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SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILA INCEPAND CU 01 IANUARIE 2019
Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM
1 W64020007 A02BC01 OMEPRAZOLUM OMEZ 10 mg CAPS. GASTROREZ. 10mg ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ.
DR. REDDY'S LABORATORIES P6L 30 0,259200 0,375133 0,233280 0,401053
2 W42129001 A02BC01 OMEPRAZOLUM OMEPRAZOL-RICHTER 20 mg CAPS. GASTROREZ. 20mg ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ.
GEDEON RICHTER ROMANIA SA P-6L 14 0,518400 0,203742 0,466560 0,255582
3 W51990001 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,305933 0,466560 0,357773
4 W52044001 A02BC01 OMEPRAZOLUM OMEPRAZOL TERAPIA 20 mg CAPS. GASTROREZ. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,302266 0,466560 0,354106
5 W52887001 A02BC01 OMEPRAZOLUM OMEPRAZOL ARENA 20 mg CAPS. GASTROREZ. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,283933 0,466560 0,335773
6 W53138001 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,213600 0,466560 0,265440
7 W55651001 A02BC01 OMEPRAZOLUM OMEPRAZOL ROMPHARM 20 mg CAPS. GASTROREZ. 20mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,259600 0,466560 0,311440
8 W56195002 A02BC01 OMEPRAZOLUM ORTANOL 20 mg CAPS. GASTROREZ. 20mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 14 0,320000 0,000000 0,288000 0,032000
9 W58105001 A02BC01 OMEPRAZOLUM OMEZ 20mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L 30 0,518400 0,261266 0,466560 0,313106
10 W57295005 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mgCAPS. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 0,336785 0,000000 0,303106 0,033679
11 W60470001 A02BC01 OMEPRAZOLUM OMEPRAZOL ATB 20 mg CAPS. GASTROREZ. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L 20 0,518400 0,373600 0,466560 0,425440
12 W60303002 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L 28 0,396785 0,000000 0,357106 0,039679
13 W59906022 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 2 BLISTERE DIN OPA-AL-PEÎD-PE-DESICANT-PEÎD/AL A CATE 14 CAPSULE GASTROREZISTENTE P6L 28 0,396785 0,000000 0,357106 0,039679
14 W59906021 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 4 BLISTERE DIN OPA-AL-PEÎD-PE-DESICANT-PEÎD/AL A CATE 7 CAPSULE GASTROREZISTENTE P6L 28 0,396785 0,000000 0,357106 0,039679
15 W61506002 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRLROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L 28 0,518400 0,317671 0,466560 0,369511
16 W53138002 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 10 CAPS. GASTROREZ. P6L 30 0,518400 0,213600 0,466560 0,265440
17 W64021007 A02BC01 OMEPRAZOLUM OMEZ 20 mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0,518400 0,240600 0,466560 0,292440
18 W64023001 A02BC01 OMEPRAZOLUM OMEPRAZOL DR. REDDY'S 20 mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P6L 30 0,518400 0,261933 0,466560 0,313773
19 W14125001 A02BC01 OMEPRAZOLUM ORTANOL 40 mg CAPS. GASTROREZ. 40mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L 7 0,817142 0,000000 0,735427 0,081715
20 W57296002 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mgCAPS. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 14 CAPS. GASTROREZ. P6L 14 0,604285 0,000000 0,543856 0,060429
21 W64022007 A02BC01 OMEPRAZOLUM OMEZ 40 mg CAPS. GASTROREZ. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0,681000 0,000000 0,612900 0,068100
22 W57994002 A02BC01 OMEPRAZOLUM OMEDAR 20 mg COMPR. GASTROREZ. 20mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ. P-6L 28 0,518400 0,045528 0,466560 0,097368
23 W56141001 A02BC01 OMEPRAZOLUM OMEZ 40 mg PULB. PT. SOL. PERF. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF. S/P-RF 1 15,947999 1,772001 14,353199 3,366801
24 W60679001 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF. 40mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 15,947999 1,772001 14,353199 3,366801
25 W42951001 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,259200 0,252228 0,233280 0,278148
26 W03936001 A02BC03 LANSOPRAZOLUM LANZUL CAPS. GASTROREZ. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ. P-6L 14 0,518400 0,171600 0,466560 0,223440
27 W42952001 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,518400 0,368742 0,466560 0,420582
28 W53686002 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA ARENA 100 mg COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,242000 0,000000 0,217800 0,024200
29 W08691002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,109000 0,000000 0,098100 0,010900
30 W04254002 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,112874 0,041626 0,101586 0,052914
31 W52253001 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID LAROPHARM COMPR. 10mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-6L 40 0,112874 0,003376 0,101586 0,014664
32 W54362003 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L 40 0,109500 0,000000 0,098550 0,010950
33 W52254001 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID BIOFARM 1mg/5ml SIROP 1mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 100 ML SIROP + MASURA DOZATOARE P-RF 1 9,480000 0,000000 8,532000 0,948000
34 W57360001 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 5mg/ml SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 5 2,888000 0,000000 2,599200 0,288800
35 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 1,164200 0,000000 1,047780 0,116420
36 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 1,210400 0,015400 1,089360 0,136440
37 W58710002 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100 2,420800 0,288300 2,178720 0,530380
38 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM * URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 60,520058 42,149942 54,468052 48,201948
39 W62376001 A06AD11 LACTULOSUM DUPHALAC® LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,778246 3,551754 7,000421 4,329579
40 W64011001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,778246 3,551754 7,000421 4,329579
41 W64559001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% MYLAN HEALTHCARE B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 MLP6L 1 7,778246 3,551754 7,000421 4,329579
42 W44054002 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML P-6L 1 11,370000 0,000000 10,233000 1,137000
43 W44054001 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 3,780000 0,000000 3,402000 0,378000
44 W05695001 A07AA02 NYSTATINUM NISTATINA ATB 500000 UI COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,505500 0,000000 0,454950 0,050550
45 W07440001 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0,615400 0,000000 0,553860 0,061540
46 W59162002 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L 50 0,616400 0,000000 0,554760 0,061640
47 W58461001 A07EC02 MESALAZINUM ** PENTASA 1 g COMPR. CU ELIB. PREL. 1g FERRING GMBH GERMANIA CUTIE CU 6 BLIST. AL/AL X 10 COMPR. CU ELIB. PREL. P6L 60 1,749679 1,613821 1,574711 1,788789
Pagina 1 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 2 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 3 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 4 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 5 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 6 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 7 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 8 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 9 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 10 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 11 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 12 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 13 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 14 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 15 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 16 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 17 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 18 din 19
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
NOTĂ:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se iniţiază de către medicul de specialitate în limita competenţei şi poate fi prescris în continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (1) se efectuează pentru pacienţii cu intoleranţă la acidum acetylsalicylicum.
Pagina 19 din 19
ANEXA 2b
SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE PERSONALA
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILA INCEPAND CU 01 IANUARIE 2019
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
1 W56172001 A02BC02 PANTOPRAZOLUM SELTRAZ 40 mg COMPR. FILM. GASTROREZ. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. FILM. GASTROREZISTENTE P-6L 28 0,640714 0,000000 0,320357 0,320357 0,576642 0,064072
2 W56920002 A02BC02 PANTOPRAZOLUM ZENCOPAN 20 mg COMPR. GASTROREZ. 20 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ. P6L 28 0,249285 0,000000 0,124642 0,124643 0,224356 0,024929
3 W54403001 A02BC02 PANTOPRAZOLUM PANTEXEL 20 mg COMPR. GASTROREZ. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ P-6L 28 0,348214 0,000000 0,174107 0,174107 0,313392 0,034822
4 W54684002 A02BC02 PANTOPRAZOLUM NOLPAZA 20 mg COMPR. GASTROREZ. 20mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L 30 0,288000 0,000000 0,144000 0,144000 0,259200 0,028800
5 W60432003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 20 mg COMPR. GASTROREZ. 20mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0,348333 0,000000 0,174166 0,174167 0,313499 0,034834
6 W60623001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL MACLEODS 20 mg COMPR. GASTROREZ. 20mg MACLEODS PHARMA UK LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. GASTROREZ. P6L 28 0,348214 0,000000 0,174107 0,174107 0,313392 0,034822
7 W60745001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TORRENT 20 mg COMPR. GASTROREZ. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0,348333 0,000000 0,174166 0,174167 0,313499 0,034834
8 W61230005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 20 mg COMPR. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,224000 0,000000 0,112000 0,112000 0,201600 0,022400
9 W61932062 A02BC02 PANTOPRAZOLUM CONTROLOC 20 mg COMPR. GASTROREZ. 20mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,358333 0,000000 0,179166 0,179167 0,322499 0,035834
10 W56919002 A02BC02 PANTOPRAZOLUM ZENCOPAN 40 mg COMPR. GASTROREZ. 40 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ. P6L 28 0,453928 0,000000 0,226964 0,226964 0,408535 0,045393
11 W54404002 A02BC02 PANTOPRAZOLUM PANTEXEL 40 mg COMPR. GASTROREZ. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ P-6L 28 0,640714 0,000000 0,320357 0,320357 0,576642 0,064072
12 W54685002 A02BC02 PANTOPRAZOLUM NOLPAZA 40mg COMPR. GASTROREZ. 40mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L 30 0,607000 0,000000 0,303500 0,303500 0,546300 0,060700
13 W57634001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 40 mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L 10 0,641000 0,000000 0,320500 0,320500 0,576900 0,064100
14 W57634003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TERAPIA 40 mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L 30 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
15 W59855003 A02BC02 PANTOPRAZOLUM PANTOPRAZOL ATB 40 mg COMPR. GASTROREZ. 40mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ. P6L 30 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
16 W60746001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TORRENT 40 mg COMPR. GASTROREZ. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L 30 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
17 W61231005 A02BC02 PANTOPRAZOLUM PANTOPRAZOL AUROBINDO 40 mg COMPR. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 0,408333 0,000000 0,204166 0,204167 0,367499 0,040834
18 W61933054 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg COMPR. GASTROREZ. 40mg TAKEDA GMBH GERMANIA CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ. P6L 30 0,627666 0,000000 0,313833 0,313833 0,564899 0,062767
19 W61651001 A02BC02 PANTOPRAZOLUM PANTOPRAZOL SUN 40 mg PULB. PT. SOL. INJ. 40mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA CU DOP DIN CAUCIUC SI CAPSA DIN AL, CU PULB. PT. SOL. INJ. PRF 1 9,280000 0,000000 4,640000 4,640000 8,352000 0,928000
20 W61931001 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg PULB. PT. SOL. INJ. 40mg TAKEDA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, CU CAPSA DIN AL SI DOP DIN CAUCIUC A 40 MG CU PULB. PT. SOL. INJ. PRF 1 13,420000 0,000000 6,710000 6,710000 12,078000 1,342000
21 W55421004 A02BC05 ESOMEPRAZOLUM EMANERA 20 mg CAPS. GASTROREZ. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ. P-6L 28 0,678571 0,000000 0,339285 0,339286 0,610713 0,067858
22 W56890010 A02BC05 ESOMEPRAZOLUM HELIDES 20 mg CAPS. GASTROREZ. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P-6L 28 0,457142 0,000000 0,228571 0,228571 0,411427 0,045715
23 W55422004 A02BC05 ESOMEPRAZOLUM EMANERA 40 mg CAPS. GASTROREZ. 40mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ. P-6L 28 1,093571 0,000000 0,546785 0,546786 0,984213 0,109358
24 W56889010 A02BC05 ESOMEPRAZOLUM HELIDES 40 mg CAPS. GASTROREZ. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P-6L 28 0,913928 0,000000 0,456964 0,456964 0,822535 0,091393
25 W06755002 A02BC05 ESOMEPRAZOLUM NEXIUM 20 mg COMPR. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTE P-6L 14 0,691199 0,620943 0,345599 0,966543 0,622079 0,690063
26 W56303013 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZ. 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ. P6L 14 0,691199 0,285943 0,345599 0,631543 0,622079 0,355063
27 W06756002 A02BC05 ESOMEPRAZOLUM NEXIUM 40 mg COMPR. GASTROREZ. 40mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTE P-6L 14 1,382399 0,336886 0,691199 1,028086 1,244159 0,475126
28 W56304013 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg COMPR. GASTROREZ. 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ. P6L 14 1,382399 0,061886 0,691199 0,753086 1,244159 0,200126
29 W56303002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg 20mg
COMPR. GASTROREZISTENTE TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 0,691199 0,285943 0,345599 0,631543 0,622079 0,355063
30 W56304002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg 40mg
COMPR. GASTROREZISTENTE TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 1,382399 0,061886 0,691199 0,753086 1,244159 0,200126
31 W53101001 A02BC05 ESOMEPRAZOLUM NEXIUM 10 mg 10mg
GRAN. GASTROREZ. PT. SUSP.ORALA ASTRAZENECA AB SUEDIA CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA P-6L 28 2,627857 0,000000 1,313928 1,313929 2,365071 0,262786
32 W62392007 A02BX05 BISMUTHI OXIDE ULCAMED 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,337175 0,714825 0,168587 0,883413 0,303457 0,748543
33 W62392006 A02BX05 BISMUTHI OXIDE ULCAMED 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 0,337175 0,609610 0,168587 0,778198 0,303457 0,643328
34 W04674001 A03AB06 OTILONIUM BROMIDUM SPASMOMEN (R) COMPR. FILM. 40mg A. MENARINI IND. FARM. RIUNITE SRL ITALIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,844000 0,000000 0,422000 0,422000 0,759600 0,084400
35 W05444001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE CU UN BLISTER DIN PVC-PE-PVDC/ALUMINIUM A 12 COMPRIMATE FILMATE P-RF 12 2,516111 0,221389 1,258055 1,479445 2,264499 0,473001
36 W05444002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE CU 3 BLISTERE DIN PVC-PE-PVDC/ALUMINIUM A CATE 12 COMPRIMATE FILMATE P-RF 36 2,516111 0,000000 1,258055 1,258056 2,264499 0,251612
37 W63734001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 12 COMPR. FILM. PRF 12 2,516111 0,221389 1,258055 1,479445 2,264499 0,473001
38 W63734002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL A CATE 12 COMPR. FILM. PRF 36 2,516111 0,000000 1,258055 1,258056 2,264499 0,251612
39 W63735001 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFASIGMA S.P.A. ITALIA CUTIE CU UN FLACON DIN STICLA BRUNA CONTINÂND GRANULE PENTRU 60 ML SUSPENSIE ORALA, ÎNSOTIT DE O MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML. PRF 1 15,096681 5,563319 7,548340 13,111660 13,587012 7,072988
40 W08631001 A07EA06 BUDESONIDUM ** # BUDENOFALK CAPS. GASTROREZ. 3mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ. P-RF 100 3,688500 0,000000 1,844250 1,844250 3,319650 0,368850
41 W61505003 A07EA06 BUDESONIDUM ** # CORTIMENT 9mg COMPR. ELIB. PREL. 9mg FERRING GMBH GERMANIA CUTIE CU BLIST. DIN PA-AL/PVC-AL X 30 COMPRIMATE ELIBERARE PRELUNGITA PRF 30 11,791755 3,142245 5,895877 9,038123 10,612579 4,321421
42 W58169003 A07EA06 BUDESONIDUM ** # BUDENOFALK UNO 9 mg GRANULE GASTROREZ. 9mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 30 PLICURI PET/AL/PEJD CU GRANULE GASTROREZ. PRF 30 11,791755 0,726245 5,895877 6,622123 10,612579 1,905421
43 W54445001 A07EA06 BUDESONIDUM ** # BUDENOFALK 2 mg/doza SPUMA RECTALA 2mg/doza DR. FALK PHARMA GMBH GERMANIA CUTIE X 1 FLAC. DIN AL X 14 DOZE X 1,2G SPUMA RECTALA, 14 APLICATOARE LUBREFIANTE PVC SI 14 PUNGI PL P-RF 1 319,940000 0,000000 159,970000 159,970000 287,946000 31,994000
44 W41577002 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS. P-RF 20 1,431875 0,691625 0,715937 1,407563 1,288687 0,834813
45 W63750001 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg BIOPROJET PHARMAFRANTA CUTIE CU 2 BLIST. X 10 CAPS. PRF 20 1,431875 0,691625 0,715937 1,407563 1,288687 0,834813
46 W41575002 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. ORALA 10mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 16 PLICURI X 1 G P-RF 16 1,431875 0,288750 0,715937 1,004688 1,288687 0,431938
47 W60148002 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. ORALA 30mg LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 3 G P-RF 16 1,431875 0,000000 0,715937 0,715938 1,288687 0,143188
48 W63749002 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. ORALA 30mg BIOPROJET PHARMAFRANTA CUTIE CU 16 PLICURI DIN HÂRTIE/AL/PE X 3 G PULB. ORALA PRF 16 1,431875 0,000000 0,715937 0,715938 1,288687 0,143188
49 W63610002 A08AB01 ORLISTATUM **1 XENICAL 120mg CAPS. 120mg CHEPLAPHARM ARZNEIMITTEL GMBH GERMANIA CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC)PRF 84 1,748809 0,000000 0,874404 0,874405 1,573928 0,174881
50 W00231001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 0,553666 0,066734 0,276833 0,343567 0,498299 0,122101
51 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 0,553666 0,252667 0,276833 0,529500 0,498299 0,308034
52 W44042001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF 30 1,107333 0,000000 0,553666 0,553667 0,996599 0,110734
53 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF 30 1,107333 0,086667 0,553666 0,640334 0,996599 0,197401
54 W52168003 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOCTACID 600 HR COMPR. FILM. 600mg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 100 COMPR. FILM. P-6L 100 1,941383 0,264717 0,970691 1,235409 1,747244 0,458856
55 W52168001 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOCTACID (R) 600 HR (vezi N07XN03) COMPR. FILM. 600mg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 30 COMPR. FILM.
P-6L 30 1,941383 0,426283 0,970691 1,396975 1,747244 0,620422
56 W60364001 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOSSEN 600 mg COMPR. FILM. 600mg AAA - PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 30 1,676666 0,000000 0,838333 0,838333 1,508999 0,167667
Pagina 1 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
57 W64296002 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # ACID TIOCTIC ROMPHARM 600 mg/24 mlSOL INJ. 600mg/24ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 25 ML X 24 ML SOL. INJ. PR/PRF 5 16,462000 0,000000 8,231000 8,231000 14,815800 1,646200
58 W53289002 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM) ** # THIOCTACID 600T (vezi N07XN03) SOL. INJ. 25mg/ml MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 5 FIOLE X 24 ML SOL.INJ. S/P-RF 5 16,462000 8,462000 8,231000 16,693000 14,815800 10,108200
59 W52808004 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 12,060000 0,000000 6,030000 6,030000 10,854000 1,206000
60 W64849001 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000UI/0,2ml PFIZER EUROPE MA EEIG BELGIA CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA PR/PRF 10 12,060000 0,000000 6,030000 6,030000 10,854000 1,206000
61 W62441002 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI anti-Xa/0,2ml SOL. INJ. 2000UI anti-Xa/0,2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,2 ML SOL INJ. PR/PRF 10 6,030000 0,671000 3,015000 3,686000 5,427000 1,274000
62 W63590002 B01AB05 ENOXAPARINUM ** # CLEXANE 2000 UI (20 mg)/0,2 ml SOL. INJ. 2000UI(20mg)/0,2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,2 ML SOL INJ. PR/PRF 10 6,030000 0,671000 3,015000 3,686000 5,427000 1,274000
63 W62442002 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI anti-Xa/0,4ml SOL. INJ. 4000UI anti-Xa/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,4 ML SOL INJ. PR/PRF 10 12,060000 0,096000 6,030000 6,126000 10,854000 1,302000
64 W63591002 B01AB05 ENOXAPARINUM ** # CLEXANE 4000 UI (40 mg)/0,4 ml SOL. INJ. 4000UI(40mg)/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,4 ML SOL INJ. PR/PRF 10 12,060000 0,096000 6,030000 6,126000 10,854000 1,302000
65 W63592002 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI (60 mg)/0,6 ml SOL. INJ. 6000UI(60mg)/0,6ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,6 ML SOL INJ. PR/PRF 10 15,626000 0,000000 7,813000 7,813000 14,063400 1,562600
66 W62443002 B01AB05 ENOXAPARINUM ** # CLEXANE 6000 UI anti-Xa/0,6ml SOL. INJ. 6000UIanti-Xa/0,6ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,6 ML SOL INJ. PR/PRF 10 15,626000 0,000000 7,813000 7,813000 14,063400 1,562600
67 W62444002 B01AB05 ENOXAPARINUM ** # CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 20,621666 0,000000 10,310833 10,310833 18,559499 2,062167
68 W63593002 B01AB05 ENOXAPARINUM ** # CLEXANE 8000 UI (80 mg)/0,8 ml SOL. INJ. 8000UI(80mg)/0,8ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ. PR/PRF 6 20,621666 0,000000 10,310833 10,310833 18,559499 2,062167
69 W61293001 B01AB06 NADROPARINUM ** # FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 8,039997 0,909003 4,019998 4,929002 7,235997 1,713003
70 W61291001 B01AB06 NADROPARINUM ** # FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 12,060000 1,326000 6,030000 7,356000 10,854000 2,532000
71 W61292001 B01AB06 NADROPARINUM ** # FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 16,079995 0,791005 8,039997 8,831003 14,471995 2,399005
72 W59473001 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT IN AURIU SI CAPSA DE SIGURANTA DIN PP DE CULOARE PORTOCALIE PR/PRF 10 34,457138 20,300862 17,228569 37,529431 31,011424 23,746576
73 W59475001 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE 20000 UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT CU LAC DE CULOARE VERDE SI CAPSA DE SIGURANTA DIN PP DE CULOARE VERDE INCHIS PR/PRF 10 68,914283 48,476717 34,457141 82,933859 62,022854 55,368146
74 W59472003 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 SERINGI PREUMPLUTE X 0.35 ML (3500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC VERDE PR/PRF 10 6,030000 6,823000 3,015000 9,838000 5,427000 7,426000
75 W59472004 B01AB10 TINZAPARINUM ** # INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 SERINGI PREUMPLUTE X 0.45 ML (4500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU PR/PRF 10 7,752855 2,020145 3,876427 5,896573 6,977569 2,795431
76 W59474001 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,50 ML (10000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ROSU PR/PRF 2 8,614283 29,945717 4,307141 34,252859 7,752854 30,807146
77 W59474002 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,70 ML (14000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC GALBEN PR/PRF 2 24,120000 28,445000 12,060000 40,505000 21,708000 30,857000
78 W59474003 B01AB10 TINZAPARINUM ** # INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,90 ML (18000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU PR/PRF 2 31,011427 31,303573 15,505713 46,809287 27,910284 34,404716
79 W05757002 B01AB11 SULODEXIDUM ** VESSEL DUE F CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. PVDC-PVC/AL-PVDC X 25 CAPS. MOI P-RF 50 2,078000 0,074200 1,039000 1,113200 1,870200 0,282000
80 W05757003 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P-RF 60 2,078000 0,000000 1,039000 1,039000 1,870200 0,207800
81 W60955001 B01AB11 SULODEXIDUM ** COREFLUX 250 ULS CAPS. MOI 250ULS SANIENCE S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. MOI PRF 50 1,732400 0,000000 0,866200 0,866200 1,559160 0,173240
82 W63737001 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVDC-PVC/AL-PVDC A CATE 25 CAPS. MOI P6L 50 2,078000 0,074200 1,039000 1,113200 1,870200 0,282000
83 W63737002 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P6L 60 2,078000 0,000000 1,039000 1,039000 1,870200 0,207800
84 W60954001 B01AB11 SULODEXIDUM ** COREFLUX 600 ULS/2 ml SOL INJ. 600ULS/2ml SANIENCE S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. PRF 10 6,605000 0,000000 3,302500 3,302500 5,944500 0,660500
85 W05758001 B01AB11 SULODEXIDUM ** VESSEL DUE F SOL. INJ. 600ULS/2ml ALFA WASSERMANN SPA ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML P-RF 10 7,425500 0,820500 3,712750 4,533250 6,682950 1,563050
86 W63736001 B01AB11 SULODEXIDUM ** VESSEL DUE F SOL. INJ. 600ULS/2ml ALFASIGMA S.P.A. ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML PRF 10 7,425500 0,820500 3,712750 4,533250 6,682950 1,563050
87 W54317002 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 COMPR. FILM. P-RF 30 0,611666 0,000000 0,305833 0,305833 0,550499 0,061167
88 W54317003 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 90 COMPR. FILM. P-RF 90 0,592000 0,000000 0,296000 0,296000 0,532800 0,059200
89 W54973001 B01AC04 CLOPIDOGRELUM ** TROGRAN 75 mg COMPR. FILM. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 1,100998 0,064359 0,550499 0,614858 0,990898 0,174459
90 W55445003 B01AC04 CLOPIDOGRELUM ** TESSYRON 75 mg COMPR. FILM. 75mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM. P-RF 30 0,725333 0,000000 0,362666 0,362667 0,652799 0,072534
91 W55972003 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL DR. REDDY'S 75 mg COMPR. FILM. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 1,100998 0,026668 0,550499 0,577167 0,990898 0,136768
92 W56912006 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 30 1,100998 0,026668 0,550499 0,577167 0,990898 0,136768
93 W57177005 B01AC04 CLOPIDOGRELUM ** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,604642 0,000000 0,302321 0,302321 0,544177 0,060465
94 W57992002 B01AC04 CLOPIDOGRELUM ** DEPLATT 75 mg COMPR. FILM. 75mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,968000 0,000000 0,484000 0,484000 0,871200 0,096800
95 W54317007 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 30 COMPRIMATE FILMATE P-RF 30 0,611666 0,000000 0,305833 0,305833 0,550499 0,061167
96 W54317009 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 90 COMPRIMATE FILMATE P-RF 90 0,592000 0,000000 0,296000 0,296000 0,532800 0,059200
97 W59687002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,625000 0,000000 0,312500 0,312500 0,562500 0,062500
98 W61520001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 1,100998 0,546859 0,550499 1,097358 0,990898 0,656959
99 W58717002 B01AC18 TRIFLUSALUM PLATROX 300 mg CAPS. 300 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 5 BLIST. AL-PVC/PVDC X 10 CAPS. PRF 50 0,550499 0,184301 0,275249 0,459551 0,495449 0,239351
100 W53412001 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 0,550499 0,184101 0,275249 0,459351 0,495449 0,239151
101 W52943002 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. (AL/AL) X 10 CAPS. (30X1 BLISTER PERFORAT UNIDOZA ) P-RF 30 5,718666 0,067000 2,859333 2,926333 5,146799 0,638867
102 W52943003 B01AE07 DABIGATRANUM ETEXILATUM ** PRADAXA 110mg CAPS. 110mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 6 BLIST. (AL/AL) X 10 CAPS. (60X1 BLISTER PERFORAT UNIDOZA ) P-RF 60 5,696333 0,000000 2,848166 2,848167 5,126699 0,569634
103 W60379002 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. P-RF 10 11,420000 0,623000 5,710000 6,333000 10,278000 1,765000
104 W60379003 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. P-RF 30 11,420000 0,000000 5,710000 5,710000 10,278000 1,142000
105 W63896002 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. PRF 10 11,420000 0,623000 5,710000 6,333000 10,278000 1,765000
106 W63896003 B01AF01 RIVAROXABANUM ** XARELTO 10mg COMPR. FILM. 10mg BAYER AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. PRF 30 11,420000 0,000000 5,710000 5,710000 10,278000 1,142000
107 W57283004 B01AF02 APIXABANUM ** ELIQUIS COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG MAREA BRITANIE CUTIE CU BLIST. PERFORATE DINPVC/PVDC/AL A 60 X 1 COMPR. FILM. PRF 60 5,619000 0,000000 2,809500 2,809500 5,057100 0,561900
108 W57283003 B01AF02 APIXABANUM ** ELIQUIS COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 5,619000 0,000000 2,809500 2,809500 5,057100 0,561900
109 W61204003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 2,5mg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 2,5mg/0,5ml IRLANDA
ASPEN PHARMA TRADING LIMITED P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA 10 19,705000 0,000000 9,852500 9,852500 17,734500 1,970500
110 W61202003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 7,5mg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 7,5mg/0,6ml IRLANDA
ASPEN PHARMA TRADING LIMITED P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE 10 51,805875 7,630125 25,902937 33,533063 46,625287 12,810713
111 W51230001 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 32,734000 0,000000 16,367000 16,367000 29,460600 3,273400
112 W63258002 C01EB17 IVABRADINUM ** IVABRADINE ZENTIVA 5 mg COMPR. FILM. 5 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 0,233876 0,575919 0,809795 1,036654 0,349060
113 W42777003 C01EB17 IVABRADINUM ** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 1,151838 0,735483 0,575919 1,311402 1,036654 0,850667
114 W62962004 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 0,234947 0,575919 0,810866 1,036654 0,350131
115 W62962014 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. P6L 56 1,151838 0,234947 0,575919 0,810866 1,036654 0,350131
116 W63479001 C01EB17 IVABRADINUM ** RAENOM 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 0,234947 0,575919 0,810866 1,036654 0,350131
117 W63443003 C01EB17 IVABRADINUM ** FELOCORD 5 mg COMPR. FILM. 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 1,553519 0,575919 2,129438 1,036654 1,668703
118 W63904002 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,151838 1,139054 0,575919 1,714973 1,036654 1,254238
119 W63775001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. PRF 56 1,151838 1,553519 0,575919 2,129438 1,036654 1,668703
Pagina 2 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
120 W42779003 C01EB17 IVABRADINUM ** CORLENTOR 7,5mg COMPR. FILM. 7,5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 1,727758 0,159563 0,863879 1,023442 1,554982 0,332339
121 W62963004 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,727758 0,020099 0,863879 0,883978 1,554982 0,192875
122 W62963014 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. P6L 56 1,727758 0,020099 0,863879 0,883978 1,554982 0,192875
123 W63259002 C01EB17 IVABRADINUM ** IVABRADINE ZENTIVA 7,5 mg COMPR. FILM. 7,5mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,585892 0,000000 0,792946 0,792946 1,427302 0,158590
124 W63480001 C01EB17 IVABRADINUM ** RAENOM 7,5 mg COMPR. FILM. 7,5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,727758 0,202777 0,863879 1,066656 1,554982 0,375553
125 W63444003 C01EB17 IVABRADINUM ** FELOCORD 7,5 mg COMPR. FILM. 7,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,727758 0,885277 0,863879 1,749156 1,554982 1,058053
126 W63905001 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 7,5 mg COMPR. FILM. 7,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,727758 0,772420 0,863879 1,636299 1,554982 0,945196
127 W63776001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. P6L 56 1,727758 0,885277 0,863879 1,749156 1,554982 1,058053
128 W62327003 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 mg COMPR. FILM. 0,2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,969839 0,166946 0,484919 0,651866 0,872855 0,263930
129 W62333003 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 mg COMPR. FILM. 0,4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 1,371428 0,000000 0,685714 0,685714 1,234285 0,137143
130 W05447001 C02AC06 RILMENIDINUM TENAXUM COMPR. 1mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 1,056000 0,000000 0,528000 0,528000 0,950400 0,105600
131 W42324004 C03DA04 EPLERENONUM * # INSPRA 25 mg COMPR. FILM. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 2,144749 1,272251 1,072374 2,344626 1,930274 1,486726
132 W42325004 C03DA04 EPLERENONUM * # INSPRA 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM. P-RF 30 3,441333 0,000000 1,720666 1,720667 3,097199 0,344134
133 W04501004 C07AB12 NEBIVOLOLUM NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,672857 0,000000 0,336428 0,336429 0,605571 0,067286
134 W52443005 C07AB12 NEBIVOLOLUM NEBIVOLOL ACTAVIS 5 mg COMPR. 5mg ACTAVIS S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,382666 0,000000 0,191333 0,191333 0,344399 0,038267
135 W53839001 C07AB12 NEBIVOLOLUM NOLET 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC- PE- PVDC/AL X 10 COMPR. P-6L 30 0,442333 0,000000 0,221166 0,221167 0,398099 0,044234
136 W55035003 C07AB12 NEBIVOLOLUM NEBINORM 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,199666 0,000000 0,099833 0,099833 0,179699 0,019967
137 W58211001 C07AB12 NEBIVOLOLUM NEBIVOLOL TORRENT 5 mg COMPR. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L 30 0,442333 0,000000 0,221166 0,221167 0,398099 0,044234
138 W64198003 C07AB12 NEBIVOLOLUM NEBIVOLOL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. P6L 30 0,438666 0,000000 0,219333 0,219333 0,394799 0,043867
139 W64800005 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVDC/AL X 10 COMPR. P6L 30 0,382666 0,000000 0,191333 0,191333 0,344399 0,038267
140 W57345001 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
141 W57345002 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
142 W57345003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg COMPR. FILM. 2,5mg/6,25mg MERCK KGAA GERMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,575333 0,000333 0,287666 0,288000 0,517799 0,057867
143 W57344001 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
144 W57344002 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 0,575333 0,000000 0,287666 0,287667 0,517799 0,057534
145 W57344003 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg COMPR. FILM. 5mg/6,25mg MERCK KGAA GERMANIA CUTIE CU 1 BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 0,575333 0,009667 0,287666 0,297334 0,517799 0,067201
146 W62093003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 25 mg/5 mg COMPR. FILM. 25mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,056919 0,004152 2,028459 2,032612 3,651227 0,409844
147 W62095003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 25 mg/7,5 mg COMPR. FILM. 25mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,056919 0,004152 2,028459 2,032612 3,651227 0,409844
148 W62094003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 50 mg/5 mg COMPR. FILM. 50mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,056919 0,004152 2,028459 2,032612 3,651227 0,409844
149 W62096003 C07FX05 COMBINATII (METOPROLOLUM+IVABRADINUM) ** IMPLICOR 50 mg/7,5 mg COMPR. FILM. 50mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 4,044464 0,000000 2,022232 2,022232 3,640017 0,404447
150 W03916002 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 0,278399 0,418386 0,139199 0,557586 0,250559 0,446226
151 W03916001 C08CA09 LACIDIPINUM LACIPIL 4 mg COMPR. FILM. 4mg GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L 14 0,278399 0,417315 0,139199 0,556515 0,250559 0,445155
152 W12827004 C08CA13 LERCANIDIPINUM LERIDIP COMPR. FILM. 10mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR.FILM. P-6L 60 0,278399 0,394767 0,139199 0,533967 0,250559 0,422607
153 W55999006 C08CA13 LERCANIDIPINUM LERPIN 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-6L 50 0,278399 0,173601 0,139199 0,312801 0,250559 0,201441
154 W43062014 C08CA13 LERCANIDIPINUM LERIDIP 20 COMPR. FILM. 20mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 0,556799 0,505534 0,278399 0,783934 0,501119 0,561214
155 W56001006 C08CA13 LERCANIDIPINUM LERPIN 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-6L 50 0,556799 0,158601 0,278399 0,437001 0,501119 0,214281
156 W54042001 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,313200 0,628800 0,156600 0,785400 0,281880 0,660120
157 W54042002 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313200 0,628800 0,156600 0,785400 0,281880 0,660120
158 W54194003 C09AA04 PERINDOPRILUM PRENESSA 4 mg COMPR. 4mg KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 0,313200 0,091466 0,156600 0,248066 0,281880 0,122786
159 W55290004 C09AA04 PERINDOPRILUM PRINDEX 4 mg COMPR. 4mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L 30 0,313200 0,102800 0,156600 0,259400 0,281880 0,134120
160 W61726001 C09AA04 PERINDOPRILUM ERNYOM 4 mg COMPR. 4mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,313200 0,227466 0,156600 0,384066 0,281880 0,258786
161 W54043001 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,626400 1,162933 0,313200 1,476133 0,563760 1,225573
162 W54043002 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,626400 1,162933 0,313200 1,476133 0,563760 1,225573
163 W55291004 C09AA04 PERINDOPRILUM PRINDEX 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU BLIST. AL/AL X 30 COMPR.
