Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11...

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Transcript of Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11...

Page 1: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid
Page 2: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid
Page 3: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid
Page 4: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid
Page 5: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

ANEXA 2aN

r crt

.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

crip

tie

cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

1 W64020007 A02BC01 OMEPRAZOLUM OMEZ 10 mg CAPS. GASTROREZ. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. GASTROREZ. P6L 30 0,259200 0,375133 0,233280 0,4010532 W42129001 A02BC01 OMEPRAZOLUM OMEPRAZOL-RICHTER 20 mg CAPS. GASTROREZ. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L 14 0,518400 0,203742 0,466560 0,2555823 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 0,3577734 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 0,3541065 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 0,3357736 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 0,2654407 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 0,3114408 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 0,0320009 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 0,03367911 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 0,42544012 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 0,03967913 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 0,03967914 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 GASTROREZISTENTEP6L 28 0,396785 0,000000 0,357106 0,03967915 W61506002 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L 28 0,518400 0,317671 0,466560 0,36951116 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 0,26544017 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 0,29244018 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 0,31377319 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 0,08171520 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 0,06042921 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 0,06810022 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 0,09736823 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 3,36680124 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 3,36680125 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 0,27814826 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 0,22344027 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 0,42058228 W53686002 A03AD01 PAPAVERINI HYDROCHLORIDUMPAPAVERINA 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 0,02420029 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 0,01090030 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 0,05291431 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 0,01466432 W54362003 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID ARENA 10 mgCOMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L 40 0,109500 0,000000 0,098550 0,01095033 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 0,94800034 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 0,28880035 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 0,11642036 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 0,13644037 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 0,53038038 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 48,20194839 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 4,32957940 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 4,32957941 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 4,32957942 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 1,13700043 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 0,37800044 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 0,05055045 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 0,06154046 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 0,06164047 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

SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR 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

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Page 6: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

crip

tie

cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

48 W58055001 A07EC02 MESALAZINUM ** PENTASA 500mg COMPR. ELIB. PREL. 500mg FERRING GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 100 0,874839 0,514361 0,787355 0,60184549 W04124001 A07EC02 MESALAZINUM ** SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0,437418 0,183682 0,393676 0,22742450 W04126001 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 0,874839 0,305261 0,787355 0,39274551 W04126002 A07EC02 MESALAZINUM ** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 50 0,874839 0,411161 0,787355 0,49864552 W60408001 A07EC02 MESALAZINUM ** MESALAZINA SOFARFARM 400 mg COMPR. GASTROREZISTENTE 400mg SOFARFARM S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 0,699870 0,153796 0,629883 0,22378353 W60409003 A07EC02 MESALAZINUM ** MESALAZINA SOFARFARM 800 mg COMPR. GASTROREZISTENTE 800mg SOFARFARM S.R.L. ROMANIA CUTIE CU 8 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 120 1,399743 0,104840 1,259768 0,24481554 W61355001 A07EC02 MESALAZINUM ** PENTASA 2 g GRAN. ELIB. PREL. 2g FERRING GMBH GERMANIA CUTIE CU 60 PLICURI PET/AL/PEJD X 2 G GRANULE CU ELIB. PREL. P6L 60 3,499361 3,224972 3,149424 3,57490955 W58054001 A07EC02 MESALAZINUM ** PENTASA 1000mg SUPOZ. 1000mg FERRING GMBH GERMANIA CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI P-6L 28 6,200000 0,337500 5,580000 0,95750056 W56484005 A07EC02 MESALAZINUM ** SALOFALK 1 g SUPOZ. 1g DR. FALK PHARMA GMBH GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L 30 6,200000 0,000000 5,580000 0,62000057 W04125003 A07EC02 MESALAZINUM ** SALOFALK (R) 250 mg SUPOZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 1,549995 0,740005 1,394995 0,89500558 W04127003 A07EC02 MESALAZINUM ** SALOFALK (R) 500 mg SUPOZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 3,100000 0,690000 2,790000 1,00000059 W04128001 A07EC02 MESALAZINUM ** SALOFALK 4 g/ 60 ml SUSP. RECTALA 4g/60ml DR. FALK PHARMA GMBH GERMANIA CUTIE X 7 BLIST. AL/PE CONTINAND FIECARE CATE 1 FLACON UNIDOZA X 60 ML SUSPENSIE RECTALA + APLICA P-6L 7 21,984285 0,000000 19,785856 2,19842960 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 0,000000 0,213899 0,02376761 W07616001 B01AC05 TICLOPIDINUM 1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0,275249 1,595251 0,247724 1,62277662 W07968001 B01AC05 TICLOPIDINUM 1) IPATON COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P6L 20 0,275249 0,448751 0,247724 0,47627663 W05001002 B02BA01 PHYTOMENADIONUM FITOMENADION TERAPIA 10 mg/ml SOL. INJ. 10mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML S/P-RF 5 3,519999 0,000001 3,167999 0,35200164 W10038001 B03AA07 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES COMPR. FILM. 100mg+60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM. P-6L 50 0,310299 0,013901 0,279269 0,04493165 W10038010 B03AA07 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES 100 mg+60 mg COMPR. FILM. 100mg+60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, AVAND CAPAC DIN PE CU COMPENSATOR X 120 COMPR. FILM. P6L 120 0,305666 0,000000 0,275099 0,03056766 W08016001 B03AA07 FERROSI SULFAS TARDYFERON 80 mg DRAJ. ELIB. PREL. 80mg LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L 30 0,299141 0,083859 0,269226 0,11377467 W44026001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT MALTOFER COMPR. MAST. 100mg VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MASTIC. P-6L 30 0,782666 0,000000 0,704399 0,07826768 W54079001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM FORTE 50 mg/ml PICATURI ORALE, SOL. 50mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 ML PICATURI ORALE, SOLUTIE P-6L 1 9,610000 0,000000 8,649000 0,96100069 W51228001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) PICATURI ORALE-SOL. 50mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON CU PICURATOR X 30 MLP-6L 1 13,337500 1,242500 12,003750 2,57625070 W51231001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) SIROP 10mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON X 150 ML + O MASURA DOZATOARE P-6L 1 13,337500 3,492500 12,003750 4,82625071 W52797001 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM 50mg/5ml SIROP 50mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE GRADATA DE LA 2,5 - 20 MLP-6L 1 8,891666 2,048334 8,002499 2,93750172 W42875001 B03BB01 ACIDUM FOLICUM ACIFOL 5 mg COMPR. FILM. 5mg ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-6L 30 0,269000 0,000000 0,242100 0,02690073 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 0,000000 0,131400 0,01460074 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 0,000000 1,564200 0,17380075 W59968001 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,687533 0,035967 0,618779 0,10472176 W59968002 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,687533 0,014133 0,618779 0,08288777 W59968003 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 0,673400 0,000000 0,606060 0,06734078 W56891002 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,346875 0,012125 0,312187 0,04681379 W56891004 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 0,346875 0,000125 0,312187 0,03481380 W12499003 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-RF 100 0,346500 0,000000 0,311850 0,03465081 W62345001 C01BC03 PROPAFENONUM RYTMONORM 150 mg COMPR. FILM. 150mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM. PRF 50 0,346875 0,204525 0,312187 0,23921382 W62339001 C01BC03 PROPAFENONUM RYTMONORM 70 mg/20 ml SOL. INJ. 70mg/20ml MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. PRF 5 6,166000 0,000000 5,549400 0,61660083 W06951001 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 0,362249 0,125751 0,326024 0,16197684 W00311002 C01BD01 AMIODARONUM AMIODARONA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,320333 0,000000 0,288299 0,03203485 W53954002 C01BD01 AMIODARONUM AMIODARONA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,267000 0,000000 0,240300 0,02670086 W06951002 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. P-RF 30 0,362249 0,125751 0,326024 0,16197687 W64483001 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,362249 0,125751 0,326024 0,16197688 W64483002 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. PRF 30 0,362249 0,125751 0,326024 0,16197689 W04591002 C01DA02 NITROGLYCERINUM NITROMINT 2,6 mg COMPR. ELIB. PREL. 2,6mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL. P-6L 60 0,128640 0,050526 0,115776 0,06339090 W42792002 C01DA02 NITROGLYCERINUM NITROGLICERINA 0,5 mg COMPR. SUBLING. 0,5mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE P-6L 20 0,092986 0,117514 0,083687 0,12681391 W04587001 C01DA02 NITROGLYCERINUM NITRODERM (R) TTS 5 SIST. TERAP. TRANSDERM. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC P-6L 10 1,641000 0,000000 1,476900 0,16410092 W07257001 C01DA02 NITROGLYCERINUM NITROMINT SPRAY SUBLINGUAL 0,4mg/doza EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L 1 13,390000 0,000000 12,051000 1,33900093 W07257002 C01DA02 NITROGLYCERINUM NITROMINT SPRAY SUBLINGUAL 0,4mg/doza EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN PLASTIC X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L 1 13,390000 0,000000 12,051000 1,33900094 W44053001 C01DA08 ISOSORBIDI DINITRAS ISOSORBID DINITRAT 10 mg COMPR. 10mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3, BLIST. AL/PVC X 20 COMPR. P-6L 60 0,032666 0,000000 0,029399 0,00326795 W53684002 C01DA08 ISOSORBIDI DINITRAS ISOSORBID DINITRAT ARENA 10 mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,041230 0,025103 0,037107 0,02922696 W54816001 C01DA08 ISOSORBIDI DINITRAS ISODINIT(R) RETARD COMPR. ELIB. PREL. 20mg PHARMAKI GENERICS LIMITED MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. ELIB. PREL. P-6L 60 0,071666 0,000000 0,064499 0,00716797 W62347001 C01DA14 ISOSORBIDI MONONITRAS OLICARD 40 mg RETARD CAPS. ELIB. PREL. 40mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 0,247386 0,218614 0,222647 0,24335398 W13871002 C01DA14 ISOSORBIDI MONONITRAS MONONITRON (R) EP 60 mg COMPR. ELIB. PREL. 60mg ZENTIVA S.A ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 40 0,371079 0,623421 0,333971 0,66052999 W53697001 C01EA01 ALPROSTADILUM ** PRIDAX 20mcg CONC. PT. SOL. PERF. 20mcg GEBRO PHARMA GMBH AUSTRIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF S/P-RF 5 50,511999 4,580001 45,460799 9,631201100 W58530002 C01EA01 ALPROSTADILUM ** VASAPROSTAN 20 µg/ml PULB. PT. SOL. PERF. 20µg/ml UCB PHARMA GMBH GERMANIA CUTIE CU 15 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE, CU CAPACITATE DE 5 ML, CONTINÂND 48,2 MG PULB. PT. SOL. PERF. PRF 15 48,985333 0,000000 44,086799 4,898534101 W04208001 C02AB01 METHYLDOPUM DOPEGYT COMPR. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 0,583600 0,000000 0,525240 0,058360102 W01369003 C02AC01 CLONIDINUM CLONIDINA SINTOFARM 0,15 mg COMPR. 0,15mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,242459 0,010141 0,218213 0,034387103 W60265001 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 0,242459 0,026941 0,218213 0,051187

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Page 7: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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Contributie maxima a asiguratului / UT (pt. asiguratii care

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104 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 0,000000 0,163800 0,018200105 W62788001 C03BA11 INDAPAMIDUM INDAPAMIDA SLAVIA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 0,330224 0,034442 0,297201 0,067465106 W56973001 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 1,5 mg COMPR. CU ELIB. PRELUNGITA 1,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L 30 0,330224 0,038109 0,297201 0,071132107 W61972001 C03BA11 INDAPAMIDUM INDAPAMID SR ZENTIVA 1,5 mg COMPR. ELIB. PREL 1,5 mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P6L 30 0,330224 0,038109 0,297201 0,071132108 W03592001 C03BA11 INDAPAMIDUM TERTENSIF SR 1,5 mg COMPR. ELIB. PREL. 1,5mg LES LAB. SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-6L 30 0,330224 0,230109 0,297201 0,263132109 W13662001 C03BA11 INDAPAMIDUM INDAPAMID LPH 1,5 mg COMPR. ELIB. PREL. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,330224 0,037442 0,297201 0,070465110 W52005001 C03BA11 INDAPAMIDUM INDAPAMID MCC 1,5 mg COMPR. ELIB. PREL. 1,5mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,330224 0,038109 0,297201 0,071132111 W53212001 C03BA11 INDAPAMIDUM IDUREN SR 1,5 mg COMPR. ELIB. PREL. 1,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 0,330224 0,038109 0,297201 0,071132112 W56877001 C03BA11 INDAPAMIDUM INDAPAMIDA SR TORRENT 1,5 mg COMPR. ELIB. PREL. 1,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0,330224 0,037442 0,297201 0,070465113 W62164001 C03BA11 INDAPAMIDUM INDAPAMIDA ATB 1,5 mg COMPR. ELIB. PREL. 1,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 0,330224 0,037442 0,297201 0,070465114 W13675001 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,549000 0,000000 0,494100 0,054900115 W43065002 C03BA11 INDAPAMIDUM RAWEL SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,278333 0,000000 0,250499 0,027834116 W52836001 C03BA11 INDAPAMIDUM IMPAMID SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. ELIB. PREL. P-6L 30 0,330224 0,038109 0,297201 0,071132117 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 0,000000 0,148500 0,016500118 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 0,000000 0,148500 0,016500119 W43155001 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 0,165250 0,035750 0,148725 0,052275120 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 0,165250 0,163750 0,148725 0,180275121 W60369001 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,165250 0,120750 0,148725 0,137275122 W03264003 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATEP-6L 30 0,165250 0,000750 0,148725 0,017275123 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 0,000000 1,195200 0,132800124 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 0,000000 0,713700 0,079300125 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 0,232666 0,118734 0,209399 0,142001126 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 0,232666 0,121667 0,209399 0,144934127 W54823001 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,465332 0,000001 0,418798 0,046535128 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 0,465332 0,126334 0,418798 0,172868129 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 0,232666 0,001334 0,209399 0,024601130 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 0,232666 0,156934 0,209399 0,180201131 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 0,000000 0,203850 0,022650132 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 0,465332 0,258168 0,418798 0,304702133 W58726003 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)DIUROCARD 50 mg/20 mg CAPS. 50mg/20 mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 1,108833 0,001167 0,997949 0,112051134 W07005001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)DIUREX 50 mg/20 mg CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-6L 20 1,108833 0,164667 0,997949 0,275551135 W60585002 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 1,105333 0,000000 0,994799 0,110534136 W60585001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6L 20 1,108833 0,119167 0,997949 0,230051137 W13574002 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. CU ELIB. PREL. P-6L 40 0,335041 0,277459 0,301536 0,310964138 W53002004 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,335041 0,022959 0,301536 0,056464139 W53002005 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0,335041 0,023359 0,301536 0,056864140 W13301002 C04AD03 PENTOXIFYLLINUM ANGIOPENT 400 mg COMPR. ELIB. PREL. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 40 0,335041 0,271209 0,301536 0,304714141 W53506005 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0,495600 0,000000 0,446040 0,049560142 W53506006 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 100 0,479400 0,000000 0,431460 0,047940143 W54452002 C04AD03 PENTOXIFYLLINUM VASONIT RETARD 600 mg COMPR. ELIB. PREL. 600mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 50 0,502562 0,209238 0,452305 0,259495144 W13301001 C04AD03 PENTOXIFYLLINUM ANGIOPENT 400 mg COMPR. FILM. ELIB. PREL. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,335000 0,000000 0,301500 0,033500145 W53123003 C04AD03 PENTOXIFYLLINUM OXIFLUX 400 mg COMPR. FILM. ELIB. PREL. 400mg LABORMED PHARMA S.A. ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 60 0,335041 0,000125 0,301536 0,033630146 W13302001 C04AD03 PENTOXIFYLLINUM ANGIOPENT 600 mg COMPR. FILM. ELIB. PREL. 600mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,502562 0,363438 0,452305 0,413695147 W56674001 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 10 mg COMPR. 10 mg BIO EEL S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 25 COMPR. P6L 50 0,026875 0,044325 0,024187 0,047013148 W08683002 C07AA05 PROPRANOLOLUM PROPRANOLOL 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,026875 0,059125 0,024187 0,061813149 W12724002 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,104800 0,000000 0,094320 0,010480150 W08684002 C07AA05 PROPRANOLOLUM PROPRANOLOL 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,104800 0,000000 0,094320 0,010480151 W53681002 C07AA05 PROPRANOLOLUM PROPRANOLOL ARENA 40 mg COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,107500 0,000900 0,096750 0,011650152 W41673003 C07AA07 SOTALOLUM SOTAGAMMA 80 COMPR. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 100 0,215000 0,128000 0,193500 0,149500153 W08420005 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 0,215000 0,129200 0,193500 0,150700154 W62335001 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,215000 0,330500 0,193500 0,352000155 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 0,229599 0,082067 0,206639 0,105027156 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 0,229599 0,082401 0,206639 0,105361157 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 0,229599 0,029401 0,206639 0,052361158 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 0,229599 0,082067 0,206639 0,105027159 W52230001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,229599 0,082067 0,206639 0,105027

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Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

