SI PORTOCALIU) PE GATUL FIOLEI PENTRU IDENTIFICARE X 1 ML SOL. INJ. 5 4.640000 4.640000 0.000000
67 W62871001 C01EA01 ALPROSTADILUM ** ALPROSTADIL "REMEDIA" 500 µg CONC. PT. SOL. PERF. 500µg ROMANIA
FARMACEUTICA REMEDIA DISTRIBUTION&LOGISTICS S.R.L. PR
CUTIE CU 5 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE DE CULOARE GALBENA, A CÂTE 1 ML CONCENTRAT PENTRU SOL. PERF. 5 232.260000 232.260000 132.844000
68 W67256001 C01EA01 ALPROSTADILUM ** PROSTIN VR 500 mcg/1 ml SOL INJ. 500mcg/1ml PFIZER ROMANIA S.R.L. ROMANIA CUTIE CU 1 FIOLA A 1 ML SOL. INJ. PR 1 193.550000 193.550000 0.000000
69 W56319001 C05AA01 COMBINATII HEMORZON 20 mg/10 mg/8,3 mg SUPOZ. 20mg/10mg/8,3mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOSUDATE OPACE PVC/PE X 3 SUPOZ. P-6L 6 2.573333 2.573333 0.000000
70 W56319003 C05AA01 COMBINATII HEMORZON 20 mg/10 mg/8,3 mg SUPOZ. 20mg/10mg/8,3mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA OPACA PVC/PE X 6 SUPOZ. P6L 6 2.573333 2.573333 0.000000
71 W01826001 C05AA01 COMBINATII HEMORZON 10 mg/5 mg/4 mg/g UNGUENT 10mg/5mg/4mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 18 G UNG. P-6L 1 23.700000 23.700000 0.000000
72 W67017001 C05AA08 COMBINATII ULTRAPROCT SUPOZITOARE SUPOZ. FARA CONCENTRATIE KARO PHARMA AB SUEDIA CUTIE CU 2 FOLII AL/PE X 5 SUPOZ. PRF 10 2.555000 2.555000 0.000000
73 W67016002 C05AA08 COMBINATII ULTRAPROCT UNGUENT RECTAL UNGUENT RECTAL FARA CONCENTRATIE KARO PHARMA AB SUEDIA CUTIE X 1 TUB AL X 30 G + 1 CANULA PEJD PRF 1 45.660000 45.660000 0.000000
74 W54548001 C05AD01 COMBINATII DOXIPROCT 40 mg+20 mg/g UNGUENT RECTAL 40mg+20mg/g OM PHARMA S.A. PORTUGALIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT RECTAL + CANULA APLICATOARE P-6L 1 23.900000 23.900000 0.000000
75 W00727001 C05BX01 CALCII DOBESILAS DOXILEK 500 mg CAPS. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC. X 10 CAPS. P-6L 30 1.131666 1.131666 0.000000
76 W63052001 C05CA54 TROXERUTINUM (COMBINATII) GINKOR FORT CAPS. FARA CONCENTRATIE TONIPHARM FRANTA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 1.143333 1.143333 0.000000
77 W63888002 C08CA06 NIMODIPINUM NIMOTOP 30 mg COMPR. FILM. 30mg BAYER AG GERMANIA CUTIE CU 10 BLIST. AL/PP X 10 COMPR. FILM. P-RF 100 0.759000 0.759000 0.000000
78 W63888004 C08CA06 NIMODIPINUM NIMOTOP 30 mg COMPR. FILM. 30mg BAYER AG GERMANIA CUTIE CU 10 BLIST. DIN PVC-PVDC/AL A X 10 COMPR. FILM. PRF 100 0.759000 0.759000 0.000000
79 W63887002 C08CA06 NIMODIPINUM NIMOTOP 10 mg/50 ml SOL. PERF. 10mg/50ml BAYER AG GERMANIA PR
AMBALAJ MULTIPLU (FOLIE DE PLASTIC ETICHETATA) CU 5 CUTII A CÂTE 1 FLAC. DIN STICLA, TIP II, DE CULOARE BRUNA A 50 ML SOL. PERF. SI CÂTE 1 PERFUZOR DIN PE 5 117.952000 117.952000 0.000000
80 W08541001 D01AC05 ISOCONAZOLUM IZOCON 10 mg/g CREMA 10mg/g ROMINKO S.A. ROMANIA CUTIE X 1 TUB DIN AL X 25 G CREMA P-RF 1 10.320000 10.320000 0.000000
81 W66058002 D01AC05 ISOCONAZOLUM TRAVOGEN 10 mg/g CREMA 10mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA PRF 1 18.600000 18.600000 0.000000
82 W66598002 D01AC05 ISOCONAZOLUM TRAVOGEN 10 mg/g CREMA 10mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 30 G CREMA PRF 1 18.600000 18.600000 0.000000
83 W41982001 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA 2% TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB PEJD X 15 G P-RF 1 3.840000 3.840000 0.000000
84 W67030001 D01AC08 KETOCONAZOLUM KETOCONAZOL FITERMAN 20 mg/g CREMA 20 mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE CU 1 TUB AL X 20 G CREMA PRF 1 5.120000 5.120000 0.000000
85 W57514001 D01AC08 KETOCONAZOLUM NIZORAL 20 mg/g CREMA 20mg/g JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 4.608000 4.608000 1.292000
86 W01868001 D05AXN1 COMBINATII ASORIAN 0,415 mg/ml+2,595 mg/ml+103,800 mg/ml SOL. CUT. BIOFARM SA
0,415mg/ml+2,595mg/ml+103,800m ROMANIA CUTIE X 1 FLACON X 100 ML P-RF 1 14.280000 14.280000 0.000000
87 W03176001 D07AC04 FLUOCINOLONI ACETONIDUM FLUOCINOLON ACETONID LAROPHARM 0,25 mg/g UNGUENT 0,25mg/g LAROPHARM SRL ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 8.460000 8.460000 0.000000
88 W01894001 D07CB01 COMBINATII NIDOFLOR CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 23.700000 23.700000 0.000000
89 W61211001 D07CC02 COMBINATII FLUOCINOLON N ATB 0,25 mg/5 mg/g UNGUENT 0,25mg/5mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 18 G UNG. PRF 1 11.230000 11.230000 0.000000
90 W52916002 D07CC02 COMBINATII (FLUOCINOLONUM+GENTAMICINUM) FLUOCINOLON G FITERMAN 0,25 mg/+1 mg/g CREMA 0,25mg/+1mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 35 G CREMA P-RF 1 16.390000 16.390000 0.000000
91 W52916001 D07CC02 COMBINATII (FLUOCINOLONUM+GENTAMICINUM) FLUOCINOLON G FITERMAN 0,25 mg/+1 mg/g CREMA 0,25mg/+1mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA P-RF 1 9.380000 9.380000 0.000000
92 W13665001 D07XB02 COMBINATII TRIAMCINOLON S ATB 1 mg/30 mg/g CREMA 1mg/30mg/g ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 15.960000 15.960000 0.000000
93 W57647001 D07XC01 COMBINATII (BETAMETHASONUM+ACIDUM SALICYLICUM) DIPROSALIC 0,64 mg+20 mg/g SOL. CUT. 0,64mg+20mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR P-RF 1 14.750000 14.750000 0.000000
94 W54922001 D07XC01 COMBINATII (BETAMETHASONUM+ACIDUM SALICYLICUM) SAL-EKARZIN 0,50 mg/30 mg pe gram UNGUENT 0,50mg/30mg pe gram ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB AL X 15 G UNGUENT P-RF 1 15.960000 15.960000 0.000000
95 W57646001 D07XC01 COMBINATII (BETAMETHASONUM+ACIDUM SALICYLICUM) DIPROSALIC 0,64 mg+30 mg/g UNGUENT 0,64 mg+30 mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 6.210000 6.210000 0.000000
96 W66059001 D07XC04 COMBINATII TRAVOCORT 10 mg/1 mg/1 g CREMA 10mg/1mg/1g INTENDIS GMBH GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA P6L 1 27.970000 27.970000 0.000000
97 W66599001 D07XC04 COMBINATII TRAVOCORT 10 mg/1 mg/1 g CREMA 10mg/1mg/1g LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL X 30 G CREMA P6L 1 27.970000 27.970000 0.000000
98 W52917001 D07XCN1 COMBINATII (FLUOCINOLONUM+DEXPANTHENOLUM) FLUOCINOLON D FITERMAN 0,25 mg+50 mg/g CREMA 0,25mg+50mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE CU 1 TUB AL X 20 G CREMA P-RF 1 9.380000 9.380000 0.000000
99 W63161001 D10AF52 COMBINATII ZINERYT 40 mg/12 mg/ml PULB. + SOLV. SOL. CUT. 40mg/12mg/ml LEO PHARMA A/S DANEMARCA PRF
CUTIE CU 1 FLAC. DIN PEÎD, CU APLICATOR SI CAPAC DIN PP CARE CONTINE PULBERE CUTANATA SI 1 FLAC. DIN PEÎD, CU APLICATOR SI CAPAC DIN PP CARE CONTINE SOLVENT, PENTRU 30 ML SOLUTIE CUTANATA 1 32.880000 32.880000 0.000000
100 W67797001 D10AF52 COMBINATII ZINERYT 40 mg/12 mg/ml PULB. + SOLV. SOL. CUT. 40mg/12mg/ml CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE CU 1 FLAC. DIN PEÎD, CU APLICATOR SI CAPAC DIN PP CARE CONTINE PULBERE CUTANATA SI 1 FLAC. DIN PEÎD, CU APLICATOR SI CAPAC DIN PP CARE CONTINE SOLVENT, PENTRU 30 ML SOLUTIE CUTANATA PRF 1 32.880000 32.880000 0.000000
101 W63162001 D11AH01 TACROLIMUSUM PROTOPIC 0,03% UNGUENT 0,03% LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB X 10 G PR 1 34.670000 34.670000 0.000000
102 W63163001 D11AH01 TACROLIMUSUM PROTOPIC 0,1% UNGUENT 0,1% LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB X 10 G PR 1 38.160000 38.160000 0.000000