REPUBLICA CEHA P-6L 30 0,626400 0,030933 0,313200 0,344133 0,563760 0,093573
164 W58117004 C09AA04 PERINDOPRILUM PRENESSA 8 mg COMPR. 8mg KRKA POLSKA SP Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,626400 0,078933 0,313200 0,392133 0,563760 0,141573
165 W61727001 C09AA04 PERINDOPRILUM ERNYOM 8 mg COMPR. 8mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,626400 0,174266 0,313200 0,487466 0,563760 0,236906
166 W42663001 C09AA04 PERINDOPRILUM PRESTARIUM 10 mg COMPR. FILM. 10 mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,782999 0,290001 0,391499 0,681501 0,704699 0,368301
167 W59480001 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,782999 0,005334 0,391499 0,396834 0,704699 0,083634
168 W42664001 C09AA04 PERINDOPRILUM PRESTARIUM 5 mg COMPR. FILM. 5mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 0,391499 0,519501 0,195749 0,715251 0,352349 0,558651
169 W59479001 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 5 mg COMPR. FILM. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0,391499 0,285834 0,195749 0,481584 0,352349 0,324984
170 W62353001 C09AA10 TRANDOLAPRILUM GOPTEN® 0,5 mg CAPS. 0,5mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0,078300 0,286200 0,039150 0,325350 0,070470 0,294030
171 W62355001 C09AA10 TRANDOLAPRILUM GOPTEN® 2 mg CAPS. 2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,313200 0,327514 0,156600 0,484114 0,281880 0,358834
172 W62357001 C09AA10 TRANDOLAPRILUM GOPTEN® 4 mg CAPS. 4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0,626400 0,577171 0,313200 0,890371 0,563760 0,639811
173 W13178003 C09AA15 ZOFENOPRILUM ZOMEN (R) 30 mg COMPR. FILM. 30mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,313200 1,169300 0,156600 1,325900 0,281880 1,200620
174 W13177003 C09AA15 ZOFENOPRILUM ZOMEN (R) 7,5 mg COMPR. FILM. 7,5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,078300 0,690628 0,039150 0,729778 0,070470 0,698458
175 W56887001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 2 mg/0,625 mg COMPR. 2 mg/0,625mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L 30 0,589000 0,000000 0,294500 0,294500 0,530100 0,058900
176 W52394004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg COMPR. 2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,387666 0,000000 0,193833 0,193833 0,348899 0,038767
177 W57158001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) DANURIT 2 mg/0,625 mg COMPR. 2mg/0,625mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,589000 0,000000 0,294500 0,294500 0,530100 0,058900
178 W56888001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 4 mg/1,25mg COMPR. 4 mg/1,25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L 30 0,798666 0,000000 0,399333 0,399333 0,718799 0,079867
179 W52393004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg COMPR. 4mg/1,25mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,662666 0,000000 0,331333 0,331333 0,596399 0,066267
180 W57157001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) DANURIT 4 mg/1,25mg COMPR. 4mg/1,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,837333 0,000000 0,418666 0,418667 0,753599 0,083734
181 W56278004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg COMPR. 8mg/2,5mg KRKA-POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,889006 0,162327 0,444503 0,606830 0,800105 0,251228
182 W54255004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLITERAX 10 mg/2,5mg COMPR. FILM. 10mg/2,5mg LES LAB. SERVIER FRANTA CUTIE X 1 FLAC. DIN PP CU CAPAC PEJD CU SILICAGEL X 30 COMPR. FILM. P-6L 30 0,889006 0,264994 0,444503 0,709497 0,800105 0,353895
Pagina 3 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
183 W63520001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 10 mg/2,5 mg COMPR. FILM. 10mg/2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. X 30 COMPR. FILM. P6L 30 0,889006 0,313994 0,444503 0,758497 0,800105 0,402895
184 W52783004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG 2,5mg/0,625mg COMPR. FILM. 2,5mg/0,625mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 0,889006 0,183994 0,444503 0,628497 0,800105 0,272895
185 W60020001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 2,5 mg/0,625 mg COMPR. FILM. 2,5mg/0,625mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L 30 0,357333 0,000000 0,178666 0,178667 0,321599 0,035734
186 W52784004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG FORTE 5mg/1,25mg COMPR. FILM. 5mg/1,25mg LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. P-6L 30 0,889006 0,184327 0,444503 0,628830 0,800105 0,273228
187 W60021001 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 5 mg/1,25 mg COMPR. FILM. 5mg/1,25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L 30 0,628000 0,000000 0,314000 0,314000 0,565200 0,062800
188 W43136001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE COMPR. FILM. 10mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,565333 0,000000 0,282666 0,282667 0,508799 0,056534
189 W64843001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE COMPR. FILM. 10mg/12,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,565333 0,000000 0,282666 0,282667 0,508799 0,056534
190 W43137001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE FORTE COMPR. FILM. 20mg/12,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,889006 0,129327 0,444503 0,573830 0,800105 0,218228
191 W64844001 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM) ACCUZIDE FORTE COMPR. FILM. 20mg/12,5mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 3 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. P-6L 30 0,889006 0,129327 0,444503 0,573830 0,800105 0,218228
192 W53990002 C09BB02 COMBINATII (NITRENDIPINUM+ENALAPRILUM) ENEAS COMPR. 20mg+10mg GALENICA S.A. GRECIA CUTIE X 3 BLIST. PA-PVC-AL/AL X 10 COMPR. P-6L 30 3,083000 0,000000 1,541500 1,541500 2,774700 0,308300
193 W58750001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 4 mg/ 10 mg COMPR. 4mg/10 mg GEDEON RICHTER ROMÂNIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,754649 0,011684 0,377324 0,389009 0,679184 0,087149
194 W57913007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/10 mg COMPR. 4mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,738666 0,000000 0,369333 0,369333 0,664799 0,073867
195 W64004001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 4 mg/10 mg COMPR. 4mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,743666 0,000000 0,371833 0,371833 0,669299 0,074367
196 W57912007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/5 mg COMPR. 4mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,485132 0,100534 0,242566 0,343100 0,436618 0,149048
197 W58748001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 4 mg/ 5 mg COMPR. 4mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,485132 0,129201 0,242566 0,371767 0,436618 0,177715
198 W64003001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 4 mg/5 mg COMPR. 4mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,485132 0,169868 0,242566 0,412434 0,436618 0,218382
199 W57915007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/10 mg COMPR. 8mg/10mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,970264 0,145736 0,485132 0,630868 0,873237 0,242763
200 W58751001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 8 mg/ 10 mg COMPR. 8mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,970264 0,181736 0,485132 0,666868 0,873237 0,278763
201 W64006001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 8 mg/10 mg COMPR. 8mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,970264 0,138736 0,485132 0,623868 0,873237 0,235763
202 W57914007 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/5 mg COMPR. 8mg/5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,700746 0,197587 0,350373 0,547960 0,630671 0,267662
203 W58749001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) BEATIL 8 mg/ 5 mg COMPR. 8mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L 30 0,700746 0,242254 0,350373 0,592627 0,630671 0,312329
204 W64005001 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM) PERINDOPRIL/AMLODIPINA ZENTIVA 8 mg/5 mg COMPR. 8mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. A/AL (OPA-AL-PVC/AL) X 30 COMPR. P6L 30 0,700746 0,172920 0,350373 0,523293 0,630671 0,242995
205 W62329002 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg COMPR. CU ELIB. MODIF. 240mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,949642 0,213929 0,974821 1,188750 1,754677 0,408894
206 W62331002 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg COMPR. CU ELIB. MODIF. 240mg/4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 1,949642 0,637143 0,974821 1,611964 1,754677 0,832108
207 W62349001 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA COMPR. ELIB. MOD. 180mg/2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. ELIB. MODIF. P-6L 28 1,735714 0,000000 0,867857 0,867857 1,562142 0,173572
208 W60513005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 4mg/10mg/1,25mg COMPR. 4mg/10mg/1,25mgKRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,977000 0,000000 0,488500 0,488500 0,879300 0,097700
209 W60512005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 4 mg/5mg/1,25 mg COMPR. 4mg/5mg/1,25mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,775029 0,141637 0,387514 0,529152 0,697526 0,219140
210 W60515005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 8 mg/10 mg/2,5 mg COMPR. 8mg/10mg/2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 1,318666 0,000000 0,659333 0,659333 1,186799 0,131867
211 W60514005 C09BX01 COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM) CO-AMLESSA 8 mg/5 mg/2,5 mg COMPR. 8mg/5mg/2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 1,145976 0,057024 0,572988 0,630012 1,031378 0,171622
212 W61004001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 10mg/2,5mg/10mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,558948 0,544385 0,779474 1,323859 1,403053 0,700280
213 W61003001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 10mg/2,5mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,154865 0,746801 0,577432 1,324234 1,039378 0,862288
214 W61002001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 5mg/1,25mg/10mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 1,183556 0,322110 0,591778 0,913888 1,065200 0,440466
215 W61001001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 5mg/1,25mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM. P6L 30 0,779473 0,597193 0,389736 0,986930 0,701525 0,675141
216 W56930003 C09CA03 VALSARTANUM DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 1,362213 0,231715 0,681106 0,912822 1,225991 0,367937
217 W57790002 C09CA03 VALSARTANUM AVASSAN 160 mg COMPR. FILM. 160mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,127500 0,000000 0,563750 0,563750 1,014750 0,112750
218 W57676003 C09CA03 VALSARTANUM VALSARTAN TORRENT 160 mg COMPR. FILM. 160mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,486938 0,000000 0,243469 0,243469 0,438244 0,048694
219 W58146002 C09CA03 VALSARTANUM VALSARTAN ZENTIVA 160 mg COMPR. FILM. 160mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM. P-6L 28 0,591428 0,000000 0,295714 0,295714 0,532285 0,059143
220 W58950003 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,750714 0,000000 0,375357 0,375357 0,675642 0,075072
221 W58950013 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,750714 0,000000 0,375357 0,375357 0,675642 0,075072
222 W56929003 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L 28 0,340553 2,227661 0,170276 2,397938 0,306497 2,261717
223 W57789002 C09CA03 VALSARTANUM AVASSAN 40 mg COMPR. FILM. 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,340553 1,323018 0,170276 1,493295 0,306497 1,357074
224 W58948003 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,340553 0,090161 0,170276 0,260438 0,306497 0,124217
225 W58948013 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,340553 0,090161 0,170276 0,260438 0,306497 0,124217
226 W56931003 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 0,681106 0,513894 0,340553 0,854447 0,612995 0,582005
227 W57675003 C09CA03 VALSARTANUM VALSARTAN TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L 98 0,308367 0,000000 0,154183 0,154184 0,277530 0,030837
228 W58145002 C09CA03 VALSARTANUM VALSARTAN ZENTIVA 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM. P-6L 28 0,550714 0,000000 0,275357 0,275357 0,495642 0,055072
229 W58949003 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,402142 0,000000 0,201071 0,201071 0,361927 0,040215
230 W58949013 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,402142 0,000000 0,201071 0,201071 0,361927 0,040215
231 W55631001 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA P-6L
CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) 1 4,086639 20,793361 2,043319 22,836681 3,677975 21,202025
232 W59429005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,388571 0,000000 0,194285 0,194286 0,349713 0,038858
233 W59430005 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,543571 0,000000 0,271785 0,271786 0,489213 0,054358
234 W54081003 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,681106 0,144251 0,340553 0,484804 0,612995 0,212362
235 W55941002 C09CA04 IRBESARTANUM IFIRMASTA 150 mg COMPR. FILM. 150mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,566428 0,000000 0,283214 0,283214 0,509785 0,056643
236 W59580002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,596071 0,000000 0,298035 0,298036 0,536463 0,059608
237 W60637002 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,681106 0,524608 0,340553 0,865161 0,612995 0,592719
238 W63000003 C09CA04 IRBESARTANUM IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,629642 0,000000 0,314821 0,314821 0,566677 0,062965
239 W63001003 C09CA04 IRBESARTANUM IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 0,855714 0,000000 0,427857 0,427857 0,770142 0,085572
240 W54082003 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 300 mg COMPR. FILM. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 1,132500 0,000000 0,566250 0,566250 1,019250 0,113250
241 W55942002 C09CA04 IRBESARTANUM IFIRMASTA 300mg COMPR. FILM. 300mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,855714 0,000000 0,427857 0,427857 0,770142 0,085572
242 W59581002 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL)P-6L 28 0,932857 0,000000 0,466428 0,466429 0,839571 0,093286
243 W60638002 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.P-6L 28 1,362213 0,238501 0,681106 0,919608 1,225991 0,374723
244 W55622005 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 1,118571 0,000000 0,559285 0,559286 1,006713 0,111858
245 W54889004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P-6L 28 0,532142 0,000000 0,266071 0,266071 0,478927 0,053215
Pagina 4 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
246 W55592003 C09CA06 CANDESARTANUM CILEXETIL KARBIS 16 mg COMPR. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,769000 0,000000 0,384500 0,384500 0,692100 0,076900
247 W58808002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,362213 0,068144 0,681106 0,749251 1,225991 0,204366
248 W58874004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,784333 0,000000 0,392166 0,392167 0,705899 0,078434
249 W59606002 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN LABORMED 16 mg COMPR. 16mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR. P6L 28 1,118571 0,000000 0,559285 0,559286 1,006713 0,111858
250 W60125003 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,706666 0,000000 0,353333 0,353333 0,635999 0,070667
251 W61496002 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 16 mg COMPR. 16mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 1,118666 0,000000 0,559333 0,559333 1,006799 0,111867
252 W61638001 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN VIM SPECTRUM 16 mg COMPR. 16mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,912500 0,000000 0,456250 0,456250 0,821250 0,091250
253 W62724001 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN ATB 16 mg COMPR. 16mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,730333 0,000000 0,365166 0,365167 0,657299 0,073034
254 W58252021 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN MYLAN 16 mg COMPR. 16mg GENERICS (UK) LTD.MAREA BRITANIE CUTIE CU BLISTERE DIN PVC/AL X 30 COMPRIMATE P6L 30 0,864333 0,000000 0,432166 0,432167 0,777899 0,086434
255 W55593003 C09CA06 CANDESARTANUM CILEXETIL KARBIS 32 mg COMPR. 32mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 1,379333 0,000000 0,689666 0,689667 1,241399 0,137934
256 W58806001 C09CA06 CANDESARTANUM CILEXETIL ATACAND 32 mg COMPR. 32mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 1,848928 0,000000 0,924464 0,924464 1,664035 0,184893
257 W58875004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,993666 0,000000 0,496833 0,496833 0,894299 0,099367
258 W61497002 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 32 mg COMPR. 32mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 1,526000 0,000000 0,763000 0,763000 1,373400 0,152600
259 W61640001 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN VIM SPECTRUM 32 mg COMPR. 32mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 1,014285 0,000000 0,507142 0,507143 0,912856 0,101429
260 W64539008 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 32 mg COMPR. 32mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P6L 28 1,472500 0,000000 0,736250 0,736250 1,325250 0,147250
261 W55621005 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 8 mg COMPR. 8mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.P-6L 28 0,558928 0,000000 0,279464 0,279464 0,503035 0,055893
262 W54885004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P-6L 28 0,381428 0,000000 0,190714 0,190714 0,343285 0,038143
263 W55591003 C09CA06 CANDESARTANUM CILEXETIL KARBIS 8 mg COMPR. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,557333 0,000000 0,278666 0,278667 0,501599 0,055734
264 W58807002 C09CA06 CANDESARTANUM CILEXETIL ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,681106 0,179608 0,340553 0,520161 0,612995 0,247719
265 W58873004 C09CA06 CANDESARTANUM CILEXETIL CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,551666 0,000000 0,275833 0,275833 0,496499 0,055167
266 W59607002 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN LABORMED 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L 28 0,558571 0,000000 0,279285 0,279286 0,502713 0,055858
267 W60124003 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,516333 0,000000 0,258166 0,258167 0,464699 0,051634
268 W61495004 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL MCC 8 mg COMPR. 8mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,559333 0,000000 0,279666 0,279667 0,503399 0,055934
269 W61636001 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN VIM SPECTRUM 8 mg COMPR. 8mg S.C.VIM SPECTRUM S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,558928 0,000000 0,279464 0,279464 0,503035 0,055893
270 W62723001 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN ATB 8 mg COMPR. 8mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 COMPR. P6L 30 0,558666 0,000000 0,279333 0,279333 0,502799 0,055867
271 W58251021 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN MYLAN 8 mg COMPR. 8mg GENERICS (UK) LTD.MAREA BRITANIE CUTIE CU BLISTERE DIN PVC/AL X 30 COMPRIMATE P6L 30 0,476666 0,000000 0,238333 0,238333 0,428999 0,047667
272 W56746002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 40mg COMPR. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 0,553571 0,000000 0,276785 0,276786 0,498213 0,055358
273 W55585002 C09CA07 TELMISARTANUM TOLURA 40 mg COMPR. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,605357 0,000000 0,302678 0,302679 0,544821 0,060536
274 W55534001 C09CA07 TELMISARTANUM TEZEO 40 mg COMPR. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,621000 0,000000 0,310500 0,310500 0,558900 0,062100
275 W58256003 C09CA07 TELMISARTANUM TELMISARTAN MYLAN 40 mg COMPR. 40mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. OPA-AL/PVC/AL X 30 COMPR. P6L 30 0,490333 0,000000 0,245166 0,245167 0,441299 0,049034
276 W59495002 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 40 mg COMPR. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR. P6L 56 0,681106 0,023001 0,340553 0,363554 0,612995 0,091112
277 W56747002 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 80mg COMPR. 80 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,747857 0,000000 0,373928 0,373929 0,673071 0,074786
278 W05785002 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 1,362213 0,085644 0,681106 0,766751 1,225991 0,221866
279 W55586002 C09CA07 TELMISARTANUM TOLURA 80 mg COMPR. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,840714 0,000000 0,420357 0,420357 0,756642 0,084072
280 W55535001 C09CA07 TELMISARTANUM TEZEO 80 mg COMPR. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,788333 0,000000 0,394166 0,394167 0,709499 0,078834
281 W58257003 C09CA07 TELMISARTANUM TELMISARTAN MYLAN 80 mg COMPR. 80mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. OPA-AL/PVC/AL X 30 COMPR. P6L 30 0,750333 0,000000 0,375166 0,375167 0,675299 0,075034
282 W59401002 C09CA07 TELMISARTANUM TELMISARTAN RANBAXY 80 mg COMPR. 80mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. P6L 28 1,028571 0,000000 0,514285 0,514286 0,925713 0,102858
283 W59496002 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 80 mg COMPR. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR. P6L 56 0,918571 0,000000 0,459285 0,459286 0,826713 0,091858
284 W57129003 C09CA07 TELMISARTANUM TELMARK 40 mg COMPR. FILM. 40mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,624642 0,000000 0,312321 0,312321 0,562177 0,062465
285 W57130003 C09CA07 TELMISARTANUM TELMARK 80 mg COMPR. FILM. 80mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 0,793928 0,000000 0,396964 0,396964 0,714535 0,079393
286 W56252005 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA HL 100 mg/12,5 mg COMPR.FILM 100mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,651071 0,000000 0,325535 0,325536 0,585963 0,065108
287 W43460003 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA H COMPR.FILM50mg+ 12,50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,479285 0,000000 0,239642 0,239643 0,431356 0,047929
288 W57669001 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 160 mg/12,5 mg COMPR. FILM. 160mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,499818 0,349912 0,849730 0,629841 0,569801
289 W57668001 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 80 mg/12,5 mg COMPR. FILM. 80mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,301604 0,349912 0,651516 0,629841 0,371587
290 W07646001 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. 150mg/12,5mg FRANTA
SANOFI PHARMA - BRISTOL MYERS SQUIBB CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,699824 0,509461 0,349912 0,859373 0,629841 0,579444
291 W07647001 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. 300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,699824 0,827676 0,349912 1,177588 0,629841 0,897659
292 W59584002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,643214 0,000000 0,321607 0,321607 0,578892 0,064322
293 W59585002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 0,699824 0,325890 0,349912 0,675802 0,629841 0,395873
294 W60639002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. FILM. 150mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,699824 0,509461 0,349912 0,859373 0,629841 0,579444
295 W61154002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,111961 0,349912 0,461873 0,629841 0,181944
296 W61154011 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,111961 0,349912 0,461873 0,629841 0,181944
297 W60640002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg COMPR. FILM. 300mg/12,5mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,699824 0,827676 0,349912 1,177588 0,629841 0,897659
298 W61158002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,213747 0,349912 0,563659 0,629841 0,283730
299 W61158011 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,213747 0,349912 0,563659 0,629841 0,283730
300 W60641002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg COMPR. FILM. 300mg/25mg SANOFI CLIR SNC FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,699824 0,829461 0,349912 1,179373 0,629841 0,899444
301 W61159002 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,180176 0,349912 0,530088 0,629841 0,250159
302 W61159011 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg COMPR. FILM. 300mg/25mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,699824 0,180176 0,349912 0,530088 0,629841 0,250159
303 W57991006 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN HIDROCLOROTIAZIDA TORRENT 16 mg/12,5 mg COMPR. 16mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR.