160 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 0,229599 0,082401 0,206639 0,105361161 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 0,229599 0,025734 0,206639 0,048694162 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 0,229599 0,073401 0,206639 0,096361163 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 0,000000 0,193799 0,021534164 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 0,229599 0,082734 0,206639 0,105694165 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 0,057399 0,046267 0,051659 0,052007166 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 0,057399 0,046267 0,051659 0,052007167 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 0,057399 0,046101 0,051659 0,051841168 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 0,114799 0,077201 0,103319 0,088681169 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 0,114799 0,065701 0,103319 0,077181170 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 0,114799 0,058201 0,103319 0,069681171 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 0,114799 0,077201 0,103319 0,088681172 W52231001 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,114799 0,141534 0,103319 0,153014173 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 0,114799 0,067201 0,103319 0,078681174 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 0,114799 0,077201 0,103319 0,088681175 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 0,114799 0,075701 0,103319 0,087181176 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 0,114799 0,077201 0,103319 0,088681177 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 0,109059 0,117941 0,098153 0,128847178 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 0,218119 0,159547 0,196307 0,181359179 W59569003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mgCOMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,229599 0,082067 0,206639 0,105027180 W59568003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,114799 0,076201 0,103319 0,087681181 W04260001 C07AB02 METOPROLOLUM BETALOC (R) ZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL.P-6L 30 0,229599 0,250734 0,206639 0,273694182 W04262001 C07AB02 METOPROLOLUM BETALOC (R) ZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL.P-6L 30 0,114799 0,265867 0,103319 0,277347183 W43226004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF.P-6L 30 0,109059 0,117941 0,098153 0,128847184 W43227004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF.P-6L 30 0,218119 0,159547 0,196307 0,181359185 W00491003 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,385333 0,000000 0,346799 0,038534186 W53950002 C07AB03 ATENOLOLUM ATENOLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,341500 0,000000 0,307350 0,034150187 W61517001 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,371500 0,000000 0,334350 0,037150188 W00492003 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,214666 0,000000 0,193199 0,021467189 W53949002 C07AB03 ATENOLOLUM ATENOLOL ARENA 50 MG COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,195000 0,000000 0,175500 0,019500190 W61516001 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,207000 0,000000 0,186300 0,020700191 W12507001 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM.P-6L 28 0,344399 0,030243 0,309959 0,064683192 W12507003 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 6 BLIST. PVC/AL X 14 COMPR. FILM. P6L 84 0,344399 0,352386 0,309959 0,386826193 W64210003 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 14 COMPR. FILM. P6L 84 0,344399 0,352386 0,309959 0,386826194 W59208001 C07AB07 BISOPROLOLUM BISOBLOCK 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,243333 0,000000 0,218999 0,024334195 W58764001 C07AB07 BISOPROLOLUM BOREZ 10 mg COMPR. FILM. 10 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,344399 0,038267 0,309959 0,072707196 W00625001 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,344399 0,528267 0,309959 0,562707197 W13630003 C07AB07 BISOPROLOLUM BISOGAMMA 10 mg COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 100 0,273200 0,000000 0,245880 0,027320198 W43154001 C07AB07 BISOPROLOLUM BISOTENS 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,344399 0,020934 0,309959 0,055374199 W58248003 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,344399 0,034267 0,309959 0,068707200 W60359002 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,344399 0,476267 0,309959 0,510707201 W60569004 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,344399 0,021267 0,309959 0,055707202 W58765001 C07AB07 BISOPROLOLUM BOREZ 2,5 mg COMPR. FILM. 2,5 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,086099 0,169567 0,077489 0,178177203 W60357002 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,086099 0,227234 0,077489 0,235844204 W60567004 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,086099 0,133567 0,077489 0,142177205 W00626001 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.P-6L 30 0,172199 0,342801 0,154979 0,360021206 W43153001 C07AB07 BISOPROLOLUM BISOTENS 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,172199 0,045134 0,154979 0,062354207 W58244003 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 0,172199 0,044134 0,154979 0,061354208 W60358002 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,172199 0,237801 0,154979 0,255021209 W60568004 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,172199 0,045134 0,154979 0,062354210 W13629005 C07AB07 BISOPROLOLUM BISOGAMMA 5 mg COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 100 0,156100 0,000000 0,140490 0,015610211 W59931001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,248249 0,044084 0,223424 0,068909212 W12649001 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,248249 0,024608 0,223424 0,049433213 W42058001 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,248249 0,047751 0,223424 0,072576214 W42659001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,248249 0,238751 0,223424 0,263576215 W53658001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,248249 0,105251 0,223424 0,130076

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

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cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

216 W53751001 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,248249 0,157417 0,223424 0,182242217 W58304001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,5 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,248249 0,227751 0,223424 0,252576218 W63454001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,248249 0,238751 0,223424 0,263576219 W12648002 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 0,373571 0,000000 0,336213 0,037358220 W42059001 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,496499 0,054501 0,446849 0,104151221 W42658001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,496499 0,137167 0,446849 0,186817222 W53752001 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,496499 0,055167 0,446849 0,104817223 W58305001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,496499 0,138501 0,446849 0,188151224 W59932001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,334333 0,000000 0,300899 0,033434225 W63455001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,496499 0,080167 0,446849 0,129817226 W41867002 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,124124 0,071947 0,111711 0,084360227 W41912001 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,124124 0,052542 0,111711 0,064955228 W42660001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0,124124 0,126876 0,111711 0,139289229 W53663001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,124124 0,116376 0,111711 0,128789230 W53750001 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,124124 0,070542 0,111711 0,082955231 W59930001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,124124 0,065876 0,111711 0,078289232 W63453001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0,124124 0,126876 0,111711 0,139289233 W58955007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,248249 0,013179 0,223424 0,038004234 W58956007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,290000 0,000000 0,261000 0,029000235 W58954007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,124124 0,058733 0,111711 0,071146236 W41513001 C08CA01 AMLODIPINUM AMLOHEXAL 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774237 W42020001 C08CA01 AMLODIPINUM TENOX (R) 10 COMPR. 10mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,278399 0,029601 0,250559 0,057441238 W52404001 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 10 mg COMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P-6L 30 0,278399 0,029601 0,250559 0,057441239 W53430001 C08CA01 AMLODIPINUM ALMACOR 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774240 W55742001 C08CA01 AMLODIPINUM AMLODIPINA LPH 10 mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774241 W57500001 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774242 W57500002 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774243 W57802007 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,229000 0,000000 0,206100 0,022900244 W59686002 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,278399 0,009267 0,250559 0,037107245 W59528001 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,278399 0,197601 0,250559 0,225441246 W60290001 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 10 mg COMPR. 10mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,278399 0,030601 0,250559 0,058441247 W60373002 C08CA01 AMLODIPINUM AMLODIPINA ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,278399 0,030934 0,250559 0,058774248 W61982001 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 20 0,278399 0,030601 0,250559 0,058441249 W61982002 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,278399 0,030934 0,250559 0,058774250 W41512001 C08CA01 AMLODIPINUM AMLOHEXAL 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 0,139199 0,250467 0,125279 0,264387251 W42019001 C08CA01 AMLODIPINUM TENOX (R) 5 COMPR. 5mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,139199 0,102801 0,125279 0,116721252 W52403001 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 5 mg COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.P-6L 30 0,139199 0,051801 0,125279 0,065721253 W53429001 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,139199 0,104134 0,125279 0,118054254 W55743001 C08CA01 AMLODIPINUM AMLODIPINA LPH 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,139199 0,250467 0,125279 0,264387255 W57499001 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,139199 0,250467 0,125279 0,264387256 W57499002 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 0,139199 0,250467 0,125279 0,264387257 W57801007 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,139199 0,040134 0,125279 0,054054258 W59685002 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 5 mg COMPR. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,115000 0,000000 0,103500 0,011500259 W59527001 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,139199 0,315467 0,125279 0,329387260 W60289001 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 5 mg COMPR. 5mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,139199 0,250801 0,125279 0,264721261 W60372002 C08CA01 AMLODIPINUM AMLODIPINA ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,139199 0,147801 0,125279 0,161721262 W61981001 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 20 0,139199 0,250801 0,125279 0,264721263 W61981002 C08CA01 AMLODIPINUM AMLODIPINA VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,139199 0,250467 0,125279 0,264387264 W03102002 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 0,278399 0,510934 0,250559 0,538774265 W03104001 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X, 30 COMPR. ELIB. PREL. P-6L 30 0,139199 0,447801 0,125279 0,461721266 W42170001 C08CA02 FELODIPINUM SISTAR 10 mg COMPR. FILM. ELIB. MODIF. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,278399 0,637267 0,250559 0,665107267 W42168001 C08CA02 FELODIPINUM SISTAR 5 mg COMPR. FILM. ELIB. MODIF. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,139199 0,439134 0,125279 0,453054268 W06813001 C08CA02 FELODIPINUM AURONAL 10 mg COMPR. FILM. ELIB. PREL. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0,278399 0,637267 0,250559 0,665107269 W53011001 C08CA02 FELODIPINUM FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,278399 0,084601 0,250559 0,112441270 W06814001 C08CA02 FELODIPINUM AURONAL 2,5 mg COMPR. FILM. ELIB. PREL. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0,069599 0,456734 0,062639 0,463694271 W06815001 C08CA02 FELODIPINUM AURONAL 5 mg COMPR. FILM. ELIB. PREL. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 0,139199 0,438467 0,125279 0,452387

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272 W53010001 C08CA02 FELODIPINUM FELODIPIN SANDOZ 5 mg COMPR. FILM. ELIB. PREL. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 0,139199 0,265134 0,125279 0,279054273 W57951001 C08CA05 NIFEDIPINUM ADALAT CR 30 COMPR. ELIB. MODIF. 30mg BAYER PHARMA AG GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L 28 0,139199 0,425801 0,125279 0,439721274 W63872001 C08CA05 NIFEDIPINUM ADALAT CR 30 COMPR. ELIB. MODIF. 30mg BAYER AG GERMANIA CUTIE CU 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P6L 28 0,139199 0,425801 0,125279 0,439721275 W04542001 C08CA05 NIFEDIPINUM NIFEDIPIN RETARD TERAPIA 20 mg COMPR. ELIB. PREL. 20mg TERAPIA SA ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 50 0,092799 0,143001 0,083519 0,152281276 W60127001 C08DA01 VERAPAMILUM VERAPAMIL ARENA 40 mg CAPS. 40mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,103999 0,017334 0,093599 0,027734277 W57108002 C08DA01 VERAPAMILUM VERAPAMIL ARENA 80 mg CAPS. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,208000 0,002666 0,187200 0,023466278 W62364001 C08DA01 VERAPAMILUM ISOPTIN RR 240 mg COMPR. ELIB. PREL. 240mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,624000 0,177000 0,561600 0,239400279 W06068001 C08DA01 VERAPAMILUM CORDAMIL 40 mg COMPR. FILM. 40mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0,103999 0,012667 0,093599 0,023067280 W06069001 C08DA01 VERAPAMILUM CORDAMIL 80 mg COMPR. FILM. 80mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 0,208000 0,000000 0,187200 0,020800281 W52127001 C08DA01 VERAPAMILUM VERAPAMIL 40 mg DRAJ. 40mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 0,103999 0,154201 0,093599 0,164601282 W62445001 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 40 mg DRAJ. 40mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 25 DRAJ. P6L 50 0,103999 0,154201 0,093599 0,164601283 W52126003 C08DA01 VERAPAMILUM VERAPAMIL 80 mg DRAJ. 80mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 0,208000 0,000000 0,187200 0,020800284 W62446002 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 80 mg DRAJ. 80mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 25 DRAJ. P6L 50 0,208000 0,000000 0,187200 0,020800285 W62446001 C08DA01 VERAPAMILUM VERAPAMIL SANOFI 80 mg DRAJ. 80mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 10 DRAJ. P6L 50 0,208000 0,000000 0,187200 0,020800286 W59964001 C08DB01 DILTIAZEMUM DILTIAZEM SR ROMPHARM 180 mg CAPS. ELIB. PREL. 180mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 0,793915 0,462085 0,714523 0,541477287 W59963001 C08DB01 DILTIAZEMUM DILTIAZEM SR ROMPHARM 90 mg CAPS. ELIB. PREL. 90mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 7 CAPS. ELIB. PREL. P6L 21 0,240000 0,000000 0,216000 0,024000288 W44079001 C08DB01 DILTIAZEMUM DILTIAZEM EIPICO 60 mg COMPR. 60mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2, BLIST. AL/PVC X 10 COMPR. P-6L 20 0,264638 0,018862 0,238174 0,045326289 W12201003 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L 50 0,264638 0,027762 0,238174 0,054226290 W53585001 C08DB01 DILTIAZEMUM DILTIAZEM BIOEEL 60 mg COMPR. 60mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. DIN AL/ PVC X 10 COMPR. P-6L 20 0,264638 0,018862 0,238174 0,045326291 W41897003 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. DIN PVC/AL X 10 COMPRIMATEP-6L 60 0,264638 0,029862 0,238174 0,056326292 W02586002 C08DB01 DILTIAZEMUM DILZEM 90 mg RETARD COMPR. ELIB. PREL. 90mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 0,368666 0,000000 0,331799 0,036867293 W00775001 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,071033 0,070470 0,078863294 W06860001 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,078300 0,080200 0,070470 0,088030295 W00774002 C09AA01 CAPTOPRILUM CAPTOPRIL LAROPHARM 25 mgCOMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,078300 0,086700 0,070470 0,094530296 W43029001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,078300 0,046700 0,070470 0,054530297 W06857001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,045366 0,070470 0,053196298 W08550001 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,046033 0,070470 0,053863299 W41981002 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,084366 0,070470 0,092196300 W53677002 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,078300 0,046700 0,070470 0,054530301 W53678001 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,145500 0,000000 0,130950 0,014550302 W00777001 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,085733 0,140940 0,101393303 W06862001 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156600 0,046900 0,140940 0,062560304 W43028001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,145500 0,000000 0,130950 0,014550305 W42060001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,007400 0,140940 0,023060306 W00776003 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,143333 0,000000 0,128999 0,014334307 W12405001 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,156600 0,053900 0,140940 0,069560308 W02920004 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,156600 0,053066 0,140940 0,068726309 W02922001 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,156600 0,053900 0,140940 0,069560310 W41447001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0,156600 0,043900 0,140940 0,059560311 W51276001 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,156600 0,166257 0,140940 0,181917312 W53672002 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,156600 0,053400 0,140940 0,069060313 W53672003 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0,156600 0,053200 0,140940 0,068860314 W53672004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0,156600 0,053300 0,140940 0,068960315 W53666002 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0,156600 0,053900 0,140940 0,069560316 W58491002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,156600 0,052900 0,140940 0,068560317 W62035001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,156600 0,053900 0,140940 0,069560318 W12199001 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,313200 0,034800 0,281880 0,066120319 W02921003 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,313200 0,035133 0,281880 0,066453320 W02923001 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,313200 0,034800 0,281880 0,066120321 W51277001 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,313200 0,222871 0,281880 0,254191322 W53674001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313200 0,035133 0,281880 0,066453323 W53674004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0,313200 0,035000 0,281880 0,066320324 W56712001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,313200 0,034800 0,281880 0,066120325 W58492001 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,313200 0,034800 0,281880 0,066120326 W62036001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,313200 0,034800 0,281880 0,066120327 W12198001 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,078300 0,019700 0,070470 0,027530

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Page 11: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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ambalaj

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(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

328 W02925001 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,078300 0,020200 0,070470 0,028030329 W51275001 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,078300 0,073128 0,070470 0,080958330 W12811003 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,078300 0,019700 0,070470 0,027530331 W53673001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,020366 0,070470 0,028196332 W58490002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,078300 0,016700 0,070470 0,024530333 W62034001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0,078300 0,019700 0,070470 0,027530334 W58233001 C09AA02 ENALAPRILUM ENAP 1,25 mg/ml SOL. INJ./PERF. 1,25mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR/PRF 5 3,374000 0,000000 3,036600 0,337400335 W12794001 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,156600 0,389400 0,140940 0,405060336 W42156001 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,156600 0,408900 0,140940 0,424560337 W42593001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,156600 0,097066 0,140940 0,112726338 W43054001 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,111066 0,140940 0,126726339 W53748003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,156600 0,128066 0,140940 0,143726340 W53916002 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,279066 0,140940 0,294726341 W54841001 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,156600 0,250185 0,140940 0,265845342 W54843001 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,039150 0,286207 0,035235 0,290122343 W12793001 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,313200 0,528466 0,281880 0,559786344 W42088001 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,313200 0,511300 0,281880 0,542620345 W42594001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313200 0,043800 0,281880 0,075120346 W53747003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,313200 0,085800 0,281880 0,117120347 W53917002 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,313200 0,541800 0,281880 0,573120348 W54840001 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,313200 0,370371 0,281880 0,401691349 W43055002 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR.P-6L 20 0,313200 0,138300 0,281880 0,169620350 W53918002 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,626400 0,805600 0,563760 0,868240351 W12795001 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,078300 0,200033 0,070470 0,207863352 W43053001 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,078300 0,124700 0,070470 0,132530353 W53746003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,078300 0,125033 0,070470 0,132863354 W54842001 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,078300 0,198485 0,070470 0,206315355 W51933002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,251071 0,000000 0,225963 0,025108356 W64367002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,251071 0,000000 0,225963 0,025108357 W42940001 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,318000 0,000000 0,286200 0,031800358 W42972001 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,318000 0,000000 0,286200 0,031800359 W43524001 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,318214 0,000000 0,286392 0,031822360 W54354001 C09AA05 RAMIPRILUM TRITACE 10 COMPR. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,489285 0,000000 0,440356 0,048929361 W55273002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,200714 0,000000 0,180642 0,020072362 W60133002 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,318000 0,000000 0,286200 0,031800363 W60133005 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,318000 0,000000 0,286200 0,031800364 W62447001 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,489285 0,000000 0,440356 0,048929365 W62662001 C09AA05 RAMIPRILUM RAMIPRIL ATB 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,251000 0,000000 0,225900 0,025100366 W64288002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0,200714 0,000000 0,180642 0,020072367 W51934002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 0,156600 0,000900 0,140940 0,016560368 W64365002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,156600 0,000900 0,140940 0,016560369 W42939001 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,156600 0,020733 0,140940 0,036393370 W42970001 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,156600 0,024733 0,140940 0,040393371 W43522001 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,156600 0,018400 0,140940 0,034060372 W54352003 C09AA05 RAMIPRILUM TRITACE(R) 2,5 COMPR. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,156600 0,122328 0,140940 0,137988373 W60131006 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,156600 0,024733 0,140940 0,040393374 W62451001 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,156600 0,122328 0,140940 0,137988375 W62660001 C09AA05 RAMIPRILUM RAMIPRIL ATB 2,5 mg COMPR. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,156600 0,000400 0,140940 0,016060376 W51932002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,181071 0,000000 0,162963 0,018108377 W64366002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,181071 0,000000 0,162963 0,018108378 W42237001 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,261333 0,000000 0,235199 0,026134379 W42971001 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,260333 0,000000 0,234299 0,026034380 W43523001 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,252142 0,000000 0,226927 0,025215381 W54353001 C09AA05 RAMIPRILUM TRITACE® 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,313200 0,088942 0,281880 0,120262382 W55272005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,140357 0,000000 0,126321 0,014036383 W60132003 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,261333 0,000000 0,235199 0,026134