Pagina 74 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
103 W57974002 D11AH02 PIMECROLIMUS ELIDEL 10 mg/g CREMA 10mg/g MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 TUB AL X 30 G CREMA P-RF 1 128.170000 128.170000 0.000000
104 W63536001 G01AF01 METRONIDAZOLUM FLAGYL 500 mg OVULE 500mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PE/PVC X 5 OVULE P-RF 10 0.864000 0.864000 0.000000
105 W01963001 G01BA COMBINATII TERGYNAN FLORA COMPR. VAG. FARA CONCENTRATIE LAB. BOUCHARA-RECORDATI FRANTA CUTIE X 1 FOLIE HARTIE/PE/AL/PE X 10 COMPR. VAG. P-RF 10 2.866000 2.866000 0.000000
106 W08363002 G01BA COMBINATII CERVUGID OVULE FARA CONCENTRATIE IRCON SRL ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC-PE X 6 OVULE P-RF 12 3.106666 3.106666 0.000000
107 W63415001 G01BA COMBINATII ZIFEX COMPLEX OVULE FARA CONCENTRATIE ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC/PE X 7 OVULE PRF 7 4.717142 4.717142 0.000000
108 W63415002 G01BA COMBINATII ZIFEX COMPLEX OVULE FARA CONCENTRATIE ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC X 7 OVULE PRF 7 4.717142 4.717142 0.000000
109 W61424001 G03AC06 MEDROXYPROGESTERONUM SAYANA 104 mg SUSP. INJ. IN SERINGA PREUMPLUTA 104mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU O SERINGA PREUMPLUTA DE UNICA FOLOSINTA CU AC DE DIMENSIUNEA 26G, 3/8, DIN STICLA INCOLORA, CU CAPAC SI PISTON DIN CAUCIUC BROMOBUTILIC, CARE CONTINE 0,65 ML SUSPENSIE INJECTABILA PRF 1 124.490000 124.490000 0.000000
110 W65275001 G03AC06 MEDROXYPROGESTERONUM SAYANA 104 mg SUSP. INJ. IN SERINGA PREUMPLUTA 104mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 SERINGA PREUMPLUTA DE UNICA FOLOSINTA CU AC DE DIMENSIUNEA 26G, 3/8, DIN STICLA INCOLORA, CU CAPAC SI PISTON DIN CAUCIUC BROMOBUTILIC, CARE CONTINE 0,65 ML SUSPENSIE INJECTABILA PRF 1 124.490000 124.490000 0.000000
111 W63441001 G03GA01 GONADOTROPHINUM CHORIONICUM PREGNYL 5000 UI PULB+SOLV. PT. SOL. INJ. 5000UI/ml MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLACON, DIN STICLA INCOLORA, CONTINÂND PULBERE SI 1 FLACON, DIN STICLA INCOLORA, CONTINÂND SOLVENT PENTRU SOL. INJ. PRF 1 25.620000 25.620000 0.000000
112 W64578003 G03GA02 MENOTROPINUM MERIOFERT 150 UI PULB+SOLV. PT. SOL. INJ. 150UI IBSA FARMACEUTICI ITALIA S.R.L. ITALIA CUTIE CU 10 SETURI CARE CONTIN: FLACOANE CU PULB. PT. SOL. INJ. SI FIOLE CU SOLVENT PT. SOL. INJ. PR 10 163.629000 163.629000 0.000000
113 W64577003 G03GA02 MENOTROPINUM MERIOFERT 75 UI PULB+SOLV. PT. SOL. INJ. 75UI IBSA FARMACEUTICI ITALIA S.R.L. ITALIA CUTIE CU 10 SETURI CARE CONTIN: FLACOANE CU PULB. PT. SOL. INJ. SI FIOLE CU SOLVENT PT. SOL. INJ. PR 10 74.909000 74.909000 0.000000
114 W53997001 G03GA02 MENOTROPINUM MENOPUR 75 UI PULB. + SOLV. PT. SOL. INJ. 75UI FERRING GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 10 FIOLE X 1 ML SOLV. PT. SOL. INJ. PR 10 75.490000 75.490000 0.000000
115 W60841001 G03GA02 MENOTROPINUM MENOPUR 1200 UI PULB. SI SOLV. PT. SOL. INJ. 1200UI FERRING GMBH GERMANIA CUTIE CU 1 FLAC. CU PULB. PT SOL. INJ., 2 SERINGI PRE-UMPLUTE CU SOLV. PENTRU RECONSTITUIRE, 1 AC PENTRU RECONSTITUIRE SI 18 SERINGI DE UNICA FOLOSINTA PENTRU ADMINISTRARE, GRADATE ÎN UNITATI FSH/LH CU ACE PRE-FIXATE PR 1 1,410.980000 1,410.980000 0.000000
116 W60840001 G03GA02 MENOTROPINUM MENOPUR 600 UI PULB. SI SOLV. PT. SOL. INJ. 600UI FERRING GMBH GERMANIA CUTIE CU 1 FLAC. CU PULB. PT. SOL. INJ., 1 SERINGA PRE-UMPLUTA CU SOLV. PT. RECONSTITUIRE, 1 AC PENTRU RECONSTITUIRE SI 9 SERINGI DE UNICA FOLOSINTA PENTRU ADMINISTRARE, GRADATE ÎN UNITATI FSH/LH CU ACE PRE-FIXATE PR 1 740.330000 740.330000 0.000000
117 W57400001 H01AC03 MECASERMINUM **1 INCRELEX 10mg/ml SOL. INJ. 10mg/ml IPSEN PHARMA FRANTA CUTIE X 1 FLAC X 4ML SOL. INJ. PR 1 2,624.720000 2,624.720000 0.000000
118 W10690001 H03AA03 COMBINATII NOVOTHYRAL (R) 100 COMPR. 100mcg+20mcg MERCK KGAA CUTIE X 4 BLIST. AL/PP X 25 COMPR.
GERMANIA P-6L 100 0.332400 0.332400 0.000000
119 W66150001 H03AA03 COMBINATII NOVOTHYRAL 100/20 micrograme COMPR. 100micrograme/20micrograme MERCK ROMANIA SRL ROMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P6L 100 0.332400 0.332400 0.000000
120 W65525002 J01DB04 CEFAZOLINUM ZOLINEF 1 g PULB. PT. SOL. INJ./PERF. 1g ROMANIA
MEDOCHEMIE ROMANIA SRL CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML, INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC SI CAPSA DETASABILA DIN AL CU PULB. PT. SOL. INJ./PERF. PRF 10 5.325000 5.325000 0.000000
121 W53787001 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 1 32.234040 32.234040 3.555960
122 W53787002 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 10 32.234040 32.234040 2.168960
123 W53787003 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 50 27.578400 27.578400 0.000000
124 W53787004 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 100 26.861700 26.861700 0.000000
125 W62087001 J01GB03 GENTAMICINUM GENTAMICINA EIPICO 40 mg/ml SOL INJ. 40mg/ml E.I.P.I.CO MED S.R.L. ROMANIA CUTIE CU 3 FLAC. DIN STICLA TIP I INCOLORA CU CAPACITATEA DE 2,5 ML, CONTINAND 2 ML SOL. INJ. PRF 3 1.093333 1.093333 0.000000
126 W03308001 J01GB03 GENTAMICINUM GENTAMICIN KRKA 40 mg/1 ml SOL. INJ. 40mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 0.817000 0.817000 0.000000
127 W03309001 J01GB03 GENTAMICINUM GENTAMICIN KRKA 80 mg/2 ml SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 1.097000 1.097000 0.000000
128 W52501003 J01XB01 COLISTINUM COLISTINA ATB 1.000.000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, ÎNCHISE CU DOP DIN CAUCIUC HALOBUTILIC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC FLIP-OFF DIN POLIPROPILENA, CONTINÂND PULB. PENTRU SOL. INJ./PERF. PR 10 34.587000 34.587000 0.000000
129 W08947008 J02AC03 VORICONAZOLUM ** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 19.905199 19.905199 47.911586
130 W61017005 J02AC03 VORICONAZOLUM ** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 19.905199 19.905199 44.228372
131 W61628005 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 16.755714 16.755714 0.000000
132 W61628006 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 16.587666 16.587666 0.000000
133 W61817001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM PRF 28 19.905199 19.905199 20.413729
134 W64073003 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 19.905199 19.905199 9.843372
135 W64073005 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 19.905199 19.905199 7.311943
136 W64073008 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 19.905199 19.905199 6.050872
137 W64931001 J02AC03 VORICONAZOLUM ** VFEND 200 mg COMPR. FILM. 200mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 19.905199 19.905199 47.911586
138 W65715001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg SPANIA
ACCORD HEALTHCARE S.L.U. CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 19.905199 19.905199 20.413729
139 W64072003 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 28.455000 28.455000 0.000000
140 W64072005 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 25.906071 25.906071 0.000000
141 W64072008 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 24.660714 24.660714 0.000000
142 W41889001 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 1,827.390000 1,827.390000 0.000000
143 W64930001 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR PRF 1 1,827.390000 1,827.390000 0.000000
144 W63845001 J02AC05 ISAVUCONAZOLUM ** CRESEMBA 100 mg CAPS. 100mg BASILEA MEDICAL LTD MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 CAPS. PRF 14 197.005000 197.005000 0.000000
145 W65622001 J02AC05 ISAVUCONAZOLUM ** CRESEMBA 100 mg CAPS. 100mg BASILEA PHARMACEUTICA DEUTSCHLAND GMBH GERMANIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS. PRF 14 197.005000 197.005000 0.000000
146 W67584001 J06BB16 PALIVIZUMABUM ** SYNAGIS 50 mg/ 0,5 ml SOL INJ. 100mg/ml ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. DE 0,5 ML CARE CONTINE 50 MG PALIVIZUMAB. PRF 1 1,994.840000 1,994.840000 0.000000
147 W04988001 M01AA01 PHENYLBUTAZONUM FENILBUTAZONA 250 mg SUPOZ. 250mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 2.465000 2.465000 0.000000
148 W59221003 M01AB55 COMBINATII TRATUL PLUS CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 30 0.602000 0.602000 0.000000
149 W59221004 M01AB55 COMBINATII TRATUL PLUS CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 50 0.571000 0.571000 0.000000
150 W64231003 M01AB55 COMBINATII NEODOLPASSE 0,30 mg+0,12 mg/ml SOL. PERF. 0,30mg+0,12mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 250 ML SOL. PERF. PR 10 34.837000 34.837000 0.000000
151 W65281002 M01AB55 COMBINATII (DICLOFENACUM+MISOPROSTOLUM ) ARTHROTEC 75 mg/0,2 mg COMPR. GASTROREZ. 75mg+0,200mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 2 BLIST. AL X 10 COMPR. GASTROREZ. P-6L 20 1.635500 1.635500 0.000000
152 W14016001 M01AB55 COMBINATII (PARACETAMOLUM+DICLOFENACUM) ACECLOFEN 500 mg/50 mg SUPOZ. 500mg+50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL/PE X 3 SUPOZ. P-6L 6 2.660000 2.660000 0.000000
153 W14016003 M01AB55 COMBINATII (PARACETAMOLUM+DICLOFENACUM) ACECLOFEN 500 mg/50 mg SUPOZ. 500mg/50mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA AL/PE X 6 SUPOZ. P6L 6 2.660000 2.660000 0.000000
154 W02034002 M01AB55 DICLOFENACUM+MISOPROSTOLUM ARTHROTEC 75 COMPR. GASTROREZ. 75mg+0,200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL X 10 COMPR. GASTROREZ. P-6L 20 1.635500 1.635500 0.000000
155 W61050001 M01AE01 IBUPROFENUM CALMOLIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6L 20 0.214000 0.214000 0.000000
156 W13106001 M01AE01 IBUPROFENUM PADUDEN SR 300 mg CAPS. ELIB. PREL. 300mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-6L 10 2.918000 2.918000 0.000000
157 W62191001 M01AE01 IBUPROFENUM BRUFEN RETARD 800 mg COMPR. ELIB. PREL. 800mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. CU ELIB. PREL. P6L 30 0.849666 0.849666 0.000000
158 W62192002 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P6L 30 0.256800 0.256800 0.373533