P6L 56 0,675178 0,000000 0,337589 0,337589 0,607660 0,067518
304 W58871004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 16mg/12,5mg COMPR. 16mg/12,5mgZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,699824 0,074176 0,349912 0,424088 0,629841 0,144159
305 W57535004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 8 mg/12,5 mg COMPR. 8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIT. PVC-PVDC/AL X 30 COMPR. P6L 30 0,463333 0,000000 0,231666 0,231667 0,416999 0,046334
306 W57535013 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) KARBICOMBI 8 mg/12,5 mg COMPR. 8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,463333 0,000000 0,231666 0,231667 0,416999 0,046334
307 W58870004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 8mg/12,5mg COMPR. 8mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,464666 0,000000 0,232333 0,232333 0,418199 0,046467
308 W59718002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/12,5 mg COMPR. 80 mg/12,5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,699824 0,424818 0,349912 0,774730 0,629841 0,494801
Pagina 5 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
309 W59819005 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/12,5mg COMPR. 80 mg/12,5mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
310 W59820005 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TOLUCOMBI 80 mg/25mg COMPR. 80 mg/25mg KRKA D.D. SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE PRF 30 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
311 W59719001 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) ACTELSAR HCT 80 mg/25mg COMPR. 80 mg/25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF 28 0,699824 0,450176 0,349912 0,800088 0,629841 0,520159
312 W12033002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/12,5mg COMPR. 80/12,5mg GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 28 0,699824 0,936247 0,349912 1,286159 0,629841 1,006230
313 W53178002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/25mg COMPR. 80/25mg GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-6L 28 0,699824 1,013390 0,349912 1,363302 0,629841 1,083373
314 W59921007 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg COMPR. 80mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
315 W59921008 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg COMPR. 80mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/PVC/PVDC X 30 COMPR. P6L 30 0,699824 0,088509 0,349912 0,438421 0,629841 0,158492
316 W60206003 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/12,5 mg COMPR. 80mg/12,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,699824 0,027509 0,349912 0,377421 0,629841 0,097492
317 W60248003 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMARK PLUS 80mg/12,5mg COMPR. 80mg/12,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE P-6L 30 0,699824 0,418176 0,349912 0,768088 0,629841 0,488159
318 W60207003 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TEZEO HCT 80 mg/25 mg COMPR. 80mg/25mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,699824 0,304176 0,349912 0,654088 0,629841 0,374159
319 W60249003 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMARK PLUS 80mg/25mg COMPR. 80mg/25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE P-6L 30 0,699824 0,419842 0,349912 0,769754 0,629841 0,489825
320 W51851005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 2,586428 0,608214 1,293214 1,901428 2,327785 0,866857
321 W64723005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 2,586428 0,608214 1,293214 1,901428 2,327785 0,866857
322 W51852005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 2,510356 0,493394 1,255178 1,748572 2,259320 0,744430
323 W64722005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 2,510356 0,493394 1,255178 1,748572 2,259320 0,744430
324 W51853005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L 56 1,293214 1,900714 0,646607 2,547321 1,163892 2,030036
325 W64721005 C09DB01 COMBINATII (AMLODIPINUM+VALSARTANUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P6L 56 1,293214 1,900714 0,646607 2,547321 1,163892 2,030036
326 W53445002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 20 mg/5 mg COMPR. FILM. 20mg/5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 1,293214 0,508928 0,646607 1,155535 1,163892 0,638250
327 W57427002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 20 mg/5 mg COMPR. FILM. 20mg/5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 2,146428 0,646607 2,793035 1,163892 2,275750
328 W64084002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 20 mg/5 mg COMPR. FILM. 20mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 1,042500 0,646607 1,689107 1,163892 1,171822
329 W64151010 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 28X1 COMPR. FILM. P6L 28 1,293214 0,952143 0,646607 1,598750 1,163892 1,081465
330 W64151011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 30X1 COMPR. FILM. P6L 30 1,293214 0,877119 0,646607 1,523726 1,163892 1,006441
331 W64151002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 0,952143 0,646607 1,598750 1,163892 1,081465
332 W64245001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 1,042500 0,646607 1,689107 1,163892 1,171822
333 W64151003 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 20 mg/5 mg COMPR. FILM. 20mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,293214 0,877119 0,646607 1,523726 1,163892 1,006441
334 W64245006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 1,042500 0,646607 1,689107 1,163892 1,171822
335 W64426002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 20 mg/5 mg COMPR. FILM. 20mg/5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,293214 2,146428 0,646607 2,793035 1,163892 2,275750
336 W53447002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/10 mg COMPR. FILM. 40mg/10mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 2,386428 0,000000 1,193214 1,193214 2,147785 0,238643
337 W57425002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/10 mg COMPR. FILM. 40mg/10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,586428 1,183929 1,293214 2,477143 2,327785 1,442572
338 W64086002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 40 mg/10 mg COMPR. FILM. 40mg/10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,560000 0,000000 1,280000 1,280000 2,304000 0,256000
339 W64153010 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 28X1 COMPR. FILM. P6L 28 2,555000 0,000000 1,277500 1,277500 2,299500 0,255500
340 W64153011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 30X1 COMPR. FILM. P6L 30 2,555333 0,000000 1,277666 1,277667 2,299799 0,255534
341 W64153002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,555000 0,000000 1,277500 1,277500 2,299500 0,255500
342 W64247001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,560000 0,000000 1,280000 1,280000 2,304000 0,256000
343 W64153003 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/10 mg COMPR. FILM. 40mg/10mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 2,555333 0,000000 1,277666 1,277667 2,299799 0,255534
344 W64247006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/10 mg COMPR. FILM. 40mg/10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,560000 0,000000 1,280000 1,280000 2,304000 0,256000
345 W64428002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/10 mg COMPR. FILM. 40mg/10mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,586428 1,183929 1,293214 2,477143 2,327785 1,442572
346 W53446002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM INOVUM 40 mg/5 mg COMPR. FILM. 40mg/5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBOURG CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 2,288214 0,000000 1,144107 1,144107 2,059392 0,228822
347 W57426002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/5 mg COMPR. FILM. 40mg/5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 1,111857 1,163892 2,275750 2,095006 1,344636
348 W64085002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ZENTIVA 40 mg/5 mg COMPR. FILM. 40mg/5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,007929 1,163892 1,171822 2,095006 0,240708
349 W64152010 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 28X1 COMPR. FILM. P6L 28 2,327785 0,044715 1,163892 1,208608 2,095006 0,277494
350 W64152011 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI OPA-AL-PVC/AL X 30X1 COMPR. FILM. P6L 30 2,327785 0,044881 1,163892 1,208774 2,095006 0,277660
351 W64152002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,044715 1,163892 1,208608 2,095006 0,277494
352 W64246001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,007929 1,163892 1,171822 2,095006 0,240708
353 W64152003 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLSSA 40 mg/5 mg COMPR. FILM. 40mg/5mg HCS BVBA BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 2,327785 0,044881 1,163892 1,208774 2,095006 0,277660
354 W64246006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 40 mg/5 mg COMPR. FILM. 40mg/5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 0,007929 1,163892 1,171822 2,095006 0,240708
355 W64427002 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM SEVIKAR 40 mg/5 mg COMPR. FILM. 40mg/5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,327785 1,111857 1,163892 2,275750 2,095006 1,344636
356 W57234002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,140249 0,346536 1,570124 1,916661 2,826224 0,660561
357 W64768002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,148854 0,337931 1,574427 1,912358 2,833968 0,652817
358 W57236002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,355336 0,193235 1,677668 1,870903 3,019802 0,528769
359 W64769002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 10mg/160mg/25 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,355336 0,193235 1,677668 1,870903 3,019802 0,528769
360 W57233002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,054216 0,057569 1,527108 1,584677 2,748794 0,362991
361 W64770002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,062818 0,048967 1,531409 1,580376 2,756536 0,355249
362 W57235002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,112500 0,000000 1,556250 1,556250 2,801250 0,311250
363 W64771002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 3,112500 0,000000 1,556250 1,556250 2,801250 0,311250
364 W51412001 C10AA04 FLUVASTATINUM LESCOL XL 80 mg COMPR. ELIB. PREL. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 (4X7) COMPR. ELIB. PREL. P-6L 28 0,773199 0,243229 0,386599 0,629829 0,695879 0,320549
365 W12893001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 0,289949 0,607384 0,144974 0,752359 0,260954 0,636379
366 W54696007 C10AA05 ATORVASTATINUM ATORIS 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,289949 0,075717 0,144974 0,220692 0,260954 0,104712
367 W55516003 C10AA05 ATORVASTATINUM ASCORD 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,289949 0,454384 0,144974 0,599359 0,260954 0,483379
368 W59346005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 10 mg COMPR. FILM. 10mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,234333 0,000000 0,117166 0,117167 0,210899 0,023434
369 W59408001 C10AA05 ATORVASTATINUM STAVRA 10 mg COMPR. FILM. 10mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,289949 0,104384 0,144974 0,249359 0,260954 0,133379
370 W57297016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,289949 0,061717 0,144974 0,206692 0,260954 0,090712
371 W61225003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,136000 0,000000 0,068000 0,068000 0,122400 0,013600
Pagina 6 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
372 W62152005 C10AA05 ATORVASTATINUM TORVACARD 10 mg COMPR. FILM. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,289949 0,001717 0,144974 0,146692 0,260954 0,030712
373 W64099007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,136000 0,000000 0,068000 0,068000 0,122400 0,013600
374 W64877001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,289949 0,607384 0,144974 0,752359 0,260954 0,636379
375 W12894001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 0,579899 0,592767 0,289949 0,882717 0,521909 0,650757
376 W54697007 C10AA05 ATORVASTATINUM ATORIS 20 mg COMPR. FILM. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,501333 0,000000 0,250666 0,250667 0,451199 0,050134
377 W55517003 C10AA05 ATORVASTATINUM ASCORD 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,579899 0,386767 0,289949 0,676717 0,521909 0,444757
378 W59347005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 20 mg COMPR. FILM. 20mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,281333 0,000000 0,140666 0,140667 0,253199 0,028134
379 W59409001 C10AA05 ATORVASTATINUM STAVRA 20 mg COMPR. FILM. 20mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,537666 0,000000 0,268833 0,268833 0,483899 0,053767
380 W57298016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 20 mg COMPR. FILM. 20mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,322000 0,000000 0,161000 0,161000 0,289800 0,032200
381 W61226003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,281000 0,000000 0,140500 0,140500 0,252900 0,028100
382 W62153005 C10AA05 ATORVASTATINUM TORVACARD 20 mg COMPR. FILM. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,430333 0,000000 0,215166 0,215167 0,387299 0,043034
383 W64100007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,265666 0,000000 0,132833 0,132833 0,239099 0,026567
384 W64878001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,579899 0,592767 0,289949 0,882717 0,521909 0,650757
385 W57506007 C10AA05 ATORVASTATINUM ATORIS 30 mg COMPR. FILM. 30mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,640333 0,000000 0,320166 0,320167 0,576299 0,064034
386 W12895001 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. P-6L 14 1,159799 0,168772 0,579899 0,748672 1,043819 0,284752
387 W54698004 C10AA05 ATORVASTATINUM ATORIS 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 14 COMPR.FILM. P-6L 14 1,086428 0,000000 0,543214 0,543214 0,977785 0,108643
388 W54698007 C10AA05 ATORVASTATINUM ATORIS 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,681000 0,000000 0,340500 0,340500 0,612900 0,068100
389 W55518003 C10AA05 ATORVASTATINUM ASCORD 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 1,123666 0,000000 0,561833 0,561833 1,011299 0,112367
390 W59348005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 40 mg COMPR. FILM. 40mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,109000 0,000000 0,554500 0,554500 0,998100 0,110900
391 W59410001 C10AA05 ATORVASTATINUM STAVRA 40 mg COMPR. FILM. 40mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,908000 0,000000 0,454000 0,454000 0,817200 0,090800
392 W57299016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 40 mg COMPR. FILM. 40mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,644666 0,000000 0,322333 0,322333 0,580199 0,064467
393 W61227003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,483333 0,000000 0,241666 0,241667 0,434999 0,048334
394 W62154005 C10AA05 ATORVASTATINUM TORVACARD 40 mg COMPR. FILM. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,667333 0,000000 0,333666 0,333667 0,600599 0,066734
395 W64101007 C10AA05 ATORVASTATINUM ATORVASTATINA ACCORD 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,559333 0,000000 0,279666 0,279667 0,503399 0,055934
396 W61227016 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,483333 0,000000 0,241666 0,241667 0,434999 0,048334
397 W57507007 C10AA05 ATORVASTATINUM ATORIS 60 mg COMPR. FILM. 60mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,054333 0,000000 0,527166 0,527167 0,948899 0,105434
398 W12897001 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. P-6L 14 1,101428 0,000000 0,550714 0,550714 0,991285 0,110143
399 W55519003 C10AA05 ATORVASTATINUM ASCORD 80 mg COMPR. FILM. 80mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 1,111333 0,000000 0,555666 0,555667 1,000199 0,111134
400 W57508007 C10AA05 ATORVASTATINUM ATORIS 80 mg COMPR. FILM. 80mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,071333 0,000000 0,535666 0,535667 0,964199 0,107134
401 W59349005 C10AA05 ATORVASTATINUM ATORVASTATIN RANBAXY 80 mg COMPR. FILM. 80mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,111333 0,000000 0,555666 0,555667 1,000199 0,111134
402 W59411001 C10AA05 ATORVASTATINUM STAVRA 80 mg COMPR. FILM. 80mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 1,111000 0,000000 0,555500 0,555500 0,999900 0,111100
403 W57300016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 80 mg COMPR. FILM. 80mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,093333 0,000000 0,546666 0,546667 0,983999 0,109334
404 W61228003 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,775666 0,000000 0,387833 0,387833 0,698099 0,077567
405 W62155005 C10AA05 ATORVASTATINUM TORVACARD 80 mg COMPR. FILM. 80mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,111333 0,000000 0,555666 0,555667 1,000199 0,111134
406 W61228013 C10AA05 ATORVASTATINUM ATORVASTATINA AUROBINDO 80 mg COMPR. FILM. 80mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. FILM. P6L 30 0,775666 0,000000 0,387833 0,387833 0,698099 0,077567
407 W57308006 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBHGERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,408666 0,000000 0,204333 0,204333 0,367799 0,040867
408 W13864001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 0,579899 2,746529 0,289949 3,036479 0,521909 2,804519
409 W55327002 C10AA07 ROSUVASTATINUM ROSUCARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,579899 0,077434 0,289949 0,367384 0,521909 0,135424
410 W57059005 C10AA07 ROSUVASTATINUM ROSWERA 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,579899 0,065767 0,289949 0,355717 0,521909 0,123757
411 W55990002 C10AA07 ROSUVASTATINUM ROSTAT 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,579899 0,211434 0,289949 0,501384 0,521909 0,269424
412 W59899004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,579899 0,727958 0,289949 1,017908 0,521909 0,785948
413 W59899017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,579899 0,727958 0,289949 1,017908 0,521909 0,785948
414 W59657004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,406333 0,000000 0,203166 0,203167 0,365699 0,040634
415 W60392003 C10AA07 ROSUVASTATINUM ROVASTAMED 10mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,377500 0,000000 0,188750 0,188750 0,339750 0,037750
416 W61054001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,579899 0,312767 0,289949 0,602717 0,521909 0,370757
417 W62399023 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,579899 0,016434 0,289949 0,306384 0,521909 0,074424
418 W62948004 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTD T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-POLIAMIDA/AL/PEJD DESICANT/PEID X 30 COMPR. FILM. P6L 30 0,308666 0,000000 0,154333 0,154333 0,277799 0,030867
419 W62948019 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTD. T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-OPA/AL/PVC X 30 COMPR. FILM. P6L 30 0,308666 0,000000 0,154333 0,154333 0,277799 0,030867
420 W64682002 C10AA07 ROSUVASTATINUM ROSI 10 mg COMPR. FILM. 10mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,579899 1,617767 0,289949 1,907717 0,521909 1,675757
421 W57309006 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBHGERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,810333 0,000000 0,405166 0,405167 0,729299 0,081034
422 W13865001 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 1,159799 3,705201 0,579899 4,285101 1,043819 3,821181
423 W55328002 C10AA07 ROSUVASTATINUM ROSUCARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,920333 0,000000 0,460166 0,460167 0,828299 0,092034
424 W57061005 C10AA07 ROSUVASTATINUM ROSWERA 20 mg COMPR. FILM. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,955666 0,000000 0,477833 0,477833 0,860099 0,095567
425 W59900004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,159799 0,719486 0,579899 1,299386 1,043819 0,835466
426 W59900017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 1,159799 0,719486 0,579899 1,299386 1,043819 0,835466
427 W59658004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,808000 0,000000 0,404000 0,404000 0,727200 0,080800
428 W60393003 C10AA07 ROSUVASTATINUM ROVASTAMED 20mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,152142 0,000000 0,576071 0,576071 1,036927 0,115215
429 W61055001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 1,055000 0,000000 0,527500 0,527500 0,949500 0,105500
430 W62400023 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,159799 0,052867 0,579899 0,632767 1,043819 0,168847
431 W62949004 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 20 mg COMPR. FILM. 20mg GENERICS (UK) LTD T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-POLIAMIDA/AL/PEJD DESICANT/PEID X 30 COMPR. FILM. P6L 30 0,618000 0,000000 0,309000 0,309000 0,556200 0,061800
432 W62949019 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 20 mg COMPR. FILM. 20mg GENERICS (UK) LTD. T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-OPA/AL/PVC X 30 COMPR. FILM. P6L 30 0,618000 0,000000 0,309000 0,309000 0,556200 0,061800
433 W64684002 C10AA07 ROSUVASTATINUM ROSI 20 mg COMPR. FILM. 20mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 1,159799 2,170867 0,579899 2,750767 1,043819 2,286847
434 W55329002 C10AA07 ROSUVASTATINUM ROSUCARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,351000 0,000000 0,675500 0,675500 1,215900 0,135100
Pagina 7 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
435 W57063005 C10AA07 ROSUVASTATINUM ROSWERA 40 mg COMPR. FILM. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 1,157000 0,000000 0,578500 0,578500 1,041300 0,115700
436 W55992002 C10AA07 ROSUVASTATINUM ROSTAT 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 1,154000 0,000000 0,577000 0,577000 1,038600 0,115400
437 W59901017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 2,319598 0,612902 1,159799 1,772701 2,087638 0,844862
438 W59901004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 2,319598 0,612902 1,159799 1,772701 2,087638 0,844862
439 W59659004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,214666 0,000000 0,607333 0,607333 1,093199 0,121467
440 W60394003 C10AA07 ROSUVASTATINUM ROVASTAMED 40mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,727500 0,000000 0,863750 0,863750 1,554750 0,172750
441 W61056001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 2,319598 0,311402 1,159799 1,471201 2,087638 0,543362
442 W64686002 C10AA07 ROSUVASTATINUM ROSI 40 mg COMPR. FILM. 40mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 2,319598 0,461068 1,159799 1,620867 2,087638 0,693028
443 W43678001 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 0,289949 2,346122 0,144974 2,491097 0,260954 2,375117
444 W57058005 C10AA07 ROSUVASTATINUM ROSWERA 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,289949 0,039384 0,144974 0,184359 0,260954 0,068379
445 W55989002 C10AA07 ROSUVASTATINUM ROSTAT 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,289949 0,494384 0,144974 0,639359 0,260954 0,523379
446 W59898004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,289949 1,610051 0,144974 1,755026 0,260954 1,639046
447 W59898017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,289949 1,610051 0,144974 1,755026 0,260954 1,639046
448 W59656004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 5 mg COMPR. FILM. 5mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,203333 0,000000 0,101666 0,101667 0,182999 0,020334
449 W60391003 C10AA07 ROSUVASTATINUM ROVASTAMED 5mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,289949 0,790765 0,144974 0,935740 0,260954 0,819760
450 W61053001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,289949 0,521717 0,144974 0,666692 0,260954 0,550712
451 W62947004 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 5 mg COMPR. FILM. 5mg GENERICS (UK) LTD T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-POLIAMIDA/AL/PEJD DESICANT/PEID X 30 COMPR. FILM. P6L 30 0,154666 0,000000 0,077333 0,077333 0,139199 0,015467
452 W62947019 C10AA07 ROSUVASTATINUM ROSUVASTATINA MYLAN 5 mg COMPR. FILM. 5mg GENERICS (UK) LTD. T/A MYLAN MAREA BRITANIE CUTIE CU BLIST. AL-OPA/AL/PVC X 30 COMPR. FILM. P6L 30 0,154666 0,000000 0,077333 0,077333 0,139199 0,015467
453 W53771001 C10AB02 BEZAFIBRATUM BEZAFIBRAT ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC/AL X 10 COMPR. P-6L 20 0,403500 0,000000 0,201750 0,201750 0,363150 0,040350
454 W51918006 C10AX09 EZETIMIBUM EZETROL (R) COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 28 3,032333 1,306238 1,516166 2,822405 2,729099 1,609472
455 W60949001 C10AX09 EZETIMIBUM COLTOWAN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-PE-PVC/AL X 30 COMPR. PRF 30 3,032333 0,787333 1,516166 2,303500 2,729099 1,090567
456 W63969006 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR.
PRF 30 3,032333 0,000000 1,516166 1,516167 2,729099 0,303234
457 W63969016 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL-PVC/ACLAR X 30 COMPR. PRF 30 3,032333 0,000000 1,516166 1,516167 2,729099 0,303234
458 W61288003 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** LIPOCOMB 10 mg/10 mg CAPS. 10mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 4,102000 0,000000 2,051000 2,051000 3,691800 0,410200
459 W61295003 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** LIPOCOMB 20 mg/10 mg CAPS. 20mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 4,200583 0,295750 2,100291 2,396042 3,780524 0,715809
460 W43316001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/10mg COMPR. FILM. 10mg/10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,732666 0,076667 0,366333 0,443000 0,659399 0,149934
461 W56680001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 10 mg/10 mg COMPR. FILM. 10mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,709666 0,000000 0,354833 0,354833 0,638699 0,070967
462 W43315001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) CADUET 10mg/5mg COMPR. FILM. 10mg/5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM. P-6L 30 0,732666 0,069000 0,366333 0,435333 0,659399 0,142267
463 W56679001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 10 mg/5 mg COMPR. FILM. 10mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,577666 0,000000 0,288833 0,288833 0,519899 0,057767
464 W56682001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 20 mg/10 mg COMPR. FILM. 20mg/10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,732666 0,487667 0,366333 0,854000 0,659399 0,560934
465 W56681001 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) DUPLECOR 20 mg/5 mg COMPR. FILM. 20mg/5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 0,732666 0,213334 0,366333 0,579667 0,659399 0,286601
466 W05806001 D01BA02 TERBINAFINUM LAMISIL (R) COMPR. 250mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. X 14 COMPR. P-RF 14 1,093660 0,630625 0,546830 1,177455 0,984294 0,739991
467 W43931014 D01BA02 TERBINAFINUM TERBINAFINE 250 mg COMPR. 250mg ACTAVIS GROUP HFISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 28 0,750000 0,000000 0,375000 0,375000 0,675000 0,075000
468 W53418001 D01BA02 TERBINAFINUM TERBINAFINA SLAVIA 250mg COMPR. 250mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR. P-RF 14 1,093660 0,327054 0,546830 0,873884 0,984294 0,436420
469 W61192002 D01BA02 TERBINAFINUM TERBINAFINA ARENA 250 mg COMPR. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-RF 28 1,093660 0,114554 0,546830 0,661384 0,984294 0,223920
470 W58498001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * DAIVOBET 50 micrograme/0,5 mg/g GEL 50micrograme/0,5mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLAC. PEID CU DUZA DIN PEJD SI CAPAC DIN PEID X 15 G GEL PRF 1 55,160000 0,000000 27,580000 27,580000 49,644000 5,516000
471 W56194001 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) * DAIVOBET 50 micrograme/0,5mg/g UNGUENT 50micrograme/0,5mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE CU 1 TUB DIN AL/EPOXIFENOL X 15 G UNGUENT P-RF 1 55,160000 0,000000 27,580000 27,580000 49,644000 5,516000
472 W53799002 D05BB02 ACITRETINUM ** NEOTIGASON 10 mg CAPS. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 CAPS. P-RF 30 1,639666 0,000000 0,819833 0,819833 1,475699 0,163967
473 W59985001 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g CREMA 20mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 11,290000 0,000000 5,645000 5,645000 10,161000 1,129000
474 W59986001 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g UNGUENT 20mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 11,317499 0,082501 5,658749 5,741251 10,185749 1,214251
475 W54309001 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA CUTIE X 500 G CREMA PRF 1 105,740000 0,000000 52,870000 52,870000 95,166000 10,574000
476 W56789001 D06BB04 PODOPHYLLOTOXINUM * WARTEC 1,5 mg/g CREMA 1,5 mg/g GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 16,774285 65,725715 8,387142 74,112858 15,096856 67,403144
477 W43172001 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE P-RF 1 39,140000 0,000000 19,570000 19,570000 35,226000 3,914000
478 W63433001 D06BB04 PODOPHYLLOTOXINUM * CONDYLINE SOL. CUT. 5mg/ml LEO PHARMA A/S DANEMARCA CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE P-RF 1 39,140000 0,000000 19,570000 19,570000 35,226000 3,914000
479 W07761001 D06BB10 IMIQUIMODUM * ALDARA 5% CREMA 5% MEDA AB SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA P-RF 12 22,525833 0,000000 11,262916 11,262917 20,273249 2,252584
480 W63158001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID 1 mg/g CREMA 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN AL CU 30 G CREMA PRF 1 12,302500 0,227500 6,151250 6,378750 11,072250 1,457750
481 W63159001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID LIPOCREAM 1mg/g CREMA 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN AL X 30 G CREMA PRF 1 12,302500 0,197500 6,151250 6,348750 11,072250 1,427750
482 W63157001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID CRELO 1 mg/g EMULSIE CUT. 1mg/g LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN PEJD DE CULOARE ALBA OPAC, PREVAZUT CU APLICATOR PT. PICURARE DIN PEJD INCOLORA X 30 G EMULSIE CUTANATA PRF 1 12,302500 0,457500 6,151250 6,608750 11,072250 1,687750
483 W63160001 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID 1 mg/ml SOL. CUT. 1mg/ml LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLACON DIN PEJD, PREVAZUT CU APLICATOR PENTRU PICURARE DIN PEJD X 30 ML SOL. CUTANATA PRF 1 11,710000 0,000000 5,855000 5,855000 10,539000 1,171000
484 W57223001 D07AC13 MOMETASONUM ELOCOM CREMA 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3,710000 2,020000 1,855000 3,875000 3,339000 2,391000
485 W59624001 D07AC13 MOMETASONUM MOMETAZONA ATB 1 mg/g CREMA 1mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG.
P6L 1 3,710000 0,000000 1,855000 1,855000 3,339000 0,371000
486 W57222001 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 3,710000 2,020000 1,855000 3,875000 3,339000 2,391000
487 W59623001 D07AC13 MOMETASONUM MOMETAZONA ATB 1 mg/g UNGUENT 1mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG.
P6L 1 3,710000 0,000000 1,855000 1,855000 3,339000 0,371000
488 W61468004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 22,476000 2,904000 11,238000 14,142000 20,228400 5,151600
489 W63875004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 22,476000 2,904000 11,238000 14,142000 20,228400 5,151600
490 W61468005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G CREMA P-RF 1 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000
491 W63875005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G CREMA PRF 1 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000
492 W61466002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA PRF 1 34,970000 0,000000 17,485000 17,485000 31,473000 3,497000
493 W63873002 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA PRF 1 34,970000 0,000000 17,485000 17,485000 31,473000 3,497000
494 W61467004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT P-RF 1 22,476000 3,654000 11,238000 14,892000 20,228400 5,901600
495 W63874004 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G UNGUENT PRF 1 22,476000 3,654000 11,238000 14,892000 20,228400 5,901600
496 W61467005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G UNGUENT P-RF 1 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000
497 W63874005 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent UNGUENT 1mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G UNGUENT PRF 1 37,460000 0,000000 18,730000 18,730000 33,714000 3,746000
Pagina 8 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
498 W13497001 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE CREMA 0,05% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 10,600000 0,000000 5,300000 5,300000 9,540000 1,060000
499 W13088001 D07AC17 FLUTICASONUM PROPIONAT CUTIVATE UNGUENT 0,005% GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 10,600000 0,000000 5,300000 5,300000 9,540000 1,060000
500 W55012001 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g CREMA 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G CREMA P-RF 1 6,320000 6,810000 3,160000 9,970000 5,688000 7,442000
501 W63648001 D07AD01 CLOBETASOLUM * CLOBETAZOL ATB 0,5 mg/g CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 25 G CREMA PRF 1 6,320000 2,110000 3,160000 5,270000 5,688000 2,742000
502 W12704002 D07AD01 CLOBETASOLUM * DERMOVATE (R) SOL. CUT. 0,05% GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON CU PICURATOR DIN PP X 25 ML P-RF 1 5,690000 0,000000 2,845000 2,845000 5,121000 0,569000
503 W55013001 D07AD01 CLOBETASOLUM * DERMOVATE 0,5 mg/g UNGUENT 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G UNGUENT P-RF 1 6,320000 3,400000 3,160000 6,560000 5,688000 4,032000
504 W61823001 D07AD01 CLOBETASOLUM * CLOBETAZOL ATB 0,5 mg/g UNGUENT 0,5mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 25 G UNGUENT PRF 1 6,320000 0,000000 3,160000 3,160000 5,688000 0,632000
505 W60525001 D07CA01 COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H CREMA 20mg/g+10mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 22,160000 0,000000 11,080000 11,080000 19,944000 2,216000
506 W59984001 D07CC01 COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg pe gram LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 16,930000 5,870000 8,465000 14,335000 15,237000 7,563000
507 W59984002 D07CC01 COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg pe gram LEO PHARMA A/S DANEMARCA CUTIE CU 1 TUB DIN AL X 20 G CREMA PRF 1 22,573333 7,056667 11,286666 18,343334 20,315999 9,314001
508 W56787001 D10AD54 COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL GEL 0.5mg/g+20mg/g GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 TUB DIN AL X 30 G GEL P6L 1 39,560000 0,000000 19,780000 19,780000 35,604000 3,956000
509 W61504001 D10AX03 ACIDUM AZELAICUM SKINOREN CREMA 200mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 32,020000 0,000000 16,010000 16,010000 28,818000 3,202000
510 W63891001 D10AX03 ACIDUM AZELAICUM SKINOREN 200 mg/g CREMA 200mg/g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA PRF 1 32,020000 0,000000 16,010000 16,010000 28,818000 3,202000
511 W61503002 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB AL X 50 G GEL P-RF 1 40,025000 11,005000 20,012500 31,017500 36,022500 15,007500
512 W64050003 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g BAYER AG GERMANIA CUTIE CU 1 TUB AL X 50 G GEL PRF 1 40,025000 11,005000 20,012500 31,017500 36,022500 15,007500
513 W03829001 D10BA01 ISOTRETINOINUM ** ROACCUTANE 10 mg CAPS. MOI 10mg ROCHE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. MOI P-RF 30 1,127583 0,545417 0,563791 1,109209 1,014824 0,658176
514 W57698001 D10BA01 ISOTRETINOINUM ** SOTRET 10 mg CAPS. MOI 10mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF 30 1,123666 0,000000 0,561833 0,561833 1,011299 0,112367
515 W57699001 D10BA01 ISOTRETINOINUM ** SOTRET 20 mg CAPS. MOI 20mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF 30 2,255166 0,007834 1,127583 1,135417 2,029649 0,233351
516 W51716002 G01AA51 COMBINATII MACMIROR COMPLEX CAPS. MOI VAG. 500mg/200000UI POLICHEM SA LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG. P-RF 12 2,160333 1,230500 1,080166 2,310667 1,944299 1,446534
517 W64599001 G01AA51 COMBINATII POLYGYNAX VIRGO CAPS. MOI VAG. FARA FRANTA CUTIE CU 1 BLIST. PVC/PVDC TRANSPARENT/AL X 6 CAPS. VAG. MOI
LABORATOIRE INNOTECH INTERNATIONAL PRF 6 2,160333 0,314667 1,080166 1,394834 1,944299 0,530701
518 W01949002 G01AA51 COMBINATII POLYGYNAX CAPS. MOI VAG. LAB. INNOTECH INT.FRANTA CUTIE CU 2 BLIST. PVC-PVDC/AL X 6 CAPS. MOI. VAG.