Pagina 7 din 19

Page 12: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

crip

tie

cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

384 W60132008 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,261333 0,000000 0,235199 0,026134385 W62382001 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,313200 0,088942 0,281880 0,120262386 W62661001 C09AA05 RAMIPRILUM RAMIPRIL ATB 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR.P6L 30 0,181333 0,000000 0,163199 0,018134387 W64287005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0,140357 0,000000 0,126321 0,014036388 W05345001 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM.P-6L 30 0,104399 0,318934 0,093959 0,329374389 W64842001 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0,104399 0,318934 0,093959 0,329374390 W41466001 C09AA06 QUINAPRILUM ACCUPRO 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,208799 0,398867 0,187919 0,419747391 W64840001 C09AA06 QUINAPRILUM ACCUPRO 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0,208799 0,398867 0,187919 0,419747392 W41465001 C09AA06 QUINAPRILUM ACCUPRO 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 0,052199 0,150134 0,046979 0,155354393 W64841001 C09AA06 QUINAPRILUM ACCUPRO 5 mg COMPR. FILM. 5mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. AL/PA/AL/PVC X 10 COMPR. FILM. P6L 30 0,052199 0,150134 0,046979 0,155354394 W52069001 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 0,104399 0,296267 0,093959 0,306707395 W61581001 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,104399 0,512386 0,093959 0,522826396 W64284006 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,104399 0,296267 0,093959 0,306707397 W52068001 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR. P-6L 30 0,208799 0,372534 0,187919 0,393414398 W61582001 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg PHARMASWISS CESKÁ REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 0,208799 0,685486 0,187919 0,706366399 W64285006 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,208799 0,372534 0,187919 0,393414400 W01855001 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP HL COMPR. 10mg+12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,332000 0,000000 0,298800 0,033200401 W01854001 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP H COMPR. 10mg+25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,396000 0,000000 0,356400 0,039600402 W42590001 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP (R) HL 20 mg/12,5 mg COMPR. 20 mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0,433500 0,000000 0,390150 0,043350403 W52320001 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 5 mg/25mg COMPR. 5mg/25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 0,393571 0,000000 0,354213 0,039358404 W54356001 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 5 PLUS COMPR. 5mg/25mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,444503 0,109782 0,400052 0,154233405 W62429001 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 5 PLUS COMPR. 5mg/25mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/ AL X 28 COMPR. P6L 28 0,444503 0,109782 0,400052 0,154233406 W58838001 C09CA01 LOSARTANUM LODIAL 100mg COMPR. FILM. 100 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 2 BLIST. DIN PVC/AL X 15 COMPR. FILM. P6L 30 0,681106 0,319894 0,612995 0,388005407 W53261001 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 0,681106 0,496227 0,612995 0,564338408 W53261003 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0,681106 0,496227 0,612995 0,564338409 W58235006 C09CA01 LOSARTANUM LORISTA 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,545357 0,000000 0,490821 0,054536410 W58837001 C09CA01 LOSARTANUM LODIAL 50mg COMPR. FILM. 50 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPR. FILM. P6L 30 0,340553 0,011113 0,306497 0,045169411 W53260001 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 0,340553 0,011113 0,306497 0,045169412 W53260003 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 0,340553 0,011113 0,306497 0,045169413 W56259005 C09CA01 LOSARTANUM COZAAR 50 mg COMPR. FILM. 50mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 0,340553 0,201589 0,306497 0,235645414 W58237004 C09CA01 LOSARTANUM LORISTA 50 mg COMPR. FILM. 50mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 0,340553 0,011589 0,306497 0,045645415 W60908002 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 10 mg COMPR. FILM. 10 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,096649 0,244422 0,086984 0,254087416 W12477002 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,096649 0,117993 0,086984 0,127658417 W42158001 C10AA01 SIMVASTATINUM SINTENAL 10 mg COMPR. FILM. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,096649 0,231684 0,086984 0,241349418 W08725001 C10AA01 SIMVASTATINUM VASILIP 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,096649 0,203708 0,086984 0,213373419 W42328001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,096649 0,244351 0,086984 0,254016420 W56959001 C10AA01 SIMVASTATINUM SIMVACARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,096649 0,059065 0,086984 0,068730421 W58957005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,050333 0,000000 0,045299 0,005034422 W59878005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,096649 0,059351 0,086984 0,069016423 W60907002 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 20 mg COMPR. FILM. 20 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,193299 0,262772 0,173969 0,282102424 W12478002 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,193299 0,262772 0,173969 0,282102425 W51357002 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 0,193299 0,508486 0,173969 0,527816426 W42159001 C10AA01 SIMVASTATINUM SINTENAL 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,193299 0,262701 0,173969 0,282031427 W08479001 C10AA01 SIMVASTATINUM VASILIP 20 mg COMPR. FILM. 20mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,193299 0,262415 0,173969 0,281745428 W42327001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,193299 0,262701 0,173969 0,282031429 W56960001 C10AA01 SIMVASTATINUM SIMVACARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,193299 0,065272 0,173969 0,084602430 W58958005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,193299 0,054701 0,173969 0,074031431 W59879005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,193299 0,262701 0,173969 0,282031432 W41703002 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 30 mg COMPR. FILM. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,289949 0,218384 0,260954 0,247379433 W60906002 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 40 mg COMPR. FILM. 40 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,386599 0,778758 0,347939 0,817418434 W13137001 C10AA01 SIMVASTATINUM VASILIP (R) 40 mg COMPR. FILM. 40mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 7 COMPR. FILM P-6L 28 0,386599 0,392686 0,347939 0,431346435 W41446002 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,386599 0,192686 0,347939 0,231346436 W41547001 C10AA01 SIMVASTATINUM SINTENAL 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,386599 0,736734 0,347939 0,775394437 W52431001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,386599 0,741067 0,347939 0,779727438 W56961001 C10AA01 SIMVASTATINUM SIMVACARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,356071 0,000000 0,320463 0,035608439 W58959005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,341000 0,000000 0,306900 0,034100

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440 W59880005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,386599 0,552734 0,347939 0,591394441 W06752001 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 0,128866 0,424134 0,115979 0,437021442 W57367004 C10AA02 LOVASTATINUM LOVASTATINA ARENA 20 mg COMPR. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,128866 0,813134 0,115979 0,826021443 W43037001 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L 28 0,193299 0,676343 0,173969 0,695673444 W43843001 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR.P-6L 28 0,386599 0,999115 0,347939 1,037775445 W43325002 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,747599 0,083067 0,672839 0,157827446 W13251001 C10AB05 FENOFIBRATUM LIPIVIM CAPS. PULB. MICRONIZATA 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,927666 0,000000 0,834899 0,092767447 W62360002 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. ELIB. MODIF. 160mg MYLAN MEDICAL SAS FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,934499 0,126167 0,841049 0,219617448 W62362001 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg MYLAN MEDICAL SAS FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,934499 0,194834 0,841049 0,288284449 W13742001 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 7,380000 0,000000 6,642000 0,738000450 W12026001 D07AA02 HYDROCORTISONUM HIDROCORTIZON ATB 10mg/g UNGUENT 10mg/g ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB DIN AL X 20 G UNGUENT P-RF 1 8,070000 0,000000 7,263000 0,807000451 W53912001 D07AC01 BETAMETHASONUM EKARZIN 0,5MG/G CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 8,070000 0,000000 7,263000 0,807000452 W44047001 D07AC01 BETAMETHASONUM BETADERM 1 mg/g CREMA 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 3,695400 2,364600 3,325860 2,734140453 W44048001 D07AC01 BETAMETHASONUM BETADERM 1mg/g UNGUENT 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 3,695400 2,364600 3,325860 2,734140454 W60232003 G02AB03 ERGOMETRINUM MALEAT DE ERGOMETRINA ZENTIVA 0,2 mg/ml SOL. INJ. 0,2mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE P-RF 5 1,556000 0,000000 1,400400 0,155600455 W63442002 G03BA03 TESTOSTERONUM * UNDESTOR TESTOCAPS 40 mg CAPS. MOI 40mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI PRF 60 0,853000 0,000000 0,767700 0,085300456 W62752001 G03BA03 TESTOSTERONUM * ANDROGEL 16,2 mg/g GEL 16,2mg/g BESINS HEALTHCARE BELGIA CUTIE CU 1 RECIPIENT MULTIDOZA DIN PP, CARE CONTINE UN REZERVOR DIN PEJD, PREVAZUT CU UN ADAPTOR LA CARE SE CONECTEAZA O POMPA DOZATOARE CU 88 G GEL PRF 1 183,182925 68,757075 164,864632 87,075368457 W64727001 G03BA03 TESTOSTERONUM * TESTAVAN 20 mg/g GEL TRANSDERMIC 20mg/g FERRING CONTROLLED THERAPEUTICS LIMITED MAREA BRITANIE CUTIE CU 1 RECIPIENT MULTIDOZA CU POMPA DOZATOARE CARE CONTINE 85,5 G GEL TRANSDERMIC SI POATE ELIBERA 56 DOZE MASURATE PR/PRF 1 219,726994 17,833006 197,754294 39,805706458 W59344003 G03BA03 TESTOSTERONUM * TESTIM 50 mg GEL TRANSDERMIC 50mg FERRING GMBH GERMANIA CUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMIC PR/PRF 30 5,903333 0,000000 5,312999 0,590334459 W59232002 G03BA03 TESTOSTERONUM * NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER PHARMA AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 6 ML A 4 ML SOL. INJ. PR/PRF 1 449,819999 0,000001 404,837999 44,982001460 W63885002 G03BA03 TESTOSTERONUM * NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 6 ML A 4 ML SOL. INJ. PR/PRF 1 449,819999 0,000001 404,837999 44,982001461 W55402001 G03CA03 ESTRADIOLUM * OESTROGEL 0,6 mg/g GEL 0,6mg/g LABORATOIRES BESINS INTERNATIONAL FRANTA CUTIE CU 1 TUB AL X 80 G GEL + DISPOZITIV DE DOZARE DIN POLISTIREN P-6L 1 14,560000 0,000000 13,104000 1,456000462 W62058001 G03CA03 ESTRADIOLUM * LENZETTO 1,53 mg/doza SPRAY TRANSDERMIC, SOL. 1,53mg/doza GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU UN FLAC. DIN STICLA CARE CONTINE 8,1 ML SOL., PREVAZUT CU O POMPA DOZATOARE P6L 1 28,318230 19,571770 25,486407 22,403593463 W51724001 G04CAN1 DOXAZOSINUM DOXAZOSIN ARENA 1 mg (vezi C02CA04) COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. DIN AL/PVC X 10 COMPR. P-6L 30 0,142987 0,713346 0,128688 0,727645464 W51724001 G04CAN1 DOXAZOSINUM DOXAZOSIN ARENA 1 mg (vezi C02CA04) COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. DIN AL/PVC X 10 COMPR. P-6L 30 0,142987 0,713346 0,128688 0,727645465 W08648002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,285975 0,335358 0,257377 0,363956466 W08648002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,285975 0,335358 0,257377 0,363956467 W08649002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 0,571950 0,100383 0,514755 0,157578468 W08649002 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 0,571950 0,100383 0,514755 0,157578469 W13893002 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0,571950 0,434121 0,514755 0,491316470 W13893002 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L 28 0,571950 0,434121 0,514755 0,491316471 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 17,447499 4,122501 15,702749 5,867251472 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 8,723749 0,556251 7,851374 1,428626473 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 MLPRF 1 32,670000 0,000000 29,403000 3,267000474 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 0,095000 0,049000 0,085500 0,058500475 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 0,000000 0,085500 0,009500476 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,095000 0,035333 0,085500 0,044833477 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 0,095000 0,045000 0,085500 0,054500478 W44080001 H02AB09 HYDROCORTISONUM * HYDROCORTISONE SUCCINAT SODIC LIOF. + SOLV. PT. SOL. INJ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 3,723999 0,406001 3,351599 0,778401479 W58639001 H02AB09 HYDROCORTISONUM * HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF.500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV. PR/PRF 1 12,530000 0,000000 11,277000 1,253000480 W58638001 H02AB09 HYDROCORTISONUM * HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 3,723999 3,736001 3,351599 4,108401481 W51922003 H02AB09 HYDROCORTISONUM * HIDROCORTIZON ZENTIVA 19.6mg/5ml SOL. INJ. 19,6mg/5ml ZENTIVA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 1 ML SOL. A + 5 FIOLE DIN STICLA BRUNA CU CAPACITATEA DE 5ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 4 ML SOL. B S/P-RF 5 0,975315 3,684685 0,877783 3,782217482 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 0,000000 0,394200 0,043800483 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 0,000000 0,343800 0,038200484 W00347001 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,324500 0,000000 0,292050 0,032450485 W00346001 J01CA04 AMOXICILLINUM AMOXICILINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,355500 0,019500 0,319950 0,055050486 W42903001 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,336000 0,000000 0,302400 0,033600487 W00351001 J01CA04 AMOXICILLINUM AMOXICILINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,488249 0,144751 0,439424 0,193576488 W08428003 J01CA04 AMOXICILLINUM AMOXICILINA FORTE FARMEX 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,488249 0,127751 0,439424 0,176576489 W08428001 J01CA04 AMOXICILLINUM AMOXICILINA FORTE FARMEX 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0,459000 0,000000 0,413100 0,045900490 W13739001 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 0,488249 0,132751 0,439424 0,181576491 W42902001 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,488249 0,030751 0,439424 0,079576492 W41600001 J01CA04 AMOXICILLINUM OSPAMOX 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.P-RF 12 0,875833 0,000000 0,788249 0,087584493 W41578001 J01CA04 AMOXICILLINUM OSPAMOX 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 0,488249 0,029251 0,439424 0,078076494 W42893001 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 2,133000 4,057000 1,919700 4,270300495 W41580002 J01CA04 AMOXICILLINUM OSPAMOX (R) 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 5,1 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 2,133000 4,057000 1,919700 4,270300