Pagina 75 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
159 W62192005 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.256800 0.256800 0.373533
160 W65626001 M01AE01 IBUPROFENUM IBUPROFEN AUROBINDO 600 mg COMPR. FILM. 600 mg ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L
AUROBINDO PHARMA ROMANIA S.R.L. 10 0.399000 0.399000 0.000000
161 W66486001 M01AE01 IBUPROFENUM IBUPROFEN AMRING 600 mg COMPR. FILM. 600mg AMRING FARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 0.478800 0.478800 0.291700
162 W66862001 M01AE01 IBUPROFENUM IBUPROFEN B. BRAUN 200 mg SOL. PERF. 200mg B. BRAUN MELSUNGEN AG GERMANIA CUTIE CU 10 FLAC. DIN PEJD PREVAZUTE CU INCHIDERE TIP TWINCAP (CAPAC CU DOUA PORTURI DE ACCES) A CATE 50 ML PRF 10 27.062000 27.062000 0.000000
163 W66862002 M01AE01 IBUPROFENUM IBUPROFEN B. BRAUN 200 mg SOL. PERF. 200mg B. BRAUN MELSUNGEN AG GERMANIA CUTIE CU 20 FLAC. DIN PEJD PREVAZUTE CU INCHIDERE TIP TWINCAP (CAPAC CU DOUA PORTURI DE ACCES) A CATE 50 ML PRF 20 25.508000 25.508000 0.000000
164 W63757001 M01AE01 IBUPROFENUM IBUPROFEN B. BRAUN 400 mg SOL. PERF. 400mg B. BRAUN MELSUNGEN AG GERMANIA CUTIE CU 10 FLAC. PEJD PREVAZUTE CU INCHIDERE TIP TWINCAP (CAPAC CU DOUA PORTURI DE ACCES) A CATE 100 ML PRF 10 17.365000 17.365000 0.000000
165 W67253003 M01AE01 IBUPROFENUM IBUPROFEN KABI 400 mg SOL. PERF. 400mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 40 FLAC. DIN PEJD A 100 ML SOL. PERF. PRF 40 18.547750 18.547750 0.000000
166 W63800001 M01AE01 IBUPROFENUM IBUPROFEN B. BRAUN 600 mg SOL. PERF. 600mg B. BRAUN MELSUNGEN AG GERMANIA CUTIE CU 10 FLAC. DIN PEJD PREVAZUTE CU INCHIDERE TIP TWINCAP (CAPAC CU DOUA PORTURI DE ACCES) X 100 ML PRF 10 28.701000 28.701000 0.000000
167 W64400001 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC DIN STICLA BRUNA X 100 ML SUSP. ORALA, CONSTITUIT DIN CAPAC INTERN SI CAPAC EXTERN DIN PP, PREVAZUT CU ADAPTOR PT. SERINGA DIN PE SI O SERINGA DOZATOARE PE/PS GRADATA LA FIECARE 0,25 ML, PT. MASURAREA VOLUMELOR PANA LA 6 ML PRF 1 12.310000 12.310000 0.000000
168 W64400002 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CONSTITUIT DIN CAPAC INTERN DIN PE SI CAPAC EXTERN DIN PP, PREVAZUT CU ADAPTOR PT. SERINGA DIN PE SI O SERINGA DOZATOARE PE/PS GRADATA LA FIECARE 0,25 ML, PT. MASURAREA VOLUMELOR PANA LA 6 ML PRF 1 12.310000 12.310000 0.000000
169 W67972001 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml OPELLA HEALTHCARE ROMANIA SRL ROMANIA CUTIE CU 1 FLAC DIN STICLA BRUNA X 100 ML SUSP. ORALA, CONSTITUIT DIN CAPAC INTERN SI CAPAC EXTERN DIN PP, PREVAZUT CU ADAPTOR PT. SERINGA DIN PE SI O SERINGA DOZATOARE PE/PS GRADATA LA FIECARE 0,25 ML, PT. MASURAREA VOLUMELOR PANA LA 6 ML PRF 1 12.310000 12.310000 0.000000
170 W67972002 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml OPELLA HEALTHCARE ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CONSTITUIT DIN CAPAC INTERN DIN PE SI CAPAC EXTERN DIN PP, PREVAZUT CU ADAPTOR PT. SERINGA DIN PE SI O SERINGA DOZATOARE PE/PS GRADATA LA FIECARE 0,25 ML, PT. MASURAREA VOLUMELOR PANA LA 6 ML PRF 1 12.310000 12.310000 0.000000
171 W62190001 M01AE01 IBUPROFENUM BRUFEN 20 mg/ml SUSP. ORALA 20mg/ml BGP PRODUCTS AB SUEDIA CUTIE CU 1 FLAC. DIN PET DE CULOARE BRUNA CU CAPAC DIN AL SI SIGILIU DIN PEJD + SERINGA DOZATOARE DIN PP DE 5 ML, A 100 ML SUSP. ORALA P6L 1 14.760000 14.760000 0.000000
172 W04449002 M01AE02 NAPROXENUM REUXEN 250 mg COMPR. 250mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.829000 0.829000 0.000000
173 W66456002 M01AE02 NAPROXENUM NAPROXEN AUROBINDO 250 mg COMPR. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 10 0.801000 0.801000 0.000000
174 W04450002 M01AE02 NAPROXENUM REUXEN 500 mg COMPR. 500mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.626400 0.626400 0.693100
175 W66457002 M01AE02 NAPROXENUM NAPROXEN AUROBINDO 500 mg COMPR. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 10 0.522000 0.522000 0.000000
176 W59074003 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.407333 0.407333 0.000000
177 W59075003 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0.591000 0.591000 0.000000
178 W00167001 M01AG01 ACIDUM MEFENAMICUM VIDAN 500 mg COMPR. FILM. 500mg VIANEX SA GRECIA CUTIE X 3 BLIST. AL/PVC X 8 COMPR. FILM. P-6L 24 0.796250 0.796250 0.000000
179 W41953001 M01AH04 PARECOXIBUM DYNASTAT 40mg PULB. PT. SOL. INJ. 40mg PFIZER LIMITED MAREA BRITANIE CUTIE X 10 FLAC. X 40 MG PULB. PT. SOL. INJ. S/P-RF 10 33.246000 33.246000 0.000000
180 W64924001 M01AH04 PARECOXIBUM DYNASTAT 40 mg PULB. PT. SOL. INJ. 40mg BELGIA
PFIZER EUROPE MA EEIG CUTIE CU 10 FLAC. X 40 MG PULB. PT. SOL. INJ. PRF 10 33.246000 33.246000 0.000000
181 W60375001 M03BB03 CHLORZOXAZONUM CLORZOXAZONA ARENA 250 mg COMPR. ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
250mg 30 0.253333 0.253333 0.000000
182 W66127002 M03BB03 CHLORZOXAZONUM CLORZOXAZONA-RICHTER 250 mg COMPR. 250mg
GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0.303999 0.303999 0.096501
183 W58624003 N02AA59 COMBINATII ( PARACETAMOLUM + CODEINUM) ULTRACOD 500 mg/30 mg COMPR. 500 mg/30 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 1.359000 1.359000 0.000000
184 W51721001 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) PARADOREN 500mg/30mg COMPR. 500mg+30mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 1.284500 1.284500 0.000000
185 W61948001 N02AJ08 COMBINATII (IBUPROFENUM+CODEINUM) BRUFEN PLUS 400 mg/30 mg COMPR. FILM. 400mg/30mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. AL/PVDC-PVC/PVDC X 30 COMPR. FILM. PRF 30 1.030666 1.030666 0.000000
186 W66551001 N02AJ08 COMBINATII (IBUPROFENUM+CODEINUM) BRUFEN PLUS 400 mg/30 mg COMPR. FILM. 400mg/30mg MYLAN IRE HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. AL/PVDC-PVC/PVDC X 30 COMPR. FILM. PRF 30 1.030666 1.030666 0.000000
187 W42786002 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN 500 mg COMPR. 500mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.472500 0.472500 0.000000