FARA CONCENTRATIE P-RF 12 2,160333 0,541333 1,080166 1,621500 1,944299 0,757367
519 W51914001 G01AA51 COMBINATII MACMIROR COMPLEX CREMA VAG. 10g/400000UI POLICHEM SA LUXEMBURG CUTIE X 1 TUB DIN AL CREMA VAG. X 30 G + APLICATOR P-RF 1 36,490000 0,000000 18,245000 18,245000 32,841000 3,649000
520 W03126002 G01AF12 FENTICONAZOLUM LOMEXIN 1000 mg CAPS. MOI VAG. 1000mg RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 2 CAPS. VAG. MOI P-RF 2 27,980000 0,000000 13,990000 13,990000 25,182000 2,798000
521 W03125002 G01AF12 FENTICONAZOLUM LOMEXIN 600 mg CAPS. MOI VAG. 600mg RECORDATI SPA ITALIA CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE P-RF 1 15,860000 0,000000 7,930000 7,930000 14,274000 1,586000
522 W03123004 G01AF12 FENTICONAZOLUM LOMEXIN CREMA VAGINALA CREMA VAG. 2% RECORDATI SPA ITALIA CUTIE X 1 TUB AL + APLICATOR X 78 G CREMA P-RF 1 37,900000 0,000000 18,950000 18,950000 34,110000 3,790000
523 W54844001 G01AF15 BUTOCONAZOLUM GYNOFORT 2% CREMA VAG. 20mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 APLICATOR PREUMPLUT UNIDOZA DIN PP CU 5 G CREMA VAG. P-RF 1 4,661769 31,128231 2,330884 33,459116 4,195592 31,594408
524 W52516001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLODIN COMPR. VAG. 500mg/200mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. TRANSPARENT DIN AL/PVC X 5 COMPR. VAG. P-RF 10 1,622678 0,016322 0,811339 0,827661 1,460410 0,178590
525 W63731001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON CREMA VAG. 40mg/g+200mg/g ALFASIGMA S.P.A. ITALIA CUTIE CU 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN PP PRF 1 9,736069 4,173931 4,868034 9,041966 8,762462 5,147538
526 W63733001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON OVULE 500mg/100mg ALFASIGMA S.P.A. ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULEPRF 10 1,622678 2,375322 0,811339 3,186661 1,460410 2,537590
527 W61909001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC-PE X 7 OVULE PRF 7 1,622678 0,000179 0,811339 0,811518 1,460410 0,162447
528 W61909002 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC X 7 OVULE PRF 7 1,622678 0,000179 0,811339 0,811518 1,460410 0,162447
529 W61909003 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE DIN PVC-PE X 7 OVULE PRF 14 1,622142 0,000000 0,811071 0,811071 1,459927 0,162215
530 W61909004 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) ZIFEX DUO 500 mg/200 mg OVULE 500mg/200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE DIN PVC X 7 OVULE PRF 14 1,622142 0,000000 0,811071 0,811071 1,459927 0,162215
531 W63732001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE ALFASIGMA S.P.A. ITALIA P-RF
CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE 5 1,622191 3,135809 0,811095 3,946905 1,459971 3,298029
532 W58814001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore 20micrograme/24ore
SISTEM CU CEDARE INTRAUTERINA BAYER OY FINLANDA P-RF
CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR 1 474,300000 0,000000 237,150000 237,150000 426,870000 47,430000
533 W64655001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore 20micrograme/24ore
SISTEM CU CEDARE INTRAUTERINA BAYER AG GERMANIA PRF
CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR 1 474,300000 0,000000 237,150000 237,150000 426,870000 47,430000
534 W00716002 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 5,797750 5,387250 2,898875 8,286125 5,217975 5,967025
535 W00716001 G02CB03 CABERGOLINUM * DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 5,797750 4,642250 2,898875 7,541125 5,217975 5,222025
536 W63310001 G03CA04 ESTRIOLUM * OVESTIN 0,5 mg OVULE 0,5 mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 3 BLIST. PVC/PE X 5 OVULE PRF 15 1,464000 0,000000 0,732000 0,732000 1,317600 0,146400
537 W12902001 G03CX01 TIBOLONUM ** LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 1,653571 0,000000 0,826785 0,826786 1,488213 0,165358
538 W63437001 G03CX01 TIBOLONUM ** LIVIAL 2,5 mg COMPR. 2,5mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 28 COMPR. PRF 28 1,653571 0,000000 0,826785 0,826786 1,488213 0,165358
539 W12320001 G03DA04 PROGESTERONUM * UTROGESTAN (R) 100 mg CAPS. MOI 100mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI P-6L 30 0,629958 0,215042 0,314979 0,530021 0,566962 0,278038
540 W61647001 G03DA04 PROGESTERONUM * AREFAM 100 mg CAPS. MOI 100mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPSULE MOI P-6L 30 0,578333 0,000000 0,289166 0,289167 0,520499 0,057834
541 W42276001 G03DA04 PROGESTERONUM * UTROGESTAN (R) 200 mg CAPS. MOI 200mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. AL/PVC X 7 CAPS. MOI P-6L 14 1,259916 0,693655 0,629958 1,323613 1,133924 0,819647
542 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 P-6L 30 1,259916 0,034417 0,629958 0,664375 1,133924 0,160409
543 W62500001 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 TUB DIN AL X 45 G GEL + DISPOZITIV DE DOZARE (APLICATOR GRADAT DIN PP, PREVAZUT CU FANTA DOZATOARE PT. ETALAREA A 2,5 G GEL 1 8,228437 0,001563 4,114218 4,115782 7,405593 0,824407
544 W58088001 G03DA04 PROGESTERONUM * PROGESTOGEL 10 mg/g GEL 10mg/g LABORATOIRES BESINS INTERNATIONAL FRANTA CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE PRF 1 14,628332 7,301668 7,314166 14,615834 13,165498 8,764502
545 W62500002 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA P6L
CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE (APLICATOR GRADAT DIN PP, PREVAZUT CU FANTA DOZATOARE PT. ETALAREA A 2,5 G GEL 1 14,620000 0,000000 7,310000 7,310000 13,158000 1,462000
546 W60214001 G03DA04 PROGESTERONUM * MASTOPROFEN 10 mg/g GEL 10mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GELP6L 1 7,314166 0,185834 3,657083 3,842917 6,582749 0,917251
547 W61888001 G03DA04 PROGESTERONUM * CRINONE 80 mg/g GEL VAGINAL 80mg/g MERCK ROMANIA SRL ROMANIA P6L
CUTIE CU 6 APLICATOARE DOZA UNICA DIN PE, CONTINÂND GEL VAGINAL, PREVAZUTE CU VÂRF CARE SE DESFACE PRIN RASUCIRE, AMBALATE SEPARAT ÎNTR-O FOLIE DIN HÂRTIE/AL/RASINA IONOMERICA 6 12,421666 0,000000 6,210833 6,210833 11,179499 1,242167
548 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 1,172500 0,000000 0,586250 0,586250 1,055250 0,117250
549 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 1,172500 0,000000 0,586250 0,586250 1,055250 0,117250
550 W04045001 G03DC03 LYNESTRENOLUM * ORGAMETRIL 5 mg COMPR. 5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 30 COMPR. P-6L 30 0,269000 0,000000 0,134500 0,134500 0,242100 0,026900
551 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 0,269000 0,000000 0,134500 0,134500 0,242100 0,026900
552 W58801001 G03FA17 COMBINATII ** ANGELIQ COMPR. FILM. 1mg+2mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P6L 28 2,172142 0,000000 1,086071 1,086071 1,954927 0,217215
553 W64042001 G03FA17 COMBINATII (ESTRADIOLUM + DROSPIRENONUM) ** ANGELIQ 1 mg + 2 mg COMPR. FILM. 1mg+2mg BAYER AG GERMANIA P6L
CUTIE CU 1 ETUI DE CARTON X 1 BLIST. TIP CALENDAR PVC/AL X 28 COMPR. FILM. 28 2,172142 0,000000 1,086071 1,086071 1,954927 0,217215
554 W58805001 G03FB01 COMBINATII ** CYCLO-PROGYNOVA DRAJ. FARA CONCENTRATIE BAYER PHARMA AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P-6L 21 0,393333 0,000000 0,196666 0,196667 0,353999 0,039334
555 W64044001 G03FB01 COMBINATII ** CYCLO-PROGYNOVA DRAJ. FARA CONCENTRATIE BAYER AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P6L 21 0,393333 0,000000 0,196666 0,196667 0,353999 0,039334
556 W61928001 G03FB08 ESTRADIOL + DIDROGESTERON **FEMOSTON 2/10, comprimate filmate COMPR. FILM. 2 mg/10 mg BGP PRODUCTS B.V.OLANDA P-RF
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) 28 0,393333 0,655952 0,196666 0,852619 0,353999 0,695286
557 W64557001 G03FB08 ESTRADIOL + DIDROGESTERON **FEMOSTON 2/10 COMPR. FILM. FARA MYLAN HEALTHCARE B.V. OLANDA P-RF
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) 28 0,393333 0,655952 0,196666 0,852619 0,353999 0,695286
558 W60481002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE P-RF/R
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. 1 103,716666 24,603334 51,858333 76,461667 93,344999 34,975001
559 W63029001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 300 UI/0,5 ml SOL INJ. 300UI/0,5ml TEVA B.V. OLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.5 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 414,866666 5,993334 207,433333 213,426667 373,379999 47,480001
560 W63030001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 450UI/0,75ml SOL INJ. 450UI/0,75ml TEVA B.V. OLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.75 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 595,870000 0,000000 297,935000 297,935000 536,283000 59,587000
Pagina 9 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
561 W63031001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 900UI/1,5ml SOL INJ. 900UI/1,5ml TEVA B.V. OLANDA CUTIE X 1 CARTUS (STICLA TIP I) X 1.5ML SOLUTIE INJECTABILA + 20 ACE PENTRU INJECTIE PR/PRF 1 1.091,710000 0,000000 545,855000 545,855000 982,539000 109,171000
562 W60480002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 300 UI/0,5 ml ( 22 µg/0,5 ml) 300UI/0,5ml MERCK SERONO EUROPE LIMITED
SOL. INJ. IN STILOU INJECTOR PREUMPLUT MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. P-RF/R 1 414,866666 22,343334 207,433333 229,776667 373,379999 63,830001
563 W60485002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) 450UI/0,75ml MERCK SERONO EUROPE LIMITED
SOL. INJ. IN STILOU INJECTOR PREUMPLUT MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA P-RF/R 1 622,300000 8,810000 311,150000 319,960000 560,070000 71,040000
564 W60477002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 900 UI/1,5ml (66 µg/1,5 ml) 900UI/1,5ml MERCK SERONO EUROPE LIMITED
SOL. INJ. IN STILOU INJECTOR PREUMPLUT MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA P-RF/R 1 1.177,650000 0,000000 588,825000 588,825000 1.059,885000 117,765000
565 W61937001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml MERCK SHARP & DOHME CUTIE X 1 CARTUS + 6 ACE
MAREA BRITANIE PR/PRF 1 414,700720 6,929280 207,350360 214,279640 373,230648 48,399352
566 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 1 414,700720 6,929280 207,350360 214,279640 373,230648 48,399352
567 W43251001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.244,102160 95,107840 622,051080 717,158920 1.119,691944 219,518056
568 W61938001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.244,102160 95,107840 622,051080 717,158920 1.119,691944 219,518056
569 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 1.244,102160 95,107840 622,051080 717,158920 1.119,691944 219,518056
570 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 1 134,870000 0,000000 67,435000 67,435000 121,383000 13,487000
571 W53455002 G03XC01 RALOXIFENUM EVISTA 60mg COMPR. FILM. 60mg DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR) P-RF 28 2,470357 0,000000 1,235178 1,235179 2,223321 0,247036
572 W62337001 G04BD04 OXYBUTYNINUM DRIPTANE® 5 mg COMPR. 5mg MYLAN MEDICAL SAS FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. PRF 60 0,376500 0,000000 0,188250 0,188250 0,338850 0,037650
573 W57773001 G04BD07 TOLTERODINUM ** # UROFLOW 1 COMPR. FILM. 1mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,380953 0,464761 0,190476 0,655238 0,342857 0,502857
574 W57774001 G04BD07 TOLTERODINUM ** # UROFLOW 2 COMPR. FILM. 2mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,761906 0,114879 0,380953 0,495832 0,685715 0,191070
575 W56677002 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 10 mg COMPR. FILM. 10 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 3,047624 0,338709 1,523812 1,862521 2,742861 0,643472
576 W43104001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 10 mg COMPR. FILM. 10mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 3,047624 1,333709 1,523812 2,857521 2,742861 1,638472
577 W62757002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 3,047624 0,338376 1,523812 1,862188 2,742861 0,643139
578 W63709008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 3,047624 0,481376 1,523812 2,005188 2,742861 0,786139
579 W63709010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 3,047624 0,304376 1,523812 1,828188 2,742861 0,609139
580 W63709013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 3,047624 0,130820 1,523812 1,654632 2,742861 0,435583
581 W63709001 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 3,047624 0,481376 1,523812 2,005188 2,742861 0,786139
582 W63709003 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 3,047624 0,304376 1,523812 1,828188 2,742861 0,609139
583 W63709006 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 3,047624 0,130820 1,523812 1,654632 2,742861 0,435583
584 W56676002 G04BD08 SOLIFENACINUM SUCCINATE ** # ZEVESIN 5 mg COMPR. FILM. 5 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 1,523812 0,558854 0,761906 1,320760 1,371430 0,711236
585 W43105001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 5 mg COMPR. FILM. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 1,523812 1,851854 0,761906 2,613760 1,371430 2,004236
586 W62756002 G04BD08 SOLIFENACINUM SUCCINATE ** # SOLIFENACIN AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 1,523812 1,519854 0,761906 2,281760 1,371430 1,672236
587 W63708008 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. PRF 10 1,523812 1,756188 0,761906 2,518094 1,371430 1,908570
588 W63708010 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. PRF 30 1,523812 1,491188 0,761906 2,253094 1,371430 1,643570
589 W63708013 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. PRF 90 1,523812 1,335076 0,761906 2,096982 1,371430 1,487458
590 W63708001 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 1,523812 1,756188 0,761906 2,518094 1,371430 1,908570
591 W63708003 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 1,523812 1,491188 0,761906 2,253094 1,371430 1,643570
592 W63708006 G04BD08 SOLIFENACINUM SUCCINATE ** # VEZIMED 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 90 COMPR. FILM. PRF 90 1,523812 1,335076 0,761906 2,096982 1,371430 1,487458
593 W62488001 G04BD08 SOLIFENACINUM SUCCINATE ** # VESICARE 1 mg/ml SUSP. ORALA 1mg/ml ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA BRUNA DIN PET CARE CONTINE 150 ML SUSP. ORALA P6L 1 45,714371 137,625629 22,857185 160,482815 41,142933 142,197067
594 W43786001 G04BD09 TROSPIUM INKONTAN 15 mg COMPR. FILM. 15mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,571429 0,816237 0,285714 1,101952 0,514286 0,873380
595 W43789001 G04BD09 TROSPIUM INKONTAN 30 mg COMPR. FILM. 30mg PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 1,142859 1,093807 0,571429 1,665237 1,028573 1,208093
596 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 0,744333 0,000000 0,372166 0,372167 0,669899 0,074434
597 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 1,455333 0,000000 0,727666 0,727667 1,309799 0,145534
598 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 1,455333 0,000000 0,727666 0,727667 1,309799 0,145534
599 W62397002 G04CA01 ALFUZOSINUM XATRAL LP 5 mg COMPR. ELIB. PREL. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. ELIB. PREL. P-6L 28 0,613571 0,000000 0,306785 0,306786 0,552213 0,061358
600 W42715001 G04CA02 TAMSULOSINUM TAMSOL 0,4 mg CAPS. ELIB. MODIF. 0,4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-6L 30 0,961000 0,000000 0,480500 0,480500 0,864900 0,096100
601 W56791001 G04CA02 TAMSULOSINUM FOKUSIN CAPS. ELIB. MODIF. 0,4mg ZENTIVA KS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF. P-6L 30 0,640000 0,000000 0,320000 0,320000 0,576000 0,064000
602 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 0,640000 0,000000 0,320000 0,320000 0,576000 0,064000
603 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 1,059666 0,000000 0,529833 0,529833 0,953699 0,105967
604 W42850001 G04CA02 TAMSULOSINUM CONTIFLO MR CAPS. ELIB. PREL.0,4mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,523000 0,000000 0,261500 0,261500 0,470700 0,052300
605 W59360008 G04CA02 TAMSULOSINUM TAMSULOSIN AUROBINDO 400 micrograme CAPS. ELIB. PREL.400micrograme AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 CAPS. ELIB. PREL. P6L 30 0,622000 0,000000 0,311000 0,311000 0,559800 0,062200
606 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 0,622000 0,000000 0,311000 0,311000 0,559800 0,062200
607 W43106001 G04CA02 TAMSULOSINUM OMNIC TOCAS (R) 0,4 0,4mg
COMPR. FILM. ELIB. PREL. ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 FOLII AL/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 1,143900 0,136100 0,571950 0,708050 1,029510 0,250490
608 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 1,003392 0,241608 0,501696 0,743304 0,903052 0,341948
609 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 0,922857 0,000000 0,461428 0,461429 0,830571 0,092286
610 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 1,069332 0,582668 0,534666 1,117334 0,962398 0,689602
611 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 1,069332 1,110668 0,534666 1,645334 0,962398 1,217602
612 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 1,069332 0,001001 0,534666 0,535667 0,962398 0,107935
613 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 0,993666 0,000000 0,496833 0,496833 0,894299 0,099367
614 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 1,069332 1,132668 0,534666 1,667334 0,962398 1,239602
615 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 1,069332 0,557001 0,534666 1,091667 0,962398 0,663935
616 W63857002 G04CB02 DUTASTERIDUM * AVATERID 0,5 mg CAPS. MOI 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. MOI P6L 30 1,068333 0,000000 0,534166 0,534167 0,961499 0,106834
617 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 1 402,500000 0,000000 201,250000 201,250000 362,250000 40,250000
618 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 1 402,500000 0,000000 201,250000 201,250000 362,250000 40,250000
619 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 1 301,875000 165,885000 150,937500 316,822500 271,687500 196,072500
620 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 1 727,810000 0,000000 363,905000 363,905000 655,029000 72,781000
621 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 1 377,343750 15,256250 188,671875 203,928125 339,609375 52,990625
622 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 1 754,687500 243,842500 377,343750 621,186250 679,218750 319,311250
623 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 1 377,343750 24,966250 188,671875 213,638125 339,609375 62,700625
Pagina 10 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
624 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 1 746,850000 0,000000 373,425000 373,425000 672,165000 74,685000
625 W54046001 H01AC01 SOMATROPINUM ** # NORDITROPIN SIMPLEXx 10 mg/1,5ml SOL. INJ. IN CARTUS 10mg/1,5ml NOVO NORDISK A/S DANEMARCA CUTIE X 1 CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ. P-RF 1 754,687500 405,182500 377,343750 782,526250 679,218750 480,651250
626 W61936001 H01CC01 GANIRELIXUM ** # ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT P-RF/R 1 129,333571 13,016429 64,666785 77,683215 116,400213 25,949787
627 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 1 129,333571 13,016429 64,666785 77,683215 116,400213 25,949787
628 W06895002 H01CC02 CETRORELIXUM ** # CETROTIDE 0,25 mg PULB+SOLV. PT. SOL. INJ. 0,25mg SERONO EUROPE LTD. MAREA BRITANIE P-RF 7
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 116,317142 0,000000 58,158571 58,158571 104,685427 11,631715
629 W03165001 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 0,424600 0,000000 0,212300 0,212300 0,382140 0,042460
630 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 17,160000 0,000000 8,580000 8,580000 15,444000 1,716000
631 W54546003 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,328725 0,123075 0,164362 0,287438 0,295852 0,155948
632 W54545003 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 0,557400 0,000000 0,278700 0,278700 0,501660 0,055740
633 W54547004 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 0,164362 0,172938 0,082181 0,255119 0,147925 0,189375
634 W58901002 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/500mg ANTIBIOTICE S.A. ROMANIA 50
CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 15,800600 0,000000 7,900300 7,900300 14,220540 1,580060
635 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 2,851666 0,000000 1,425833 1,425833 2,566499 0,285167
636 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 23,774995 2,885005 11,887497 14,772503 21,397495 5,262505
637 W05561001 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 1,5 Mil. UI COMPR. FILM. 1,5 M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF 16 0,665625 0,000000 0,332812 0,332813 0,599062 0,066563
638 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 0,665625 0,000000 0,332812 0,332813 0,599062 0,066563
639 W13604002 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 3 Mil. UI COMPR. FILM. 3M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 10 1,463140 1,260860 0,731570 1,992430 1,316826 1,407174
640 W13604003 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. LABORATOIRES AVENTIS FRANTA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM. PRF 10 1,463140 1,260860 0,731570 1,992430 1,316826 1,407174
641 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 1,463140 1,260860 0,731570 1,992430 1,316826 1,407174
642 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 1,463140 1,260860 0,731570 1,992430 1,316826 1,407174
643 W42271001 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS.P-RF 6 3,466666 0,000000 1,733333 1,733333 3,119999 0,346667
644 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 3,657853 1,115480 1,828926 2,944407 3,292067 1,481266
645 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 3,657853 1,115480 1,828926 2,944407 3,292067 1,481266
646 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 1,828924 2,524409 0,914462 3,438871 1,646031 2,707302
647 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 1,828924 2,524409 0,914462 3,438871 1,646031 2,707302
648 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 3,263333 0,000000 1,631666 1,631667 2,936999 0,326334
649 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 3,308333 0,000000 1,654166 1,654167 2,977499 0,330834
650 W00519001 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 7,315707 1,724293 3,657853 5,382147 6,584136 2,455864
651 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 3,440000 0,000000 1,720000 1,720000 3,096000 0,344000
652 W43486001 J01FA10 AZITHROMYCINUM AZIBIOT 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 5,596666 0,000000 2,798333 2,798333 5,036999 0,559667
653 W52840001 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 5,876666 0,000000 2,938333 2,938333 5,288999 0,587667
654 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 5,876666 0,000000 2,938333 2,938333 5,288999 0,587667
655 W57032001 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 5,356666 0,000000 2,678333 2,678333 4,820999 0,535667
656 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 5,876666 0,000000 2,938333 2,938333 5,288999 0,587667
657 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 4,816666 0,000000 2,408333 2,408333 4,334999 0,481667
658 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 7,315707 1,724293 3,657853 5,382147 6,584136 2,455864
659 W53281001 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA P-RF 1
CUTIE X 1 FLACON DIN PE CU PULBERE PENTRU 15ML SUSPENSIE ORALA RECONSTITUITA + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENTRU ADMINISTRAREA ORALA + O LINGURITA DOZATOARE 15,240000 0,000000 7,620000 7,620000 13,716000 1,524000
660 W42901001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA 13,264197 7,085803 6,632098 13,717902 11,937777 8,412223
661 W42877002 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA P-RF 1
CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (800 MG) SUSP. ORALA 14,680000 0,000000 7,340000 7,340000 13,212000 1,468000
662 W00520003 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 43,970000 0,000000 21,985000 21,985000 39,573000 4,397000
663 W64358003 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA PRF 1
CUTIE CU 1 FLAC. DIN PEID CONTINAND PULB. PT. 37,5 ML SUSP. ORALA, O SERINGA PT. ADMINISTRARE ORALA DIN PE/PS SAU PP/PP SI O LINGURITA DOZATOARE 43,970000 0,000000 21,985000 21,985000 39,573000 4,397000
664 W00520001 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLJANA D.O.O. SLOVENIA P-RF 1
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE 33,300000 0,000000 16,650000 16,650000 29,970000 3,330000
665 W64358002 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA PRF 1
CUTIE CU 1 FLAC. DIN PEID CONTINAND PULB. PT. 30 ML SUSP. ORALA, O SERINGA PT. ADMINISTRARE ORALA DIN PE/PS SAU PP/PP SI O LINGURITA DOZATOARE 33,300000 0,000000 16,650000 16,650000 29,970000 3,330000
666 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 0,560937 0,197813 0,280468 0,478282 0,504843 0,253907
667 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 0,930000 0,000000 0,465000 0,465000 0,837000 0,093000
668 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 2,243749 0,545626 1,121874 1,667501 2,019374 0,770001
669 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 2,243749 0,127917 1,121874 1,249792 2,019374 0,352292
670 W52786004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 250 mg COMPR. FILM. 250mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 7 1,138571 0,000000 0,569285 0,569286 1,024713 0,113858
671 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 2,441250 0,173035 1,220625 1,393660 2,197125 0,417160
672 W60574001 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 1,646000 0,000000 0,823000 0,823000 1,481400 0,164600
673 W60574002 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 1,622000 0,000000 0,811000 0,811000 1,459800 0,162200
674 W61631003 J01MA12 LEVOFLOXACINUM LEVALOX 250 mg COMPR. FILM. 250mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 2,441250 0,197321 1,220625 1,417946 2,197125 0,441446
675 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 4,661428 0,000000 2,330714 2,330714 4,195285 0,466143
676 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 3,454285 0,000000 1,727142 1,727143 3,108856 0,345429
677 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 4,882500 0,538928 2,441250 2,980178 4,394250 1,027178
678 W56993002 J01MA12 LEVOFLOXACINUM LEVOTOR 500 mg COMPR. FILM. 500mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF 7 3,390000 0,000000 1,695000 1,695000 3,051000 0,339000
679 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 4,656000 0,000000 2,328000 2,328000 4,190400 0,465600
680 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 4,397000 0,000000 2,198500 2,198500 3,957300 0,439700
681 W61706003 J01MA12 LEVOFLOXACINUM LEVALOX 500 mg COMPR. FILM. 500mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 4,374285 0,000000 2,187142 2,187143 3,936856 0,437429
682 W57939001 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF 5 4,882500 4,859500 2,441250 7,300750 4,394250 5,347750
683 W59332001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 4,882500 0,047500 2,441250 2,488750 4,394250 0,535750
684 W60545001 J01MA14 MOXIFLOXACINUM MOFIL 400 mg COMPR. FILM. 400mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR. FILM. PRF 5 4,882500 2,439500 2,441250 4,880750 4,394250 2,927750
685 W60943001 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA PRF 5
CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINÂND 5 COMPRIMATE FILMATE 4,882500 2,481500 2,441250 4,922750 4,394250 2,969750
686 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 4,882500 4,859500 2,441250 7,300750 4,394250 5,347750
Pagina 11 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
687 W03837002 J02AC02 ITRACONAZOLUM * ORUNGAL CAPS. 100mg BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF
JANSSEN PHARMACEUTICA N.V. 15 3,364000 0,000000 1,682000 1,682000 3,027600 0,336400
688 W43051001 J02AC02 ITRACONAZOLUM * ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS.P-RF 15 2,186000 0,000000 1,093000 1,093000 1,967400 0,218600
689 W53958001 J02AC02 ITRACONAZOLUM * MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF 15 2,186000 0,000000 1,093000 1,093000 1,967400 0,218600
690 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 2,186000 0,000000 1,093000 1,093000 1,967400 0,218600
691 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 2,186000 0,000000 1,093000 1,093000 1,967400 0,218600
692 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 2,186000 0,000000 1,093000 1,093000 1,967400 0,218600
693 W58707001 J05AB11 VALACYCLOVIRUM * # VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF 10 4,886000 0,000000 2,443000 2,443000 4,397400 0,488600
694 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 3,297000 0,000000 1,648500 1,648500 2,967300 0,329700
695 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 50,557142 0,000000 25,278571 25,278571 45,501427 5,055715
696 W12490001 L01AA01 CYCLOPHOSPHAMIDUM * ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,571400 0,000000 0,285700 0,285700 0,514260 0,057140
697 W10173001 L02AE03 GOSERELINUM ** # ZOLADEX (R) IMPLANT 3,6mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG S/P-RF 1 195,782498 1,257502 97,891249 99,148751 176,204248 20,835752
698 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 1 195,782498 1,257502 97,891249 99,148751 176,204248 20,835752
699 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 14,405714 0,000000 7,202857 7,202857 12,965142 1,440572
700 W55726001 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 X 2 ML SOLV. + 1 BLIST. CU 1 SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE 699,730000 0,000000 349,865000 349,865000 629,757000 69,973000
701 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 378,690000 0,000000 189,345000 189,345000 340,821000 37,869000
702 W58059001 L02AE04 TRIPTORELINUM ** # GONAPEPTYL ZILNIC 0,1 mg/ml SOL. INJ. 0,1mg/ml FERRING GMBH GERMANIA CUTIE X 7 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF 7 1,972857 24,301428 0,986428 25,287857 1,775571 24,498714
703 W58059002 L02AE04 TRIPTORELINUM ** # GONAPEPTYL ZILNIC 0,1 mg/ml SOL. INJ. 0,1mg/ml FERRING GMBH GERMANIA CUTIE X 28 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF 28 1,972857 21,245714 0,986428 22,232143 1,775571 21,443000
704 W60846001 L04AX01 AZATHIOPRINUM * IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,686400 0,000000 0,343200 0,343200 0,617760 0,068640
705 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 0,454799 0,568201 0,227399 0,795601 0,409319 0,613681
706 W62179001 M01AC05 LORNOXICAMUM XEFO 8 mg/ 2 ml PULB. + SOLV. PT. SOL. INJ. 8mg/2ml TAKEDA AUSTRIA GMBH AUSTRIA PRF 10
CUTIE CU 10 FLAC. DIN STICLA BRUNA CU PULB. PT. SOL. INJ. + 10 FIOLE DIN STICLA INCOLORA X 2 ML SOLV. PT. SOL. INJ. 1,378665 8,205335 0,689332 8,894668 1,240798 8,343202
707 W06864001 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 0,494474 0,399526 0,247237 0,646763 0,445026 0,448974
708 W60403002 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN TROMETAMOL SANDOZ 25mg COMPR. FILM. 25mg SANDOZ S.R.L. ROMANIA CUTIE BLIST. DIN PVC-PVDC/AL X 20 COMPRIMATE FILMATE P6L 20 0,494474 0,102026 0,247237 0,349263 0,445026 0,151474
709 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. 2,396000 0,288000 1,198000 1,486000 2,156400 0,527600
710 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. 2,396000 0,288000 1,198000 1,486000 2,156400 0,527600