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496 W42892002 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg/ 5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 20 G PULB. PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE PE CU GRADATII PT. 1,25 ML, 2,5 ML, 5 ML P-RF 1 4,266000 0,984000 3,839400 1,410600497 W00388002 J01CA04 AMOXICILLINUM OSPAMOX 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 4,266000 0,914000 3,839400 1,340600498 W41595001 J01CE02 PHENOXYMETHYLPENICILLINUMOSPEN (R) 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,315000 0,000000 0,283500 0,031500499 W41594003 J01CE02 PHENOXYMETHYLPENICILLINUMOSPEN® 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. P-RF 12 0,481499 0,074334 0,433349 0,122484500 W41596001 J01CE02 PHENOXYMETHYLPENICILLINUMOSPEN (R) 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 0,160499 0,077001 0,144449 0,093051501 W55413001 J01CE02 PHENOXYMETHYLPENICILLINUMOSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE P-RF 1 0,213999 9,166001 0,192599 9,187401502 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 5,178279 0,711721 4,660451 1,229549503 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 0,000000 4,385790 0,487310504 W04675002 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,323580 0,063920 0,291222 0,096278505 W11729001 J01CF04 OXACILLINUM OXACILINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,323580 0,088420 0,291222 0,120778506 W07274001 J01CF04 OXACILLINUM OXACILINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,647160 0,172840 0,582444 0,237556507 W13743001 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,647160 0,028840 0,582444 0,093556508 W12910001 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,588500 0,000000 0,529650 0,058850509 W43092001 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,647160 0,121840 0,582444 0,186556510 W12910003 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,647160 0,142840 0,582444 0,207556511 W60469001 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 5,565099 0,244901 5,008589 0,801411512 W60469003 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 4,830400 0,000000 4,347360 0,483040513 W60468001 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 2,782549 2,577451 2,504294 2,855706514 W60468003 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 2,782549 1,729151 2,504294 2,007406515 W55354004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN SR 1000 mg/62,5 mgCOMPR. ELIB. PREL. 1000mg/62,5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU BLIST. AL/PVC-AL-PP X 28 COMPR. ELIB. PREL. P-RF 28 1,157278 0,573079 1,041550 0,688807516 W00400003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg COMPR. FILM. 1000mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM. P-RF 14 1,012618 0,000239 0,911356 0,101501517 W57628002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 500 mg/125mg COMPR. FILM. 500 mg/125 mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM.P-RF 28 0,578639 0,043861 0,520775 0,101725518 W54453002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500mg/125mg COMPR. FILM. 500mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 0,578639 0,043503 0,520775 0,101367519 W55163002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT P-RF 14 0,578639 0,377789 0,520775 0,435653520 W64211008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg COMPR. FILM. 500mg/125mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 0,574285 0,000000 0,516856 0,057429521 W55401002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 875 mg/125 mg COMPR. FILM. 875mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1,012618 0,000239 0,911356 0,101501522 W55164001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT P-RF 14 1,012618 0,544524 0,911356 0,645786523 W59497004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 875 mg/125 mg COMPR. FILM. 875mg/125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL INTRODUSE IN PUNGI DE POLIESTER/AL/POLIESTER/PE X 14 COMPR. FILM. PRF 14 1,012618 0,000239 0,911356 0,101501524 W59497007 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 875 mg/125 mg COMPR. FILM. 875mg/125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL INTRODUSE IN PUNGI DE POLIESTER/AL/POLIESTER/PE X 21 COMPR. FILM. PRF 21 1,011904 0,000000 0,910713 0,101191525 W64212008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM. 875mg/125mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1,002857 0,000000 0,902571 0,100286526 W62046002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 625mg SANDOZ S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 0,578639 0,711361 0,520775 0,769225527 W00399001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 156,25mg/5ml PULB. PT. SUSP. ORALA 156,25mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 MG PULB. PT. 100 ML SUSP. ORALA P-RF 1 9,029687 1,880313 8,126718 2,783282528 W08783002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 14,100000 0,000000 12,690000 1,410000529 W55355001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALAP-RF 1 10,113250 0,456750 9,101925 1,468075530 W55355004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 10,113250 0,456750 9,101925 1,468075531 W55355005 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA +LINGURITA DOZATOARE PRF 1 10,113250 0,686750 9,101925 1,698075532 W55355006 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA +LINGURITA DOZATOARE PRF 1 20,226500 0,933500 18,203850 2,956150533 W55342003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN ES 600mg/42,9 mg/5 ml PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CONTINÂND PULB. PENTRU 100 ML SUSPENSIE SI O LINGURITA DOZATOARE DIN POLISTIREN, MARCAT CU GRADATII PT. MASURAREA VOLUMELOR 2,5 ML SI 5,0 ML P-RF 1 37,470000 0,000000 33,723000 3,747000534 W00402001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 312,5mg/5ml PULB. PT.SUSP. ORALA 312,5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 18,059375 1,940625 16,253437 3,746563535 W01016005 J01DB01 CEFALEXINUM CEFALEXINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,488587 0,161413 0,439728 0,210272536 W12083001 J01DB01 CEFALEXINUM CEFALEXINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0,488587 0,167913 0,439728 0,216772537 W12084001 J01DB01 CEFALEXINUM CEFALEXINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,977175 0,170825 0,879457 0,268543538 W06883003 J01DB01 CEFALEXINUM CEFALEXINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,977175 0,005825 0,879457 0,103543539 W43520001 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,977175 0,116825 0,879457 0,214543540 W41665001 J01DB01 CEFALEXINUM OSPEXIN 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 1,436666 0,000000 1,292999 0,143667541 W41666001 J01DB01 CEFALEXINUM OSPEXIN 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF 12 0,977175 0,105325 0,879457 0,203043542 W44127002 J01DB01 CEFALEXINUM KEFLEX (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 10,617500 0,832500 9,555750 1,894250543 W43089001 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 250 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 10,340000 0,000000 9,306000 1,034000544 W41651001 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33G GRANULE PT. 60ML SUSP.+ LINGURITA DOZATOARE X 5ML P-RF 1 10,340000 0,000000 9,306000 1,034000545 W64364001 J01DB01 CEFALEXINUM KEFLEX® 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PRF 1 10,617500 0,832500 9,555750 1,894250546 W01001001 J01DB05 CEFADROXILUM CEXYL 250 mg CAPS. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,488587 1,537413 0,439728 1,586272547 W41662001 J01DB05 CEFADROXILUM CEXYL 500 mg CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 0,977175 0,111825 0,879457 0,209543548 W55436001 J01DB05 CEFADROXILUM CEFORAN 500 mg CAPS. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,977175 0,446825 0,879457 0,544543549 W41663002 J01DB05 CEFADROXILUM CEXYL 1000 mg COMPR. FILM. 1000mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/PVDC X 10. COMPR. FILM.P-RF 10 1,954350 0,450650 1,758915 0,646085550 W41659001 J01DB05 CEFADROXILUM CEXYL 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 5,308750 7,851250 4,777875 8,382125551 W41660001 J01DB05 CEFADROXILUM CEXYL 250 mg/5 ml GRAN. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 10,617500 1,402500 9,555750 2,464250

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552 W53168001 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 1,034100 0,114900 0,930690 0,218310553 W53168002 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 1,034100 0,114900 0,930690 0,218310554 W53169001 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 1,961000 0,000000 1,764900 0,196100555 W53169002 J01DC02 CEFUROXIMUM CEFUROXIMA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 1,961000 0,000000 1,764900 0,196100556 W12655001 J01DC02 CEFUROXIMUM ZINNAT (R) 125 mg COMPR. FILM. 125mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 1,190000 0,000000 1,071000 0,119000557 W12657001 J01DC02 CEFUROXIMUM ZINNAT (R) 250 mg COMPR. FILM. 250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X, 10 COMPR.FILM P-RF 10 1,034100 0,714900 0,930690 0,818310558 W62257003 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 1,034100 0,114900 0,930690 0,218310559 W12659001 J01DC02 CEFUROXIMUM ZINNAT (R) 500 mg COMPR. FILM. 500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR.FILM P-RF 10 2,068200 0,936800 1,861380 1,143620560 W62258003 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF 10 1,961000 0,000000 1,764900 0,196100561 W12552001 J01DC02 CEFUROXIMUM ZINNAT GRAN. PT. SUSP. ORALA 125mg/5ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA BRUNA CONTINAND GRANULE PT. 50 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 12,719999 8,480001 11,447999 9,752001562 W00985003 J01DC04 CEFACLORUM CEFACLOR ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,517050 1,138950 0,465345 1,190655563 W56967001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250 mg CAPS. 250mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 0,517050 0,489616 0,465345 0,541321564 W52029001 J01DC04 CEFACLORUM CLORACEF (R) FORTE 500 CAPS. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 1,034100 0,825275 0,930690 0,928685565 W55271001 J01DC04 CEFACLORUM CEFACLOR ARENA 500 mg CAPS. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,034100 2,013900 0,930690 2,117310566 W56966001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 500 mg CAPS. 500mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 1,034100 0,825900 0,930690 0,929310567 W58458001 J01DC04 CEFACLORUM CECLOR MR 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1,034100 1,681900 0,930690 1,785310568 W58459001 J01DC04 CEFACLORUM CECLOR MR 750 mg COMPR. CU ELIB. PREL. 750mg ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1,551150 2,359850 1,396035 2,514965569 W44130002 J01DC04 CEFACLORUM CECLOR (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 9,540000 4,390000 8,586000 5,344000570 W56969001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 125mg/5ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA P-RF 1 9,540000 0,000000 8,586000 0,954000571 W56968001 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250mg/5ml GRAN. PT. SUSP. ORALA 250 mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA P-RF 1 18,910000 0,000000 17,019000 1,891000572 W44129002 J01DC04 CEFACLORUM CECLOR (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 19,080000 10,000000 17,172000 11,908000573 W64369001 J01DC04 CEFACLORUM CECLOR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. PEID CONTINAND GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE DIN POLISTIREN PRF 1 19,080000 10,000000 17,172000 11,908000574 W12210001 J01DC04 CEFACLORUM CEFAKLOR 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 7,631999 1,908001 6,868799 2,671201575 W51321001 J01DC04 CEFACLORUM CEFAKLOR 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 15,263999 2,146001 13,737599 3,672401576 W57455001 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 2,152250 0,201750 1,937025 0,416975577 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 0,000000 3,419100 0,379900578 W60256001 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE PRF 5 8,609000 1,943000 7,748100 2,803900579 W60256003 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF 10 8,609000 1,413000 7,748100 2,273900580 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 0,000000 7,506000 0,834000581 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 43,045000 34,275000 38,740500 38,579500582 W05741001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,380000 0,041500 0,342000 0,079500583 W05738001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,366500 0,000000 0,329850 0,036650584 W12479001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,380000 0,004500 0,342000 0,042500585 W53671001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,380000 0,041500 0,342000 0,079500586 W44046001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML P-RF 1 4,960000 0,000000 4,464000 0,496000587 W05739001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SUSP. ORALA 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 4,425750 5,944250 3,983175 6,386825588 W02983002 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,386500 0,000000 0,347850 0,038650589 W61210001 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,438942 0,085058 0,395047 0,128953590 W62391001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg BGP PRODUCTS LTD. MAREA BRITANIE CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2,194713 0,591287 1,975241 0,810759591 W63492001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg MYLAN PRODUCTS LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2,194713 0,591287 1,975241 0,810759592 W14043001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 1,097356 0,121929 0,987620 0,231665593 W44093001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 1,097356 0,048358 0,987620 0,158094594 W08490001 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 1,097356 0,203358 0,987620 0,313094595 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 0,885714 0,000000 0,797142 0,088572596 W62390002 J01FA09 CLARITHROMYCINUM KLACID 250 mg COMPR. FILM. 250mg BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1,097356 0,953358 0,987620 1,063094597 W14044001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 2,012857 0,000000 1,811571 0,201286598 W44087001 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 2,148571 0,000000 1,933713 0,214858599 W08491001 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 2,024285 0,000000 1,821856 0,202429600 W54044001 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 1,947500 0,000000 1,752750 0,194750601 W60254003 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 1,777142 0,000000 1,599427 0,177715602 W41838002 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB. PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,194713 0,369572 1,975241 0,589044603 W62389002 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 MLPRF 1 24,870376 2,799624 22,383338 5,286662604 W44092001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALAP-RF 1 13,500000 0,000000 12,150000 1,350000605 W62389001 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 MLPRF 1 14,922225 5,847775 13,430002 7,339998606 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 29,844451 3,645549 26,860005 6,629995607 W58393002 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA PRF 1 17,800000 0,000000 16,020000 1,780000

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Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

608 W62343001 J01FA09 CLARITHROMYCINUM KLACID I.V. 500 mg PULB. PT. CONC. PT. SOL. PERF. 500mg MYLAN MEDICAL SAS FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA I, DE CAPACITATE 15 ML CONTINAND PULB. PT. CONC. PT. SOL. PERF. PRF 1 41,630000 0,000000 37,467000 4,163000609 W07914001 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,019375 1,098562 0,141438610 W53584001 J01MA01 OFLOXACINUM OFLOXACINA LAROPHARM 200 mg COMPR. FILM. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10COMPR. FILM.P-RF 10 1,220625 0,019375 1,098562 0,141438611 W56957001 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,965375 1,098562 1,087438612 W54037001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,244125 3,832875 0,219712 3,857288613 W54037002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,244125 3,340875 0,219712 3,365288614 W44077004 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,610312 0,109688 0,549280 0,170720615 W01273001 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,610312 0,133688 0,549280 0,194720616 W01288001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,610312 0,109688 0,549280 0,170720617 W01271002 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,610312 0,135688 0,549280 0,196720618 W07862001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,610312 0,146688 0,549280 0,207720619 W54038001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,610312 0,107688 0,549280 0,168720620 W54038002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,610312 0,061688 0,549280 0,122720621 W62110003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,518000 0,000000 0,466200 0,051800622 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1,220625 0,026375 1,098562 0,148438623 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,969000 0,000000 0,872100 0,096900624 W01289001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,172375 1,098562 0,294438625 W01272001 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,223375 1,098562 0,345438626 W07863001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,958000 0,000000 0,862200 0,095800627 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 0,223375 1,098562 0,345438628 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,008000 0,000000 0,907200 0,100800629 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,897500 0,000000 0,807750 0,089750630 W62111003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,758000 0,000000 0,682200 0,075800631 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1,083000 0,000000 0,974700 0,108300632 W54040001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,830937 2,246063 1,647843 2,429157633 W57948001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,441250 10,647321 2,197125 10,891446634 W63880001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,441250 10,647321 2,197125 10,891446635 W57949001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 1,220625 8,739375 1,098562 8,861438636 W63879001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 1,220625 8,739375 1,098562 8,861438637 W52445001 J01MA03 PEFLOXACINUM PEFLOXACIN LAROPHARM COMPR. FILM. 400mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,220625 1,824375 1,098562 1,946438638 W14009001 J01MA06 NORFLOXACINUM NORFLOXACIN LAROPHARM 400 mg COMPR. FILM. 400mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,859000 0,104000 0,773100 0,189900639 W41800001 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,859000 0,000000 0,773100 0,085900640 W07984001 J01MA06 NORFLOXACINUM NOLICIN 400 mg COMPR. FILM. 400mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,832000 0,000000 0,748800 0,083200641 W58303001 J01MA06 NORFLOXACINUM NORFLOXACIN HELCOR 400 mg COMPR. FILM. 400mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,859000 0,068000 0,773100 0,153900642 W62811001 J01MA06 NORFLOXACINUM NORFLOXACINA ATB 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,859000 0,068000 0,773100 0,153900643 W42791002 J01MB02 ACIDUM NALIDIXICUM NALIXID 500 mg CAPS. 500mg ZENTIVA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 1,066666 0,000000 0,959999 0,106667644 W53689002 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,251666 0,000000 0,226499 0,025167645 W53689002 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,251666 0,000000 0,226499 0,025167646 W08257001 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,344700 0,038300 0,310230 0,072770647 W63535001 J01XD01 METRONIDAZOLUM FLAGYL 250 mg (vezi P01AB01) COMPR. FILM. 250mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,344700 0,038300 0,310230 0,072770648 W08257001 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 0,344700 0,038300 0,310230 0,072770649 W63535001 J01XD01 METRONIDAZOLUM FLAGYL 250 mg (vezi P01AB01) COMPR. FILM. 250mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,344700 0,038300 0,310230 0,072770650 W42139002 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 9,129166 0,000000 8,216249 0,912917651 W42139001 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 9,434583 0,505417 8,491124 1,448876652 W42138002 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 8,950833 0,000000 8,055749 0,895084653 W42138001 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 9,434583 0,305417 8,491124 1,248876654 W08927001 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 10 4,717291 0,555709 4,245561 1,027439655 W08927002 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 10 4,717291 0,555709 4,245561 1,027439656 W08927003 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 20 4,717291 0,290709 4,245561 0,762439657 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 3,086613 3,653387 2,777951 3,962049658 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L.ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 3,086613 1,674815 2,777951 1,983477659 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 3,086613 0,263387 2,777951 0,572049660 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072661 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 6,990080 4,166928 7,453072662 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.P-RF 1 4,629920 2,920080 4,166928 3,383072663 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L.ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,629920 2,030080 4,166928 2,493072

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

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cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

664 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072665 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 2,900080 4,166928 3,363072666 W52334001 J02AC01 FLUCONAZOLUM FLUCONAZOL LAROPHARM 150 mg CAPS. 150mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPSULA P-RF 1 4,629920 2,900080 4,166928 3,363072667 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072668 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4,629920 2,900080 4,166928 3,363072669 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 4,629920 2,900080 4,166928 3,363072670 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 4,629920 1,670080 4,166928 2,133072671 W60221003 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072672 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 4,629920 2,920080 4,166928 3,383072673 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L.ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 6,145714 0,000000 5,531142 0,614572674 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 1,543306 1,383836 1,388975 1,538167675 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,543306 2,960979 1,388975 3,115310676 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.P-RF 7 1,543306 1,383836 1,388975 1,538167677 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L.ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 1,543306 0,528122 1,388975 0,682453678 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,543306 1,382408 1,388975 1,536739679 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,543306 0,976694 1,388975 1,131025680 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 1,543306 1,383836 1,388975 1,538167681 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 1,543306 0,182408 1,388975 0,336739682 W58322002 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN PEÎD, DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CE CONTINE PULB. PENTRU 35 ML SUSP. ORALA SI O SERINGA DIN PP DE 5 ML CU MARCAJ LA FIECARE 0,2 ML PRF 1 10,803148 20,026852 9,722833 21,107167683 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,846337 0,257663 0,761703 0,342297684 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,846337 0,323163 0,761703 0,407797685 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,846337 0,281663 0,761703 0,366297686 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,692675 0,435325 1,523407 0,604593687 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,846337 0,090663 0,761703 0,175297688 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR.P-RF 20 0,755000 0,000000 0,679500 0,075500689 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mgCOMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,846337 0,095163 0,761703 0,179797690 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,846337 0,095163 0,761703 0,179797691 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR.P-RF 10 1,692675 1,211325 1,523407 1,380593692 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 49,248000 0,000000 44,323200 4,924800693 W42120001 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 0,072337 0,016163 0,065103 0,023397694 W53947002 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MGCAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,072337 0,005329 0,065103 0,012563695 W53948002 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,144674 0,047826 0,130206 0,062294696 W03600001 M01AB01 INDOMETACINUM INDOMETACIN ATB 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 0,270900 0,474100 0,243810 0,501190697 W03609001 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,270900 0,453100 0,243810 0,480190698 W12694002 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 0,270900 0,450100 0,243810 0,477190699 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 0,434022 2,145478 0,390619 2,188881700 W63730001 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P6L 20 0,434022 2,145478 0,390619 2,188881701 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 0,217011 0,369655 0,195309 0,391357702 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 0,289348 0,083652 0,260413 0,112587703 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 0,000000 0,155700 0,017300704 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 0,289348 0,080652 0,260413 0,109587705 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 0,289348 0,080652 0,260413 0,109587706 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 0,000000 0,111150 0,012350707 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 0,000000 0,111150 0,012350708 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 0,072337 0,135663 0,065103 0,142897709 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 0,000000 0,110999 0,012334710 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 0,000000 0,799200 0,088800711 W14114001 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 0,541800 0,056533 0,487620 0,110713712 W12288001 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 0,541800 0,056200 0,487620 0,110380713 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 0,541800 0,060200 0,487620 0,114380714 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 0,067725 0,568941 0,060952 0,575714715 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 0,067725 0,564275 0,060952 0,571048716 W56142001 M01AB15 KETOROLACUM TROMETHAMIN KETOROL COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,096449 0,272051 0,086804 0,281696717 W44108003 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L 20 0,096449 0,456551 0,086804 0,466196718 W44107001 M01AB15 KETOROLACUM TROMETHAMIN KETANOV SOL. INJ. 30mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML P-RF 10 1,927800 0,776200 1,735020 0,968980719 W56143003 M01AB15 KETOROLACUM TROMETHAMIN KETOROL SOL. INJ. 30mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-RF 10 1,927800 0,214200 1,735020 0,406980