188 W41738001 N02BB02 METAMIZOLUM NATRIUM ALINDOR 500 mg COMPR. 500mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0.472500 0.472500 0.000000
189 W08609001 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN 500 mg COMPR. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0.467500 0.467500 0.000000
190 W53162001 N02BB02 METAMIZOLUM NATRIUM ALGOBLOCK COMPR. 500mg BIOFARM S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0.472500 0.472500 0.000000
191 W57650001 N02BB02 METAMIZOLUM NATRIUM ALGOZONE 500mg COMPR. 500mg LABORMED PHARMA S.A. ROMANIA CUTIE X 2 BLIST.PVC-PVDC/AL A CATE 10 COMPR. P-RF 20 0.472500 0.472500 0.000000
192 W65928001 N02BB02 METAMIZOLUM NATRIUM CENTRALGIN 500 mg COMPR. 500mg S.C. SINTOFARM S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0.437500 0.437500 0.000000
193 W61617002 N02BB02 METAMIZOLUM NATRIUM LOCAMIN 500 mg/ml PIC. ORALE, SOL. 500mg/ml STADA ARZNEIMITTEL AG GERMANIA PRF
CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD SI CAPAC DIN PEID/PP SECURIZAT PT. COPII X 50 ML PIC. ORALE,SOL. 1 22.560000 22.560000 7.890000
194 W66957002 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN 500 mg/ml PIC. ORALE, SOL. 500mg/ml ZENTIVA, K.S. REPUBLICA CEHA PRF
CUTIE CU FLACON DIN STICLA BRUNA, CU CAPACITATE DE 50 ML, PREVAZUT CU PICURATOR DIN PEJD SI CAPAC PREVAZUT CU SISTEM DE SIGURANA PENTRU COPII DIN PEÎD/PP, CARE CONTINE 50 ML PICATURI ORALE, SOLUTIE 1 18.800000 18.800000 0.000000
195 W66616002 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg/ml PIC. ORALE, SOL. 500mg/ml BIOEEL SRL ROMANIA PRF
CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 20 ML PIC. ORALE, SOL. 1 8.470000 8.470000 0.000000
196 W66616004 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg/ml PIC. ORALE, SOL. 500mg/ml BIOEEL SRL ROMANIA PRF
CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 100 ML PIC. ORALE, SOL. 1 31.340000 31.340000 0.000000
197 W42787003 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN 1 g/2 ml SOL. INJ. 1g/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1.459920 1.459920 1.166080
198 W42787002 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN 1 g/2 ml SOL. INJ. 1g/2ml ZENTIVA S.A. ROMANIA P-RF
CUTIE CU 10 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE ALB SI UN INEL (GALBEN) PE GATUL FIOLEI X 2 ML SOL. INJ. 10 1.459920 1.459920 1.141080
199 W66590001 N02BB02 METAMIZOLUM NATRIUM METAMIZOL KALCEKS 500 mg/ml SOL. INJ. 500 mg/ml AS KALCEKS LETONIA CUTIE CU 5 FIOLE CU CAPACITATEA DE 2 ML SOL. INJ. PRF 5 1.272000 1.272000 0.000000
200 W66590002 N02BB02 METAMIZOLUM NATRIUM METAMIZOL KALCEKS 500 mg/ml SOL. INJ. 500 mg/ml AS KALCEKS LETONIA CUTIE CU 10 FIOLE CU CAPACITATEA DE 2 ML SOL. INJ. PRF 10 1.273000 1.273000 0.000000
201 W66590003 N02BB02 METAMIZOLUM NATRIUM METAMIZOL KALCEKS 500 mg/ml SOL. INJ. 500 mg/ml AS KALCEKS LETONIA CUTIE CU 100 FIOLE CU CAPACITATEA DE 2 ML SOL. INJ. PRF 100 1.216600 1.216600 0.000000
202 W66590004 N02BB02 METAMIZOLUM NATRIUM METAMIZOL KALCEKS 500 mg/ml SOL. INJ. 500 mg/ml AS KALCEKS LETONIA CUTIE CU 5 FIOLE CU CAPACITATEA DE 5 ML SOL. INJ. PRF 5 1.526000 1.526000 0.000000
203 W66590005 N02BB02 METAMIZOLUM NATRIUM METAMIZOL KALCEKS 500 mg/ml SOL. INJ. 500 mg/ml AS KALCEKS LETONIA CUTIE CU 10 FIOLE CU CAPACITATEA DE 5 ML SOL. INJ. PRF 10 1.525000 1.525000 0.000000
204 W66590006 N02BB02 METAMIZOLUM NATRIUM METAMIZOL KALCEKS 500 mg/ml SOL. INJ. 500 mg/ml AS KALCEKS LETONIA CUTIE CU 100 FIOLE CU CAPACITATEA DE 5 ML SOL. INJ. PRF 100 1.353600 1.353600 0.000000
205 W57866001 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN 300 mg SUPOZ. 300mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE, OPACE DIN PVC X 6 SUPOZ. PRF 12 1.384166 1.384166 0.000000
206 W66196001 N02BB02 METAMIZOLUM NATRIUM TISALGIN 300 mg SUPOZ. 300mg TIS FARMACEUTIC S.A. ROMANIA CUTIE CU 2 BLIST. PVC/PE X 3 SUPOZ. PRF 6 1.391666 1.391666 0.000000
207 W66196002 N02BB02 METAMIZOLUM NATRIUM TISALGIN 300 mg SUPOZ. 300mg TIS FARMACEUTIC S.A. ROMANIA CUTIE CU 2 BLIST. PVC/PE X 5 SUPOZ. PRF 10 1.391000 1.391000 0.000000
208 W68139001 N05CD08 MIDAZOLAMUM MIDAZOLAM KALCEKS 1 mg/ml SOL INJ./PERF. 1mg/ml PHARMNET PLUS S.R.L. ROMANIA CUTIE CU 10 FIOLE A 5 ML SOL. INJ./PERF. PR 10 10.494000 10.494000 0.000000
209 W67320001 N05CD08 MIDAZOLAMUM MIDAZOLAM HYPERICUM 5 mg/ml SOL INJ./PERF. 5mg/ml HYPERICUM S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA INCOLORA TIP I A CATE 10 ML SOL. INJ./PERF. PR 10 27.050000 27.050000 0.000000
210 W67954022 N05CD08 MIDAZOLAMUM MIDAZOLAM HAMELN 5 mg/ml SOL INJ./PERF. 5mg/ml HAMELN PHARMA GMBH GERMANIA CUTIE CU 10 FIOLE A CATE 10 ML SOL. INJ./PERF. PRF 10 26.825000 26.825000 0.000000
211 W66102001 N05CD08 MIDAZOLAMUM MIDAZOLAM SUN 1 mg/ml 1mg/ml
SOL. INJ. /PERF. IN SERINGA PREUMPLUTA OLANDA
SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. PRF
CUTIE CU 1 SERINGA PREUMPLUTA PREVAZUTA CU CAPAC CU FILET SI DOP DIN CAUCIUC X 50 ML SOL. INJ./PERF. + 1 SACULET ABSORBANT DE OXIGEN 1 32.190000 32.190000 59.820000
212 W66103001 N05CD08 MIDAZOLAMUM MIDAZOLAM SUN 2 mg/ml 2mg/ml
SOL. INJ. /PERF. IN SERINGA PREUMPLUTA OLANDA
SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. PRF
CUTIE CU 1 SERINGA PREUMPLUTA PREVAZUTA CU CAPAC CU FILET SI DOP DIN CAUCIUC X 50 ML SOL. INJ./PERF. + 1 SACULET ABSORBANT DE OXIGEN 1 124.650000 124.650000 0.000000
213 W67777002 N05CD08 MIDAZOLAMUM MIDAZOLAM DESITIN 10 mg SOLUTIE BUCOFARINGIANA 10 mg/2ml DESITIN ARZNEIMITTEL GMBH GERMANIA PRF
CUTIE CU 4 SERINGI PREUMPLUTE DIN PP, PENTRU ADMINISTRARE ORALA, DE CULOAREA CHIHLIMBARULUI,FARA AC, PREVAZUTE CU PISTON DIN PP SI CAPAC DIN PEÎD, AMBALATE ÎN CÂTE UN TUB PROTECTOR DIN PLASTIC 4 144.860000 144.860000 0.000000
214 W67774002 N05CD08 MIDAZOLAMUM MIDAZOLAM DESITIN 2,5 mg SOLUTIE BUCOFARINGIANA 2,5 mg/0.5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 4 SERINGI PREUMPLUTE DIN PP, PENTRU ADMINISTRARE ORALA, DE CULOAREA CHIHLIMBARULUI,FARA AC, PREVAZUTE CU PISTON DIN PP SI CAPAC DIN PEÎD, AMBALATE ÎN CÂTE UN TUB PROTECTOR DIN PLASTIC PRF 4 144.860000 144.860000 0.000000