711 W43063001 M01AE17 DEXKETOPROFENUM TADOR INJECT SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF.
MENARINI INTERNATIONAL OPERATIONS S.A. P-RF 5 2,396000 1,512000 1,198000 2,710000 2,156400 1,751600
712 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. 2,396000 0,386000 1,198000 1,584000 2,156400 0,625600
713 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. 2,396000 0,385000 1,198000 1,583000 2,156400 0,624600
714 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. 1,697374 0,085626 0,848687 0,934313 1,527636 0,255364
715 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. 1,668833 0,000000 0,834416 0,834417 1,501949 0,166884
716 W08360009 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/ACLAR/AL X 10 CAPS. P-RF 30 0,635000 0,311000 0,317500 0,628500 0,571500 0,374500
717 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 0,635000 0,311000 0,317500 0,628500 0,571500 0,374500
718 W60458003 M01AH01 CELECOXIBUM ALGOXIB 100 mg CAPS. 100mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 0,615333 0,000000 0,307666 0,307667 0,553799 0,061534
719 W60519003 M01AH01 CELECOXIBUM ACLEXA 100 mg CAPS. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,615333 0,000000 0,307666 0,307667 0,553799 0,061534
720 W60596003 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,614666 0,000000 0,307333 0,307333 0,553199 0,061467
721 W61088003 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 100 mg CAPS. 100mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 0,615333 0,000000 0,307666 0,307667 0,553799 0,061534
722 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 1,270000 0,257000 0,635000 0,892000 1,143000 0,384000
723 W08361007 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. PVC/ACLAR/AL X 10 CAPS. P-RF 10 1,270000 0,308000 0,635000 0,943000 1,143000 0,435000
724 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 1,270000 0,308000 0,635000 0,943000 1,143000 0,435000
725 W08361009 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/ACLAR/AL X 10 CAPS. P-RF 30 1,270000 0,257000 0,635000 0,892000 1,143000 0,384000
726 W60459003 M01AH01 CELECOXIBUM ALGOXIB 200 mg CAPS. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 1,241000 0,000000 0,620500 0,620500 1,116900 0,124100
727 W60520003 M01AH01 CELECOXIBUM ACLEXA 200 mg CAPS. 200mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,241000 0,000000 0,620500 0,620500 1,116900 0,124100
728 W60597003 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 200 mg CAPS. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1,241000 0,000000 0,620500 0,620500 1,116900 0,124100
729 W60625003 M01AH01 CELECOXIBUM CELETOR 200 mg CAPS. 200mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 1,241000 0,000000 0,620500 0,620500 1,116900 0,124100
730 W61089003 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 200 mg CAPS. 200mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 1,241000 0,000000 0,620500 0,620500 1,116900 0,124100
731 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 2,540000 0,578571 1,270000 1,848571 2,286000 0,832571
732 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 2,540000 0,479285 1,270000 1,749285 2,286000 0,733285
733 W62615001 M01AH05 ETORICOXIBUM IMESOL 120 mg COMPR. FILM. 120mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 7 COMPR. FILM. PRF 7 2,540000 0,548571 1,270000 1,818571 2,286000 0,802571
734 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 2,540000 0,548571 1,270000 1,818571 2,286000 0,802571
735 W62716002 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 120 mg COMPR. FILM. 120mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,381428 0,000000 1,190714 1,190714 2,143285 0,238143
736 W62798002 M01AH05 ETORICOXIBUM DOLOXIB 120 mg COMPR. FILM. 120mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2,540000 0,000000 1,270000 1,270000 2,286000 0,254000
737 W62798003 M01AH05 ETORICOXIBUM DOLOXIB 120 mg COMPR. FILM. 120mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 2,540000 0,195000 1,270000 1,465000 2,286000 0,449000
738 W62798005 M01AH05 ETORICOXIBUM DOLOXIB 120 mg COMPR. FILM. 120mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 2,362857 0,000000 1,181428 1,181429 2,126571 0,236286
739 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 2,540000 0,450000 1,270000 1,720000 2,286000 0,704000
740 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 2,540000 0,548571 1,270000 1,818571 2,286000 0,802571
741 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 2,540000 0,548571 1,270000 1,818571 2,286000 0,802571
742 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 2,315714 0,000000 1,157857 1,157857 2,084142 0,231572
743 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 2,540000 0,153571 1,270000 1,423571 2,286000 0,407571
744 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 2,287142 0,000000 1,143571 1,143571 2,058427 0,228715
745 W53204001 M01AH05 ETORICOXIBUM ARCOXIA 30 mg COMPR. FILM. 30mg MERCK SHARP & DOHME ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 28 0,635000 0,973928 0,317500 1,291428 0,571500 1,037428
746 W62612001 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. PRF 28 0,635000 1,377857 0,317500 1,695357 0,571500 1,441357
747 W62612002 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 28X1 COMPR. FILM. PRF 28 0,635000 1,377857 0,317500 1,695357 0,571500 1,441357
748 W62713003 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 30 mg COMPR. FILM. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,635000 1,377857 0,317500 1,695357 0,571500 1,441357
749 W62795001 M01AH05 ETORICOXIBUM DOLOXIB 30 mg COMPR. FILM. 30mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 0,635000 1,465000 0,317500 1,782500 0,571500 1,528500
Pagina 12 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
750 W62795002 M01AH05 ETORICOXIBUM DOLOXIB 30 mg COMPR. FILM. 30mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0,635000 1,398928 0,317500 1,716428 0,571500 1,462428
751 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 0,635000 0,973928 0,317500 1,291428 0,571500 1,037428
752 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 0,635000 1,371785 0,317500 1,689285 0,571500 1,435285
753 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 0,635000 0,973928 0,317500 1,291428 0,571500 1,037428
754 W63425007 M01AH05 ETORICOXIBUM KOSTAROX 30 mg COMPR. FILM. 30mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,635000 0,973214 0,317500 1,290714 0,571500 1,036714
755 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 0,635000 1,281428 0,317500 1,598928 0,571500 1,344928
756 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 0,635000 0,856071 0,317500 1,173571 0,571500 0,919571
757 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 1,270000 0,990714 0,635000 1,625714 1,143000 1,117714
758 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 1,270000 0,990714 0,635000 1,625714 1,143000 1,117714
759 W62613001 M01AH05 ETORICOXIBUM IMESOL 60 mg COMPR. FILM. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1,270000 0,968571 0,635000 1,603571 1,143000 1,095571
760 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 1,270000 0,968571 0,635000 1,603571 1,143000 1,095571
761 W62714002 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 60 mg COMPR. FILM. 60mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,270000 0,687857 0,635000 1,322857 1,143000 0,814857
762 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 1,270000 0,688571 0,635000 1,323571 1,143000 0,815571
763 W62796002 M01AH05 ETORICOXIBUM DOLOXIB 60 mg COMPR. FILM. 60mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,270000 0,687857 0,635000 1,322857 1,143000 0,814857
764 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 1,270000 0,396428 0,635000 1,031428 1,143000 0,523428
765 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 1,270000 0,370000 0,635000 1,005000 1,143000 0,497000
766 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 1,270000 0,909285 0,635000 1,544285 1,143000 1,036285
767 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 1,270000 0,838928 0,635000 1,473928 1,143000 0,965928
768 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 1,270000 0,453571 0,635000 1,088571 1,143000 0,580571
769 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 1,270000 0,742142 0,635000 1,377142 1,143000 0,869142
770 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 1,270000 0,387142 0,635000 1,022142 1,143000 0,514142
771 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 1,905000 0,500714 0,952500 1,453214 1,714500 0,691214
772 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 1,905000 0,500714 0,952500 1,453214 1,714500 0,691214
773 W62614001 M01AH05 ETORICOXIBUM IMESOL 90 mg COMPR. FILM. 90mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1,905000 0,477857 0,952500 1,430357 1,714500 0,668357
774 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 1,905000 0,477857 0,952500 1,430357 1,714500 0,668357
775 W62715004 M01AH05 ETORICOXIBUM ETORICOXIB TEVA 90 mg COMPR. FILM. 90mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,760714 0,000000 0,880357 0,880357 1,584642 0,176072
776 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 1,905000 0,179285 0,952500 1,131785 1,714500 0,369785
777 W62797002 M01AH05 ETORICOXIBUM DOLOXIB 90 mg COMPR. FILM. 90mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,905000 0,179285 0,952500 1,131785 1,714500 0,369785
778 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 1,773928 0,000000 0,886964 0,886964 1,596535 0,177393
779 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 1,905000 0,475714 0,952500 1,428214 1,714500 0,666214
780 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 1,905000 0,409285 0,952500 1,361785 1,714500 0,599785
781 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 1,905000 0,335000 0,952500 1,287500 1,714500 0,525500
782 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 1,833571 0,000000 0,916785 0,916786 1,650213 0,183358
783 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 1,905000 0,366428 0,952500 1,318928 1,714500 0,556928
784 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 1,825000 0,000000 0,912500 0,912500 1,642500 0,182500
785 W10193001 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,408780 0,026420 0,204390 0,230810 0,367902 0,067298
786 W10194001 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,701400 0,000000 0,350700 0,350700 0,631260 0,070140
787 W54297001 M05BA04 ACIDUM ALENDRONICUM * TEVANAT 70 mg COMPR. 70 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L 4 2,847500 0,000000 1,423750 1,423750 2,562750 0,284750
788 W58352002 M05BA04 ACIDUM ALENDRONICUM * ACID ALENDRONIC AUROBINDO 70 mgCOMPR. 70mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR. P6L 4 2,620000 0,000000 1,310000 1,310000 2,358000 0,262000
789 W60296004 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 6,054300 3,265700 3,027150 6,292850 5,448870 3,871130
790 W60296002 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 4 COMPR. P6L 4 6,054300 2,968200 3,027150 5,995350 5,448870 3,573630
791 W52948001 M05BA04 ACIDUM ALENDRONICUM * ALENDRONAT SANDOZ 70 mg COMPR. FILM. 70mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM P-6L 2 5,155000 0,000000 2,577500 2,577500 4,639500 0,515500
792 W56763001 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L 12 6,054300 2,514866 3,027150 5,542016 5,448870 3,120296
793 W56763002 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM. P-6L 2 6,054300 3,265700 3,027150 6,292850 5,448870 3,871130
794 W56763003 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 6,054300 2,968200 3,027150 5,995350 5,448870 3,573630
795 W54377002 M05BA07 ACIDUM RISEDRONICUM * LORINE 35mg COMPR. FILM. 35mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L 4 6,054300 1,553200 3,027150 4,580350 5,448870 2,158630
796 W55565003 M05BA07 ACIDUM RISEDRONICUM * OSODENS 35 mg COMPR. FILM. 35mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 6,054300 1,550700 3,027150 4,577850 5,448870 2,156130
797 W60074002 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT SODIC ZENTIVA 35mg COMPR. FILM. 35mg ZENTIVA KS REPUBLICA CEHA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE P-6L 4 3,910000 0,000000 1,955000 1,955000 3,519000 0,391000
798 W59460003 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 35 mg COMPR. FILM. 35mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L 4 3,910000 0,000000 1,955000 1,955000 3,519000 0,391000
799 W61163003 M05BA07 ACIDUM RISEDRONICUM * ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 6,054300 5,270700 3,027150 8,297850 5,448870 5,876130
800 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 12,973500 10,536500 6,486750 17,023250 11,676150 11,833850
801 W62565001 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 12,973500 9,356500 6,486750 15,843250 11,676150 10,653850
802 W42702002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UIMERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P-6L 4 6,054300 2,968200 3,027150 5,995350 5,448870 3,573630
803 W63914002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/2800 UI COMPR. 70mg/2800UIAUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,054300 0,770700 3,027150 3,797850 5,448870 1,376130
804 W63922002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/2800 UI COMPR. 70mg/2800UIZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,054300 6,805700 3,027150 9,832850 5,448870 7,411130
805 W64728002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UIMERCK SHARP & DOHME OLANDA CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P6L 4 6,054300 2,968200 3,027150 5,995350 5,448870 3,573630
806 W52559001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UIMERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P-6L 2 6,054300 3,265700 3,027150 6,292850 5,448870 3,871130
807 W62143003 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UITEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR., AMBALAJ TIP CALENDAR P6L 4 6,054300 0,193200 3,027150 3,220350 5,448870 0,798630
808 W62143001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UITEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. P6L 4 6,054300 1,560700 3,027150 4,587850 5,448870 2,166130
809 W62143002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UITEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4X1 COMPR. P6L 4 6,054300 1,560700 3,027150 4,587850 5,448870 2,166130
810 W63074002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL SANDOZ 70 mg/5600 UI COMPR. 70mg/5600UISANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 4 COMPR.P6L 4 6,054300 1,500700 3,027150 4,527850 5,448870 2,106130
811 W63915002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/5600 UI COMPR. 70mg/5600UIAUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,054300 0,770700 3,027150 3,797850 5,448870 1,376130
812 W63923002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/5600 UI COMPR. 70mg/5600UIZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 6,054300 1,308200 3,027150 4,335350 5,448870 1,913630
Pagina 13 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
813 W64729001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UIMERCK SHARP & DOHME OLANDA CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P6L 2 6,054300 3,265700 3,027150 6,292850 5,448870 3,871130
814 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 0,849579 0,413587 0,424789 0,838377 0,764621 0,498545
815 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 1,699162 0,347671 0,849581 1,197252 1,529245 0,517588
816 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 1,699162 0,455338 0,849581 1,304919 1,529245 0,625255
817 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 2,548745 3,236255 1,274372 4,510628 2,293870 3,491130
818 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 3,398324 0,081342 1,699162 1,780504 3,058491 0,421175
819 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 3,398324 0,271676 1,699162 1,970838 3,058491 0,611509
820 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 1,277571 0,918143 0,638785 1,556929 1,149813 1,045901
821 W44119001 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 60 mg COMPR. ELIB. PREL. 60mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 0,572500 0,000000 0,286250 0,286250 0,515250 0,057250
822 W44120001 N02AA08 DIHYDROCODEINUM * DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 0,958178 0,312357 0,479089 0,791446 0,862360 0,408175
823 W60400003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAUMOBOL 37,5mg/325mg CAPS. 37,5mg/325mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 2 BLISTERE PVC/PE/PVDC/AL X 15 CAPSULE PRF 30 0,287000 0,253666 0,143500 0,397166 0,258300 0,282366
824 W60400001 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAUMOBOL 37,5mg/325mg CAPS. 37,5mg/325mg ROMPHARM COMPANY SRL ROMANIA CUTIE CU 1 BLIST. DIN PVC/PE/PVDC/AL A 15 CAPS. PRF 15 0,287000 0,267000 0,143500 0,410500 0,258300 0,295700
825 W61518001 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 10 0,287000 0,480000 0,143500 0,623500 0,258300 0,508700
826 W61518002 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 2 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 20 0,287000 0,480500 0,143500 0,624000 0,258300 0,509200
827 W61518003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 3 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 30 0,287000 0,480333 0,143500 0,623833 0,258300 0,509033
828 W61518004 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) ZALDIAR COMPR. FILM. 37,5mg+325mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 5 BLIST.DIN HÂRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF 50 0,287000 0,408400 0,143500 0,551900 0,258300 0,437100
829 W54375003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-RF 20 0,286500 0,000000 0,143250 0,143250 0,257850 0,028650
830 W54375004 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 0,287000 0,000000 0,143500 0,143500 0,258300 0,028700
831 W62652002 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) TRAMADOL/PARACETAMOL AUROBINDO 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. PRF 20 0,287000 0,000500 0,143500 0,144000 0,258300 0,029200
832 W58620002 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF 20 0,574000 0,000000 0,287000 0,287000 0,516600 0,057400
833 W58620003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMP. FILM. PRF 30 0,574000 0,000666 0,287000 0,287666 0,516600 0,058066
834 W61588003 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) PALGOTAL 75 mg/650 mg COMPR. FILM. 75mg/650mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVCDC/AL X 30 COMPR. FILM. PRF 30 0,566000 0,000000 0,283000 0,283000 0,509400 0,056600
835 W41745001 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 1,405714 0,000000 0,702857 0,702857 1,265142 0,140572
836 W41745002 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 1,291428 0,000000 0,645714 0,645714 1,162285 0,129143
837 W64907001 N03AX16 PREGABALINUM ** # LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 1,405714 0,000000 0,702857 0,702857 1,265142 0,140572
838 W41747001 N03AX16 PREGABALINUM ** # LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 2,619285 0,000000 1,309642 1,309643 2,357356 0,261929
839 W41743001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 1,091428 0,000000 0,545714 0,545714 0,982285 0,109143
840 W41743002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 1,055000 0,000000 0,527500 0,527500 0,949500 0,105500
841 W64906002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 1,055000 0,000000 0,527500 0,527500 0,949500 0,105500
842 W64906001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 1,091428 0,000000 0,545714 0,545714 0,982285 0,109143
843 W60055001 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL ZENTIVA 0,18 mg COMPR. 0,18 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.PRF 30 0,196205 0,211128 0,098102 0,309231 0,176584 0,230749
844 W53525002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,196205 0,253128 0,098102 0,351231 0,176584 0,272749
845 W54712001 N04BC05 PRAMIPEXOLUM * MEDOPEXOL 0,18 mg COMPR. 0,18mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 0,196205 0,370461 0,098102 0,468564 0,176584 0,390082
846 W55286001 N04BC05 PRAMIPEXOLUM * GLEPARK 0,18 mg COMPR. 0,18mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 0,196205 0,129461 0,098102 0,227564 0,176584 0,149082
847 W60054001 N04BC05 PRAMIPEXOLUM * PRAMIPEXOL ZENTIVA 0,7 mg COMPR. 0,7 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.PRF 30 0,763020 1,384313 0,381510 1,765823 0,686718 1,460615
848 W53527002 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,763020 1,269980 0,381510 1,651490 0,686718 1,346282
849 W54713001 N04BC05 PRAMIPEXOLUM * MEDOPEXOL 0,7 mg COMPR. 0,7mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 0,763020 1,372646 0,381510 1,754156 0,686718 1,448948
850 W55288001 N04BC05 PRAMIPEXOLUM * GLEPARK 0,7 mg COMPR. 0,7mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 0,763020 1,208646 0,381510 1,590156 0,686718 1,284948
851 W54798001 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,26 mg COMPR. ELIB. PREL. 0,26mg GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITAP-RF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH 10 0,283407 1,243593 0,141703 1,385297 0,255066 1,271934
852 W60244001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA P-RF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 30 0,283407 0,386259 0,141703 0,527963 0,255066 0,414600
853 W60802001 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,26 mg COMPR. ELIB. PREL. 0,26mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF 10 0,283407 0,386593 0,141703 0,528297 0,255066 0,414934
854 W54799002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,52 mg COMPR. ELIB. PREL. 0,52mg GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-RF
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA 30 0,566815 1,625185 0,283407 1,908593 0,510133 1,681867
855 W60240001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,52mg COMPR. ELIB. PREL. 0,52mg KRKA D.D. SLOVENIA P-RF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 30 0,566815 0,907518 0,283407 1,190926 0,510133 0,964200
856 W60803002 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,52 mg COMPR. ELIB. PREL. 0,52mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 0,566815 0,907518 0,283407 1,190926 0,510133 0,964200
857 W54800002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 1,05 mg COMPR. ELIB. PREL. 1,05mg GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-RF
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA 30 1,144530 3,026470 0,572265 3,598735 1,030077 3,140923
858 W60241001 N04BC05 PRAMIPEXOLUM * OPRYMEA 1,05mg COMPR. ELIB. PREL. 1,05mg KRKA D.D. SLOVENIA P-RF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 30 1,144530 0,838803 0,572265 1,411068 1,030077 0,953256
859 W60243001 N04BC05 PRAMIPEXOLUM * OPRYMEA 2,10mg COMPR. ELIB. PREL. 2,10mg KRKA D.D. SLOVENIA P-RF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA 30 2,289061 1,477272 1,144530 2,621803 2,060154 1,706179
860 W54801002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 2,1 mg COMPR. ELIB. PREL. 2,1mg GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-RF
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA 30 2,289061 5,260272 1,144530 6,404803 2,060154 5,489179
861 W60805002 N04BC05 PRAMIPEXOLUM * CALMOLAN 2,1 mg COMPR. ELIB. PREL. 2,1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 2,289061 1,630272 1,144530 2,774803 2,060154 1,859179
862 W54802002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 3,15 mg COMPR. ELIB. PREL. 3,15mg GERMANIA
BOEHRINGER INGELHEIM INTERNATIONAL GMBH P-RF
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA 30 3,433592 4,746741 1,716796 6,463537 3,090232 5,090101
863 W62151001 N04BC05 PRAMIPEXOLUM * OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 3,433592 4,747074 1,716796 6,463870 3,090232 5,090434
864 W10479001 N04BC08 PIRIBEDILUM ** PRONORAN 50 mg DRAJ. ELIB. PREL. 50mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL. P-RF 30 0,681268 0,303732 0,340634 0,644366 0,613141 0,371859
865 W05889001 N05AL03 TIAPRIDUM TIAPRIDAL (R) 100 mg COMPR. 100mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,397000 0,000000 0,198500 0,198500 0,357300 0,039700
866 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 0,397000 0,000000 0,198500 0,198500 0,357300 0,039700
867 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 0,259166 0,000000 0,129583 0,129583 0,233249 0,025917
868 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 0,136686 0,021314 0,068343 0,089657 0,123017 0,034983
869 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 0,820333 0,000000 0,410166 0,410167 0,738299 0,082034
870 W59844001 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 0,649285 0,000000 0,324642 0,324643 0,584356 0,064929
871 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 0,964434 0,366994 0,482217 0,849211 0,867990 0,463438
872 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 0,894285 0,000000 0,447142 0,447143 0,804856 0,089429
873 W54882002 N06AB10 ESCITALOPRAMUM ** ESLOREX 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,649333 0,000000 0,324666 0,324667 0,584399 0,064934
874 W55813002 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0,821428 0,000000 0,410714 0,410714 0,739285 0,082143
875 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 0,552142 0,000000 0,276071 0,276071 0,496927 0,055215
Pagina 14 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
876 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 0,552500 0,000000 0,276250 0,276250 0,497250 0,055250
877 W60685003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM. 10mg ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
ACTAVIS GROUP PTC EHF. PRF 28 0,523928 0,000000 0,261964 0,261964 0,471535 0,052393
878 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 0,812000 0,000000 0,406000 0,406000 0,730800 0,081200
879 W60777003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,512857 0,000000 0,256428 0,256429 0,461571 0,051286
880 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 0,805714 0,000000 0,402857 0,402857 0,725142 0,080572
881 W59846001 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 1,014285 0,000000 0,507142 0,507143 0,912856 0,101429
882 W60686003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 1,252142 0,000000 0,626071 0,626071 1,126927 0,125215
883 W13019001 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 20 1,175624 0,068376 0,587812 0,656188 1,058061 0,185939
884 W13019004 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 60 1,152833 0,000000 0,576416 0,576417 1,037549 0,115284
885 W13019002 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF 60 1,152833 0,000000 0,576416 0,576417 1,037549 0,115284
886 W13019003 N06AX05 TRAZODONUM ** TRITTICO AC 150 mg COMPR. ELIB. PREL. 150mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF 20 1,175624 0,068376 0,587812 0,656188 1,058061 0,185939
887 W08616002 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-RF 30 0,587812 0,091188 0,293906 0,385094 0,529030 0,149970
888 W08616001 N06AX05 TRAZODONUM ** TRITTICO AC 75 mg COMPR. ELIB. PREL. 75mg ANGELINI FRANCESCO SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. ELIB. PREL. P-RF 30 0,587812 0,091188 0,293906 0,385094 0,529030 0,149970
889 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 2,053666 0,000000 1,026833 1,026833 1,848299 0,205367
890 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 0,485000 0,000000 0,242500 0,242500 0,436500 0,048500
891 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 0,468888 0,000000 0,234444 0,234444 0,421999 0,046889
892 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 0,485000 0,000000 0,242500 0,242500 0,436500 0,048500
893 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 0,485000 0,000000 0,242500 0,242500 0,436500 0,048500
894 W41558001 N06AX14 TIANEPTINUM ** COAXIL (R) DRAJ. 12,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 0,485000 0,260333 0,242500 0,502833 0,436500 0,308833
895 W43297002 N06AX21 DULOXETINUM ** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 0,635714 1,143928 0,317857 1,461785 0,572142 1,207500
896 W61820005 N06AX21 DULOXETINUM ** DULSEVIA 30 mg CAPS. GASTROREZ. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ. PRF 30 0,635714 0,458286 0,317857 0,776143 0,572142 0,521858
897 W61959001 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,586071 0,317857 0,903928 0,572142 0,649643
898 W61959002 N06AX21 DULOXETINUM ** ZATINEX 30 mg CAPS. GASTROREZ. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,586071 0,317857 0,903928 0,572142 0,649643
899 W62006001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 30 mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,706428 0,317857 1,024285 0,572142 0,770000
900 W62305004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 30 mg CAPS. GASTROREZ. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 0,635714 0,564286 0,317857 0,882143 0,572142 0,627858
901 W62054001 N06AX21 DULOXETINUM ** DULOXETINE ZENTIVA 30 mg CAPS. GASTROREZ. 30mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,606786 0,317857 0,924643 0,572142 0,670358
902 W62274004 N06AX21 DULOXETINUM ** DULASOLAN 30 mg CAPS. GASTROREZ. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 30 CAPS. GASTOREZ. PRF 30 0,635714 0,468619 0,317857 0,786476 0,572142 0,532191
903 W62301003 N06AX21 DULOXETINUM ** DULOXETINA STADA 30 mg CAPS. GASTROREZ. 30mg STADA M&D SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 1,337500 0,317857 1,655357 0,572142 1,401072
904 W62808002 N06AX21 DULOXETINUM ** DULOXETINA SANDOZ 30 mg CAPS. GASTROREZ. 30mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,408214 0,317857 0,726071 0,572142 0,471786
905 W62801002 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,521428 0,317857 0,839285 0,572142 0,585000
906 W62801012 N06AX21 DULOXETINUM ** ONELAR 30 mg CAPS. GASTROREZ. 30mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,521428 0,317857 0,839285 0,572142 0,585000
907 W63955004 N06AX21 DULOXETINUM ** DOZZEX 30 mg CAPS. GASTROREZ. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 0,635714 0,616786 0,317857 0,934643 0,572142 0,680358
908 W63230001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 45 mg CAPS. GASTROREZ. 45mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 0,953571 1,378571 0,476785 1,855357 0,858213 1,473929
909 W43298001 N06AX21 DULOXETINUM ** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 1,271428 1,438572 0,635714 2,074286 1,144285 1,565715
910 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 1,180000 0,000000 0,590000 0,590000 1,062000 0,118000
911 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 1,243571 0,000000 0,621785 0,621786 1,119213 0,124358
912 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 1,243571 0,000000 0,621785 0,621786 1,119213 0,124358
913 W62007001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 60 mg CAPS. GASTROREZ. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 1,271428 1,329643 0,635714 1,965357 1,144285 1,456786
914 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 1,207142 0,000000 0,603571 0,603571 1,086427 0,120715
915 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 1,053214 0,000000 0,526607 0,526607 0,947892 0,105322
916 W62306004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 60 mg CAPS. GASTROREZ. 60mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,271428 0,968905 0,635714 1,604619 1,144285 1,096048
917 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 1,108000 0,000000 0,554000 0,554000 0,997200 0,110800
918 W62803003 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. GASTROREZ. PRF 30 1,271428 0,524238 0,635714 1,159952 1,144285 0,651381
919 W62803013 N06AX21 DULOXETINUM ** ONELAR 60 mg CAPS. GASTROREZ. 60mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,271428 0,524238 0,635714 1,159952 1,144285 0,651381
920 W62809001 N06AX21 DULOXETINUM ** DULOXETINA SANDOZ 60 mg CAPS. GASTROREZ. 60mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,082500 0,000000 0,541250 0,541250 0,974250 0,108250
921 W63956004 N06AX21 DULOXETINUM ** DOZZEX 60 mg CAPS. GASTROREZ. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TRANSPARENTE PVC-PCTFE/AL X 28 CAPS. GASTROREZ. PRF 28 1,271428 0,027857 0,635714 0,663571 1,144285 0,155000
922 W08060001 N06BX16 PRAMIRACETAMUM ** # PRAMISTAR COMPR. FILM. 600mg F.I.R.M.A. S.P.A. (MENARINI GROUP) ITALIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR.FILM. P-6L 20 3,856000 0,000000 1,928000 1,928000 3,470400 0,385600
923 W58635002 N06BX18 VINPOCETINUM VINPOCETINA VIM SPECTRUM 5 mg CAPS. 5mg VIM SPECTRUM SRLROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L 50 0,172000 0,000000 0,086000 0,086000 0,154800 0,017200
924 W54827001 N06BX18 VINPOCETINUM CAVINTON(R) FORTE COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-6L 30 0,362666 0,056000 0,181333 0,237333 0,326399 0,092267
925 W57876003 N07CA01 BETAHISTINUM VERTIMED 16 mg COMPR. 16mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR.P6L 30 0,306999 0,071001 0,153499 0,224501 0,276299 0,101701
926 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 0,306999 0,306334 0,153499 0,459834 0,276299 0,337034
927 W61221004 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,290666 0,000000 0,145333 0,145333 0,261599 0,029067
928 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 0,455333 0,000000 0,227666 0,227667 0,409799 0,045534
929 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 0,460499 0,041001 0,230249 0,271251 0,414449 0,087051
930 W55890001 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 20 0,460499 0,041001 0,230249 0,271251 0,414449 0,087051
931 W55890002 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 5 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 50 0,460499 0,040901 0,230249 0,271151 0,414449 0,086951
932 W57877003 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR.P6L 30 0,460333 0,000000 0,230166 0,230167 0,414299 0,046034
933 W57877006 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 60 COMPR.P6L 60 0,460499 0,000167 0,230249 0,230417 0,414449 0,046217
934 W58315002 N07CA01 BETAHISTINUM VESTIBO 24 mg COMPR. 24mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,447000 0,000000 0,223500 0,223500 0,402300 0,044700
935 W55890003 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 6 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 60 0,460499 0,041001 0,230249 0,271251 0,414449 0,087051
936 W61222003 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 24 mg COMPR. 24mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0,372833 0,000000 0,186416 0,186417 0,335549 0,037284
937 W61738004 N07CA01 BETAHISTINUM MARBETA 24 mg COMPR. 24mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 60 0,460499 0,041001 0,230249 0,271251 0,414449 0,087051
938 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 0,460499 0,286334 0,230249 0,516584 0,414449 0,332384
Pagina 15 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
939 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 0,460499 0,311501 0,230249 0,541751 0,414449 0,357551
940 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 0,433500 0,000000 0,216750 0,216750 0,390150 0,043350
941 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 0,433666 0,000000 0,216833 0,216833 0,390299 0,043367
942 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 0,460499 0,311501 0,230249 0,541751 0,414449 0,357551
943 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 0,460499 0,286334 0,230249 0,516584 0,414449 0,332384
944 W55889001 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 30 0,153499 0,046834 0,076749 0,123584 0,138149 0,062184
945 W55889002 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 10 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 100 0,153499 0,046501 0,076749 0,123251 0,138149 0,061851
946 W57875009 N07CA01 BETAHISTINUM VERTIMED 8 mg COMPR. 8mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 100 COMPR. P6L 100 0,153499 0,034301 0,076749 0,111051 0,138149 0,049651
947 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 0,153499 0,046501 0,076749 0,123251 0,138149 0,061851
948 W61220006 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg COMPR. 8mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 0,153499 0,034301 0,076749 0,111051 0,138149 0,049651
949 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 0,153499 0,135601 0,076749 0,212351 0,138149 0,150951
950 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 0,153499 0,135601 0,076749 0,212351 0,138149 0,150951
951 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 0,460499 0,365334 0,230249 0,595584 0,414449 0,411384
952 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 1,085800 0,000000 0,542900 0,542900 0,977220 0,108580
953 W02144003 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT COMPR. FARA CONCENTRATIE HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-RF 100 1,335200 0,249400 0,667600 0,917000 1,201680 0,382920
954 W02144006 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM) ARLEVERT COMPR. FARA CONCENTRATIE HENNIG ARZNEIMITTEL GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 24 COMPR. P-RF 48 1,335200 0,335841 0,667600 1,003441 1,201680 0,469361
955 W55730003 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml 215,2mg/ml
SOL. INJ./CONC. PT. SOL. PERF. EVER NEURO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 27,204000 0,000000 13,602000 13,602000 24,483600 2,720400
956 W55730002 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml 215,2mg/ml
SOL. INJ./CONC. PT. SOL. PERF. EVER NEURO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 14,869000 3,801000 7,434500 11,235500 13,382100 5,287900
957 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 0,553166 0,000000 0,276583 0,276583 0,497849 0,055317
958 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 0,553166 0,000000 0,276583 0,276583 0,497849 0,055317
959 W60598001 R01AD09 MOMETASONUM * MOMETAZONA FUROAT CIPLA 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza CIPLA (EU) LIMITED MAREA BRITANIE CUTIE CU UN FLAC. DIN PEID, PREVAZUT CU POMPA DOZATOARE MANUALA DIN PP CARE CONTINE 18 G SUSPENSIE, ECHIVALENT CU 140 DOZE PRF 1 17,430000 4,160000 8,715000 12,875000 15,687000 5,903000
960 W59422002 R01AD09 MOMETASONUM * MOMETAZONA FUROAT SANDOZ 50 micrograme/doza SPRAY NAZ.,SUSP. 50micrograme/doza SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID PREVAZUT CU O POMPA PULVERIZATOARE NAZALA DIN PE/PP CARE CONTINE 18 G SUSP. NAZALA CORESPUNZATOR LA 140 DOZE MASURATE PRF 1 13,270000 0,000000 6,635000 6,635000 11,943000 1,327000
961 W57437001 R01AD09 MOMETASONUM * NASONEX 50mcg/doza SPRAY NAZAL SUSP. 50mcg/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DIN PE PREVAZUT CU POMPA DOZATOARE, DISPOZITIV DE ACTIONARE DIN PP SI CAPAC, CU UN VOLUM DE 23,5 ML SUSPENSIE PT. 140 PULVERIZARI SPRAY NAZAL, SUSPENSIE P-RF 1 17,430000 10,970000 8,715000 19,685000 15,687000 12,713000
962 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 93,420000 0,000000 46,710000 46,710000 84,078000 9,342000
963 W57928002 R03AC13 FORMOTEROLUM ** ATIMOS 0,012mg/doza SOL. DE INHALAT PRESURIZATA 0,012mg/doza TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FLACON X 100 DOZE + VALVA DOZATOARE P-6L 1 116,020000 0,000000 58,010000 58,010000 104,418000 11,602000
964 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 2,233000 2,127333 1,116500 3,243833 2,009700 2,350633
965 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 2,233000 2,127333 1,116500 3,243833 2,009700 2,350633
966 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 4,466000 0,000000 2,233000 2,233000 4,019400 0,446600
967 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 4,466000 0,000000 2,233000 2,233000 4,019400 0,446600
968 W60119001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/100 micrograme PULB. INHAL. 50micrograme/100micrograme GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL. P6L 1 32,532000 68,938000 16,266000 85,204000 29,278800 72,191200
969 W60120001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/250 micrograme PULB. INHAL. 50micrograme/250micrograme GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL. P6L 1 81,330000 53,400000 40,665000 94,065000 73,197000 61,533000
970 W60121001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE DISKUS 50 micrograme/500 micrograme PULB. INHAL. 50micrograme/500micrograme GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL. P6L 1 162,660000 0,000000 81,330000 81,330000 146,394000 16,266000
971 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 1 114,900000 0,000000 57,450000 57,450000 103,410000 11,490000
972 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 81,330000 6,940000 40,665000 47,605000 73,197000 15,073000
973 W12104001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE 25 mcg/125 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/125mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L 1 81,330000 53,800000 40,665000 94,465000 73,197000 61,933000
974 W12105001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERETIDE 25 mcg/50 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/50mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L 1 32,532000 77,348000 16,266000 93,614000 29,278800 80,601200
975 W61943001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/125 micrograme/doza SUSP. INHAL. PRESURIZATA 25micrograme/125micrograme/doz CIPLA EUROPE NV BELGIA PRF
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 1 81,330000 14,490000 40,665000 55,155000 73,197000 22,623000
976 W61945001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/250 micrograme/doza SUSP. INHAL. PRESURIZATA 25micrograme/250micrograme/doz CIPLA EUROPE NV BELGIA PRF
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 1 121,760000 0,000000 60,880000 60,880000 109,584000 12,176000
977 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 1 123,660000 0,000000 61,830000 61,830000 111,294000 12,366000
978 W56427001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 160micrograme/4,5micrograme/in ASTRAZENECA AB SUEDIA P6L
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 1 67,286666 13,233334 33,643333 46,876667 60,557999 19,962001
979 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 1 117,040000 0,000000 58,520000 58,520000 105,336000 11,704000
980 W56428001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie PULB. DE INHAL. 320micrograme/9micrograme/inha ASTRAZENECA AB SUEDIA P6L
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 1 134,573333 18,326667 67,286666 85,613334 121,115999 31,784001
981 W56426001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 80micrograme/4,5micrograme/inh ASTRAZENECA AB SUEDIA P6L
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. 1 67,286666 12,043334 33,643333 45,686667 60,557999 18,772001
982 W62789001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT 160 micrograme/4,5 micrograme/inhalatie SUSP. DE INHALAT PRESURIZATA 160micrograme/4,5micrograme ASTRAZENECA AB SUEDIA P6L
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 1 134,573333 11,436667 67,286666 78,723334 121,115999 24,894001
983 W57995002 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER 100/6 micrograme pe doza SOL. DE INHALAT PRESURIZATA 100/6micrograme pe doza CHIESI PHARMACEUTICALS GMBH AUSTRIA PRF
CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS IN DISPOZITIVUL DE ADMINISTRARE DIN PE CU CAPAC PROTECTOR DIN PLASTIC A 180 DOZE SOL. DE INHALAT 1 201,859999 16,370001 100,929999 117,300001 181,673999 36,556001
984 W59645001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 125 micrograme/5 micrograme SUSP. INHAL. PRESURIZATA 125micrograme/5micrograme MUNDIPHARMA GES.M.B.H AUSTRIA P6L
CUTIE CU 1 FLAC. DIN AL (INHALATOR) PREVAZUT CU VALVA DOZATOARE SI DISPOZITIV DE ADMINISTRARE DIN PP X 120 DOZE SUSP. DE INHALAT PRESURIZATA 1 131,602500 28,117500 65,801250 93,918750 118,442250 41,277750
985 W59644001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 50 micrograme/5 microgrameSUSP. INHAL. PRESURIZATA 50micrograme/5micrograme MUNDIPHARMA GES.M.B.H AUSTRIA P6L
CUTIE CU 1 FLAC. DIN AL (INHALATOR) PREVAZUT CU VALVA DOZATOARE SI DISPOZITIV DE ADMINISTRARE DIN PP X 120 DOZE SUSP. DE INHALAT PRESURIZATA 1 122,230000 0,000000 61,115000 61,115000 110,007000 12,223000
986 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 7,945000 0,000000 3,972500 3,972500 7,150500 0,794500
987 W64767001 R03AL04 COMBINATII (INDACATEROLUM+GLICOPIRONIUM) ** ULTIBRO BREEZHALER 85 micrograme/43 micrograme CAPS. CU PULB. DE INHAL. 85micrograme/43micrograme IRLANDA
NOVARTIS EUROPHARM LTD. CUTIE X 30 BLISTERE PERFORATE PA-AL-PVC/AL PENTRU ELIBERAREA UNEI UNITATI DOZATE X 1 CAPSULA CU PULBERE DE INHALAT + 1 INHALATOR PR/PRF 30 7,945000 0,000000 3,972500 3,972500 7,150500 0,794500
988 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 1 228,517500 0,052500 114,258750 114,311250 205,665750 22,904250
989 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 1 228,500000 0,000000 114,250000 114,250000 205,650000 22,850000
990 W61818001 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 DINTR-UN INHALATOR RESPIMAT SI UN CARTUS, CARE FURNIZEAZA 60 DE PUFURI SOLUTIE PENTRU INHALAT (30 DE DOZE TERAPEUTICE) PRF 1 206,430000 0,000000 103,215000 103,215000 185,787000 20,643000
991 W41902002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 100 mcg PULB. INHAL.100mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 16,754400 20,235600 8,377200 28,612800 15,078960 21,911040
992 W41903002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 250 mcg PULB. INHAL.250mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 41,886000 15,714000 20,943000 36,657000 37,697400 19,902600
993 W41904002 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE DISKUS 500 mcg PULB. INHAL.500mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE P-RF 1 83,772000 9,308000 41,886000 51,194000 75,394800 17,685200
994 W03222001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE 125 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 125mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA P-RF 1 20,943000 14,877000 10,471500 25,348500 18,848700 16,971300
995 W63693001 R03BA05 FLUTICASONUM PROPIONAT * ARQUIST 125 micrograme SUSP. INHAL. PRESURIZATA 125micrograme AMRING FARMA SRLROMANIA CUTIE CU 1 RECIPIENT DIN AL SUB PRESIUNE PREVAZUT CU O VALVA DE MASURARE, UN DOZATOR DIN PP CU CAPAC, INTRODUS ÎNTR-O PUNGA DE AL CU SACULET DE SILICAGEL CARE CONTINE 120 DOZE SUSP. DE INHALAT PRESURIZATA PRF 1 41,886000 4,204000 20,943000 25,147000 37,697400 8,392600
996 W63695001 R03BA05 FLUTICASONUM PROPIONAT * ARQUIST 250 micrograme SUSP. INHAL. PRESURIZATA 250micrograme AMRING FARMA SRLROMANIA CUTIE CU 1 RECIPIENT DIN AL SUB PRESIUNE PREVAZUT CU O VALVA DE MASURARE, UN DOZATOR DIN PP CU CAPAC, INTRODUS ÎNTR-O PUNGA DE AL CU SACULET DE SILICAGEL CARE CONTINE 120 DOZE SUSP. DE INHALAT PRESURIZATA PRF 1 79,150000 0,000000 39,575000 39,575000 71,235000 7,915000
997 W41591001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE (R) 50 INHALER CFC - Free 50mcg/doza
SUSP. INHAL. PRESURIZATA GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE P-RF 1 16,754400 19,955600 8,377200 28,332800 15,078960 21,631040
998 W12420003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 0,5 mg/2 ml 0,5mg/2ml
SUSP. INHAL. PRIN NEBULIZATOR GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP PRF 10 0,558479 2,395521 0,279239 2,674761 0,502631 2,451369
999 W12419003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 2 mg/2 ml 2mg/2ml
SUSP. INHAL. PRIN NEBULIZATOR GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP PRF 10 2,233919 6,409081 1,116959 7,526041 2,010527 6,632473
1.000 W57957001 R03BA07 MOMETASONUM * ASMANEX TWISTHALER 200 µg PULB. INHAL.200µg/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L 1 33,553750 7,256250 16,776875 24,033125 30,198375 10,611625
1.001 W57956002 R03BA07 MOMETASONUM * ASMANEX TWISTHALER 400 µg PULB. INHAL.400µg/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L 1 62,270000 0,000000 31,135000 31,135000 56,043000 6,227000
Pagina 16 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
1.002 W64226001 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER SOL. DE INHALAT PRESURIZATA ASTRAZENECA AB SUEDIA
160micrograme/doza CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA PRF 1 90,310000 0,000000 45,155000 45,155000 81,279000 9,031000
1.003 W62428001 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER SOL. DE INHALAT PRESURIZATA 160µg/doza TAKEDA GMBH GERMANIA CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA P-RF 1 90,310000 0,000000 45,155000 45,155000 81,279000 9,031000
1.004 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 4,602333 0,430333 2,301166 2,731500 4,142099 0,890567
1.005 W63214002 R03BB04 TIOTROPIUM * GREGAL 10 micrograme PULB. DE INHAL. CAPSULA 10micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEÎD CU CAPAC CU FILET DIN PP, FOLIE PROTECTOARE DIN PE, INEL DE SIGILARE SI CU REZERVOR DIN PEÎD CARE CONTINE SILICAGEL CU 30 CAPSULE SI UN INHALATOR ZONDA PRF 30 4,040333 0,000000 2,020166 2,020167 3,636299 0,404034
1.006 W58575001 R03BB04 TIOTROPIUM * SPIRIVA RESPIMAT 2,5 micrograme SOL. DE INHALAT 2,5micrograme BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 AMBALAJ UNIC CU UN INHALATOR RESPIMAT SI UN CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. PT. INHALAT PRF 1 138,070000 0,000000 69,035000 69,035000 124,263000 13,807000
1.007 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 4,602333 0,396667 2,301166 2,697834 4,142099 0,856901
1.008 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 4,602333 0,396667 2,301166 2,697834 4,142099 0,856901
1.009 W42796002 R03DA05 AMINOPHYLLINUM MIOFILIN 100 mg CAPS. 100mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,182002 0,014998 0,091001 0,105999 0,163801 0,033199
1.010 W42330001 R03DA05 AMINOPHYLLINUM AMINOFILINA EEL COMPR. 100mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0,148200 0,000000 0,074100 0,074100 0,133380 0,014820
1.011 W53945002 R03DA05 AMINOPHYLLINUM AMINOFILINA ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-RF 40 0,182002 0,007498 0,091001 0,098499 0,163801 0,025699
1.012 W53946002 R03DA05 AMINOPHYLLINUM AMINOFILINA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,364005 0,057495 0,182002 0,239498 0,327604 0,093896
1.013 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 2,582000 0,000000 1,291000 1,291000 2,323800 0,258200