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720 W61916001 M01AB15 KETOROLACUM TROMETHAMIN KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml SOL. INJ. 30mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ. PRF 5 1,927800 0,214200 1,735020 0,406980721 W61916002 M01AB15 KETOROLACUM TROMETHAMIN KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml SOL. INJ. 30mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ. PRF 10 1,927800 0,214200 1,735020 0,406980722 W57635001 M01AB16 ACECLOFENACUM AFLAMIL 100mg COMPR. FILM. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR. P-6L 20 0,144674 0,359326 0,130206 0,373794723 W61427001 M01AB16 ACECLOFENACUM AFLAMIL 100 mg PULB. PT.SUSP. ORALA 100mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 20 PLICURI UNIDOZA DIN MATERIAL COMPLEX DIN HARTIE DE TIP OPALINA LAMINATA PE UN STRAT DE ALUMINIU (20 ΜM) SI FILM DIN PEJD P6L 20 0,144674 1,264326 0,130206 1,278794724 W56784001 M01AC02 TENOXICAMUM TENOXICAM ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,341100 0,429400 0,306990 0,463510725 W12900001 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) COMPR. FILM. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 0,341100 0,351900 0,306990 0,386010726 W12899001 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) LIOF. + SOLV. PT. SOL. INJ. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF 1 2,068000 3,862000 1,861200 4,068800727 W04103001 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,341100 0,241900 0,306990 0,276010728 W04103002 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 0,341100 0,242900 0,306990 0,277010729 W43917001 M01AC06 MELOXICAMUM MELOXICAM MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,341100 0,037900 0,306990 0,072010730 W53657001 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 15 mg COMPR. 15mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,341100 0,037900 0,306990 0,072010731 W60286002 M01AC06 MELOXICAMUM Meloxicam Zentiva 15 mg comprimate COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,341100 0,027900 0,306990 0,062010732 W42654003 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0,341100 0,037900 0,306990 0,072010733 W04104002 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 0,170550 0,299450 0,153495 0,316505734 W04104001 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 0,170550 0,298450 0,153495 0,315505735 W43916001 M01AC06 MELOXICAMUM MELOXICAM MCC 7,5 mg COMPR. 7,5mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIAT. AL/PVC X 10 COMPR. P-6L 20 0,170550 0,135450 0,153495 0,152505736 W53656001 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 7,5 mg COMPR. 7,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,170550 0,135450 0,153495 0,152505737 W53827001 M01AC06 MELOXICAMUM MELOXICAM LAROPHARM 7,5 mg COMPR. 7,5mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. P-6L 20 0,170550 0,134450 0,153495 0,151505738 W42653003 M01AC06 MELOXICAMUM MELOXICAM LPH 7,5 mg COMPR. 7,5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L 30 0,170550 0,134450 0,153495 0,151505739 W61229001 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 3 2,063333 0,000000 1,856999 0,206334740 W61229002 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 5 2,068000 0,000000 1,861200 0,206800741 W60600001 M01AC06 MELOXICAMUM MELOX 15 mg/1,5 ml SOL. INJ. 10mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC A 5 FIOLE TRANSPARENTE DIN STICLA CU CAPACITATEA DE 2 ML, CONTINAND 1,5 ML PRF 5 2,068000 0,000000 1,861200 0,206800742 W08929002 M01AC06 MELOXICAMUM MOVALIS 15mg/1,5ml SOL. INJ. 15mg/1,5ml BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1,5 ML SIL. INJ. P-RF 5 2,068000 0,000000 1,861200 0,206800743 W41449001 M01AC06 MELOXICAMUM MELOXICAM 15 mg SUPOZ. 15mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 1,007500 0,712500 0,906750 0,813250744 W42896001 M01AE03 KETOPROFENUM KETONAL (R) DUO 150 mg CAPS. ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 0,741712 0,149788 0,667540 0,223960745 W54212001 M01AE03 KETOPROFENUM KETOPROFEN SR TERAPIA 200 MG CAPS. ELIB. PREL. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 0,678000 0,000000 0,610200 0,067800746 W03880001 M01AE03 KETOPROFENUM KETONAL RETARD COMPR. ELIB. PREL. 150mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L 20 0,741712 0,079788 0,667540 0,153960747 W12622001 M01AE03 KETOPROFENUM PROFENID (R) 100 mg COMPR. FILM. 100mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM. P-6L 30 0,440666 0,000000 0,396599 0,044067748 W43110001 M01AE03 KETOPROFENUM KETOPROXIN 100 mg COMPR. FILM. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM.P-6L 20 0,295000 0,000000 0,265500 0,029500749 W63532001 M01AE03 KETOPROFENUM PROFENID 100 mg COMPR. FILM. 100mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. FILM. P6L 30 0,440666 0,000000 0,396599 0,044067750 W43111001 M01AE03 KETOPROFENUM KETOPROXIN 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM.P-6L 20 0,247237 0,128763 0,222513 0,153487751 W60385001 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 5 1,198000 0,000000 1,078200 0,119800752 W60385002 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 10 1,196000 0,000000 1,076400 0,119600753 W03881002 M01AE03 KETOPROFENUM KETONAL 100 mg/ 2 ml SOL. INJ. 100mg/2ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF. P-RF 10 1,023000 0,000000 0,920700 0,102300754 W54214001 M01AE03 KETOPROFENUM KETOPROFEN TERAPIA 100MG/2ML SOL. INJ./CONC. SOL. PERF. 100mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 1,198000 0,904000 1,078200 1,023800755 W14020001 M01AE03 KETOPROFENUM KETOMAG SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L 10 0,712999 0,000001 0,641699 0,071301756 W00242001 M04AA01 ALLOPURINOLUM * MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 0,165110 0,014490 0,148599 0,031001757 W00242003 M04AA01 ALLOPURINOLUM * MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 COMPR. P6L 60 0,165110 0,012556 0,148599 0,029067758 W00243001 M04AA01 ALLOPURINOLUM * MILURIT 300 mg COMPR. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 0,457666 0,000000 0,411899 0,045767759 W01429002 M04AC01 COLCHICINUM COLCHICINA COMPR. 1mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-RF 40 0,157250 0,000000 0,141525 0,015725760 W12691002 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,278186 0,037814 0,250367 0,065633761 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,278186 0,213314 0,250367 0,241133762 W60291001 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,278186 0,126814 0,250367 0,154633763 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,278186 0,141814 0,250367 0,169633764 W42957001 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,278186 0,126314 0,250367 0,154133765 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0,556374 0,132292 0,500736 0,187930766 W60236002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,556374 0,107292 0,500736 0,162930767 W61448003 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,556333 0,000000 0,500699 0,055634768 W63391001 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 0,556374 0,113626 0,500736 0,169264769 W63391003 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 0,556374 0,113626 0,500736 0,169264770 W58893002 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,834562 0,028438 0,751105 0,111895771 W60237002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,834562 0,118104 0,751105 0,201561772 W61449001 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,834000 0,000000 0,750600 0,083400773 W61449003 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,833666 0,000000 0,750299 0,083367774 W61449011 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,834000 0,000000 0,750600 0,083400775 W61449013 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,833666 0,000000 0,750299 0,083367

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776 W63389001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL.P-RF 10 0,834562 0,029438 0,751105 0,112895777 W63389002 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PP/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 0,834562 0,029438 0,751105 0,112895778 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,112749 0,000251 1,001474 0,111526779 W61450003 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,076000 0,000000 0,968400 0,107600780 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 0,834562 0,472771 0,751105 0,556228781 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1,112749 0,613584 1,001474 0,724859782 W64091001 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 5 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 5 2,221904 0,566096 1,999713 0,788287783 W64091002 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 100 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 100 2,221904 0,209696 1,999713 0,431887784 W64091003 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 2 TAVITE DIN PVC CU 10 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 10 2,221904 0,568096 1,999713 0,790287785 W05961001 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 5 1,976000 0,000000 1,778400 0,197600786 W05966001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 1,076000 0,000000 0,968400 0,107600787 W05967001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 2,221904 0,640096 1,999713 0,862287788 W05969001 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 1,218000 0,000000 1,096200 0,121800789 W59300001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 100 mg COMPR. DISP. 100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 9,878333 6,416667 8,890499 7,404501790 W59299001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 50 mg COMPR. DISP. 50mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 4,939166 3,575834 4,445249 4,069751791 W56161005 N02CC01 SUMATRIPTANUM * XIBIMER 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 9,878333 0,000000 8,890499 0,987834792 W59112004 N02CC01 SUMATRIPTANUM * SUMACTA 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 6,791666 0,000000 6,112499 0,679167793 W56160005 N02CC01 SUMATRIPTANUM * XIBIMER 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 4,939166 0,699167 4,445249 1,193084794 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 0,149350 0,068850 0,134415 0,083785795 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 0,000000 0,134249 0,014917796 W00806001 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,149200 0,000000 0,134280 0,014920797 W00797001 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,149350 0,000150 0,134415 0,015085798 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 0,149350 0,000150 0,134415 0,015085799 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 0,000000 0,134280 0,014920800 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 0,000000 0,131850 0,014650801 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 0,000000 0,133200 0,014800802 W00807001 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,298700 0,114500 0,268830 0,144370803 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 0,298700 0,114300 0,268830 0,144170804 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 0,112012 0,207788 0,100810 0,218990805 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 0,224025 0,210575 0,201622 0,232978806 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 0,448050 0,322350 0,403245 0,367155807 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 0,224025 0,121175 0,201622 0,143578808 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 0,224025 0,121175 0,201622 0,143578809 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 0,448050 0,252150 0,403245 0,296955810 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 0,448050 0,252150 0,403245 0,296955811 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 0,149350 0,216450 0,134415 0,231385812 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 0,298700 0,337633 0,268830 0,367503813 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 0,000000 22,131000 2,459000814 W56688004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,129784 0,027416 0,116805 0,040395815 W64281004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,129784 0,027416 0,116805 0,040395816 W54332002 N03AX12 GABAPENTINUM GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,129784 0,477382 0,116805 0,490361817 W60025001 N03AX12 GABAPENTINUM GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,129784 0,299049 0,116805 0,312028818 W56689004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,389355 0,082045 0,350419 0,120981819 W64282004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,389355 0,082045 0,350419 0,120981820 W41589005 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,389355 0,406945 0,350419 0,445881821 W42824001 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,389355 1,029045 0,350419 1,067981822 W43540001 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,389355 0,066645 0,350419 0,105581823 W54333001 N03AX12 GABAPENTINUM GRIMODIN 300 mg CAPS. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,389355 0,216811 0,350419 0,255747824 W60026001 N03AX12 GABAPENTINUM GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,389355 0,555811 0,350419 0,594747825 W64360001 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,389355 0,066645 0,350419 0,105581826 W56690004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,519141 0,110059 0,467226 0,161974827 W64283004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,519141 0,110059 0,467226 0,161974828 W41590005 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,519141 0,737359 0,467226 0,789274829 W42825001 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,519141 1,070259 0,467226 1,122174830 W43541001 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,519141 0,088459 0,467226 0,140374831 W54334001 N03AX12 GABAPENTINUM GRIMODIN 400 mg CAPS. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,519141 0,563692 0,467226 0,615607

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ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

832 W60027001 N03AX12 GABAPENTINUM GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,519141 0,662359 0,467226 0,714274833 W64361001 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,519141 0,088459 0,467226 0,140374834 W42826001 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 0,778712 1,516954 0,700840 1,594826835 W52419001 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,126843 0,049657 0,114158 0,062342836 W60383001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,253687 0,027313 0,228318 0,052682837 W60384001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATEPRF 30 0,393000 0,000000 0,353700 0,039300838 W56620001 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF 1 5,073750 0,616250 4,566375 1,123625839 W61980001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg/ml PIC. ORALE, SOL. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CARE CONTINE 10 ML PICATURI ORALE, SOL., PREVAZUT CU PICURATOR DIN PEJD PRF 1 5,073750 2,156250 4,566375 2,663625840 W03427002 N05AD01 HALOPERIDOLUM HALOPERIDOL - RICHTER 2mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 FLAC. PICURATOR DIN STICLA BRUNA X 10 ML PICATURI ORALE, SOLUTIE P-RF 1 5,073750 2,186250 4,566375 2,693625841 W61141001 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 50 mg/ml SOL. INJ. 50mg/ml GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 5 8,902000 0,000000 8,011800 0,890200842 W54845001 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/mlSOL. INJ. 5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 5 0,770765 1,553235 0,693688 1,630312843 W02443001 N05BA01 DIAZEPAMUM DIAZEPAM RICHTER 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,108500 0,000000 0,097650 0,010850844 W12717001 N05BA01 DIAZEPAMUM DIAZEPAM COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 0,146000 0,000000 0,131400 0,014600845 W52908001 N05BA01 DIAZEPAMUM DIAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,113500 0,000000 0,102150 0,011350846 W60414001 N05BA01 DIAZEPAMUM DIAZEPAM 5 mg/ml SOL. INJ. 10mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 2,514000 0,000000 2,262600 0,251400847 W10514001 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 10 mg SOL. RECTALA 10mg/2,5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA PRF 5 5,452000 0,000000 4,906800 0,545200848 W10515001 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 5 mg SOL. RECTALA 5mg/2,5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA PRF 5 4,770000 0,000000 4,293000 0,477000849 W60895002 N05BA03 MEDAZEPAMUM * MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLISTERE PVC/AL X 10 COMPRIMATEP-RF 20 0,134000 0,000000 0,120600 0,013400850 W60895003 N05BA03 MEDAZEPAMUM * MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 5 BLISTERE PVC/AL X 10 COMPRIMATEP-RF 50 0,122600 0,000000 0,110340 0,012260851 W12943002 N05BA03 MEDAZEPAMUM * MEDAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 20 COMPR. P-RF 20 0,138812 0,027688 0,124930 0,041570852 W53797001 N05BA03 MEDAZEPAMUM * MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,135000 0,000000 0,121500 0,013500853 W53797002 N05BA03 MEDAZEPAMUM * MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,134666 0,000000 0,121199 0,013467854 W41692001 N05BA06 LORAZEPAMUM * ANXIAR (R) 1 mg COMPR. 1 mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 0,111050 0,034950 0,099945 0,046055855 W06824001 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 1,5 mg COMPR. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,041643 0,074857 0,037478 0,079022856 W06824003 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 1,5 mg COMPR. 1,5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 0,041643 0,075023 0,037478 0,079188857 W06826001 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,083287 0,030213 0,074958 0,038542858 W55412001 N05BA08 BROMAZEPAMUM * BROMAZEPAM ARENA 3 mg COMPR. 3mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0,083287 0,030713 0,074958 0,039042859 W06826003 N05BA08 BROMAZEPAMUM * BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 0,083287 0,030379 0,074958 0,038708860 W00252001 N05BA12 ALPRAZOLAMUM * XANAX 0,25 mg COMPR. 0,25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,069406 0,128927 0,062465 0,135868861 W08624001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,25 mg COMPR. 0,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,069406 0,062094 0,062465 0,069035862 W08624003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,25 mg COMPR. 0,25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,069406 0,061927 0,062465 0,068868863 W41469001 N05BA12 ALPRAZOLAMUM * PRAZOLEX (R) 0,25 mg COMPR. 0,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,069406 0,062594 0,062465 0,069535864 W07122001 N05BA12 ALPRAZOLAMUM * FRONTIN 0,25 mg COMPR. 0,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,069406 0,061927 0,062465 0,068868865 W59969001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0,069406 0,061594 0,062465 0,068535866 W59969002 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,069406 0,062094 0,062465 0,069035867 W59969003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,25 mg COMPR. 0,25mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,069406 0,061927 0,062465 0,068868868 W00253001 N05BA12 ALPRAZOLAMUM * XANAX 0,5 mg COMPR. 0,5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,138812 0,162521 0,124930 0,176403869 W08625003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,5 mg COMPR. 0,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,138812 0,070854 0,124930 0,084736870 W08625001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 0,5 mg COMPR. 0,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,138812 0,070688 0,124930 0,084570871 W07123001 N05BA12 ALPRAZOLAMUM * FRONTIN 0,5 mg COMPR. 0,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,138812 0,070854 0,124930 0,084736872 W42783001 N05BA12 ALPRAZOLAMUM * PRAZOLEX (R) 0,5 mg COMPR. 0,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,138812 0,071188 0,124930 0,085070873 W59972001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0,138812 0,071188 0,124930 0,085070874 W59972002 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,138812 0,070688 0,124930 0,084570875 W59972003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 0,5 mg COMPR. 0,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,138812 0,070854 0,124930 0,084736876 W00254001 N05BA12 ALPRAZOLAMUM * XANAX 1 mg COMPR. 1mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,277625 0,138375 0,249862 0,166138877 W08626003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 0,277333 0,000000 0,249599 0,027734878 W08626001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,277500 0,000000 0,249750 0,027750879 W41470001 N05BA12 ALPRAZOLAMUM * PRAZOLEX (R) 1 mg COMPR. 1mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 0,277625 0,000375 0,249862 0,028138880 W07126001 N05BA12 ALPRAZOLAMUM * FRONTIN 1mg COMPR. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 0,277625 0,000375 0,249862 0,028138881 W59973001 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 0,277000 0,000000 0,249300 0,027700882 W59973002 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0,277625 0,000375 0,249862 0,028138883 W59973003 N05BA12 ALPRAZOLAMUM * ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,277625 0,000375 0,249862 0,028138884 W12245003 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH® 2,5 mg COMPR. 2.5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,058950 0,016050 0,053055 0,021945885 W59781001 N05CD02 NITRAZEPAMUM NITRAZEPAM - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,117900 0,013100 0,106110 0,024890886 W12246003 N05CD02 NITRAZEPAMUM NITRAZEPAM LPH® 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,085666 0,000000 0,077099 0,008567887 W43099001 N05CF01 ZOPICLONUM * IMOVANE 7,5 mg COMPR. FILM. 7,5mg SANOFI AVENTIS FRANTA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. FILM. P-RF 20 0,382000 0,000000 0,343800 0,038200