Pagina 76 din 80
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM

UT/ Pret de beneficiaza de compensare 100%


Nr crt.

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


cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)
215 W67775002 N05CD08 MIDAZOLAMUM MIDAZOLAM DESITIN 5 mg SOLUTIE BUCOFARINGIANA 5 mg/1ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 4 SERINGI PREUMPLUTE DIN PP, PENTRU ADMINISTRARE ORALA, DE CULOAREA CHIHLIMBARULUI,FARA AC, PREVAZUTE CU PISTON DIN PP SI CAPAC DIN PEÎD, AMBALATE ÎN CÂTE UN TUB PROTECTOR DIN PLASTIC PRF 4 144.860000 144.860000 0.000000
216 W67776002 N05CD08 MIDAZOLAMUM MIDAZOLAM DESITIN 7,5 mg SOLUTIE BUCOFARINGIANA 7,5 mg/1,5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 4 SERINGI PREUMPLUTE DIN PP, PENTRU ADMINISTRARE ORALA, DE CULOAREA CHIHLIMBARULUI,FARA AC, PREVAZUTE CU PISTON DIN PP SI CAPAC DIN PEÎD, AMBALATE ÎN CÂTE UN TUB PROTECTOR DIN PLASTIC PRF 4 144.860000 144.860000 0.000000
217 W63237002 N05CD13 CINOLAZEPAMUM GERODORM 40 mg COMPR. 40mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. AL/PVDC-PVC X 10 COMPR. PRF 30 0.841666 0.841666 0.000000
218 W43107002 N06BA04 METHYLFENIDATUM ** CONCERTA 18 mg COMPR. FILM. ELIB. PREL. 18mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 1.868000 1.868000 0.000000
219 W43108002 N06BA04 METHYLFENIDATUM ** CONCERTA 36 mg COMPR. FILM. ELIB. PREL. 36mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 3.244000 3.244000 0.000000
220 W43109002 N06BA04 METHYLFENIDATUM ** CONCERTA 54 mg COMPR. FILM. ELIB. PREL. 54mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 6.345666 6.345666 0.000000
221 W58095001 N06BX02 PYRITINOLUM ENCEPHABOL 100 mg DRAJ. 100mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 0.570400 0.570400 0.000000
222 W58096001 N06BX02 PYRITINOLUM ENCEPHABOL 200 mg DRAJ. 200mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 1.343400 1.343400 0.000000
223 W59741001 N06BX02 PYRITINOLUM ENCEPHABOL 80,5 mg/5 ml SUSP. ORALA 80,5mg/5ml MERCK KGAA GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 200 ML + 1 LINGURITA DOZATOARE DIN PP ALBA, CU GRADATII LA 1,25 ML, 2,5 ML, 5 ML P6L 1 46.460000 46.460000 0.000000
224 W08294002 N07CA02 CINNARIZINUM CINARIZINA ARENA 25 mg CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. P-6L 40 0.201000 0.201000 0.000000
225 W10590001 N07CA02 CINNARIZINUM STUGERON 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. P-6L 40 0.201000 0.201000 0.000000
226 W13160002 N07CA02 CINNARIZINUM CINARIZINA LAROPHARM 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0.201000 0.201000 0.000000
227 W05792001 P01AX08 TENONITROZOLUM ATRICAN 250 mg CAPS. MOI GASTROREZ. 250mg LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. MOI GASTROREZ. P-RF 8 1.592500 1.592500 0.000000
228 W52931002 P03AX01 BENZYLUM BENZOICUM BENZOAT DE BENZIL FITERMAN 250 mg/g CREMA 250mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 50 G CREMA P-RF 1 9.380000 9.380000 0.000000
229 W52931001 P03AX01 BENZYLUM BENZOICUM BENZOAT DE BENZIL FITERMAN 250 mg/g CREMA 250mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB DIN AL X 35 G CREMA P-RF 1 5.700000 5.700000 0.000000
230 W57359001 R01AD07 TIXOCORTOLUM PIVALONE 0,9mg/pulverizare SPRAY NAZAL SUSPENSIE 0,9mg/pulverizare PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLACON X 10 ML + POMPA DOZATOARE + APLICATOR NAZAL P-RF 1 12.020000 12.020000 0.000000
231 W65041001 R01AD07 TIXOCORTOLUM PIVALONE 0,9mg/pulverizare SPRAY NAZAL SUSPENSIE 0,9mg/pulverizare PFIZER EUROPE MA EEIG BELGIA CUTIE CU 1 FLAC. X 10 ML + POMPA DOZATOARE + APLICATOR NAZAL PRF 1 12.020000 12.020000 0.000000
232 W59773001 R01ADN1 COMBINATII (BETAMETHASONUM+TETRYZOLINUM) BIORINIL 0,5mg/1 mg/ ml SPRAY NAZ.,SUSP. 0,5 mg/1 mg/ ml THEA FARMA SPA ITALIA CUTIE X 1 FLACON X 10 ML SPRAY NAZAL, SUSP. PREVAZUT CU NEBULIZATOR P-RF 1 41.480000 41.480000 0.000000
233 W64698004 R01BA52 COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE) AERINAZE 2,5mg/120mg COMPR. ELIB. MODIF. 2,5mg/120mg MERCK SHARP & DOHME OLANDA CUTIE CU 10 COMPR. ELIB. MODIF. (BLIST.PCTFE/PVC/AL) PRF 10 2.405000 2.405000 0.000000
234 W67696004 R01BA52 COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE) AERINAZE 2,5mg/120mg COMPR. ELIB. MODIF. 2,5mg/120mg N.V. ORGANON OLANDA CUTIE CU 10 COMPR. ELIB. MODIF. (BLIST.PCTFE/PVC/AL) PRF 10 2.405000 2.405000 0.000000
235 W62181001 R01BA52 COMBINATII (LORATADINUM+PSEUDOEFEDRINUM) CLARINASE 5 mg/120 mg COMPR. ELIB. MODIF. 5mg/120mg BAYER S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 COMPR. ELIB. MODIF. P-6L 7 1.956000 1.956000 1.201142