1.014 W57009004 R03DC03 MONTELUKASTUM * ASTHATOR 10 mg COMPR. 10 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR.
P6L 28 0,901035 0,906822 0,450517 1,357340 0,810931 0,996926
1.015 W51362004 R03DC03 MONTELUKASTUM * SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L 28 0,901035 1,638965 0,450517 2,089483 0,810931 1,729069
1.016 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 0,870666 0,000000 0,435333 0,435333 0,783599 0,087067
1.017 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 0,901035 0,126465 0,450517 0,576983 0,810931 0,216569
1.018 W58991005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 10 mg COMPR. FILM. 10mg MALTA
AUROBINDO PHARMA (MALTA) LIMITED CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,901035 0,091107 0,450517 0,541625 0,810931 0,181211
1.019 W61626002 R03DC03 MONTELUKASTUM * MONTELUKAST CIPLA 10 mg COMPR. FILM. 10mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. LAMINATE FORMATE DIN 3 STRATURI AL/AL SI AL (NYLON-AL-PVC/AL) X 28 COMPR. FILM. P6L 28 0,568571 0,000000 0,284285 0,284286 0,511713 0,056858
1.020 W57010004 R03DC03 MONTELUKASTUM * ASTHATOR 4 mg COMPR. MAST. 4 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 0,633714 1,039143 0,316857 1,356000 0,570342 1,102515
1.021 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 0,457000 0,000000 0,228500 0,228500 0,411300 0,045700
1.022 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 0,630000 0,000000 0,315000 0,315000 0,567000 0,063000
1.023 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 0,633714 0,123428 0,316857 0,440285 0,570342 0,186800
1.024 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 0,633714 1,853786 0,316857 2,170643 0,570342 1,917158
1.025 W57011004 R03DC03 MONTELUKASTUM * ASTHATOR 5 mg COMPR. MAST. 5 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 0,792142 1,015715 0,396071 1,411786 0,712927 1,094930
1.026 W51361004 R03DC03 MONTELUKASTUM * SINGULAIR (R) COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 28 0,792142 1,747858 0,396071 2,143929 0,712927 1,827073
1.027 W56570005 R03DC03 MONTELUKASTUM * MONTELUKAST ACTAVIS 5 mg COMPR. MAST. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L 30 0,509333 0,000000 0,254666 0,254667 0,458399 0,050934
1.028 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 0,792142 0,004643 0,396071 0,400714 0,712927 0,083858
1.029 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 0,792142 0,022858 0,396071 0,418929 0,712927 0,102073
1.030 W58090003 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg GRANULE 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 0,633714 1,853786 0,316857 2,170643 0,570342 1,917158
1.031 W55198002 R03DX03 FENSPIRIDUM EURESPAL 80 mg 80mg
COMPR. CU ELIBERARE PRELUNGITA LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.CU ELIBERARE PRELUGITA P-6L 30 0,563174 0,056159 0,281587 0,337746 0,506856 0,112477
1.032 W63192001 R03DX03 FENSPIRIDUM EPISTAT 80 mg COMPR. ELIB. PREL. 80mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. ELIB. PREL. P6L 30 0,563174 0,081826 0,281587 0,363413 0,506856 0,138144
1.033 W03117002 R03DX03 FENSPIRIDUM EURESPAL 2 mg/ml SIROP 2mg/ml LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLACON PVC DE CULOARE BRUNA X 150 ML P-6L 1 21,450000 0,000000 10,725000 10,725000 19,305000 2,145000
1.034 W61978001 R05DA09 DEXTROMETHORPHANUM ROFEDEX 10 mg COMPR. 10mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,186854 0,102646 0,093427 0,196073 0,168168 0,121332
1.035 W59312001 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE 20 mg COMPR. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,370500 0,000000 0,185250 0,185250 0,333450 0,037050
1.036 W61979001 R05DA09 DEXTROMETHORPHANUM ROFEDEX 20 mg COMPR. 20mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,357500 0,000000 0,178750 0,178750 0,321750 0,035750
1.037 W06856002 R05DA09 DEXTROMETHORPHANUM ROFEDEX SIROP 15mg/5ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOARE P-RF 1 5,605628 0,144372 2,802814 2,947186 5,045065 0,704935
1.038 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 2,793471 5,806529 1,396735 7,203265 2,514123 6,085877
1.039 W56019002 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN JUNIOR SOL. ORALA 3,75mg/5ml PFIZER CORPORATION AUSTRIA GMBH AUSTRIA CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M P-RF 1 9,400000 0,000000 4,700000 4,700000 8,460000 0,940000
1.040 W56020002 R05DA09 DEXTROMETHORPHANUM ROBITUSSIN ANTITUSSICUM SOL. ORALA 7,5mg/5ml PFIZER CORPORATION AUSTRIA GMBH AUSTRIA CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M P-RF 1 2,802813 6,597187 1,401406 7,998594 2,522531 6,877469
1.041 W12852011 R06AE09 LEVOCETIRIZINUM XYZAL (R) COMPR. FILM. 5mg U.C.B. GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 0,889000 0,000000 0,444500 0,444500 0,800100 0,088900
1.042 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 0,591000 0,000000 0,295500 0,295500 0,531900 0,059100
1.043 W58148003 R06AE09 LEVOCETIRIZINUM XYZAL PIC. ORALE, SOL. 5mg/ml UCB PHARMA GMBHGERMANIA P-6L
CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR 1 27,100000 0,000000 13,550000 13,550000 24,390000 2,710000
1.044 W58334001 R06AE09 LEVOCETIRIZINUM ZENARO 0,5 mg/ml SIROP 0,5mg/ml ZENTIVA, K.S. REPUBLICA CEHA P6L
CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPAC DIN PP PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 200ML SIROP + 1 LINGURITA DOZATOARE DE 5ML 1 25,080000 0,000000 12,540000 12,540000 22,572000 2,508000
1.045 W58016006 R06AX27 DESLORATADINUM DESLORATADINA ACTAVIS COMPR. FILM. 5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X30 PRF 30 0,263000 0,000000 0,131500 0,131500 0,236700 0,026300
1.046 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 0,382666 0,000000 0,191333 0,191333 0,344399 0,038267
1.047 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 0,449499 0,132834 0,224749 0,357584 0,404549 0,177784
1.048 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 0,449499 0,095501 0,224749 0,320251 0,404549 0,140451
1.049 W60471006 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 10 0,449499 0,277501 0,224749 0,502251 0,404549 0,322451
1.050 W60471011 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 30 0,449499 0,277167 0,224749 0,501917 0,404549 0,322117
1.051 W63751004 R06AX27 DESLORATADINUM DESLORATADINA AMRING 5 mg COMPR. FILM. 5mg AMRING FARMA SRLROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 COMPR. FILM. P6L 30 0,375000 0,000000 0,187500 0,187500 0,337500 0,037500
1.052 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 0,417666 0,000000 0,208833 0,208833 0,375899 0,041767
1.053 W64699011 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME OLANDA CUTIE CU 30 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 30 0,449499 0,277167 0,224749 0,501917 0,404549 0,322117
1.054 W64699006 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME OLANDA CUTIE CU 10 COMPR. FILM. ( PCTFE/ PVC/AL) PRF 10 0,449499 0,277501 0,224749 0,502251 0,404549 0,322451
1.055 W60473008 R06AX27 DESLORATADINUM AERIUS 2,5mg COMPR. ORODISPERSABILE 2,5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF 30 0,224749 0,762917 0,112374 0,875292 0,202274 0,785392
1.056 W64701008 R06AX27 DESLORATADINUM AERIUS 2,5 mg COMPR. ORODISPERSABILE 2,5mg MERCK SHARP & DOHME OLANDA CUTIE CU 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) PRF 30 0,224749 0,762917 0,112374 0,875292 0,202274 0,785392
1.057 W60472008 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. ORODISPERSABILE 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF 30 0,449499 0,538167 0,224749 0,762917 0,404549 0,583117
1.058 W64700008 R06AX27 DESLORATADINUM AERIUS 5 mg COMPR. ORODISPERSABILE 5mg MERCK SHARP & DOHME OLANDA CUTIE CU 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) PRF 30 0,449499 0,538167 0,224749 0,762917 0,404549 0,583117
1.059 W58720004 R06AX27 DESLORATADINUM DESLORATADINA SANDOZ 0.5 mg/ml SOL. ORALA 0,5 mg/ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 125 ML X 120 ML, SOL. ORALA + LINGURITA DOZATOARE DE 2,5 ML SI 5 ML SAU CU SERINGA DOZATOARE DE 5 ML, MARCATA LA FIECARE 0,5ML P6L 1 11,200000 0,000000 5,600000 5,600000 10,080000 1,120000
1.060 W60474006 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SOL. ORALA 0,5mg/ml MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML P-RF 1 11,200000 1,990000 5,600000 7,590000 10,080000 3,110000
1.061 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 11,200000 0,000000 5,600000 5,600000 10,080000 1,120000
1.062 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 11,200000 1,990000 5,600000 7,590000 10,080000 3,110000
1.063 W44051001 S01AA11 GENTAMICINUM GENTAMICIN SULPHATE PIC. OFT., SOL 0,3% E.I.P.I.CO. MED S.R.L.ROMANIA CUTIE X 1 FLACON X 10ML P-RF 1 4,960000 0,000000 2,480000 2,480000 4,464000 0,496000
1.064 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 4,300000 0,000000 2,150000 2,150000 3,870000 0,430000
Pagina 17 din 18
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie
maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
1.065 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 6,699999 0,800001 3,349999 4,150001 6,029999 1,470001
1.066 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 6,699999 0,800001 3,349999 4,150001 6,029999 1,470001
1.067 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 6,699999 2,560001 3,349999 5,910001 6,029999 3,230001
1.068 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 6,699999 2,560001 3,349999 5,910001 6,029999 3,230001
1.069 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 5,025000 3,985000 2,512500 6,497500 4,522500 4,487500
1.070 W63543001 S01AA12 TOBRAMYCINUM TOBREX® UNG. OFT. 0,3% NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 TUB DIN AL X 3,5 G UNGUENT OFTALMIC P-RF 1 5,025000 3,985000 2,512500 6,497500 4,522500 4,487500
1.071 W12757001 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 15,500000 0,000000 7,750000 7,750000 13,950000 1,550000
1.072 W41510001 S01AA23 NETILMICINUM NETTACIN (R) PICATURI OFT.-SOL. 0,3% S.I.F.I. SPA ITALIA CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML P-RF 15 1,346220 0,761780 0,673110 1,434890 1,211598 0,896402
1.073 W43512001 S01AA23 NETILMICINUM NETTAVISC 3mg/g UNG. OFT. 3mg/g S.I.F.I. SPA ITALIA CUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR P-RF 1 22,437000 11,923000 11,218500 23,141500 20,193300 14,166700
1.074 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 10,825000 2,795000 5,412500 8,207500 9,742500 3,877500
1.075 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 14,840000 0,000000 7,420000 7,420000 13,356000 1,484000
1.076 W55648001 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT., SUSPENSIE P-RF 1 5,730000 0,030000 2,865000 2,895000 5,157000 0,603000
1.077 W55648002 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 10 ML PIC. OFT., SUSPENSIE P-RF 1 10,650000 0,000000 5,325000 5,325000 9,585000 1,065000
1.078 W02427001 S01BA01 DEXAMETHASONUM MAXIDEX (R) PICATURI OFT.-SUSP. 0,1% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 5,730000 0,000000 2,865000 2,865000 5,157000 0,573000
1.079 W63597001 S01BA01 DEXAMETHASONUM MAXIDEX 1 mg/ml PICATURI OFT.-SUSP. 1 mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 5,730000 0,000000 2,865000 2,865000 5,157000 0,573000
1.080 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 4,920000 0,000000 2,460000 2,460000 4,428000 0,492000
1.081 W43769001 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.,SOL. 4,55 mg/1,32 mg/ml S.I.F.I. SPA ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.SOL. P-RF 1 7,281000 25,929000 3,640500 29,569500 6,552900 26,657100
1.082 W43768002 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.SOL. UNIDOZA 4,55 mg/1,32 mg/ml S.I.F.I. SPA ITALIA CUTIE X 20 FLAC. UNIDOZA DIN PEJD X 0,3 ML PIC.OFT. SOL. P-RF 20 0,436859 2,366641 0,218429 2,585071 0,393173 2,410327
1.083 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 7,281000 6,359000 3,640500 9,999500 6,552900 7,087100
1.084 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 5,320000 0,000000 2,660000 2,660000 4,788000 0,532000
1.085 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 7,281000 0,809000 3,640500 4,449500 6,552900 1,537100
1.086 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 7,281000 0,809000 3,640500 4,449500 6,552900 1,537100
1.087 W02225001 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX (R) UNG. OFT. 3 mg/1 mg/g ALCON COUVREUR NV BELGIA CUTIE X 1 TUB AL, PREVAZUT CU APLICATOR PEID X 3,5 G P-RF 1 5,096700 8,523300 2,548350 11,071650 4,587030 9,032970
1.088 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 5,096700 8,523300 2,548350 11,071650 4,587030 9,032970
1.089 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 19,120000 0,050000 9,560000 9,610000 17,208000 1,962000
1.090 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 18,970000 0,000000 9,485000 9,485000 17,073000 1,897000
1.091 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 19,120000 0,050000 9,560000 9,610000 17,208000 1,962000
1.092 W64476001 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. X 5 ML PRF 1 19,120000 0,050000 9,560000 9,610000 17,208000 1,962000
NOTĂ:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se iniţiază de medicul de specialitate în limita competenţei şi poate fi prescris în continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**1) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii şi pot fi administrate şi
în regim de spitalizare de zi;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (2) se prescrie numai în etapa pregătitoare pentru colonoscopie;
- Pentru medicamentele corespunzătoare DCI-urilor notate cu (#) regulile de prescriere sunt stabilite prin Contractul-cadru.
Pagina 18 din 18
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, 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 IANUARIE 2019
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,237666 0,237666 0,000000
2 W58535002 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,146000 0,146000 0,000000
3 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 1,738000 1,738000 0,000000
4 W43198002 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 0,182000 0,182000 0,000000
5 W03265002 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,165000 0,165000 0,000000
6 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,165000 0,165000 0,000000
7 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,198000 0,198000 0,003000
8 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 0,198000 0,198000 0,131000
9 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,198000 0,198000 0,088000
10 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 0,166000 0,166000 0,000000
11 W58282001 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,328000 1,328000 0,000000
12 W54824001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,793000 0,793000 0,000000
13 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 0,271800 0,271800 0,079600
14 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 0,271800 0,271800 0,082533
15 W54823001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,465333 0,465333 0,000000
16 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 0,558399 0,558399 0,033267
17 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 0,234000 0,234000 0,000000
18 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 0,271800 0,271800 0,117800
19 W52138001 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,226500 0,226500 0,000000
20 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 0,558399 0,558399 0,165101
21 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 0,258399 0,258399 0,053267
22 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 0,258399 0,258399 0,053601
23 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 0,258399 0,258399 0,000601
24 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 0,258399 0,258399 0,053267
25 W52230001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,258399 0,258399 0,053267
26 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 0,258399 0,258399 0,053601
27 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 0,255333 0,255333 0,000000
28 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 0,258399 0,258399 0,044601
29 W59297001 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 0,215333 0,215333 0,000000
30 W61716001 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 100 mg COMPR. 100mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,258399 0,258399 0,053934
31 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 0,103666 0,103666 0,000000
32 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 0,103666 0,103666 0,000000
33 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 0,103500 0,103500 0,000000
34 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 0,192000 0,192000 0,000000
35 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 0,180500 0,180500 0,000000
36 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 0,173000 0,173000 0,000000
37 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 0,192000 0,192000 0,000000
38 W52231001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,207600 0,207600 0,048733
39 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 0,182000 0,182000 0,000000
40 W53940001 C07AB02 METOPROLOLUM METOPROLOL ARENA 50 MG COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,192000 0,192000 0,000000
41 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 0,190500 0,190500 0,000000
42 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 0,192000 0,192000 0,000000
43 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 0,227000 0,227000 0,000000
44 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 0,377666 0,377666 0,000000
Pagina 1 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 2 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 3 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 4 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W00009002 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,237666 0,237666 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 0,611666 0,611666 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 0,592000 0,592000 0,000000
3 W54973001 B01AC04 CLOPIDOGRELUM ** TROGRAN 75 mg COMPR. FILM. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,710400 0,710400 0,454957
4 W55445003 B01AC04 CLOPIDOGRELUM ** TESSYRON 75 mg COMPR. FILM. 75mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM. P-RF 30 0,710400 0,710400 0,014933
5 W55972003 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL DR. REDDY'S 75 mg COMPR. FILM. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 0,710400 0,710400 0,417266
6 W56912006 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL TERAPIA 75 mg COMPR. FILM. 75mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 30 0,710400 0,710400 0,417266
7 W57177005 B01AC04 CLOPIDOGRELUM ** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,604642 0,604642 0,000000
8 W57992002 B01AC04 CLOPIDOGRELUM ** DEPLATT 75 mg COMPR. FILM. 75mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,710400 0,710400 0,257600
9 W54317007 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 30 COMPRIMATE FILMATE P-RF 30 0,611666 0,611666 0,000000
10 W54317009 B01AC04 CLOPIDOGRELUM ** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 90 COMPRIMATE FILMATE P-RF 90 0,592000 0,592000 0,000000
11 W59687002 B01AC04 CLOPIDOGRELUM ** CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF 28 0,625000 0,625000 0,000000
12 W61520001 B01AC04 CLOPIDOGRELUM ** PLAVIX 75mg COMPR. FILM. 75mg SANOFI CLIR SNC FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF 28 0,710400 0,710400 0,937457
13 W56291004 B01AC24 TICAGRELOR ** Ω BRILIQUE COMPR. FILM. 90 mg ASTRA ZENECA AB SUEDIA CUTIE X 4 BLISTERE CALENDAR DIN PVC-PVDC/AL X 14 COMPRIMATE FILMATE P-RF 56 5,835357 5,835357 0,000000
Tratamentul se iniţiază de către medicul în specialitatea cardiologie, chirurgie cardiovasculară şi chirurgie vasculară.
1 W61485001 FARA DASABUVIRUM **1 β EXVIERA 250mg COMPR. FILM. 250 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 67,778392 67,778392 0,000000
2 W61486001 FARA OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM **1 β VIEKIRAX COMPR. FILM. 12,5 mg+75 mg+50 mg ABBVIE LTD. MAREA BRITANIE CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE(AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE) PR 56 766,166964 766,166964 0,000000
3 W60057003 J05AB04 RIBAVIRINUM **1 REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2,485285 2,485285 5,789215
4 W53326004 J05AB04 RIBAVIRINUM **1 COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 2,485285 2,485285 5,451084
Pagina 5 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 6 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se initiază de către medicul în specialitatea gastroenterologie / boli infectioase si nefrologie (doar pentru pacientii cu afectare renala consecutiva infectiei cu virusuri hepatitice)
5. HEPATITA AUTOIMUNA - G5
1 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,572200 0,572200 0,000000
2 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,299500 1,299500 0,000000
3 W04237001 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 21,570000 21,570000 0,000000
4 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 9,280000 9,280000 0,000000
5 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 32,670000 32,670000 0,000000
6 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,686400 0,686400 0,000000
6. CIROZA BILIARA PRIMARA, COLANGITA SCLEROZANTA PRIMITIVA, HEPATITA CRONICA SI CIROZE DE ALTE ETIOLOGII CU COLESTAZA - G6
1 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. 100 1,164200 P6L 1,164200 0,000000
2 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. 50 1,225800 P-6L 1,225800 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 2,709100 2,709100 0,000000
4 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA P6L
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP 1 102,670000 102,670000 0,000000
7. CIROZA HEPATICA - G7
1 W62376001 A06AD11 LACTULOSUM DUPHALAC® LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 11,330000 11,330000 0,000000
2 W64011001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% BGP PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 11,330000 11,330000 0,000000
3 W64559001 A06AD11 LACTULOSUM LACTECON 667 g/l LICHID ORAL 66,7% MYLAN HEALTHCARE B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 11,330000 11,330000 0,000000
4 W44054002 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML P-6L 1 11,370000 11,370000 0,000000
5 W44054001 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 3,780000 3,780000 0,000000
6 W05444001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE CU UN BLISTER DIN PVC-PE-PVDC/ALUMINIUM A 12 COMPRIMATE FILMATE P-RF 12 2,737500 2,737500 0,000000
7 W05444002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE CU 3 BLISTERE DIN PVC-PE-PVDC/ALUMINIUM A CATE 12 COMPRIMATE FILMATE P-RF 36 2,516111 2,516111 0,000000
8 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 2,737500 2,737500 0,000000
9 W63734002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL A CATE 12 COMPR. FILM. PRF 36 2,516111 2,516111 0,000000
10 W63735001 A07AA11 RIFAXIMINUM NORMIX 200mg/10ml GRAN. PT. SUSP. ORALA 200mg/10ml ALFASIGMA S.P.A. ITALIA PRF
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. 1 20,660000 20,660000 0,000000
11 W03265002 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,165000 0,165000 0,000000
12 W42036002 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,165000 0,165000 0,000000
13 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,198000 0,198000 0,003000
14 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 0,198000 0,198000 0,131000
15 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,198000 0,198000 0,088000
16 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 0,166000 0,166000 0,000000
17 W58282001 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,328000 1,328000 0,000000
18 W54824001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,793000 0,793000 0,000000
19 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 0,271800 0,271800 0,079600
Pagina 7 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 8 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se ini țiază de către medicul in specialitatea gastroenterologie sau boli infectioase
8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10
1 W56153001 A04AA01 ONDANSETRONUM ** OSETRON 4 mg COMPR. FILM. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 2,080000 2,080000 0,000000
2 W56154001 A04AA01 ONDANSETRONUM ** OSETRON 8 mg COMPR. FILM. 8mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF 10 3,521000 3,521000 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 5,146000 5,146000 0,000000
4 W63617005 A04AA01 ONDANSETRONUM ** ONDANSETRON AUROBINDO 2 mg/ml SOL INJ./PERF. 2mg/ml AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA TIP I, PREVAZUTE CU PUNCT DE RUPERE SAU MARCAJ LINIAR X 4 ML SOL. INJ./PERF. PR 5 9,466000 9,466000 0,000000
5 W57423001 A04AA01 ONDANSETRONUM ** OSETRON 4 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE 1 BLIST. AL/PVC X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 5,198000 5,198000 0,000000
6 W57424001 A04AA01 ONDANSETRONUM ** OSETRON 8 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 5 FIOLE X 4 ML SOL. INJ. S/P-RF 5 9,562000 9,562000 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 11,952000 11,952000 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 14,342400 14,342400 0,505600
9 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 23,008000 23,008000 0,000000
10 W53091002 A04AA02 GRANISETRONUM ** GRANISETRON TEVA 1mg/1ml CONC. PT. SOL. PERF./INJ. 1mg/1ml TEVA PHARMACEUTICALS S.R.L. S
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF./INJ. 5 15,354000 15,354000 0,000000
11 W53092002 A04AA02 GRANISETRONUM ** GRANISETRON TEVA 3mg/3ml CONC. PT. SOL. PERF./INJ. 3mg/3ml TEVA PHARMACEUTICALS S.R.L. S
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3 ML CONC. PT. SOL. PERF./INJ. 5 35,782000 35,782000 0,000000
12 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 30,406000 30,406000 0,000000
13 W56568002 A04AA05 PALONOSETRONUM ** ALOXI 500mcg CAPS. MOI 500mcg HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA CUTIE X BLISTER DIN POLIAMIDA/AL/PVC X 1 CAPSULA MOALE PRF 1 303,450000 303,450000 0,000000
14 W62946001 A04AA05 PALONOSETRONUM ** PALONOSETRON ACCORD 250 micrograme SOL INJ. 250micrograme ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. CARE CONTINE 5 ML SOLUTIE PALONOSETRON PRF 1 121,560000 121,560000 0,000000
15 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 1 101,450000 101,450000 0,000000
16 W63215001 A04AA05 PALONOSETRONUM ** PALONOSETRON TEVA 250 micrograme SOL INJ. 250micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA TIP I CARE CONTINE 5 ML SOL. INJ. PRF 1 121,740000 121,740000 101,690000
17 W63848001 A04AA05 PALONOSETRONUM ** PALONOSETRON ALVOGEN 250 micrograme SOL INJ. 250micrograme ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. DIN STICLA DE TIP I X 5 ML SOL. INJ. PR 1 121,740000 121,740000 92,570000
18 W63780001 A04AA05 PALONOSETRONUM ** PALONOSETRON SANDOZ 250 micrograme SOL INJ. 250micrograme SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA X 5 ML SOL. INJ. PR 1 121,740000 121,740000 34,910000
19 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 1 121,740000 121,740000 34,920000
20 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 1 121,740000 121,740000 34,920000
21 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 1 121,740000 121,740000 101,690000
22 W63033001 A04AA05 PALONOSETRONUM ** PALONOSETRON FRESENIUS KABI 250 micrograme SOL. INJ. IN SERINGA PREUMPLUTA 250micrograme FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA CARE CONTINE 5 ML SOL. INJ. PRF 1 121,740000 121,740000 34,920000
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 47,801666 47,801666 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 1 491,150000 491,150000 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. S/P-RF 1 763,692000 763,692000 299,058000
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 1 636,410000 636,410000 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 92,048333 92,048333 0,000000
28 W07740002 B03XA01 EPOETINUM BETA ** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 288,515000 288,515000 0,000000
29 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 6 288,515000 288,515000 0,000000
30 W07741002 B03XA01 EPOETINUM BETA ** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 62,685000 62,685000 0,000000
31 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 62,685000 62,685000 0,000000
32 W42097001 B03XA01 EPOETINUM BETA ** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 999,600000 999,600000 0,000000
33 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 1 999,600000 999,600000 0,000000
34 W07742002 B03XA01 EPOETINUM BETA ** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 113,368333 113,368333 0,000000
35 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 6 113,368333 113,368333 0,000000
36 W07744002 B03XA01 EPOETINUM BETA ** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 158,691666 158,691666 0,000000
37 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 6 158,691666 158,691666 0,000000
38 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 1 231,500000 231,500000 0,000000
39 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 53,530000 53,530000 0,000000
Pagina 9 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 10 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 11 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 12 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se iniţiază de către medicul în specialitatea oncologie, hematologie, oncologie şi hematologie pediatrică sau pediatrie cu supraspecializarea în hematooncologie pediatrică/oncologie pediatrică sau competenţă în oncopediatrie sau atestat de studii complementare în oncologie şi hematologie pediatrică.