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

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cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

888 W64484001 N05CF01 ZOPICLONUM * IMOVANE 7,5 mg COMPR. FILM. 7,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. PRF 20 0,382000 0,000000 0,343800 0,038200889 W13133001 N05CF02 ZOLPIDEMUM * SANVAL (R) 10 mg COMPR. FILM. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,236000 0,000000 0,212400 0,023600890 W13133002 N05CF02 ZOLPIDEMUM * SANVAL (R) 10 mg COMPR. FILM. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 0,235000 0,000000 0,211500 0,023500891 W53913001 N05CF02 ZOLPIDEMUM * ZOLPIDEM ATB 10 MG COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,236000 0,000000 0,212400 0,023600892 W54358001 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 0,236000 0,128000 0,212400 0,151600893 W54358002 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 20 0,236000 0,127500 0,212400 0,151100894 W54358003 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 0,236000 0,127500 0,212400 0,151100895 W62440001 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 0,236000 0,128000 0,212400 0,151600896 W62440002 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 20 0,236000 0,127500 0,212400 0,151100897 W62440003 N05CF02 ZOLPIDEMUM * STILNOX 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 0,236000 0,127500 0,212400 0,151100898 W01358001 N06AA04 CLOMIPRAMINUM * ANAFRANIL (R) 10 mg DRAJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,153166 0,104500 0,137849 0,119817899 W01359001 N06AA04 CLOMIPRAMINUM * ANAFRANIL (R) 25 mg DRAJ. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,382916 0,102417 0,344624 0,140709900 W52017001 N06AA09 AMITRIPTYLINUM * AMITRIPTILINA ARENA 25 mg COMPR. FILM. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 50 0,327800 0,000000 0,295020 0,032780901 W02865001 N06AA12 DOXEPINUM * DOXEPIN 25 mg DRAJ. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 0,382916 0,417417 0,344624 0,455709902 W60729001 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,241108 0,490892 0,216997 0,515003903 W60729002 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,241108 0,444992 0,216997 0,469103904 W13241001 N06AB03 FLUOXETINUM * FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 CAPS. P-RF 14 0,482217 0,364925 0,433995 0,413147905 W13241002 N06AB03 FLUOXETINUM * FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS. P-RF 28 0,482217 0,347783 0,433995 0,396005906 W08497001 N06AB03 FLUOXETINUM * MAGRILAN 20 mg CAPS. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 0,444666 0,000000 0,400199 0,044467907 W60730001 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,482217 0,361783 0,433995 0,410005908 W60730002 N06AB03 FLUOXETINUM * FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,482217 0,263483 0,433995 0,311705909 W10228001 N06AB03 FLUOXETINUM * PROZAC 20 mg COMPR. DISP. 20mg ELI LILLY SA SPANIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 14 COMPR. DISP. P-RF 28 0,482217 0,902425 0,433995 0,950647910 W43706001 N06AB04 CITALOPRAMUM ** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 0,482217 0,958116 0,433995 1,006338911 W41796001 N06AB05 PAROXETINUM * ARKETIS COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-RF 30 0,482217 0,065449 0,433995 0,113671912 W57051001 N06AB05 PAROXETINUM * PAROXETINA ATB 20 mg COMPR. FILM. 20 mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 0,482217 0,167449 0,433995 0,215671913 W04913003 N06AB05 PAROXETINUM * SEROXAT 20 mg COMPR. FILM. 20mg SMITHKLINE BEECHAM MAREA BRITANIE CUTIE CU 3 BLIST. PVC/AL-HARTIE X 10 COMPR. FILM. P-RF 30 0,482217 0,423783 0,433995 0,472005914 W43958002 N06AB05 PAROXETINUM * PAXETIN 20 mg COMPR. FILM. 20mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM. P-RF 30 0,482217 0,065449 0,433995 0,113671915 W64362002 N06AB05 PAROXETINUM * PAXETIN 20 mg COMPR. FILM. 20mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. OPA-AL-PVC/PVC-AL-OPA X 10 COMPR. FILM. PRF 30 0,482217 0,065449 0,433995 0,113671916 W44097001 N06AB06 SERTRALINUM * SERLIFT 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 0,964434 0,385923 0,867990 0,482367917 W12874001 N06AB06 SERTRALINUM * ASENTRA (R) COMPR. FILM. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 0,964434 0,169137 0,867990 0,265581918 W52511006 N06AB06 SERTRALINUM * SETALOFT 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,758214 0,000000 0,682392 0,075822919 W55563001 N06AB06 SERTRALINUM * ZOLOFT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X BLISTERE DIN AL/PVC X 28 COMPRIMATE FILMATE P-RF 28 0,964434 0,385566 0,867990 0,482010920 W59051001 N06AB06 SERTRALINUM * ADJUVIN 100 mg COMPR. FILM. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 0,951333 0,000000 0,856199 0,095134921 W59303002 N06AB06 SERTRALINUM * STIMULOTON® 100 mg COMPR. FILM. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 0,964434 0,385566 0,867990 0,482010922 W60444001 N06AB06 SERTRALINUM * SERTRALINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,964434 0,385899 0,867990 0,482343923 W61376006 N06AB06 SERTRALINUM * SERTRALINA AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,392333 0,000000 0,353099 0,039234924 W63954004 N06AB06 SERTRALINUM * SERTRALINA ACCORD 100 mg COMPR. FILM. 100mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,740666 0,000000 0,666599 0,074067925 W44096001 N06AB06 SERTRALINUM * SERLIFT 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 0,482217 0,280640 0,433995 0,328862926 W12873001 N06AB06 SERTRALINUM * ASENTRA (R) COMPR. FILM. 50mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 0,461785 0,000000 0,415606 0,046179927 W52510006 N06AB06 SERTRALINUM * SETALOFT 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 0,373571 0,000000 0,336213 0,037358928 W55562001 N06AB06 SERTRALINUM * ZOLOFT 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X BLIST. DIN AL/PVC X 28 COMPR. FILM. P-RF 28 0,482217 0,303497 0,433995 0,351719929 W59050001 N06AB06 SERTRALINUM * ADJUVIN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 0,475666 0,000000 0,428099 0,047567930 W59302001 N06AB06 SERTRALINUM * STIMULOTON® 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-RF 30 0,482217 0,079783 0,433995 0,128005931 W60443001 N06AB06 SERTRALINUM * SERTRALINA ARENA 50 mg COMPR. FILM. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,482217 0,256449 0,433995 0,304671932 W61375006 N06AB06 SERTRALINUM * SERTRALINA AUROBINDO 50 mgCOMPR. FILM. 50mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,386333 0,000000 0,347699 0,038634933 W63953004 N06AB06 SERTRALINUM * SERTRALINA ACCORD 50 mg COMPR. FILM. 50mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 0,365666 0,000000 0,329099 0,036567934 W55564001 N06AB06 SERTRALINUM * ZOLOFT 20 mg/ml CONC. PT. SOL. ORALA 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA + 1 PIPETA GRADATA P-RF 1 11,573215 42,766785 10,415893 43,924107935 W62371001 N06AB08 FLUVOXAMINUM * FEVARIN 100mg COMPR. FILM. 100mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.P-RF 30 0,482217 0,654116 0,433995 0,702338936 W64560001 N06AB08 FLUVOXAMINUM * FEVARIN 100 COMPR. FILM. 100mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 2 BLIST. PVC/PVDC X 15 COMPR. FILM. PRF 30 0,482217 0,654116 0,433995 0,702338937 W62372001 N06AB08 FLUVOXAMINUM * FEVARIN 50mg COMPR. FILM. 50mg BGP PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.P-RF 30 0,241108 0,346892 0,216997 0,371003938 W64561001 N06AB08 FLUVOXAMINUM * FEVARIN 50 COMPR. FILM. 50mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 2 BLIST. PVC/PVDC X 15 COMPR. FILM. PRF 30 0,241108 0,346892 0,216997 0,371003939 W12823003 N06AX11 MIRTAZAPINUM * REMERON SOLTAB 30 mg COMPR. DISP. 30mg NV ORGANON OLANDA CUTIE X 5 BLIST. AL/PVC-PA-POLIESTER PERFORAT PT. ELIB. UNEI UNIT. DOZATE X 6 COMPR. DISP. P-RF 30 0,509166 1,417500 0,458249 1,468417940 W60361001 N06AX11 MIRTAZAPINUM * MIRTAZAPIN ARENA 15 mg COMPR. FILM. 15mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0,254583 0,641750 0,229124 0,667209941 W42062001 N06AX11 MIRTAZAPINUM * MIRZATEN (R) 30 mg COMPR. FILM. 30mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,507333 0,000000 0,456599 0,050734942 W44013002 N06AX11 MIRTAZAPINUM * PHARMATAZ 30 mg COMPR. FILM. 30mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL, X 10 COMPR. FILM. P-RF 30 0,509166 0,351500 0,458249 0,402417943 W56832001 N06AX11 MIRTAZAPINUM * ESPRITAL (R) 30 COMPR. FILM. 30mg ZENTIVA KS CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,507000 0,000000 0,456300 0,050700

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944 W60362001 N06AX11 MIRTAZAPINUM * MIRTAZAPIN ARENA 30 mg COMPR. FILM. 30mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0,502333 0,000000 0,452099 0,050234945 W64105002 N06AX11 MIRTAZAPINUM * VALDREN 30 mg COMPR. FILM. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU 3 BLIST. ALBE OPACE PVC/PVDC/AL X 10 COMPR. FILM.PRF 30 0,509166 0,045167 0,458249 0,096084946 W64363002 N06AX11 MIRTAZAPINUM * PHARMATAZ 30 mg COMPR. FILM. 30mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 0,509166 0,351500 0,458249 0,402417947 W60363001 N06AX11 MIRTAZAPINUM * MIRTAZAPIN ARENA 45 mg COMPR. FILM. 45mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM. PRF 30 0,763749 1,472917 0,687374 1,549292948 W53476002 N06AX11 MIRTAZAPINUM * ZULIN 30 mg COMPR. ORODISPERSABILE 30mg ANTIBIOTICE S.A. ROMANIA CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE P-RF 30 0,509166 0,001834 0,458249 0,052751949 W63233003 N06AX11 MIRTAZAPINUM * REMERON SOLTAB 30 mg COMPR. ORODISPERSABILE 30mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC-PA-POLIESTER PERFORATE PT. ELIB. UNEI UNITATI DOZATE X 6 COMPR. ORODISPERSABILE PRF 30 0,509166 1,417500 0,458249 1,468417950 W56742002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,882838 1,038947 0,794554 1,127231951 W58756003 N06AX16 VENLAFAXINUM ** ELIFY EP 150 mg CAPS. ELIB. PREL. 150 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF 30 0,882838 0,168495 0,794554 0,256779952 W64861002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,882838 1,038947 0,794554 1,127231953 W52122001 N06AX16 VENLAFAXINUM ** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,882838 0,495376 0,794554 0,583660954 W52962005 N06AX16 VENLAFAXINUM ** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,584000 0,000000 0,525600 0,058400955 W54057002 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,882838 0,018947 0,794554 0,107231956 W55396001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,882838 0,495495 0,794554 0,583779957 W61609006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,703666 0,000000 0,633299 0,070367958 W53268003 N06AX16 VENLAFAXINUM ** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,220709 0,407291 0,198638 0,429362959 W55395001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,220709 0,654957 0,198638 0,677028960 W56741002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,441419 0,665366 0,397277 0,709508961 W58755003 N06AX16 VENLAFAXINUM ** ELIFY EP 75 mg CAPS. ELIB. PREL. 75 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 0,441419 0,209247 0,397277 0,253389962 W64860002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,441419 0,665366 0,397277 0,709508963 W52123001 N06AX16 VENLAFAXINUM ** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 0,441419 0,490723 0,397277 0,534865964 W52961005 N06AX16 VENLAFAXINUM ** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,343000 0,000000 0,308700 0,034300965 W53269003 N06AX16 VENLAFAXINUM ** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,441419 0,256581 0,397277 0,300723966 W54056002 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 75 mg CAPS. ELIB. PREL. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,441419 0,250366 0,397277 0,294508967 W55397001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,441419 0,484581 0,397277 0,528723968 W61608006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,413000 0,000000 0,371700 0,041300969 W55398001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 37,5 mg COMPR. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,220709 0,654957 0,198638 0,677028970 W55399001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,294279 0,597721 0,264851 0,627149971 W55400001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 75 mg COMPR. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,441419 0,484581 0,397277 0,528723972 W52959001 N06AX16 VENLAFAXINUM ** ARGOFAN 150 SR COMPR. ELIB. PREL. 150mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,700666 0,000000 0,630599 0,070067973 W52958001 N06AX16 VENLAFAXINUM ** ARGOFAN 75 SR COMPR. ELIB. PREL. 75mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,412000 0,000000 0,370800 0,041200974 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 0,731500 0,018000 0,658350 0,091150975 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 0,000000 0,652950 0,072550976 W42888001 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 0,689400 0,320600 0,620460 0,389540977 W10714001 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0,689400 0,280600 0,620460 0,349540978 W42888001 P01AB02 TINIDAZOLUM TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM. P-RF 4 0,689400 0,320600 0,620460 0,389540979 W10714001 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 0,689400 0,280600 0,620460 0,349540980 W53579001 P02CA03 ALBENDAZOLUM ALBENDAZOL VIM SPECTRUM 200 mg COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. P-RF 2 3,280000 0,000000 2,952000 0,328000981 W00225003 P02CA03 ALBENDAZOLUM ESKAZOLE COMPR. 400mg GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 12 BLIST. PVC-PVDC/AL X 1 COMPR. P-RF 12 6,527500 0,000000 5,874750 0,652750982 W13994001 P02CA03 ALBENDAZOLUM DUADOR 200 mg COMPR. FILM. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. X 2 COMPR. FILM. P-RF 2 3,280000 0,210000 2,952000 0,538000983 W62163001 P02CA03 ALBENDAZOLUM VERMIGAL NOVO 200 mg COMPR. FILM. 200mg BIOFARM S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC-PVDC TRANSPARENT X 2 COMPR. FILM. PRF 2 3,280000 0,210000 2,952000 0,538000984 W55736001 P02CA03 ALBENDAZOLUM ALBENDAZOL LPH 200 mg COMPR.FILM 200 mg LABORMED PHARMA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. FILM.P-RF 2 3,280000 0,220000 2,952000 0,548000985 W00228001 P02CA03 ALBENDAZOLUM ZENTEL 0,4 g/10 ml SUSP. ORALA 0,4g/10ml GLAXOSMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 1 FLACON UNIDOZA DIN PVC X 10 ML SUSP. ORALA P-RF 1 4,155750 2,104250 3,740175 2,519825986 W60595001 P02CA03 ALBENDAZOLUM VERMIGAL NOVO 400 mg/10 ml SUSP. ORALA 400mg/10ml BIOFARM S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA PRF 1 4,070000 0,000000 3,663000 0,407000987 W55331001 P02CE01 LEVAMISOLUM LEVAMISOL ARENA 150 mg COMPR. 150mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 COMPR. P-RF 1 3,730000 0,000000 3,357000 0,373000988 W55330001 P02CE01 LEVAMISOLUM LEVAMISOL ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. P-RF 2 1,344990 0,305010 1,210491 0,439509989 W12650001 R03AC02 SALBUTAMOLUM VENTOLIN (R) SOL. INHAL. 5mg/ml GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FALC. DIN STICLA BRUNA X 10 ML SOL. DE INHAL. P-6L 1 1,649700 6,550300 1,484730 6,715270990 W10597001 R03AC02 SALBUTAMOLUM VENTOLIN 100 INHALER CFC-FREE SUSP. INHAL. PRESURIZATA 100mcg/doza GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE X 200 DOZE + DISPOZITIV DE ADMINISTRA P-RF 1 8,248500 2,641500 7,423650 3,466350991 W51508001 R03AC02 SALBUTAMOLUM ASTHALIN INHALER SUSP. INHAL. PRESURIZATA 100mcg/doza CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLAC. AL + VALVA DOZATOARE + DISP. ADM. X 200 DOZE SUSP. INHAL. PRESURIZATA P-6L 1 7,440000 0,000000 6,696000 0,744000992 W41683001 R03BA01 BECLOMETASONUM * CLENIL (R) JET 250 mcg SOL. INHALAT PRESURIZATA 250mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON PRESURIZAT DIN AL X 200 DOZE, PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM., "SPASER JET" CU CAPAC P-RF 1 107,370000 0,000000 96,633000 10,737000993 W43881001 R03BA02 BUDESONIDUM * FRENOLYN 200 PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA, X 1 INHALATOR X 100 DOZE P-RF 1 28,070000 0,000000 25,263000 2,807000994 W43881003 R03BA02 BUDESONIDUM * FRENOLYN 200 PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 200 DOZE P-RF 1 72,707500 5,522500 65,436750 12,793250995 W00680001 R03BA02 BUDESONIDUM * PULMICORT TURBUHALER 200 mcg/doza PULB. INHAL. 200mcg/doza ASTRAZENECA AB SUEDIA CUTIE X 1 FLACON MULTIDOZA DIN PEID X 100 DOZE PULB. INHAL. P-RF 1 36,353750 5,416250 32,718375 9,051625996 W43882002 R03BA02 BUDESONIDUM * FRENOLYN 400 PULB. INHAL. 400 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 100 DOZE P-RF 1 72,707500 8,772500 65,436750 16,043250997 W03767001 R03BB01 IPRATROPII BROMIDUM * IPRAVENT INHALER 20mcg/doza SUSP. INHAL. PRESURIZATA 20mcg/doza CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLACON AL PRESURIZAT X 200 DOZE SUSP.DE INHALAT PRESURIZATA P-6L 1 13,760000 0,000000 12,384000 1,376000998 W05494001 R03CC02 SALBUTAMOLUM SALBUTAMOL MCC 4 mg COMPR. 4mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,381500 0,000000 0,343350 0,038150999 W44064001 R03CC02 SALBUTAMOLUM SALBUTAMOL EIPICO 2mg/5ml SIROP 2mg/5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 125 ML SIROP P-6L 1 3,220000 0,000000 2,898000 0,322000