236 W62181002 R01BA52 COMBINATII (LORATADINUM+PSEUDOEFEDRINUM) CLARINASE 5 mg/120 mg COMPR. ELIB. MODIF. 5mg/120mg BAYER S.R.L. ROMANIA CUTIE CU 1 BLIST. OPA-AL-PE/LDPE-AL X 7 COMPR. ELIB. MODIF. P-6L 7 1.956000 1.956000 1.201142
237 W62181006 R01BA52 COMBINATII (LORATADINUM+PSEUDOEFEDRINUM) CLARINASE 5 mg/120 mg COMPR. ELIB. MODIF. 5mg/120mg BAYER S.R.L. ROMANIA CUTIE CU 2 BLIST. OPA-AL-PE/LDPE-AL X 7 COMPR. ELIB. MODIF. P6L 14 1.630000 1.630000 0.000000
238 W60632001 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA ZENTIVA 50 mg/ ml SOL. INJ. 50mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ PRF 5 9.556000 9.556000 0.000000
239 W53020001 R05CB01 ACETYLCYSTEINUM FLUIMUCIL 20 mg/ml PEDIATRIC SOL. ORALA 20mg/ml ZAMBON S.P.A. ITALIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SOL. ORALA + MASURA DOZATOARE (5 SI 10 ML) P-RF 1 14.440000 14.440000 0.000000
240 W53016001 R05CB01 ACETYLCYSTEINUM FLUIMUCIL 300 mg/3 ml 300mg/3ml
SOL.INJ./INHAL.NEBULIZ./INSTILATIE ENDOTRAHEOBRON. ZAMBON S.P.A. ITALIA CUTIE X 5 FIOLE DIN STICLA X 3 ML SOL.INJ/SOL.PT.INHALAT PRIN NEBULIZATOR/SOL.PT.INSTILATIE ENDOTRAH PR 5 3.942000 3.942000 0.000000
241 W63537001 R05CB03 CARBOCISTEINUM RHINATHIOL 100 mg/5 ml PENTRU COPII SIROP 100 mg/5 ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA DE TIP III X 125 ML SIROP + LINGURITA DOZATOARE DE 5 ML PRF 1 19.720000 19.720000 0.000000
242 W67973001 R05CB03 CARBOCISTEINUM RHINATHIOL 100 mg/5 ml PENTRU COPII SIROP 100 mg/5 ml ROMANIA
OPELLA HEALTHCARE ROMANIA SRL CUTIE CU 1 FLAC. DIN STICLA INCOLORA DE TIP III X 125 ML SIROP + LINGURITA DOZATOARE DE 5 ML PRF 1 19.720000 19.720000 0.000000
243 W07656001 R05CB03 CARBOCISTEINUM FLUIDOL 100mg/5ml SOL. ORALA 100mg/5ml TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PVC X 100 ML SIROP + LINGURITA DUBLA GRADATA LA 2,5 SI 5 ML P-RF 1 4.590000 4.590000 0.000000
244 W52326001 R06AD02 PROMETHAZINUM ROMERGAN SIROP 5mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 ML SIROP + MASURA DOZATOARE P-RF 1 11.110000 11.110000 0.000000
245 W13788001 R06AE05 MECLOZINUM EMETOSTOP 30 mg COMPR. 30mg SPECIFAR SA GRECIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0.781000 0.781000 0.000000
246 W62182001 R06AX13 LORATADINUM CLARITINE 1 mg/ml SIROP 1mg/ml BAYER S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 120 ML SIROP + LINGURITA DOZATOARE DIN POLISTIREN P-6L 1 29.140000 29.140000 0.000000
247 W62182004 R06AX13 LORATADINUM CLARITINE 1 mg/ml SIROP 1mg/ml BAYER S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PET X 120 ML SIROP + 1 MASURA DOZATOARE DIN PP P6L 1 29.140000 29.140000 0.000000
248 W52861001 R06AX13 LORATADINUM LORATADINA BIOFARM 5mg/5ml SIROP 5mg/5ml BIOFARM S.A. ROMANIA P6L
CUTIE CU UN FLACON DIN STICLA BRUNA X 100ML SIROP SI O MASURA DOZATOARE DIN PE, PREVAZUTA CU GRADATII DE LA 2,5 LA 20ML 1 9.780000 9.780000 0.000000
249 W41624001 S01AA24 KANAMYCINUM KANAMICINA SULFAT 1% UNG. OFT. 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL X 6 G P-RF 1 15.960000 15.960000 0.000000
250 W59768001 S01BA07 FLUOROMETHOLONUM FLUMETOL S 2 mg/ml PICATURI OFT.SUSP. 2mg/ml THEA FARMA SPA ITALIA CUTIE X 1 FLACON PEJD X 10ML PIC. OFT. SUSP. P-RF 1 48.490000 48.490000 0.000000
251 W67014001 S01BC01 INDOMETACINUM INDOCOLLYRE 1 mg/ml PICATURI OFT., SOL. 1mg/ml BAUSCH HEALTH IRELAND LIMITED IRLANDA CUTIE X 1 FLACON PICURATOR DIN POLIETILENA X 5 ML PICATURI OFT., SOL. P6L 1 21.230000 21.230000 0.000000
252 W03615001 S01BC01 INDOMETACINUM INDOCOLLYRE 1 mg/ml PICATURI OFT.-SOL. 1mg/ml LAB. CHAUVIN FRANTA CUTIE X 1 FLACON PICURATOR DIN POLIETILENA X 5 ML P-6L 1 21.230000 21.230000 0.000000
253 W02268001 S02CA05 COMBINATII OTIS-T PICATURI AURICULARE-SOL. FARA CONCENTRATIE TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PE X 10 ML PIC. AURICULARE, SOL. P-RF 1 5.690000 5.690000 0.000000
254 W10587001 S02CA05 COMBINATII SOLUTIE AURICULARA CU CLORAMFENICOL SI FLUOCINOLON SOL. AURICULARA FARA CONCENTRATIE BIOFARM SA ROMANIA CUTIE X 1 FLAC DIN STICLA BRUNA+APLICATOR TIP PIPETA X 10 ML SOL. AURICULARA P-RF 1 6.828000 6.828000 2.692000

NOTĂ:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu ** se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu **1 se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii şi pot fi
administrate şi în regim de spitalizare de zi.
- Medicamentele din această sublistă corespund DCI-urilor din nomenclatorul de produse, altele decât cele din sublistele A, B, sublista C secţiunea C1 şi sublista D. Pentru categoriile de asiguraţi
menţionate în această sublistă, medicamentele corespunzătoare denumirilor comune internaţionale din sublista A, sublista B, secţiunea C1 a sublistei C şi sublista D se vor acorda în regim de
compensare de 100% la preţ de referinţă, indiferent de indicaţia pentru care sunt prevăzute în aceste subliste.