9. EPILEPSIE - G11
1 W42801002 N03AA02 PHENOBARBITALUM FENOBARBITAL ZENTIVA 100 mg COMPR. 100 mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,192400 0,192400 0,000000
2 W57366002 N03AA02 PHENOBARBITALUM FENOBARBITAL ARENA 100mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLISTERE DIN PVC/AL A CÂTE 10 COMPRIMATE P-RF 30 0,196666 0,196666 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 2,394000 2,394000 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 0,151000 0,151000 0,000000
5 W64010002 N03AB02 PHENYTOINUM FENITOINA SODICA ACCORD 50 mg/ml SOL INJ./PERF. 50mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 5 FIOLE IN TAVITA DIN POLISTIREN, DIN STICLA TRANSPARENTA CU CAPACITATEA DE 5 ML X 5 ML SOL. INJ./PERF. PRF 5 13,014000 13,014000 0,000000
6 W64010005 N03AB02 PHENYTOINUM FENITOINA SODICA ACCORD 50 mg/ml SOL INJ./PERF. 50mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 5 FIOLE IN BLISTER DIN PVC/HARTIE, DIN STICLA TRANSPARENTA CU CAPACITATEA DE 5 ML X 5 ML SOL. INJ./PERF. PRF 5 13,014000 13,014000 0,000000
7 W55235001 N03AB02 PHENYTOINUM PHENHYDAN 250 mg/5 ml SOL. INJ. 250mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 5 ML SOL. INJ.P-RF 5 14,544000 14,544000 0,000000
8 W51397003 N03AF01 CARBAMAZEPINUM TEGRETOL (R) 200 COMPR. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 50 0,175800 0,175800 0,042400
9 W00796003 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH (R) 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE P6L 60 0,149166 0,149166 0,000000
10 W00806001 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,149200 0,149200 0,000000
11 W00797001 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,149500 0,149500 0,000000
12 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 0,149500 0,149500 0,000000
13 W62172002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA TERAPIA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,149200 0,149200 0,000000
14 W62477001 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA FARMEX 200 mg COMPR. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,146500 0,146500 0,000000
15 W62477002 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA FARMEX 200 mg COMPR. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,148000 0,148000 0,000000
16 W00807001 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,413200 0,413200 0,000000
17 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 0,413000 0,413000 0,000000
18 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 0,319800 0,319800 0,000000
19 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 0,414240 0,414240 0,020360
20 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 0,770400 0,770400 0,000000
21 W12426001 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L 50 0,345200 0,345200 0,000000
22 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 0,345200 0,345200 0,000000
23 W12428001 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P-6L 50 0,700200 0,700200 0,000000
24 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 0,700200 0,700200 0,000000
25 W51395001 N03AF01 CARBAMAZEPINUM TEGRETOL CR 200 COMPR. FILM. ELIB. PREL. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 50 0,175800 0,175800 0,190000
26 W51394001 N03AF01 CARBAMAZEPINUM TEGRETOL CR 400 COMPR. FILM. ELIB. PREL. 400mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 0,495600 0,495600 0,140733
27 W00825001 N03AF01 CARBAMAZEPINUM TIMONIL SIROP SUSP. ORALA 100mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 24,590000 24,590000 0,000000
28 W51417002 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 300 mg COMPR. FILM. 300mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 0,934000 0,934000 0,000000
29 W51416002 N03AF02 OXCARBAZEPINUM TRILEPTAL (R) 600 mg COMPR. FILM. 600mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 50 1,419800 1,419800 0,000000
30 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 0,214680 0,214680 0,159720
31 W60320001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,178900 0,178900 0,000000
32 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 0,178900 0,178900 0,000000
33 W60321001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,244400 0,244400 0,000000
34 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 0,244400 0,244400 0,000000
35 W60322001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,317400 0,317400 0,000000
36 W63236001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,317400 0,317400 0,000000
Pagina 13 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 14 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 15 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W06002001 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,592000 0,592000 0,000000
2 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 0,814700 0,814700 0,000000
3 W60962001 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM) ** DUODOPA 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 7 461,514285 461,514285 0,000000
4 W61590003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
REPUBLICA CEHA PRF 100 1,435300 1,435300 0,000000
5 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 1,366500 1,366500 0,000000
6 W61572003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,366500 1,366500 0,000000
7 W62454001 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,366500 1,366500 0,000000
8 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 1,364600 1,364600 0,000000
9 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 1,831700 1,831700 0,000000
10 W61573003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,877500 1,877500 0,000000
11 W62455001 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,877500 1,877500 0,000000
12 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. CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
REPUBLICA CEHA PRF 100 1,364600 1,364600 0,000000
13 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 1,364600 1,364600 0,000000
14 W61574003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,364800 1,364800 0,000000
15 W62456001 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,364800 1,364800 0,000000
16 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 1,364600 1,364600 0,000000
17 W61575003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 175 mg/43,75 mg/200 mg COMPR. FILM. 175mg/43,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,823000 1,823000 0,000000
18 W61592003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
REPUBLICA CEHA PRF 100 1,389240 1,389240 0,344660
19 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 1,159000 1,159000 0,000000
20 W61576003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,157700 1,157700 0,000000
21 W62457001 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,211100 1,211100 0,000000
22 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 1,389240 1,389240 0,258360
23 W61589003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5 mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,367200 1,367200 0,000000
24 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 1,367200 1,367200 0,000000
25 W61570003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,367300 1,367300 0,000000
26 W62452001 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,367300 1,367300 0,000000
27 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 1,367200 1,367200 0,000000
28 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 1,329800 1,329800 0,000000
29 W61571003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** SASTRAVI 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,595760 1,595760 0,348740
30 W62453001 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** CORBILTA 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ORION CORPORATION FINLANDA FLAC. DIN HDPE CU SISTEM DE INCHIDERE DIN PP X 100 COMPR. FILM. PRF 100 1,595760 1,595760 0,007140
31 W00264001 N04BB01 AMANTADINUM ** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 0,372800 0,372800 0,000000
32 W11164002 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 0,577750 0,577750 0,000000
Pagina 16 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 17 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W05242001 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,114000 0,114000 0,030000
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 0,095000 0,095000 0,000000
3 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,114000 0,114000 0,016333
4 W53341001 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,114000 0,114000 0,026000
5 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,686400 0,686400 0,000000
6 W52868001 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,749500 0,749500 0,000000
7 W52868002 N07AA01 NEOSTIGMINI BROMIDUM NEOSTIGMINA LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. P-6L 60 0,725500 0,725500 0,000000
8 W57190001 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg MEDA AB SUEDIA CUTIE X 1 FLAC. X 20 DRAJ. P-RF 20 0,652000 0,652000 0,000000
1 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,572200 0,572200 0,000000
2 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,299500 1,299500 0,000000
3 W04237001 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 21,570000 21,570000 0,000000
4 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 9,280000 9,280000 0,000000
5 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 32,670000 32,670000 0,000000
6 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 0,114000 0,114000 0,030000
7 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,095000 0,095000 0,000000
8 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,114000 0,114000 0,016333
9 W53341001 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,114000 0,114000 0,026000
10 W42735002 L01DB07 MITOXANTRONUM ** ONKOTRONE CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. S 1 405,750000 405,750000 0,000000
11 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,686400 0,686400 0,000000
13. BOLI PSIHICE (SCHIZOFRENIE, TULBURĂRI SCHIZOTIPALE ŞI DELIRANTE, TULBURĂRI AFECTIVE MAJORE, TULBURĂRI PSIHOTICE ACUTE ŞI BOLI PSIHICE COPII, AUTISM, TULBURĂRI CU DEFICIT DE
ATENŢIE/HIPERREACTIVITATE) - G15
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 0,214680 0,214680 0,159720
2 W60320001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,178900 0,178900 0,000000
3 W63234001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 150 mg CAPS. MOI GASTROREZ. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,178900 0,178900 0,000000
4 W60321001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,244400 0,244400 0,000000
5 W63235001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 300 mg CAPS. MOI GASTROREZ. 300mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L 100 0,244400 0,244400 0,000000
6 W60322001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,317400 0,317400 0,000000
7 W63236001 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX 500 mg CAPS. MOI GASTROREZ. 500mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L 100 0,317400 0,317400 0,000000
8 W06973001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100 0,293280 0,293280 0,069020
9 W64667001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL. 300mg SANOFI ROMANIA SRL ROMANIA CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100 0,293280 0,293280 0,069020
10 W10512001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE (R) CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. PP X 30 COMPR. ELIB. PREL. P-RF 30 0,380880 0,380880 0,113120
Pagina 18 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 19 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 20 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 21 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 22 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 23 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W52398001 N06DA02 DONEPEZILUM ** YASNAL 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU, BLIST., DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 1,176071 1,176071 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 1,310333 1,310333 0,000000
3 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 1,303666 1,303666 0,000000
4 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 1,102857 1,102857 0,000000
5 W55613001 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,323428 1,323428 0,908000
6 W55613002 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 1,323428 1,323428 0,795372
7 W55613003 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 1,323428 1,323428 0,795143
8 W55613004 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,323428 1,323428 0,722238
9 W55613005 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 1,323428 1,323428 0,685653
10 W55613006 N06DA02 DONEPEZILUM ** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 1,323428 1,323428 0,685672
11 W57673006 N06DA02 DONEPEZILUM ** DONEPEZIL TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 1,323428 1,323428 0,594238
12 W52397001 N06DA02 DONEPEZILUM ** YASNAL 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 1,029428 1,029428 0,007714
13 W53424001 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,029428 1,029428 0,178905
14 W53424002 N06DA02 DONEPEZILUM ** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 1,029428 1,029428 0,178905
15 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 0,857857 0,857857 0,000000
16 W55612001 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,029428 1,029428 0,582000
17 W55612002 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 1,029428 1,029428 0,500572
18 W55612003 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 1,029428 1,029428 0,500929
19 W55612004 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,029428 1,029428 0,500738
20 W55612005 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 1,029428 1,029428 0,421592
21 W55612006 N06DA02 DONEPEZILUM ** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 1,029428 1,029428 0,421672
22 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 1,176071 1,176071 0,000000
23 W58507012 N06DA02 DONEPEZILUM ** DONEPEZIL STADA HEMOFARM 10 mg COMPR. ORODISPERSABILE 10mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,323428 1,323428 2,563000
24 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 1,323214 1,323214 0,000000
25 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 1,323428 1,323428 3,715857
26 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 1,323428 1,323428 3,715857
27 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 1,029428 1,029428 0,134857
28 W58506012 N06DA02 DONEPEZILUM ** DONEPEZIL STADA HEMOFARM 5 mg COMPR. ORODISPERSABILE 5mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,029428 1,029428 1,777000
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 1,029428 1,029428 0,716286
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 1,029428 1,029428 0,217893
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 0,857857 0,857857 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 1,207142 1,207142 0,000000
33 W56983009 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA TORRENT 3 mg CAPS. 3mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. P-RF 56 1,448570 1,448570 0,618751
34 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 1,282142 1,282142 0,000000
35 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 2,170713 2,170713 0,104108
36 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 2,800285 2,800285 0,204000
37 W54535002 N06DA03 RIVASTIGMINUM ** NIMVASTID 1.5 mg COMPR. ORODISPERSABILE 1.5mg 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 0,857857 0,857857 0,000000
38 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 1,808928 1,808928 0,000000
Pagina 24 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
15. COLAGENOZE MAJORE (LUPUS ERITEMATOS SISTEMIC, SCLERODERMIE, POLI/DERMATOMIOZITA, VASCULITE SISTEMICE) - G 17
1 W04224001 H02AB04 METHYLPREDNISOLONUM 5) MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,572200 0,572200 0,000000
2 W04222001 H02AB04 METHYLPREDNISOLONUM 5) MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,299500 1,299500 0,000000
3 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,571400 0,571400 0,000000
Pagina 25 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se iniţiază şi se monitorizează de către medicul în specialitatea reumatologie, nefrologie, boli infecţioase, pediatrie sau medicină internă.
16. POLIARTRITA REUMATOIDĂ, ARTROPATIA PSORIAZICĂ, PSORIAZIS CRONIC SEVER ŞI ARTRITA JUVENILĂ - G 18
1 W07440001 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. 50 P-6L 0,615400 0,615400 0,000000
2 W59162002 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. 50 P6L 0,616400 0,616400 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 17,160000 17,160000 0,000000
4 W04224001 H02AB04 METHYLPREDNISOLONUM 5) MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,572200 0,572200 0,000000
5 W04222001 H02AB04 METHYLPREDNISOLONUM 5) MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,299500 1,299500 0,000000
6 W62602001 L01BA01 METHOTREXATUM METHOTREXATE 2,5 mg COMPR. FILM. 2,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLIST. X 10 COMPR. FILM. PR 100 0,372800 0,372800 0,000000
7 W62233002 L01BA01 METHOTREXATUM NAMAXIR 10 mg 10mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. 35,647500 35,647500 0,000000
8 W63589007 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1
CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 2,25 ML, CARE CONTINE 1,5 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA 50,619000 50,619000 32,461000
9 W63589010 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1
CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 2,25 ML, CARE CONTINE 2 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA 67,488000 67,488000 65,012000
10 W63589001 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1
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 33,720000 33,720000 30,800000
11 W63589004 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml 10mg/ml
SOL INJ. IN SERINGA PREUMPLUTA ROMPHARM COMPANY S.R.L. ROMANIA PR 1
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 42,777000 42,777000 5,933000
12 W62235002 L01BA01 METHOTREXATUM NAMAXIR 15 mg 15mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. 42,182500 42,182500 0,000000
13 W62237002 L01BA01 METHOTREXATUM NAMAXIR 20 mg 20mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,50 ML SOL. INJ. 56,240000 56,240000 0,000000
14 W62239002 L01BA01 METHOTREXATUM NAMAXIR 25 mg 25mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. 70,310000 70,310000 0,000000
15 W62232002 L01BA01 METHOTREXATUM NAMAXIR 7,5 mg 7,5mg
SOL INJ. IN SERINGA PREUMPLUTA ACTAVIS GROUP PTC EHF. ISLANDA PR 4
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. 28,100000 28,100000 0,000000
16 W58316007 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 50,619000 50,619000 33,311000
17 W58316010 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 67,488000 67,488000 66,372000
18 W58316001 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 33,720000 33,720000 31,440000
19 W58316004 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 42,777000 42,777000 6,443000
20 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 2,000666 2,000666 0,000000
21 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 2,825333 2,825333 0,000000
22 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 3,390399 3,390399 0,409934
23 W60267002 L04AA13 LEFLUNOMIDUM ** LEFLON 20 mg COMPR. FILM. 20mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR 30 3,390399 3,390399 0,409934
24 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,786600 1,786600 0,000000
25 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,300600 3,300600 0,000000
26 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,686400 0,686400 0,000000
27 W64135011 L04AX03 METHOTREXATUM METHOFILL 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE X 10X1 COMPR.PR 10 0,746000 0,746000 0,000000
28 W64135001 L04AX03 METHOTREXATUM METHOFILL 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 10 COMPR. PR 10 0,746000 0,746000 0,000000
29 W64134018 L04AX03 METHOTREXATUM METHOFILL 2,5 mg COMPR. 2,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE X 30X1 COMPR.PR 30 0,158333 0,158333 0,000000
30 W64134008 L04AX03 METHOTREXATUM METHOFILL 2,5 mg COMPR. 2,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. PR 30 0,158333 0,158333 0,000000
31 W44020001 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 2,579500 2,579500 0,000000
32 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 2,579500 2,579500 0,000000
33 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 0,207600 0,207600 0,379066
34 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 0,373000 0,373000 0,000000
35 W13296001 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 0,173000 0,173000 0,000000
36 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 0,370000 0,370000 0,000000
37 W51307002 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,370000 0,370000 0,000000
38 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 0,123500 0,123500 0,000000
39 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 0,123500 0,123500 0,000000
40 W54364001 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 0,208000 0,208000 0,000000
41 W54363004 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 0,123333 0,123333 0,000000
42 W55024001 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF. P-RF 5 0,888000 0,888000 0,000000
Pagina 26 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se iniţiază de către medicul din specialitatea reumatologie, nefrologie, medicină internă, pediatrie, reabilitare medicală şi dermatovenerologie.
1 W07440001 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 0,615400 0,615400 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 0,616400 0,616400 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 17,160000 17,160000 0,000000
4 W44020001 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 2,579500 2,579500 0,000000
5 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 2,579500 2,579500 0,000000
6 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 0,207600 0,207600 0,379066
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 0,373000 0,373000 0,000000
8 W13296001 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 0,173000 0,173000 0,000000
9 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 0,370000 0,370000 0,000000
10 W51307002 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,370000 0,370000 0,000000
11 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 0,123500 0,123500 0,000000
12 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 0,123500 0,123500 0,000000
13 W54364001 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 0,208000 0,208000 0,000000
14 W54363004 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 0,123333 0,123333 0,000000
15 W55024001 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF. P-RF 5 0,888000 0,888000 0,000000
16 W14114001 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0,598333 0,598333 0,000000
17 W12288001 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,598000 0,598000 0,000000
18 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 0,602000 0,602000 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 0,636666 0,636666 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 0,632000 0,632000 0,000000
Tratamentul se iniţiază de către medicul din specialitatea reumatologie sau reabilitare medicală.
18. BOLI ENDOCRINE (GUŞĂ ENDEMICĂ, INSUFICIENŢĂ SUPRARENALĂ CRONICĂ, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARĂ, TUMORI NEUROENDOCRINE ŞI OSTEOPOROZĂ SEVERĂ) - G 22
1 W00716002 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 11,185000 11,185000 0,000000
2 W00716001 G02CB03 CABERGOLINUM ** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 10,440000 10,440000 0,000000
3 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 30 282,455666 282,455666 0,000000
4 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 30 282,455666 282,455666 0,000000
5 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 30 556,572666 556,572666 0,000000
6 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 30 556,572666 556,572666 0,000000
7 W53832002 H01BA02 DESMOPRESSINUM DESMOPRESINA TEVA 0,2mg COMPR. 0,2mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL- PVC/AL X 30 COMPR. P-RF 30 2,632666 2,632666 0,000000
8 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 6,368666 6,368666 0,000000
9 W53991001 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 1 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL P-RF 10 3,515000 3,515000 0,000000
10 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 3,337666 3,337666 0,000000
11 W42954002 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 10 mg PULB.+SOLV. PT. SOL. INJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 952,230000 952,230000 0,000000
12 W42955002 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 20 mg PULB.+SOLV. PT. SOL. INJ. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 1.833,600000 1.833,600000 0,000000
Pagina 27 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 28 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W61063002 M01CC01 PENICILLAMINUM ** 4) CUPRIPEN 250mg CAPS. 250mg CN UNIFARM S.A. ROMANIA CUTIE X 3 BLIST. X 10 CAPS. PRF 30 1,503666 1,503666 0,000000
Tratamentul se iniţiază de către medicul din specialitatea endocrinologie, neurologie sau neurologie pediatrică.
1 W51230001 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA ** VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 32,734000 32,734000 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 47,801666 47,801666 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 1 491,150000 491,150000 0,000000
4 W57497004 B03XA01 EPOETINUM ALFA ** EPREX 40000 UI/ml SOL. INJ. IN SERINGA PREUMPLUTA 40 000UI/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ. S/P-RF 1 763,692000 763,692000 299,058000
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 1 636,410000 636,410000 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 92,048333 92,048333 0,000000
7 W07740002 B03XA01 EPOETINUM BETA ** NEORECORMON 10000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE S/P-RF/R 6 288,515000 288,515000 0,000000
8 W64395002 B03XA01 EPOETINUM BETA ** NEORECORMON 10000 UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/0,6ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE PR 6 288,515000 288,515000 0,000000
9 W07741002 B03XA01 EPOETINUM BETA ** NEORECORMON 2000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE S/P-RF/R 6 62,685000 62,685000 0,000000
10 W64396002 B03XA01 EPOETINUM BETA ** NEORECORMON 2000 UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE PR 6 62,685000 62,685000 0,000000
11 W42097001 B03XA01 EPOETINUM BETA ** NEORECORMON 30000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC S/P-RF/R 1 999,600000 999,600000 0,000000
12 W64397001 B03XA01 EPOETINUM BETA ** NEORECORMON 30000 UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 30000 UI/0,6ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC PR 1 999,600000 999,600000 0,000000
13 W07742002 B03XA01 EPOETINUM BETA ** NEORECORMON 4000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 113,368333 113,368333 0,000000
14 W64398002 B03XA01 EPOETINUM BETA ** NEORECORMON 4000 UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE PR 6 113,368333 113,368333 0,000000
15 W07744002 B03XA01 EPOETINUM BETA ** NEORECORMON 5000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE S/P-RF/R 6 158,691666 158,691666 0,000000
16 W64399002 B03XA01 EPOETINUM BETA ** NEORECORMON 5000 UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,3ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE PR 6 158,691666 158,691666 0,000000
17 W60969001 B03XA01 EPOETINUM ZETA ** RETACRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 231,500000 231,500000 0,000000
18 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 53,530000 53,530000 0,000000
19 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 1 506,530000 506,530000 0,000000
20 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 76,240000 76,240000 0,000000
21 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 1 615,530000 615,530000 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 1 101,650000 101,650000 0,000000
23 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 1 122,700000 122,700000 0,000000
24 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 1 144,600000 144,600000 0,000000
25 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 1 206,430000 206,430000 0,000000
26 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 4 610,730000 610,730000 0,000000
27 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 77,270000 77,270000 0,000000
28 W41531002 B03XA02 DARBEPOETINUM ALFA ** ARANESP 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X 0,3 ML P-RF/R 4 941,377500 941,377500 0,000000
29 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 4 140,815000 140,815000 0,000000
30 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 1.918,240000 1.918,240000 0,000000
31 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 4 202,455000 202,455000 0,000000
32 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 4 264,017500 264,017500 0,000000
33 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 3.149,210000 3.149,210000 0,000000
34 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 4 325,607500 325,607500 0,000000
35 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 4 387,157500 387,157500 0,000000
36 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 4 510,335000 510,335000 0,000000
37 W52309001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 100mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 100mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 806,640000 806,640000 0,000000
38 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 1 806,640000 806,640000 0,000000
39 W52310001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 150mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 150mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 1.173,930000 1.173,930000 0,000000
40 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 1.173,930000 1.173,930000 0,000000
41 W52307001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 50 mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 50 mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 438,570000 438,570000 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 1 438,570000 438,570000 0,000000
43 W52308001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA ** MIRCERA 75mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 75mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ. S/P-RF/R 1 622,740000 622,740000 0,000000
44 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 1 622,740000 622,740000 0,000000
45 W59429005 C09CA04 IRBESARTANUM ** IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,388571 0,388571 0,000000
46 W59430005 C09CA04 IRBESARTANUM ** IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 0,543571 0,543571 0,000000
Pagina 29 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
21. GLAUCOM - 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 15,300000 15,300000 0,000000
2 W61012001 S01EC03 DORZOLAMIDUM DORZOLAMIDA ARENA 20 mg/ml PIC. OFT., SOL. 20mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. ALB, OPAC DIN PE DE DENSITATE MEDIE, CU CAPACITATEA DE 10 ML, PREVAZUT CU PICURATOR SIGILAT SI UN CAPAC ASAMBLATE DIN 2 PIESE, CU 5 ML PIC. OFT., SOL. P6L 1 15,300000 15,300000 0,000000
3 W62676001 S01EC03 DORZOLAMIDUM TRUSOPT 20 mg/ml PIC. OFT., SOL. 20mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLAC. DE TIP OCUMETER PLUS ALCATUIT DINTR-UN FLAC. TRANSLUCID DIN PEÎD,CU CAPACITATEA DE 8 ML,CU PICURATOR DIN PEÎD,ÎNCHIS CU UN CAPAC ALCATUIT DIN 2 COMPONENTE SI PREVAZUT CU BANDA DE SIGURANTA, CA PARTE A ETICHETEI PROD.X5 ML SOL.OFT. P6L 1 18,360000 18,360000 5,170000
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 33,620000 33,620000 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 33,620000 33,620000 0,000000
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 33,620000 33,620000 0,000000
7 W55650001 S01ED01 TIMOLOLUM TIMOLOL ROMPHARM 0,25% PIC. OFT., SOL. 2,5mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL.P-6L 1 3,280000 3,280000 0,000000
8 W55649001 S01ED01 TIMOLOLUM TIMOLOL ROMPHARM 0,5% PIC. OFT.,SOL. 5mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL.P-6L 1 5,240000 5,240000 0,000000
9 W44059001 S01ED01 TIMOLOLUM TIMOLOL 0,25% PICATURI OFT.-SOL. 0,25% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON PEID, PREVAZUT CU PICURATOR X 5 ML P-6L 1 3,300000 3,300000 0,000000
10 W44058002 S01ED01 TIMOLOLUM TIMOLOL 0,5% PICATURI OFT.-SOL. 0,5% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON CU PICURATOR X 5 ML P-6L 1 5,580000 5,580000 0,000000
11 W43453001 S01ED02 BETAXOLOLUM BETAX PIC. OFT.-SOL. 5mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L 1 5,590000 5,590000 0,000000
12 W00605001 S01ED02 BETAXOLOLUM BETOPTIC - S PICATURI OFT.-SUSP. 0,25% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 14,330000 14,330000 0,000000
13 W63541001 S01ED02 BETAXOLOLUM BETOPTIC - S PICATURI OFT.-SUSP. 0,25% NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 14,330000 14,330000 0,000000
14 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 11,480000 11,480000 0,000000
15 W53813001 S01ED51 COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM) ** AZARGA PIC. OFT. SUSP. 10mg/ml+5mg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 5 ML SUSP. OFT. P-RF 1 59,120000 59,120000 0,000000
16 W63646001 S01ED51 COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM) ** AZARGA PIC. OFT. SUSP. 10mg/ml+5mg/ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. X 5 ML SUSP. OFT. PRF 1 59,120000 59,120000 0,000000
17 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 59,120000 59,120000 0,000000
18 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 48,610000 48,610000 0,000000
19 W51521001 S01ED51 COMBINATII (BIMATOPROSTUM + TIMOLOLUM) GANFORT PIC. OFT.,SOL. 300mcg/ml+5mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC.OFT.SOL. P-RF 1 58,332000 58,332000 11,028000
20 W60405001 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM)SIFIOPT 20 mg/5 mg/ml PIC. OFT., SOL. 20mg/5mg/ml OFTAFARMA ROMÂNIA S.R.L. ROMANIA CUTIE CU 1 FLAC. PE ALB, OPAC +PICURATOR PEID A 5 ML PIC. OFT. SOL. PRF 1 27,830000 27,830000 0,000000
21 W62674001 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 DE TIP OCUMETER PLUS X 5 ML PIC. OFT., SOL. P6L 1 33,396000 33,396000 4,434000
22 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 29,124000 29,124000 1,416000
23 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 29,124000 29,124000 1,396000
24 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 24,270000 24,270000 0,000000
25 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 62,480000 62,480000 0,000000
26 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 62,480000 62,480000 0,000000
Pagina 30 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
22. PEMFIGUS - G 27
1 W63171002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVACIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 10,110500 10,110500 0,000000
2 W63169002 H02AB02 DEXAMETHASONUM DEXAMETAZONA KRKA 4 mg COMPR. 4mg KRKA D.D. NOVO MESTO SLOVACIA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. PRF 20 1,776500 1,776500 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 0,875000 0,875000 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 0,860400 0,860400 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 0,775600 0,775600 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 1,461000 1,461000 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 1,397600 1,397600 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 1,267200 1,267200 0,000000
9 W44063002 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg 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 1,277300 1,277300 0,000000
10 W44063001 H02AB02 DEXAMETHASONUM DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ. 8mg 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 1,454000 1,454000 0,000000
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 1,501000 1,501000 0,000000
12 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-RF 50 0,572200 0,572200 0,000000
13 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF 20 1,299500 1,299500 0,000000
14 W04237001 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 21,570000 21,570000 0,000000
15 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 9,280000 9,280000 0,000000
16 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 32,670000 32,670000 0,000000
17 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 0,114000 0,114000 0,030000
18 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,095000 0,095000 0,000000
19 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,114000 0,114000 0,016333
20 W53341001 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 0,114000 0,114000 0,026000
21 W54013001 J04BA02 DAPSONUM 4) DISULONE 100 mg COMPR. DIVIZ. 100mg CN UNIFARM ROMANIA CUTIE X 100 COMPR. DIVIZIBILE P-RF 100 0,521800 0,521800 0,000000
22 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF 50 0,571400 0,571400 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 16,730000 16,730000 0,000000
24 W64372001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg TEVA B.V. OLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA PULB. PT. SOL. PERF./INJ PR 1 16,730000 16,730000 0,000000
25 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 1,786600 1,786600 0,000000
26 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 3,300600 3,300600 0,000000
27 W60846001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. P-RF 100 0,686400 0,686400 0,000000
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 6.287,390000 6.287,390000 0,000000
2 W61994001 A16AB10 VELAGLUCERASE ALFA **1 VPRIV 400 unitati PULB. PT. SOL. PERF. 400unitati Shire Pharmaceuticals Ireland Limited IRLANDA 5 FLAC. DIN STICLA X 400 UNITATI PULBERE PT. SOL. PERF. PR 5 6.668,882000 6.668,882000 0,000000
Pagina 31 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
După precizarea diagnosticului de către laboratoarele de specialitate, tratamentul se iniţiază de către medicul din specialitatea gastroenterologie, hematologie, neurologie, neurologie pediatrică şi pediatrie.