Pagina 18 din 19

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Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

crip

tie

cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 90% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de referinta)

1.000 W42239001 R03CC02 SALBUTAMOLUM VENTOLIN (R) SOL. INJ. 0,5mg/ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 5 FIOLE DIN STICLA X 1 ML P-6L 5 0,776000 0,000000 0,698400 0,0776001.001 W07705001 R03DA04 THEOPHYLLINUM TEOTARD (R) 200 mg CAPS. ELIB. PREL. 200mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-RF 40 0,256250 0,000000 0,230625 0,0256251.002 W05848001 R03DA04 THEOPHYLLINUM TEOTARD (R) 350 mg CAPS. ELIB. PREL. 350mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-RF 40 0,381250 0,000000 0,343125 0,0381251.003 W57245001 R03DX05 OMALIZUMABUM ** XOLAIR 150 mg SOL INJ. 150mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOLUTIE INJECTABILAPR/PRF 1 1.595,980000 0,000000 1.436,382000 159,5980001.004 W57244001 R03DX05 OMALIZUMABUM ** XOLAIR 75 mg SOL INJ. 75mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 0.5ML SOLUTIE INJECTABILA PR/PRF 1 810,030000 36,120000 729,027000 117,1230001.005 W01411002 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,193125 0,017541 0,173812 0,0368541.006 W01409002 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,193125 0,022475 0,173812 0,0417881.007 W01407004 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 0,174000 0,000000 0,156600 0,0174001.008 W54406001 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,193125 0,006375 0,173812 0,0256881.009 W01189001 R06AB04 CHLORPHENAMINUM CLORFENIRAMIN COMPR. 4mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,126500 0,000000 0,113850 0,0126501.010 W42728001 R06AE07 CETIRIZINUM CELERG COMPR. FILM. 10 mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 0,698850 0,456650 0,628965 0,5265351.011 W43156001 R06AE07 CETIRIZINUM CETIRIZINA LAROPHARM 10 mg COMPR. FILM. 10mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,698850 0,456150 0,628965 0,5260351.012 W59369003 R06AE07 CETIRIZINUM ZYRTEC 10 mg/ml PICATURI ORALE, SOL. 10mg/ml UCB PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA + PICURATOR DIN PEJD X 20 ML PIC. ORALE, SOL. P6L 1 13,280000 0,000000 11,952000 1,3280001.013 W11534001 R06AX17 KETOTIFENUM H - KETOTIFEN COMPR. 1mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,188000 0,004000 0,169200 0,0228001.014 W11987002 R06AX17 KETOTIFENUM KETOTIFEN COMPR. 1mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,188000 0,000000 0,169200 0,0188001.015 W52907001 R06AX17 KETOTIFENUM KETOTIFEN LAROPHARM 1 mg COMPR. 1mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,188000 0,000000 0,169200 0,0188001.016 W58781002 R06AX17 KETOTIFENUM KETOTIFEN LPH 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR P6L 30 0,181333 0,000000 0,163199 0,0181341.017 W03905001 R06AX17 KETOTIFENUM KETOF 1 mg/5 ml SIROP 1mg/5ml HEXAL AG GERMANIA CUTIE X 1 FLACON X 100 ML SIROP + MASURA DOZATOARE P-6L 1 12,480000 0,000000 11,232000 1,2480001.018 W55653001 S01BC03 DICLOFENACUM DICLOFENAC ROMPHARM PIC. OFT.-SOL. 1mg/ml ROMPHARM COMPANY SRL ROMANIA FLACON PICURATOR DIN PEJD X 5 ML PIC. OFT., SOL. P-6L 1 10,140000 0,000000 9,126000 1,0140001.019 W58663002 S01BC03 DICLOFENACUM VOLTAREN OPHTHA CD PICATURI OFT.-SOL. 0,1% LABORATOIRES THEA FRANTA CUTIE X 1 FLAC. PEJD X 5 ML PICATURI OFT.-SOL. + PICURATOR PEJD + CAPAC CU INEL DE SIGURANTAPRF 1 12,479999 2,340001 11,231999 3,5880011.020 W60088001 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL 1,3 mg/g+2,5 mg/g GEL OFT. 1,3mg/g+2,5mg/g THEA FARMA S.P.A. ITALIA CUTIE CU 1 FLAC. DIN PEJD +PICURATOR DIN PE X 5 G GEL OFT.PRF 1 15,775000 38,445000 14,197500 40,0225001.021 W59770001 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL PICATURI OFT.SUSP. 0,2g+0,5g/100ml THEA FARMA S.P.A. ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.,SUSP. + APLICATOR PT. PICURARE P-RF 1 14,680000 0,000000 13,212000 1,4680001.022 W59771001 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL UNG. OFT. 0,2g+0,5g/100g THEA FARMA S.P.A. ITALIA CUTIE X 1 TUB AL X 5 G P-RF 1 15,775000 1,095000 14,197500 2,672500

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

Page 24: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

ANEXA 2b

Nr

crt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPTara det.

APP Ambalaj Pre

scri

ptie

cant. UT/ ambalaj

Pret de referinta / UT (RON)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 50%

din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de 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 0,0640722 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 0,0249293 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 0,0348224 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 0,0288005 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 0,0348346 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 0,0348227 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 0,0348348 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 0,0224009 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 0,04539311 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 0,06407212 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 0,06070013 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 0,06410014 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 0,06403415 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 0,06403416 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 0,06403417 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 0,04083418 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 0,06276719 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 0,92800020 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 1,34200021 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 0,06785822 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 0,04571523 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 0,10935824 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 0,09139325 W06755002 A02BC05 ESOMEPRAZOLUM NEXIUM 20 mg COMPR. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTEP-6L 14 0,691199 0,620943 0,345599 0,966543 0,622079 0,69006326 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 0,35506327 W06756002 A02BC05 ESOMEPRAZOLUM NEXIUM 40 mg COMPR. GASTROREZ. 40mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTEP-6L 14 1,382399 0,336886 0,691199 1,028086 1,244159 0,47512628 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 0,20012629 W56303002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZISTENTE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 0,691199 0,285943 0,345599 0,631543 0,622079 0,35506330 W56304002 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 40mg COMPR. GASTROREZISTENTE 40mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 1,382399 0,061886 0,691199 0,753086 1,244159 0,20012631 W53101001 A02BC05 ESOMEPRAZOLUM NEXIUM 10 mg GRAN. GASTROREZ. PT. SUSP.ORALA 10mg ASTRAZENECA AB SUEDIA CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA P-6L 28 2,627857 0,000000 1,313928 1,313929 2,365071 0,26278632 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 0,74854333 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 0,64332834 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 0,08440035 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 0,47300136 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 0,25161237 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 0,47300138 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 0,25161239 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 7,07298840 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 0,36885041 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 4,32142142 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 1,90542143 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 31,99400044 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 0,83481345 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 0,83481346 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 0,43193847 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 0,14318848 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 0,14318849 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 0,17488150 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 0,12210151 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 0,30803452 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 0,11073453 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 0,19740154 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 0,45885655 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 0,62042256 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

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

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Contributie maxima a

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din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 50%

din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de 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 1,64620058 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 10,10820059 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 1,20600060 W64849001 B01AB04 DALTEPARINUM ** # FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000UI/0,2mlPFIZER 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 1,20600061 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 1,27400062 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 1,27400063 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 1,30200064 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 1,30200065 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 1,56260066 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 1,56260067 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 2,06216768 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 2,06216769 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 1,71300370 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 2,53200071 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 2,39900572 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 23,74657673 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 55,36814674 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 7,42600075 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 2,79543176 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 30,80714677 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 30,85700078 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 34,40471679 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 0,28200080 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 0,20780081 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 0,17324082 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 0,28200083 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 0,20780084 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 0,66050085 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 1,56305086 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 1,56305087 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 0,06116788 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 0,05920089 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 0,17445990 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 0,07253491 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 0,13676892 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 0,13676893 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 0,06046594 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 0,09680095 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 0,06116796 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 0,05920097 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 0,06250098 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 0,65695999 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 0,239351100 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 0,239151101 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 0,638867102 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 0,569634103 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 1,765000104 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 1,142000105 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 1,765000106 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 1,142000107 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 0,561900108 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 0,561900109 W61204003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 2,5mg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 2,5mg/0,5ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA P-RF 10 19,705000 0,000000 9,852500 9,852500 17,734500 1,970500110 W61202003 B01AX05 FONDAPARINUX SODIUM ** # ARIXTRA 7,5mg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 7,5mg/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE P-RF 10 51,805875 7,630125 25,902937 33,533063 46,625287 12,810713111 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 3,273400112 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 0,349060113 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 0,850667114 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 0,350131115 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 0,350131116 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 0,350131117 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 1,668703118 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 1,254238119 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

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din pretul de 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 0,332339121 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 0,192875122 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 0,192875123 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 0,158590124 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 0,375553125 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 1,058053126 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 0,945196127 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 1,058053128 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 0,263930129 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 0,137143130 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 0,105600131 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 1,486726132 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 0,344134133 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 0,067286134 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 0,038267135 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 0,044234136 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 0,019967137 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 0,044234138 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 0,043867139 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 0,038267140 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 0,057534141 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 0,057534142 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 0,057867143 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 0,057534144 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 0,057534145 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 0,067201146 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 0,409844147 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 0,409844148 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 0,409844149 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 0,404447150 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 0,446226151 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 0,445155152 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 0,422607153 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 0,201441154 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 0,561214155 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 0,214281156 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 0,660120157 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 0,660120158 W54194003 C09AA04 PERINDOPRILUM PRENESSA 4 mg COMPR. 4mg KRKA POLSKA SP. Z.O.O. POLONIACUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 0,313200 0,091466 0,156600 0,248066 0,281880 0,122786159 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 0,134120160 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 0,258786161 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 1,225573162 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 1,225573163 W55291004 C09AA04 PERINDOPRILUM PRINDEX 8 mg COMPR. 8mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR.P-6L 30 0,626400 0,030933 0,313200 0,344133 0,563760 0,093573164 W58117004 C09AA04 PERINDOPRILUM PRENESSA 8 mg COMPR. 8mg KRKA POLSKA SP Z O.O. POLONIACUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P6L 30 0,626400 0,078933 0,313200 0,392133 0,563760 0,141573165 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 0,236906166 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 0,368301167 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 0,083634168 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 0,558651169 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 0,324984170 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 0,294030171 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 0,358834172 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 0,639811173 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 1,200620174 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 0,698458175 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 0,058900176 W52394004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg COMPR. 2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIACUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,387666 0,000000 0,193833 0,193833 0,348899 0,038767177 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 0,058900178 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 0,079867179 W52393004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg COMPR. 4mg/1,25mg KRKA POLSKA SP ZO.O. POLONIACUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.P-6L 30 0,662666 0,000000 0,331333 0,331333 0,596399 0,066267180 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 0,083734181 W56278004 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg COMPR. 8mg/2,5mg KRKA-POLSKA SP. Z O.O. POLONIACUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 0,889006 0,162327 0,444503 0,606830 0,800105 0,251228182 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

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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 0,402895184 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 0,272895185 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 0,035734186 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 0,273228187 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 0,062800188 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 0,056534189 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 0,056534190 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 0,218228191 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 0,218228192 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 0,308300193 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 0,087149194 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 0,073867195 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 0,074367196 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 0,149048197 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 0,177715198 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 0,218382199 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 0,242763200 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 0,278763201 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 0,235763202 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 0,267662203 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 0,312329204 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 0,242995205 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 0,408894206 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 0,832108207 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 0,173572208 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 0,097700209 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 0,219140210 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 0,131867211 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 0,171622212 W61004001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 10mg/2,5mg/10mgLES 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 0,700280213 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 0,862288214 W61002001 C09BX01 COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM) TRIPLIXAM COMPR. FILM. 5mg/1,25mg/10mgLES 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 0,440466215 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 0,675141216 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 0,367937217 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 0,112750218 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 0,048694219 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 0,059143220 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 0,075072221 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 0,075072222 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 2,261717223 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 1,357074224 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 0,124217225 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 0,124217226 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 0,582005227 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 0,030837228 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 0,055072229 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 0,040215230 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 0,040215231 W55631001 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML )P-6L 1 4,086639 20,793361 2,043319 22,836681 3,677975 21,202025232 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 0,038858233 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 0,054358234 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 0,212362235 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 0,056643236 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 0,059608237 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 0,592719238 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 0,062965239 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 0,085572240 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 0,113250241 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 0,085572242 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 0,093286243 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 0,374723244 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 0,111858245 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

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Val. maxima suportata de sistemul de

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Val. maxima suportata de sistemul de

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Contributie maxima a

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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 0,076900247 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 0,204366248 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 0,078434249 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 0,111858250 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 0,070667251 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 0,111867252 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 0,091250253 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 0,073034254 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 0,086434255 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 0,137934256 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 0,184893257 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 0,099367258 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 0,152600259 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 0,101429260 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 0,147250261 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 0,055893262 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 0,038143263 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 0,055734264 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 0,247719265 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 0,055167266 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 0,055858267 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 0,051634268 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 0,055934269 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 0,055893270 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 0,055867271 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 0,047667272 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 0,055358273 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 0,060536274 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 0,062100275 W58256003 C09CA07 TELMISARTANUM TELMISARTAN MYLAN 40 mg COMPR. 40mg GENERICS (UK) LTDMAREA BRITANIE CUTIE CU BLIST. OPA-AL/PVC/AL X 30 COMPR. P6L 30 0,490333 0,000000 0,245166 0,245167 0,441299 0,049034276 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 0,091112277 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 0,074786278 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 0,221866279 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 0,084072280 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 0,078834281 W58257003 C09CA07 TELMISARTANUM TELMISARTAN MYLAN 80 mg COMPR. 80mg GENERICS (UK) LTDMAREA BRITANIE CUTIE CU BLIST. OPA-AL/PVC/AL X 30 COMPR. P6L 30 0,750333 0,000000 0,375166 0,375167 0,675299 0,075034282 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 0,102858283 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 0,091858284 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 0,062465285 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 0,079393286 W56252005 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA HL 100 mg/12,5 mg COMPR.FILM100mg/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 0,065108287 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 0,047929288 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 0,569801289 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 0,371587290 W07646001 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg COMPR. 150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 0,699824 0,509461 0,349912 0,859373 0,629841 0,579444291 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 0,897659292 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 0,064322293 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 0,395873294 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 0,579444295 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 0,181944296 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 0,181944297 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 0,897659298 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 0,283730299 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 0,283730300 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 0,899444301 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 0,250159302 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 0,250159303 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 0,067518304 W58871004 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANZENO HCT 16mg/12,5mg COMPR. 16mg/12,5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,699824 0,074176 0,349912 0,424088 0,629841 0,144159305 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 0,046334306 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 0,046334307 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 0,046467308 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

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Val. maxima suportata de sistemul de

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compensare 50% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

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din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

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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 0,158492310 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 0,158492311 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 0,520159312 W12033002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/12,5mg COMPR. 80/12,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 0,699824 0,936247 0,349912 1,286159 0,629841 1,006230313 W53178002 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) MICARDISPLUS 80/25mg COMPR. 80/25mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL) P-6L 28 0,699824 1,013390 0,349912 1,363302 0,629841 1,083373314 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 0,158492315 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 0,158492316 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 0,097492317 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 0,488159318 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 0,374159319 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 0,489825320 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 0,866857321 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 0,866857322 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 0,744430323 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 0,744430324 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 2,030036325 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 2,030036326 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 0,638250327 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 2,275750328 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 1,171822329 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 1,081465330 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 1,006441331 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 1,081465332 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 1,171822333 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 1,006441334 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 1,171822335 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 2,275750336 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 0,238643337 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 1,442572338 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 0,256000339 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 0,255500340 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 0,255534341 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 0,255500342 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 0,256000343 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 0,255534344 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 0,256000345 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 1,442572346 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 0,228822347 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 1,344636348 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 0,240708349 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 0,277494350 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 0,277660351 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 0,277494352 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 0,240708353 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 0,277660354 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 0,240708355 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 1,344636356 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 0,660561357 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 0,652817358 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 0,528769359 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 0,528769360 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 0,362991361 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 0,355249362 W57235002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mgNOVARTIS 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 0,311250363 W64771002 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT) EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mgNOVARTIS 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 0,311250364 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 0,320549365 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 0,636379366 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 0,104712367 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 0,483379368 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 0,023434369 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 0,133379370 W57297016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTDMAREA 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 0,090712371 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