Pagina 77 din 80
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, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILA INCEPAND CU 01 MARTIE 2022

Contributie maxima Val. maxima suportata de Contributie maxima


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

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

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


Nr crt.

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

1 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 0.226166 0.159500 0.045233 0.340433
2 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 0.226166 0.159500 0.045233 0.340433
3 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 0.452333 0.000000 0.090466 0.361867
4 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 0.452333 0.000000 0.090466 0.361867
5 W42867002 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 40 mg COMPR. FILM. 40mg ZENTIVA S.A ROMANIA CUTIE CU 3 BLIST.DIN PVC-PE-PVDC/AL A CATE 10 COMPR. FILM. P-6L 30 0.452333 0.000000 0.090466 0.361867
6 W54839001 A02BA03 FAMOTIDINUM QUAMATEL 20 mg PULB+SOLV. PT. SOL. INJ./PERF. 20mg 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 4.308000 0.000000 0.861600 3.446400
7 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 0.359000 0.000000 0.071800 0.287200
8 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 0.842333 0.000000 0.168466 0.673867
9 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 0.842333 0.000000 0.168466 0.673867
10 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 0.842333 0.000000 0.168466 0.673867
11 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 0.842333 0.000000 0.168466 0.673867
12 W04080002 A03AA04 MEBEVERINUM COLOSPASMIN 100 mg drajeuri DRAJ. 100mg E.I.P.I.CO. MED SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 DRAJ. P-6L 20 0.421166 0.209834 0.084233 0.546767
13 W51982001 A03AA05 TRIMEBUTINUM TRIMEBUTIN 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0.424666 0.000000 0.084933 0.339733
14 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 0.419666 0.000000 0.083933 0.335733
15 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 1.274003 0.993497 0.254800 2.012700
16 W08438001 A03AA05 TRIMEBUTINUM DEBRIDAT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L
MAREA BRITANIE 30 0.424666 0.000000 0.084933 0.339733
17 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 0.424666 0.000000 0.084933 0.339733
18 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 0.424666 0.000000 0.084933 0.339733
19 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 0.424666 0.000000 0.084933 0.339733
20 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 0.849334 0.391666 0.169866 1.071134
21 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 0.849334 0.391666 0.169866 1.071134
22 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 6.895000 4.595000 1.379000 10.111000
23 W65036002 A03AA05 TRIMEBUTINUM DEBRIDAT 24 mg/5 ml 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 6.895000 4.595000 1.379000 10.111000
24 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 13.790000 0.000000 2.758000 11.032000
25 W65036001 A03AA05 TRIMEBUTINUM DEBRIDAT 24 mg/5 ml 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 13.790000 0.000000 2.758000 11.032000
26 W12227001 A03FA03 DOMPERIDONUM MOTILIUM 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 0.161750 0.342250 0.032350 0.471650
27 W61966003 A03FA03 DOMPERIDONUM DOMOTIL 10 mg COMPR. ORODISPERSABILE 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE P6L 30 0.161750 0.815250 0.032350 0.944650
28 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 2.902499 0.071501 0.580499 2.393501
29 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 2.878666 0.000000 0.575733 2.302933
30 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 0.453700 0.619700 0.090740 0.982660
31 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 0.453700 0.046300 0.090740 0.409260
32 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 0.407400 0.000000 0.081480 0.325920
33 W42092002 A11DBN1 COMBINATII ** MILGAMMA 100+100mg DRAJ. 100mg+100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 DRAJ. P-6L 60 1.716666 0.000000 0.343333 1.373333
34 W01731002 A11DBN1 COMBINATII ** MILGAMMA (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 1.138000 0.000000 0.227600 0.910400
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 4.382000 0.000000 0.876400 3.505600
36 W13661001 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH 35 mg COMPR. CU ELIB. PREL. 35mg LABORMED PHARMA SA ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 60 0.443000 0.000000 0.088600 0.354400
37 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 0.443000 0.129666 0.088600 0.484066
38 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 0.424333 0.000000 0.084866 0.339467
39 W42406002 C01EB15 TRIMETAZIDINUM DILATAN MR 35 mg COMPR. ELIB. PREL. 35mg TERAPIA S.A. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. ELIB. PREL. P6L 60 0.443000 0.000000 0.088600 0.354400
40 W41842001 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 60 0.253142 0.037524 0.050628 0.240038
41 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 0.253142 0.129024 0.050628 0.331538
42 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 0.993166 0.422834 0.198633 1.217367
43 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 0.993166 0.000167 0.198633 0.794700
44 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 0.991666 0.000000 0.198333 0.793333
45 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 0.993166 0.422834 0.198633 1.217367
46 W67204002 C04AE02 NICERGOLINUM SERMION 30 mg COMPR. FILM. 30mg UPJOHN EESV OLANDA CUTIE CU 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM P6L 30 0.993166 0.422834 0.198633 1.217367
47 W52057002 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 0.993166 0.000167 0.198633 0.794700
48 W52057001 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 0.993000 0.000000 0.198600 0.794400
49 W06107003 C04AX07 VINCAMINUM VINCAMINA 10 mg DRAJ. 10mg BIOFARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 DRAJ. P-6L 20 0.476000 0.000000 0.095200 0.380800
50 W66812002 C05CA53 DIOSMINUM (COMBINATII) ** DETRALEX 1000 mg COMPR. FILM. 1000mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 1.968666 0.000000 0.393733 1.574933