1 W56642001 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,438000 0,438000 0,000000
2 W02885004 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,382000 0,382000 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 0,163500 0,163500 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 0,196200 0,196200 0,157300
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 4,324400 4,324400 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 5,120000 5,120000 0,000000
7 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 5,040000 5,040000 0,000000
8 W58283005 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA ATB 1000000 UI PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF/S 100 4,287700 4,287700 0,000000
9 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 2,969100 2,969100 0,000000
10 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 3,410000 3,410000 0,000000
11 W41595001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,315000 0,315000 0,000000
12 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 0,555833 0,555833 0,000000
13 W41596001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,237500 0,237500 0,000000
14 W55413001 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE P-RF 1 9,380000 9,380000 0,000000
15 W55416003 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. P-RF 1 5,847720 5,847720 0,042280
16 W55416002 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. P-RF 100 4,873100 4,873100 0,000000
17 W57455001 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 2,354000 2,354000 0,000000
18 W13701001 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,799000 3,799000 0,000000
19 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 10,008000 10,008000 0,544000
20 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 10,008000 10,008000 0,014000
21 W63368003 J01DD08 CEFIXIMUM CEFIXIMA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 8,340000 8,340000 0,000000
22 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 77,320000 77,320000 0,000000
23 W02983002 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,386500 0,386500 0,000000
24 W61210001 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,463800 0,463800 0,060200
25 W42271001 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 3,466666 3,466666 0,000000
26 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 3,915999 3,915999 0,857334
27 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 3,915999 3,915999 0,857334
28 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 4,353333 4,353333 0,000000
29 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 4,353333 4,353333 0,000000
30 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 3,263333 3,263333 0,000000
31 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 3,308333 3,308333 0,000000
32 W00519001 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 4,128000 4,128000 4,912000
33 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 3,440000 3,440000 0,000000
34 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 4,128000 4,128000 1,468666
35 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 4,128000 4,128000 1,748666
36 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 4,128000 4,128000 1,748666
37 W57032001 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 4,128000 4,128000 1,228666
38 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 4,128000 4,128000 1,748666
39 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 4,128000 4,128000 0,688666
40 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 4,128000 4,128000 4,912000
41 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 15,240000 15,240000 0,000000
42 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 20,350000 20,350000 0,000000
43 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 14,680000 14,680000 0,000000
44 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 43,970000 43,970000 0,000000
45 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 43,970000 43,970000 0,000000
46 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 33,300000 33,300000 0,000000
Pagina 32 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se iniţiază de către medicul în specialitatea dermatologie şi obstetrică-ginecologie (pentru gonoree şi infecţia cu Chlamidia).
1 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 1.232,851999 1.232,851999 511,848001
2 W60070001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
3 W60070003 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.027,376666 1.027,376666 0,000000
4 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.232,851999 1.232,851999 277,868001
5 W64826001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
6 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.965,264000 1.965,264000 1,506000
7 W64710001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL PR 2 1.965,264000 1.965,264000 1,506000
8 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 4.209,890000 4.209,890000 0,000000
9 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 4.209,890000 4.209,890000 0,000000
10 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 1.054,985000 1.054,985000 0,000000
11 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 1.855,175000 1.855,175000 0,000000
12 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 1.855,175000 1.855,175000 0,000000
13 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 1.637,720000 1.637,720000 0,000000
14 W64708001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA PR
2 CUTII A CATE 1 FLACON ( 0,8 ML SOLUTIE STERILA)+ O SERINGA STERILA+ UN AC STERIL+UN ADAPTOR STERIL PENTRU FLACON + 2 TAMPOANE CU ALCOOL 2 1.965,264000 1.965,264000 86,711000
15 W59945002 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg/0,8ml ABBVIE LTD. MAREA BRITANIE PR
2 CUTII A CATE 1 FLACON ( 0,8 ML SOLUTIE STERILA)+ O SERINGA STERILA+ UN AC STERIL+UN ADAPTOR STERIL PENTRU FLACON + 2 TAMPOANE CU ALCOOL 2 1.965,264000 1.965,264000 86,711000
Pagina 33 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 34 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 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 2 784,745000 784,745000 0,000000
2 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 2 845,965000 845,965000 0,000000
3 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 3 834,160000 834,160000 0,000000
4 W07200001 L01XC02 RITUXIMABUM **1 MABTHERA 500 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) S 1 4.581,792000 4.581,792000 681,968000
5 W64386001 L01XC02 RITUXIMABUM **1 MABTHERA 500 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLACON X 50 ML (500MG RITUXIMAB IN 50ML- 10MG/ML) PR 1 4.581,792000 4.581,792000 681,968000
6 W07199001 L01XC02 RITUXIMABUM **1 MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 941,694000 941,694000 127,131000
7 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 2 941,694000 941,694000 127,131000
8 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 3.818,160000 3.818,160000 0,000000
9 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 4.149,360000 4.149,360000 0,000000
10 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 4.113,935000 4.113,935000 0,000000
11 W62893001 L01XC02 RITUXIMABUM **1 MABTHERA 1400 mg SOL INJ. 120mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON (1400 MG RITUXIMAB /11,7 ML PR 1 7.411,040000 7.411,040000 0,000000
12 W64387001 L01XC02 RITUXIMABUM **1 MABTHERA 1400 mg SOL INJ. 120mg/ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 FLACON (1400 MG RITUXIMAB /11,7 ML) SOL. INJ. PT. ADM. SUBCUTANATA PR 1 7.411,040000 7.411,040000 0,000000
13 W52073001 L04AA24 ABATACEPTUM **1 ORENCIA PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA S 1 1.487,530000 1.487,530000 0,000000
14 W59338005 L04AA24 ABATACEPTUM **1 ORENCIA SOL INJ. IN SERINGA PRE-UMPLUTA 125mg/ml BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA CU AC CU GARDA X 125 MG/ML SOL INJ. PR 4 1.034,445000 1.034,445000 0,000000
15 W61900001 L04AA24 ABATACEPTUM **1 ORENCIA 125 mg SOL INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 125mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE 4 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE PR 4 1.034,445000 1.034,445000 0,000000
16 W63493001 L04AA37 BARICITINIB **1 OLUMIANT 4 mg COMPR. FILM. 4mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU BLIST. PVC/PE/PCTFE/ALU X 35 COMPR. FILM. PR 35 127,967428 127,967428 0,000000
17 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 4 427,557500 427,557500 0,000000
18 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 4 427,557500 427,557500 0,000000
19 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
20 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 4 440,387500 440,387500 0,000000
21 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 4 824,967500 824,967500 0,000000
22 W64812002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL MEDICINALPR 4 824,967500 824,967500 0,000000
23 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 4 440,387500 440,387500 0,000000
24 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 4 824,967500 824,967500 0,000000
25 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
26 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 4 824,967500 824,967500 0,000000
27 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 1.232,851999 1.232,851999 511,848001
28 W60070001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
29 W60070003 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.027,376666 1.027,376666 0,000000
30 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.232,851999 1.232,851999 277,868001
31 W64826001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
32 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 1.965,264000 1.965,264000 1,506000
33 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 1.965,264000 1.965,264000 1,506000
34 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 1.855,175000 1.855,175000 0,000000
35 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 1.855,175000 1.855,175000 0,000000
36 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 1.637,720000 1.637,720000 0,000000
37 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 1.630,160000 1.630,160000 0,000000
38 W57618001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.859,450000 3.859,450000 0,000000
39 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 3.859,450000 3.859,450000 0,000000
40 W53869001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. S 1 605,210000 605,210000 0,000000
41 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 1 605,210000 605,210000 0,000000
42 W53869003 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF. S 1 1.406,730000 1.406,730000 0,000000
43 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 1.406,730000 1.406,730000 0,000000
44 W53869005 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF. S 1 2.742,630000 2.742,630000 0,000000
45 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 2.742,630000 2.742,630000 0,000000
46 W61487001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 162mg SOL INJ. IN SERINGA PRE-UMPLUTA 162mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE SISTEM DE PROTECTIE PENTRU AC A CATE 0.9ML SOL. PR 4 1.055,900000 1.055,900000 0,000000
47 W64404001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 162mg SOL INJ. IN SERINGA PRE-UMPLUTA 162mg ROCHE REGISTRATION GMBH GERMANIA CUTIE CU 4 SERINGI PREUMPLUTE SISTEM DE PROTECTIE PENTRU AC A CATE 0.9ML SOL. PR 4 1.055,900000 1.055,900000 0,000000
Tratamentul se iniţiază de către medicul în specialitatea reumatologie, medicină internă, nefrologie (pentru pacienţii cu afectare renală) şi reabilitarea medicală.
Pagina 35 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 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 4 427,557500 427,557500 0,000000
2 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 4 427,557500 427,557500 0,000000
3 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
4 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 4 440,387500 440,387500 0,000000
5 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 4 824,967500 824,967500 0,000000
6 W64812002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL MEDICINALPR 4 824,967500 824,967500 0,000000
7 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 4 440,387500 440,387500 0,000000
8 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 4 824,967500 824,967500 0,000000
9 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
10 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 4 824,967500 824,967500 0,000000
11 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 1.232,851999 1.232,851999 511,848001
12 W60070001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
13 W60070003 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.027,376666 1.027,376666 0,000000
14 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.232,851999 1.232,851999 277,868001
15 W64826001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 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 1.965,264000 1.965,264000 1,506000
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 1.965,264000 1.965,264000 1,506000
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 1.855,175000 1.855,175000 0,000000
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 1.855,175000 1.855,175000 0,000000
20 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 1.637,720000 1.637,720000 0,000000
21 W57618001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.859,450000 3.859,450000 0,000000
22 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 3.859,450000 3.859,450000 0,000000
23 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 2.319,475000 2.319,475000 0,000000
24 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 2.354,880000 2.354,880000 0,000000
25 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 2.354,880000 2.354,880000 0,000000
26 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 2.319,475000 2.319,475000 0,000000
27 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 2.319,475000 2.319,475000 0,000000
28 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 2.354,880000 2.354,880000 0,000000
29 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 2.354,880000 2.354,880000 0,000000
30 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 2.319,475000 2.319,475000 0,000000
1 W61297001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 427,557500 427,557500 0,000000
2 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 4 427,557500 427,557500 0,000000
3 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
4 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 4 440,387500 440,387500 0,000000
5 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 4 824,967500 824,967500 0,000000
6 W64812002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL MEDICINALPR 4 824,967500 824,967500 0,000000
7 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 4 440,387500 440,387500 0,000000
8 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 4 824,967500 824,967500 0,000000
9 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
10 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 4 824,967500 824,967500 0,000000
11 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 1.232,851999 1.232,851999 511,848001
12 W60070001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
13 W60070003 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.027,376666 1.027,376666 0,000000
Pagina 36 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Tratamentul se iniţiază de către medicul în specialitatea reumatologie, medicină internă şi reabilitare medicală.
Pagina 37 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W52073001 L04AA24 ABATACEPTUM **1 ORENCIA PULB. PT.CONC. PT.SOL. PERF. 250mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA S 1 1.487,530000 1.487,530000 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 4 427,557500 427,557500 0,000000
3 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 4 427,557500 427,557500 0,000000
4 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 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 4 440,387500 440,387500 0,000000
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 4 824,967500 824,967500 0,000000
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 MEDICINALPR 4 824,967500 824,967500 0,000000
8 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 4 440,387500 440,387500 0,000000
9 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 4 824,967500 824,967500 0,000000
10 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
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 4 824,967500 824,967500 0,000000
12 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 1.965,264000 1.965,264000 1,506000
13 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 1.965,264000 1.965,264000 1,506000
14 W62576001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAREA BRITANIE CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.855,175000 1.855,175000 0,000000
15 W64709001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE CU 2 BLIST. CE CONTIN CATE O SERINGA PREUMPLUTA (0,4 ML SOL. STERILA) SI UN TAMPON ALCOOL PR 2 1.855,175000 1.855,175000 0,000000
16 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 1.637,720000 1.637,720000 0,000000
17 W64708001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA PR
2 CUTII A CATE 1 FLACON ( 0,8 ML SOLUTIE STERILA)+ O SERINGA STERILA+ UN AC STERIL+UN ADAPTOR STERIL PENTRU FLACON + 2 TAMPOANE CU ALCOOL 2 1.965,264000 1.965,264000 86,711000
18 W59945002 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg/0,8ml ABBVIE LTD. MAREA BRITANIE PR
2 CUTII A CATE 1 FLACON ( 0,8 ML SOLUTIE STERILA)+ O SERINGA STERILA+ UN AC STERIL+UN ADAPTOR STERIL PENTRU FLACON + 2 TAMPOANE CU ALCOOL 2 1.965,264000 1.965,264000 86,711000
19 W57618001 L04AB06 GOLIMUMAB **1 SIMPONI 50 mg SOL. INJ. IN PEN PRE-UMPLUT 50mg/0,5ml JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML PR 1 3.859,450000 3.859,450000 0,000000
20 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 3.859,450000 3.859,450000 0,000000
21 W53869001 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF. S 1 605,210000 605,210000 0,000000
22 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 1 605,210000 605,210000 0,000000
23 W53869003 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 10 ML CONC. PT. SOL. PERF. S 1 1.406,730000 1.406,730000 0,000000
24 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 1.406,730000 1.406,730000 0,000000
25 W53869005 L04AC07 TOCILIZUMABUM **1 ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC X 20 ML CONC. PT. SOL. PERF. S 1 2.742,630000 2.742,630000 0,000000
26 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 2.742,630000 2.742,630000 0,000000
1 W61297001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL P-RF/R 4 427,557500 427,557500 0,000000
2 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 4 427,557500 427,557500 0,000000
3 W62832001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
4 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 4 440,387500 440,387500 0,000000
5 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 4 824,967500 824,967500 0,000000
6 W64812002 L04AB01 ETANERCEPTUM **1 ENBREL 50mg SOL. INJ. 50mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL MEDICINALPR 4 824,967500 824,967500 0,000000
7 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 4 440,387500 440,387500 0,000000
8 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 4 824,967500 824,967500 0,000000
9 W62833001 L04AB01 ETANERCEPTUM **1 BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 739,667500 739,667500 0,000000
10 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 4 824,967500 824,967500 0,000000
11 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 1.232,851999 1.232,851999 511,848001
12 W60070001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
13 W60070003 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.027,376666 1.027,376666 0,000000
14 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.232,851999 1.232,851999 277,868001
15 W64826001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
16 W63195001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL INJ. IN PEN PREUMPLUT 40mg ABBVIE LTD MAREA BRITANIE PR
CUTIE 2 BLIST. CU CÂTE UN PEN PRE-UMPLUT (0,4 ML SOL. STERILA) SI 1 TAMPON CU ALCOOL 2 1.965,264000 1.965,264000 1,506000
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 1.965,264000 1.965,264000 1,506000
Pagina 38 din 39
Val. maxima suportata Contributie maxima
de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
NOTA:
- Pentru medicamentele corespunzătoare acestei secţiuni iniţierea tratamentului se face de către medicul de specialitate, altul decât medicul de familie, excepţie făcând medicamentele din G1 - Insuficienţă cardiacă cronică (clasa III sau IV Nyha)
poziţiile 2, 3, 4, 5, 6, 7 şi 9, (conf. HG 720/2008, cu modificarile si completarile ulterioare) pentru care iniţierea tratamentului poate fi efectuată şi de către medicul de familie;
- 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;
- 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;
- 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 (ß) se efectuează în baza contractelor cost-volum-rezultat încheiate;
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu ( Ω) se efectueaz ă în baza contractelor cost-volum încheiate.
Pagina 39 din 39
ANEXA 2d
SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PRE ȚUL DE REFERINȚĂ - CONFORM DCI-URILOR, ALTELE DECÂT CELE DIN SUBLISTELE A, B,
SUBLISTA C SECŢIUNEA C1 ŞI SUBLISTA D, CORESPUNZĂTOARE MEDICAMENTELOR, DE CARE BENEFICIAZĂ COPIII PÂNĂ LA 18 ANI, TINERII DE LA 18 LA 26 DE ANI DACĂ SUNT
ELEVI, UCENICI SAU STUDENŢI, DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LEHUZE, ÎN TRATAMENTUL AMBULATORIU,
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILĂ ÎNCEPÂND CU 01 IANUARIE 2019
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
1 W02902002 A03AD02 DROTAVERINUM NO - SPA 40 mg/2 ml SOL. INJ. 40mg/2ml UNGARIA CUTIE X 25 FIOLE X 2ML SOL. INJ.
CHINOIN PHARMACEUTICAL AND CHEMICAL WORKS CO. LTD. P-RF 25 1,071200 1,071200 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 1,071200 1,071200 0,000000
3 W60351002 A03BA01 ATROPINUM SULFAT DE ATROPINA TAKEDA 1 mg/ml SOL. INJ. 1mg/ml TAKEDA GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. S 5 1,688000 1,688000 0,000000
4 W01509001 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,394500 0,394500 0,000000
5 W43286001 A03DA02 COMBINATII ALGIFEN COMPRIMATE COMPR. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,394500 0,394500 0,000000
6 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 2,672000 2,672000 0,000000
7 W43285003 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE 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 2,672000 2,672000 0,000000
8 W43285004 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE 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 2,673000 2,673000 0,000000
9 W01529001 A05BAN3 COMBINATII ASPATOFORT (R) SOL. INJ. FARA CONCENTRATIE TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 10 ML P-RF 10 3,315000 3,315000 0,000000
10 W55728001 A06AD65 COMBINATII FORTRANS PULB. PT. SOL. ORALA FARA CONCENTRATIE IPSEN PHARMA FRANTA CUTIE CU 4 PLICURI DIN HARTIE-AL-PE X 73,69 G PULB. PT. SOL. ORALA P-RF 4 10,267500 10,267500 0,000000
11 W63100001 A06AD65 COMBINATII CLENSIA PULB. PT. SUSP. ORALAFARA CONCENTRATIE ALFA WASSERMANN S.R.L. ROMANIA PRF
CUTIE CU 8 PLICURI (4 PLICURI A (MARI) + 4 PLICURI B (MICI)) DIN HARTIE-AL-PE CARE CONTIN PULB. PT. SOL. ORALA, CORESP. UNEI SINGURE CURE DE TRATAMENT 4 14,747500 14,747500 0,000000
12 W64825001 A06AD65 COMBINATII CLENSIA PULB. PT. SUSP. ORALAFARA CONCENTRATIE ALFASIGMA ROMANIA S.R.L. ROMANIA PRF
CUTIE CU 8 PLICURI (4 PLICURI A (MARI) + 4 PLICURI B (MICI)) DIN HARTIE-AL-PE CARE CONTIN PULB. PT. SOL. ORALA, CORESP. UNEI SINGURE CURE DE TRATAMENT 4 14,747500 14,747500 0,000000
13 W04551001 A07AX03 NIFUROXAZIDUM ERCEFURYL (R) 200 mg CAPS. 200mg SANOFI-SYNTHELABO OTCFRANTA CUTIE X 2 BLIST. X 14 CAPS. P-RF 28 0,440714 0,440714 0,000000
14 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 0,440714 0,440714 0,000000
15 W60620001 A11CA01 RETINOLUM VITAMINA A FORTE BIOFARM 50000 UI CAPS. MOI 50000ui BIOFARM SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. MOIP6L 30 0,200333 0,200333 0,000000
16 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 3,240000 3,240000 0,000000
17 W51334002 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 20 CAPS. MOI. P6L 100 0,715000 0,715000 0,000000
18 W01433001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,301000 0,301000 0,000000
19 W01433003 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE CU 2 BLIST. AL/PVC X 15 COMPR. P6L 30 0,301000 0,301000 0,000000
20 W01434001 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 500 COMPR. 500UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,243333 0,243333 0,000000
21 W53793001 A11CC05 COLECALCIFEROLUM VITAMINA D3 BIOFARM 18000UI/mlPIC. ORALE, SOL. 0,45mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLACON X 10 ML PIC. ORALE, SOL. P-6L 1 5,520000 5,520000 0,000000
22 W01432001 A11CC05 COLECALCIFEROLUM VIGANTOL OIL PIC. ORALE, SOL. 0,5mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLACON DIN STICLA X 10 ML PIC. ORALE SOLUTIE, PREVAZUT CU PICURATOR P-6L 1 6,330000 6,330000 0,000000
23 W01608001 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 1000 COMPR. 1000 UI/0,55 mg MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,291666 0,291666 0,000000
24 W01609001 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 500 COMPR. 500 UI/0,55 mg MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 0,234333 0,234333 0,000000
25 W56759001 A11DA01 THIAMINUM VITAMINA B1 ZENTIVA 100 mg/2 mlSOL. INJ. 100mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,522000 1,522000 0,000000
26 W41932004 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ.P-6L 50 0,556600 0,556600 0,000000
27 W62898002 A11DAN1 BENFOTIAMINUM NEUROSSEN 300 mg COMPR. FILM. 300mg AAA-PHARMA GMBH GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 2,703000 2,703000 0,000000
28 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 1,014000 1,014000 0,000000
29 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 0,466440 0,466440 0,010560
30 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 0,388700 0,388700 0,000000
31 W42092002 A11DBN1 COMBINATII MILGAMMA (R) 100+100mg DRAJ. 100mg+100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 DRAJ.P-6L 60 1,638166 1,638166 0,000000
32 W01731002 A11DBN1 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 1,024400 1,024400 0,000000
33 W01731002 A11DBN1 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L 50 1,024400 1,024400 0,000000
34 W62895003 A11DBN1 COMBINATII NEUROSSEN INJEKT SOL. INJ. FARA CONCENTRATIE AAA-PHARMA GMBH GERMANIA CUTIE X 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML SOL. INJ. PRF 10 3,479000 3,479000 0,000000
35 W41647001 A11DBN1 COMBINATII MILGAMMA (R) 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 4,046000 4,046000 0,000000
36 W58389001 A11GA01 ACIDUM ASCORBICUM ACID ASCORBIC ARENA 750 mg SOL INJ. 750mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ.PRF 5 2,154000 2,154000 0,000000
37 W60986001 A11GA01 ACIDUM ASCORBICUM VITAMEDI-C 750 mg/5ml SOL INJ. 750mg/5ml GERMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ.PR
PASCOE PHARMAZEUTISCHE PRAPARATE GMBH 5 2,584800 2,584800 2,943200
38 W52512001 A11GA01 ACIDUM ASCORBICUM VITAMINA C ARENA 750 mg SOL. INJ. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ. P-RF 5 2,584800 2,584800 2,943200
39 W42822001 A11HA02 PYRIDOXINUM VITAMINA B6 250 mg COMPR. 250 mg ARENA GROUP SA ROMANIA CUTIE X 1 FLACON DIN PE X 20 COMPR. P-6L 20 0,497000 0,497000 0,000000
40 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 0,497000 0,497000 0,000000
41 W56758001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg/5 mlSOL. INJ. 250mg/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 2,258000 2,258000 0,000000
42 W56757001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 50 mg/2ml SOL. INJ. 50mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 1,522000 1,522000 0,000000
43 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 0,921500 0,921500 0,000000
44 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 1,105800 1,105800 2,370200
45 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 1,684000 1,684000 0,000000
46 W61534002 A16AXN1 DIVERSE ACTOVEGIN 200 mg DRAJ. 200mg TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P6L 50 3,056200 3,056200 0,000000
Pagina 1 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 2 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 3 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Pagina 4 din 5
Val. maxima suportata de Contributie maxima
sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
Nota:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.;
Medicamentele din această sublistă corespund DCI-urilor din nomenclatorul de produse, altele decât cele din sublistele A, B, sublista C secţiunea C1 şi sublista D. Pentru categoriile de asiguraţi menţionate în această sublistă,
medicamentele corespunzătoare denumirilor comune internaţionale din sublista A, sublista B, secţiunea C1 a sublistei C şi sublista D se vor acorda în regim de compensare de 100% la preţ de referinţă, indiferent de indicaţia
pentru care sunt prevăzute în aceste subliste.
Pagina 5 din 5
ANEXA 2e
SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, CU COMPLETARILE SI MODIFICARILE ULTERIOARE,
VALABILA INCEPAND CU 01 IANUARIE 2019
Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM
1 W52514001 A02BA02 RANITIDINUM RANITIDINA ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-6L 10 0,438300 0,267700 0,087660 0,618340
2 W05395003 A02BA02 RANITIDINUM RANITIDIN ARENA 150mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,219150 0,028850 0,043830 0,204170
3 W05401002 A02BA02 RANITIDINUM RANITIDINA 150 mg COMPR. 150mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,219150 0,029850 0,043830 0,205170
4 W07339001 A02BA02 RANITIDINUM RANITIDIN COMPR. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,219150 0,028850 0,043830 0,204170
5 W42722001 A02BA02 RANITIDINUM RANITIDINA LPH 150 mg COMPR. FILM. 150mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,219150 0,028850 0,043830 0,204170
6 W53915001 A02BA02 RANITIDINUM RANITIDINA ATB 150 MG COMPR. FILM. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 0,219150 0,028850 0,043830 0,204170
7 W61345001 A02BA02 RANITIDINUM RANITIDINA LAROPHARM 150 mgCOMPR. FILM. 150mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 0,219150 0,024350 0,043830 0,199670
8 W42722004 A02BA02 RANITIDINUM RANITIDINA LPH 150 mg COMPR. FILM. 150mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLISTERE DIN FOLIE PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 0,219150 0,029516 0,043830 0,204836
9 W06812001 A02BA02 RANITIDINUM ARNETIN SOL. INJ. 50mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE X 2 ML P-RF 5 1,547546 1,220454 0,309509 2,458491
10 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 0,219150 0,093183 0,043830 0,268503
11 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 0,213000 0,000000 0,042600 0,170400
12 W54838001 A02BA03 FAMOTIDINUM QUAMATEL 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,219150 0,149064 0,043830 0,324384
13 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 0,281333 0,000000 0,056266 0,225067
14 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 0,432000 0,000000 0,086400 0,345600
15 W54839001 A02BA03 FAMOTIDINUM QUAMATEL 20 mg 20mg
PULB+SOLV. PT. SOL. INJ./PERF. GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA CU PULBERE PENTRU SOLUTIE INJ./PERF. + 5 FIOLE DIN STICLA INCOLORA X 5ML SOLV. PENTRU UZ PARENTERAL S/P-RF 5 4,110000 0,000000 0,822000 3,288000
16 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 0,321500 0,000000 0,064300 0,257200
17 W05702001 A02BX02 SUCRALFATUM VENTER COMPR. 1g KRKA D.D. SLOVENIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,337175 0,005225 0,067435 0,274965
18 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 0,758666 0,000000 0,151733 0,606933
19 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 0,758666 0,000000 0,151733 0,606933
20 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 0,758666 0,000000 0,151733 0,606933
21 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 0,758666 0,000000 0,151733 0,606933
22 W04080002 A03AA04 MEBEVERINUM COLOSPASMIN DRAJ. 100mg E.I.P.I.CO. MED SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 DRAJ. P-6L 20 0,379333 0,089667 0,075866 0,393134
23 W51982001 A03AA05 TRIMEBUTINUM TRIMEBUTIN 100 COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,405333 0,000000 0,081066 0,324267
24 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 0,405333 0,000000 0,081066 0,324267
25 W08438001 A03AA05 TRIMEBUTINUM DEBRIDAT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,405333 0,000000 0,081066 0,324267
26 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 0,810668 0,373665 0,162133 1,022200
27 W42800002 A03AA05 TRIMEBUTINUM IBUTIN (R) 300 mg COMPR. FILM. ELIB. PREL. 300mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL.P-6L 20 1,216003 0,751497 0,243200 1,724300
28 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 13,160000 0,000000 2,632000 10,528000
29 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 6,909750 4,060250 1,381950 9,588050
30 W12227001 A03FA03 DOMPERIDONUM MOTILIUM 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 0,112874 0,368126 0,022574 0,458426
31 W58243002 A03FA03 DOMPERIDONUM OROPERIDYS 10 mg 10mg
COMPR. ORODISPERSABILE PIERRE FABRE MEDICAMENT FRANTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP. P6L 30 0,112874 0,588792 0,022574 0,679092
32 W61966003 A03FA03 DOMPERIDONUM DOMOTIL 10 mg 10mg
COMPR. ORODISPERSABILE ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE P6L
LABORMED PHARMA S.A. 30 0,112874 0,367459 0,022574 0,457759
33 W13661001 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH 35 mg COMPR. CU ELIB. MODIF. 35mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLISTERE X 10 COMPRIMATE CU ELIBERARE MODIFICATA P-6L 60 0,422666 0,000000 0,084533 0,338133
34 W57454001 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA ATB 35 mg COMPR. CU ELIB. PREL. 35mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 0,422666 0,000000 0,084533 0,338133
35 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 0,422666 0,189667 0,084533 0,527800
36 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 0,422666 0,000000 0,084533 0,338133
37 W41842001 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 60 0,241523 0,035810 0,048304 0,229029
38 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 0,241523 0,124477 0,048304 0,317696
39 W63061001 C04AE02 NICERGOLINUM NICERGOLINA SLAVIA 10 mg COMPR. FILM. 10mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM.P6L 30 0,311611 0,170722 0,062322 0,420011
40 W04516004 C04AE02 NICERGOLINUM SERMION COMPR. FILM. 30mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM P-6L 30 0,934833 0,477167 0,186966 1,225034
41 W42841001 C04AE02 NICERGOLINUM NICERGOLINA LPH 30 mg COMPR. FILM. 30mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,934833 0,012833 0,186966 0,760700
42 W63062001 C04AE02 NICERGOLINUM NICERGOLINA SLAVIA 30 mg COMPR. FILM. 30mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM.P6L 30 0,934833 0,004167 0,186966 0,752034
43 W63060001 C04AE02 NICERGOLINUM NICERGOLINA SLAVIA 5 mg COMPR. FILM. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM.P6L 30 0,155805 0,087528 0,031161 0,212172
44 W52057002 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 0,930666 0,000000 0,186133 0,744533
45 W52057001 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 0,929000 0,000000 0,185800 0,743200
46 W06107003 C04AX07 VINCAMINUM VINCAMINA DRAJ. 10mg BIOFARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 DRAJ. P-6L 20 0,366000 0,000000 0,073200 0,292800
47 W11615001 C05CA53 DIOSMINUM (COMBINATII) ** DETRALEX ( R ) COMPR. FILM. 500mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,940000 0,000000 0,188000 0,752000
Pagina 1 din 3
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
Pagina 2 din 3
Contributie maxima Val. maxima suportata de Contributie maxima
a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Nr crt.
NOTĂ:
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se iniţiază de către medicul de specialitate în limita competenţei şi poate fi prescris în continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate
- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.
Pagina 3 din 3