Pagina 78 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 20% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
51 W11615001 C05CA53 DIOSMINUM (COMBINATII) ** DETRALEX 500 mg COMPR. FILM. 500mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0.984416 0.000250 0.196883 0.787783
52 W58770010 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90 ** TEVOCOR 1000 mg CAPS. MOI 1000 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. PRF 30 1.514333 0.000000 0.302866 1.211467
53 W13986001 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90 ** OMACOR (R) CAPS. MOI 1000mg PRONOVA BIOPHARMA NORGE A.S. NORVEGIA FALC. DIN PEID X 28 CAPS. MOI P-RF 28 1.922166 0.407834 0.384433 1.945567
54 W65280001 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90 ** OMACOR 1000 mg CAPS. MOI 1000mg BASF AS NORVEGIA CUTIE CU 1 FLAC. PEID X 28 CAPS. MOI PRF 28 1.922166 0.407834 0.384433 1.945567
55 W53041001 D06BB03 ACICLOVIRUM ACICLOVIR TIS 50mg/g CREMA 50mg/g TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB DIN PEJD X 15 G CREMA P-RF 1 7.920000 2.100000 1.584000 8.436000
56 W55128001 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA P-RF 1 7.920000 4.780000 1.584000 11.116000
57 W58038001 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 7.920000 2.870000 1.584000 9.206000
58 W60557002 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA PRF 1 7.920000 0.660000 1.584000 6.996000
59 W66137002 D06BB03 ACICLOVIRUM ACICLOVIR FITERMAN 50 mg/g CREMA 50mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 15 G PRF 1 7.700000 0.000000 1.540000 6.160000
60 W67305002 D06BB03 ACICLOVIRUM ACICLOVIR ROMPHARM 50 mg/g CREMA 50mg/g ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 7.690000 0.000000 1.538000 6.152000
61 W66137001 D06BB03 ACICLOVIRUM ACICLOVIR FITERMAN 50 mg/g CREMA 50mg/g FITERMAN PHARMA S.R.L. ROMANIA CUTIE X 1 TUB AL X 7,5 G PRF 1 3.840000 0.000000 0.768000 3.072000
62 W60557001 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA PRF 1 2.640000 2.980000 0.528000 5.092000
63 W58038002 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL A 5 G CREMA PRF 1 2.640000 5.830000 0.528000 7.942000
64 W64910001 D06BB03 ACICLOVIRUM ACEVIREX 50 mg/g CREMA 50mg/g IRLANDA
GLAXOSMITHKLINE (IRELAND) LIMITED CUTIE CU 1 TUB DIN AL X 5 G CREMA PRF 1 2.640000 13.050000 0.528000 15.162000
65 W05099002 M01AC01 PIROXICAMUM PIROXSAL 20 mg COMPR. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST.PVC/ AL X 10 COMPR. P-6L 20 0.575100 0.580400 0.115020 1.040480
66 W12442003 M01AC01 PIROXICAMUM FLAMEXIN COMPR. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L 30 0.575100 0.371566 0.115020 0.831646
67 W05092002 M01AC01 PIROXICAMUM PIROXICAM LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST., PVC/AL X 20 COMPR. P-6L 20 0.575100 0.683900 0.115020 1.143980
68 W53944002 M01AC01 PIROXICAMUM PIROXICAM ARENA 20 MG COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.575100 0.683900 0.115020 1.143980
69 W59471001 M01AC01 PIROXICAMUM PIROXICAM HELCOR 20 mg COMPR. 20mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0.575100 0.683900 0.115020 1.143980
70 W12441001 M01AC01 PIROXICAMUM FLAMEXIN (R) PULB. PT. SOL. ORALA 20mg/plic CHIESI FARMACEUTICI SPA ITALIA CUTIE X 20 PLICURI DUBLU COMPARTIMENTAT X 3 G PULB. PT. SOL. ORALA P-6L 20 0.575100 0.920900 0.115020 1.380980
71 W09001001 M01AC01 PIROXICAMUM PIROXICAM SINTOFARM 20 mg SUPOZ. 20mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L 10 0.847000 0.000000 0.169400 0.677600
72 W08513001 M01AX17 NIMESULIDUM LEMESIL 100 mg COMPR. 100mg ANFARM HELLAS S.A. GRECIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 20 0.389662 0.046338 0.077932 0.358068
73 W08886001 M01AX17 NIMESULIDUM NIMESULID MCC 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.389662 0.046338 0.077932 0.358068
74 W42589001 M01AX17 NIMESULIDUM NIMESULID SLAVIA COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0.389662 0.046338 0.077932 0.358068
75 W43252002 M01AX17 NIMESULIDUM APONIL 100 mg COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.389662 0.046338 0.077932 0.358068
76 W43252001 M01AX17 NIMESULIDUM APONIL 100 mg COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.389662 0.046338 0.077932 0.358068
77 W51945001 M01AX17 NIMESULIDUM NIMESULIDA ARENA 100 mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.389662 0.632338 0.077932 0.944068
78 W63141001 M01AX17 NIMESULIDUM AULIN 100 mg COMPR. 100mg ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU BLIST. AL/PVC X 10 COMPR. PRF 10 0.389662 0.282338 0.077932 0.594068
79 W63142009 M01AX17 NIMESULIDUM AULIN 100 mg GRAN. PT. SUSP. ORALA 100mg/plic ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA PRF
CUTIE CU 15 PLICURI DIN AL/HÂRTIE/PE SAU AL/HÂRTIE/PE/FOLIE SURLYN A CÂTE 2 G GRANULE PENTRU SUSPENSIE ORALA 15 0.389662 0.287004 0.077932 0.598734
80 W61456002 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 10 0.389662 0.046338 0.077932 0.358068
81 W61456003 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 30 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 30 0.389662 0.046004 0.077932 0.357734
82 W54833001 M03BX04 TOLPERISONUM ** MYDOCALM 150 mg COMPR. FILM. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0.497333 0.000000 0.099466 0.397867
83 W54832001 M03BX04 TOLPERISONUM ** MYDOCALM 50 mg COMPR. FILM. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0.308182 0.101151 0.061636 0.347697
84 W55441001 M05BA06 ACIDUM IBANDRONICUM * OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P-6L 1 21.830785 12.499215 4.366157 29.963843
85 W57485004 M05BA06 ACIDUM IBANDRONICUM * OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM. P6L 1 21.830785 2.789215 4.366157 20.253843
86 W58574001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L 1 21.830785 17.539215 4.366157 35.003843
87 W63021001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 21.830785 0.709215 4.366157 18.173843
88 W66455001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg ROMANIA
AUROBINDO PHARMA ROMANIA S.R.L. CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P6L 1 21.830785 16.389215 4.366157 33.853843
89 W57932001 M05BA06 ACIDUM IBANDRONICUM * OSSICA 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE P6L 1 78.947499 20.762501 15.789499 83.920501
90 W65656001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC ACCORD 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE PR/P6L 1 78.947499 32.272501 15.789499 95.430501
91 W57484001 M05BA06 ACIDUM IBANDRONICUM * OSAGRAND 3 mg/3 ml SOL. INJ. 3mg/3ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ. P6L 1 78.947499 36.722501 15.789499 99.880501
92 W67509001 M09AX01 ACIDUM HIALURONICUM ** HYALGAN 20 mg/2 ml SOL. INJ. IN SERINGA PREUMPLUTA 20mg/2ml FIDIA FARMACEUTICI SPA ITALIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU DOP DIN ELASTOMER SI OPRITOR X 2 ML SOL. INJ. PRF 1 143.980000 0.000000 28.796000 115.184000
93 W51336001 N03AE01 CLONAZEPAMUM RIVOTRIL 0,5 mg COMPR. 0,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. P-RF 50 0.074092 0.092708 0.014818 0.151982
94 W55375001 N03AE01 CLONAZEPAMUM RIVOTRIL 2 mg COMPR. 2mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-RF 30 0.216666 0.000000 0.043333 0.173333
95 W52016002 N06BX03 PIRACETAMUM PIRACETAM ARENA 400 mg CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0.198333 0.205333 0.039666 0.364000
96 W05051001 N06BX03 PIRACETAMUM PIRACETAM SLAVIA 400 mg COMPR. 400mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. DIN PVC/AL X 10 COMPR. P-6L 40 0.198333 0.104417 0.039666 0.263084
97 W08467001 N06BX03 PIRACETAMUM PIRACETAM FARMEX 400 mg COMPR. 400mg FARMEX COMPANY SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0.198333 0.205417 0.039666 0.364084
98 W05045001 N06BX03 PIRACETAMUM PIRACETAM MCC 400mg COMPR. 400mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0.198333 0.133167 0.039666 0.291834
99 W54455002 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mg COMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 4 BLIST. PVC/AL X 10 COMPR. P-6L 40 0.198333 0.205417 0.039666 0.364084
100 W60657001 N06BX03 PIRACETAMUM PIRACETAM LAROPHARM 400 mg COMPR. 400mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.198333 0.204667 0.039666 0.363334
101 W57920002 N06BX03 PIRACETAMUM PIRACETAM HELCOR 400mg COMPR. FILM. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0.198333 0.205167 0.039666 0.363834
102 W60618001 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 400 mg COMPR. FILM. 400mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. FILM. P6L 20 0.198000 0.000000 0.039600 0.158400
103 W60618002 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 400 mg COMPR. FILM. 400mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0.198333 0.000333 0.039666 0.159000
104 W57090002 N06BX03 PIRACETAMUM NOOTROPIL 800 mg COMPR. FILM. 800mg U.C.B. PHARMA S.A. BELGIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. FILM. P6L 90 0.389000 0.000000 0.077800 0.311200
105 W57921001 N06BX03 PIRACETAMUM PIRACETAM HELCOR 800mg COMPR. FILM. 800mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 20 0.244000 0.000000 0.048800 0.195200
106 W42904001 N06BX03 PIRACETAMUM MEMOTAL 1 g/5 ml SOL. INJ. 1g/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 3.988000 0.000000 0.797600 3.190400
107 W63143002 R05CB15 ERDOSTEINUM ** ERDOMED 300 mg CAPS. 300mg ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 20 1.820000 0.000000 0.364000 1.456000
108 W63143001 R05CB15 ERDOSTEINUM ** ERDOMED 300 mg CAPS. 300mg ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 10 1.823500 0.010500 0.364700 1.469300

Pagina 79 din 80
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

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

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


Nr crt.

tara det. amba referinta / UT din pretul de compensare 20% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
109 W63144001 R05CB15 ERDOSTEINUM ** ERDOMED 175 mg/5 ml PULB. PT. SUSP. ORALA 175mg/5ml ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA A 50 G PULB. PT. OBTINEREA A 100 ML SUSP. ORALA + 1 MASURA DOZATOARE DIN PP P-6L 1 33.330000 0.000000 6.666000 26.664000

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 80 din 80

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