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beneficiaza de compensare 90%

din pretul de 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 0,030712373 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 0,013600374 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 0,636379375 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 0,650757376 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 0,050134377 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 0,444757378 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 0,028134379 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 0,053767380 W57298016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 20 mg COMPR. FILM. 20mg GENERICS (UK) LTDMAREA 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 0,032200381 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 0,028100382 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 0,043034383 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 0,026567384 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 0,650757385 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 0,064034386 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 0,284752387 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 0,108643388 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 0,068100389 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 0,112367390 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 0,110900391 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 0,090800392 W57299016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 40 mg COMPR. FILM. 40mg GENERICS (UK) LTDMAREA 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 0,064467393 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 0,048334394 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 0,066734395 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 0,055934396 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 0,048334397 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 0,105434398 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 0,110143399 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 0,111134400 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 0,107134401 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 0,111134402 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 0,111100403 W57300016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 80 mg COMPR. FILM. 80mg GENERICS (UK) LTDMAREA 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 0,109334404 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 0,077567405 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 0,111134406 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 0,077567407 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 0,040867408 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 2,804519409 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 0,135424410 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 0,123757411 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 0,269424412 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 0,785948413 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 0,785948414 W59657004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,406333 0,000000 0,203166 0,203167 0,365699 0,040634415 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 0,037750416 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 0,370757417 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 0,074424418 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 0,030867419 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 0,030867420 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 1,675757421 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 0,081034422 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 3,821181423 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 0,092034424 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 0,095567425 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 0,835466426 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 0,835466427 W59658004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,808000 0,000000 0,404000 0,404000 0,727200 0,080800428 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 0,115215429 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 0,105500430 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 0,168847431 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 0,061800432 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 0,061800433 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 2,286847434 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

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Page 31: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

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din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

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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 0,115700436 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 0,115400437 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 0,844862438 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 0,844862439 W59659004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 1,214666 0,000000 0,607333 0,607333 1,093199 0,121467440 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 0,172750441 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 0,543362442 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 0,693028443 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 2,375117444 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 0,068379445 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 0,523379446 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 1,639046447 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 1,639046448 W59656004 C10AA07 ROSUVASTATINUM ROSUVASTATINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 0,203333 0,000000 0,101666 0,101667 0,182999 0,020334449 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 0,819760450 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 0,550712451 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 0,015467452 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 0,015467453 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 0,040350454 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 1,609472455 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 1,090567456 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 0,303234457 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 0,303234458 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 0,410200459 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 0,715809460 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 0,149934461 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 0,070967462 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 0,142267463 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 0,057767464 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 0,560934465 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 0,286601466 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 0,739991467 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 0,075000468 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 0,436420469 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 0,223920470 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 5,516000471 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 5,516000472 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 0,163967473 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 1,129000474 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 1,214251475 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 10,574000476 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 67,403144477 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 3,914000478 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 3,914000479 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 2,252584480 W63158001 D07AB02 HYDROCORTISONUM BUTYRATUMLOCOID 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 1,457750481 W63159001 D07AB02 HYDROCORTISONUM BUTYRATUMLOCOID 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 1,427750482 W63157001 D07AB02 HYDROCORTISONUM BUTYRATUMLOCOID 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 1,687750483 W63160001 D07AB02 HYDROCORTISONUM BUTYRATUMLOCOID 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 1,171000484 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 2,391000485 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 0,371000486 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 2,391000487 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 0,371000488 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 5,151600489 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 5,151600490 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 3,746000491 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 3,746000492 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 3,497000493 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 3,497000494 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 5,901600495 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 5,901600496 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 3,746000497 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

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Val. maxima suportata de sistemul de

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compensare 50% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

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din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

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compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

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din pretul de 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 1,060000499 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 1,060000500 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 CREMAP-RF 1 6,320000 6,810000 3,160000 9,970000 5,688000 7,442000501 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 2,742000502 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 0,569000503 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 4,032000504 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 0,632000505 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 2,216000506 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 7,563000507 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 9,314001508 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 3,956000509 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 3,202000510 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 3,202000511 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 15,007500512 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 15,007500513 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 0,658176514 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 0,112367515 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 0,233351516 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 1,446534517 W64599001 G01AA51 COMBINATII POLYGYNAX VIRGO CAPS. MOI VAG. FARA LABORATOIRE INNOTECH INTERNATIONAL FRANTA CUTIE CU 1 BLIST. PVC/PVDC TRANSPARENT/AL X 6 CAPS. VAG. MOI PRF 6 2,160333 0,314667 1,080166 1,394834 1,944299 0,530701518 W01949002 G01AA51 COMBINATII POLYGYNAX CAPS. MOI VAG. FARA CONCENTRATIE LAB. INNOTECH INT.FRANTA CUTIE CU 2 BLIST. PVC-PVDC/AL X 6 CAPS. MOI. VAG. P-RF 12 2,160333 0,541333 1,080166 1,621500 1,944299 0,757367519 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 3,649000520 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 2,798000521 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 1,586000522 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 3,790000523 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 31,594408524 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 0,178590525 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 5,147538526 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 2,537590527 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 0,162447528 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 0,162447529 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 0,162215530 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 0,162215531 W63732001 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE ALFASIGMA S.P.A. ITALIA CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE P-RF 5 1,622191 3,135809 0,811095 3,946905 1,459971 3,298029532 W58814001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore SISTEM CU CEDARE INTRAUTERINA 20micrograme/24ore BAYER OY FINLANDA CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR P-RF 1 474,300000 0,000000 237,150000 237,150000 426,870000 47,430000533 W64655001 G02BA03 LEVONORGESTRELUM ** # MIRENA 20 micrograme/24 ore SISTEM CU CEDARE INTRAUTERINA 20micrograme/24ore BAYER AG GERMANIA CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR PRF 1 474,300000 0,000000 237,150000 237,150000 426,870000 47,430000534 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 5,967025535 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 5,222025536 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 0,146400537 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 0,165358538 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 0,165358539 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 0,278038540 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 0,057834541 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 0,819647542 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 0,160409543 W62500001 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA 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 P6L 1 8,228437 0,001563 4,114218 4,115782 7,405593 0,824407544 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 8,764502545 W62500002 G03DA04 PROGESTERONUM * PROGESTERON FITERMAN 10 mg/g GEL 10mg/g FITERMAN PHARMA S.R.L. ROMANIA 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 P6L 1 14,620000 0,000000 7,310000 7,310000 13,158000 1,462000546 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 0,917251547 W61888001 G03DA04 PROGESTERONUM * CRINONE 80 mg/g GEL VAGINAL 80mg/g MERCK ROMANIA SRL ROMANIA 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 P6L 6 12,421666 0,000000 6,210833 6,210833 11,179499 1,242167548 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 0,117250549 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 0,117250550 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 0,026900551 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 0,026900552 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 0,217215553 W64042001 G03FA17 COMBINATII (ESTRADIOLUM + DROSPIRENONUM) ** ANGELIQ 1 mg + 2 mg COMPR. FILM. 1mg+2mg BAYER AG GERMANIA CUTIE CU 1 ETUI DE CARTON X 1 BLIST. TIP CALENDAR PVC/AL X 28 COMPR. FILM. P6L 28 2,172142 0,000000 1,086071 1,086071 1,954927 0,217215554 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 0,039334555 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 0,039334556 W61928001 G03FB08 ESTRADIOL + DIDROGESTERON **FEMOSTON 2/10, comprimate filmate COMPR. FILM. 2 mg/10 mg BGP PRODUCTS B.V.OLANDA CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) P-RF 28 0,393333 0,655952 0,196666 0,852619 0,353999 0,695286557 W64557001 G03FB08 ESTRADIOL + DIDROGESTERON **FEMOSTON 2/10 COMPR. FILM. FARA MYLAN HEALTHCARE B.V. OLANDA CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE) P-RF 28 0,393333 0,655952 0,196666 0,852619 0,353999 0,695286558 W60481002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. P-RF/R 1 103,716666 24,603334 51,858333 76,461667 93,344999 34,975001559 W63029001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 300 UI/0,5 ml SOL INJ. 300UI/0,5ml TEVA B.V. OLANDA CUTIE X 1 CARTUS (STICLA TIP I) X 0.5 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE PR/PRF 1 414,866666 5,993334 207,433333 213,426667 373,379999 47,480001560 W63030001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 450UI/0,75ml SOL INJ. 450UI/0,75ml TEVA B.V. OLANDA CUTIE X 1 CARTUS (STICLA TIP I) X 0.75 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE PR/PRF 1 595,870000 0,000000 297,935000 297,935000 536,283000 59,587000

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Page 33: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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Pret de referinta / UT (RON)

Contributie maxima a

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din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 50%

din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de 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 109,171000562 W60480002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 300 UI/0,5 ml ( 22 µg/0,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. P-RF/R 1 414,866666 22,343334 207,433333 229,776667 373,379999 63,830001563 W60485002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75mlMERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA P-RF/R 1 622,300000 8,810000 311,150000 319,960000 560,070000 71,040000564 W60477002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 900 UI/1,5ml (66 µg/1,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 900UI/1,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA P-RF/R 1 1.177,650000 0,000000 588,825000 588,825000 1.059,885000 117,765000565 W61937001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36mlMERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS + 6 ACE PR/PRF 1 414,700720 6,929280 207,350360 214,279640 373,230648 48,399352566 W64697001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36mlMERCK SHARP & DOHME OLANDA CUTIE CU 1 CARTUS + 6 ACE PR/PRF 1 414,700720 6,929280 207,350360 214,279640 373,230648 48,399352567 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 219,518056568 W61938001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08mlMERCK 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 219,518056569 W64696001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08mlMERCK 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 219,518056570 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 13,487000571 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 0,247036572 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 0,037650573 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 0,502857574 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 0,191070575 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 0,643472576 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 1,638472577 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 0,643139578 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 0,786139579 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 0,609139580 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 0,435583581 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 0,786139582 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 0,609139583 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 0,435583584 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 0,711236585 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 2,004236586 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 1,672236587 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 1,908570588 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 1,643570589 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 1,487458590 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 1,908570591 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 1,643570592 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 1,487458593 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 142,197067594 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 0,873380595 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 1,208093596 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 0,074434597 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 0,145534598 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 0,145534599 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 0,061358600 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 0,096100601 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 0,064000602 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 0,064000603 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 0,105967604 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 0,052300605 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 0,062200606 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 0,062200607 W43106001 G04CA02 TAMSULOSINUM OMNIC TOCAS (R) 0,4 COMPR. FILM. ELIB. PREL. 0,4mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 FOLII AL/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 1,143900 0,136100 0,571950 0,708050 1,029510 0,250490608 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 0,341948609 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 0,092286610 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 0,689602611 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 1,217602612 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 0,107935613 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 0,099367614 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 1,239602615 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 0,663935616 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 0,106834617 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 40,250000618 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 40,250000619 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 196,072500620 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 72,781000621 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 52,990625622 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 319,311250623 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

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Pret de referinta / UT (RON)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

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din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 50% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 50%

din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 90%

din pretul de 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 74,685000625 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 480,651250626 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 25,949787627 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 25,949787628 W06895002 H01CC02 CETRORELIXUM ** # CETROTIDE 0,25 mg PULB+SOLV. PT. SOL. INJ. 0,25mg SERONO EUROPE LTD. MAREA BRITANIE CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII + 7 ACE PT. INJECTII SUBCUTANATE + 14 TAMPOANE IMBIBATE IN ALCOOL P-RF 7 116,317142 0,000000 58,158571 58,158571 104,685427 11,631715629 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 0,042460630 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 1,716000631 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 0,155948632 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 0,055740633 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 0,189375634 W58901002 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF. 1000mg/500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. PR, PRF 50 15,800600 0,000000 7,900300 7,900300 14,220540 1,580060635 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 0,285167636 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 5,262505637 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 0,066563638 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 0,066563639 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 1,407174640 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 1,407174641 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 1,407174642 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 1,407174643 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 0,346667644 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 1,481266645 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 1,481266646 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 2,707302647 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 2,707302648 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 0,326334649 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 0,330834650 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 2,455864651 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 0,344000652 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 0,559667653 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 0,587667654 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 0,587667655 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 0,535667656 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 0,587667657 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 0,481667658 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 2,455864659 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 0,000000 7,620000 7,620000 13,716000 1,524000660 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 13,264197 7,085803 6,632098 13,717902 11,937777 8,412223661 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 0,000000 7,340000 7,340000 13,212000 1,468000662 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 0,000000 21,985000 21,985000 39,573000 4,397000663 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 0,000000 21,985000 21,985000 39,573000 4,397000664 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 0,000000 16,650000 16,650000 29,970000 3,330000665 W64358002 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. DIN PEID CONTINAND PULB. PT. 30 ML SUSP. ORALA, O SERINGA PT. ADMINISTRARE ORALA DIN PE/PS SAU PP/PP SI O LINGURITA DOZATOARE PRF 1 33,300000 0,000000 16,650000 16,650000 29,970000 3,330000666 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 0,253907667 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 0,093000668 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 0,770001669 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 0,352292670 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 0,113858671 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 0,417160672 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 0,164600673 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 0,162200674 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 0,441446675 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 0,466143676 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 0,345429677 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 1,027178678 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 0,339000679 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 0,465600680 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 0,439700681 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 0,437429682 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 5,347750683 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 0,535750684 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 2,927750685 W60943001 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINÂND 5 COMPRIMATE FILMATE PRF 5 4,882500 2,481500 2,441250 4,922750 4,394250 2,969750686 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

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Val. maxima suportata de sistemul de

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Contributie maxima a

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687 W03837002 J02AC02 ITRACONAZOLUM * ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 3,364000 0,000000 1,682000 1,682000 3,027600 0,336400688 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 0,218600689 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 0,218600690 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 0,218600691 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 0,218600692 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 0,218600693 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 0,488600694 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 0,329700695 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 5,055715696 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 0,057140697 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 20,835752698 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 20,835752699 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 1,440572700 W55726001 L02AE04 TRIPTORELINUM ** # DIPHERELINE PR 11,25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 11,25mg IPSEN PHARMA FRANTA 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 S/P-RF 1 699,730000 0,000000 349,865000 349,865000 629,757000 69,973000701 W55727001 L02AE04 TRIPTORELINUM ** # DIPHERELINE 3,75 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 3,75mg IPSEN PHARMA FRANTA 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 S/P-RF 1 378,690000 0,000000 189,345000 189,345000 340,821000 37,869000702 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 24,498714703 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 21,443000704 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 0,068640705 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 0,613681706 W62179001 M01AC05 LORNOXICAMUM XEFO 8 mg/ 2 ml PULB. + SOLV. PT. SOL. INJ. 8mg/2ml TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 10 FLAC. DIN STICLA BRUNA CU PULB. PT. SOL. INJ. + 10 FIOLE DIN STICLA INCOLORA X 2 ML SOLV. PT. SOL. INJ. PRF 10 1,378665 8,205335 0,689332 8,894668 1,240798 8,343202707 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 0,448974708 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 0,151474709 W64522002 M01AE17 DEXKETOPROFENUM DEKENOR 50 mg/2 ml SOL INJ./PERF. 50mg/2ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA BRUNA, CU PUNCT DE CULOARE ALBA SI INEL DE CULOARE ALBASTRA X 2 ML SOL. INJ./PERF. PRF 5 2,396000 0,288000 1,198000 1,486000 2,156400 0,527600710 W64522003 M01AE17 DEXKETOPROFENUM DEKENOR 50 mg/2 ml SOL INJ./PERF. 50mg/2ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 10 FIOLE DIN STICLA BRUNA, CU PUNCT DE CULOARE ALBA SI INEL DE CULOARE ALBASTRA X 2 ML SOL. INJ./PERF. PRF 10 2,396000 0,288000 1,198000 1,486000 2,156400 0,527600711 W43063001 M01AE17 DEXKETOPROFENUM TADOR INJECT SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF. P-RF 5 2,396000 1,512000 1,198000 2,710000 2,156400 1,751600712 W61199001 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA (UN SUPORT A 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF. PRF 5 2,396000 0,386000 1,198000 1,584000 2,156400 0,625600713 W61199002 M01AE17 DEXKETOPROFENUM DEXKETOPROFEN ROMPHARM 50 mg/2 ml SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA (DOUA SUPORTURI A CATE 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF. PRF 10 2,396000 0,385000 1,198000 1,583000 2,156400 0,624600714 W57029003 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 30 COMPR. ELIB. MODIF. PRF 30 1,697374 0,085626 0,848687 0,934313 1,527636 0,255364715 W57029004 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL) ** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 60 COMPR. ELIB. MODIF. PRF 60 1,668833 0,000000 0,834416 0,834417 1,501949 0,166884716 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 0,374500717 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 0,374500718 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 0,061534719 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 0,061534720 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 0,061467721 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 0,061534722 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 0,384000723 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 0,435000724 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 0,435000725 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 0,384000726 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 0,124100727 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 0,124100728 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 0,124100729 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 0,124100730 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 0,124100731 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 0,832571732 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 0,733285733 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 0,802571734 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 0,802571735 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 0,238143736 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 0,254000737 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 0,449000738 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 0,236286739 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 0,704000740 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 0,802571741 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 0,802571742 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 0,231572743 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 0,407571744 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 0,228715745 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 1,037428746 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 1,441357747 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 1,441357748 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 1,441357749 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

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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 1,462428751 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 1,037428752 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 1,435285753 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 1,037428754 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 1,036714755 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 1,344928756 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 0,919571757 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 1,117714758 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 1,117714759 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 1,095571760 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 1,095571761 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 0,814857762 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 0,815571763 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 0,814857764 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 0,523428765 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 0,497000766 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 1,036285767 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 0,965928768 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 0,580571769 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 0,869142770 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 0,514142771 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 0,691214772 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 0,691214773 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 0,668357774 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 0,668357775 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 0,176072776 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 0,369785777 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 0,369785778 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 0,177393779 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 0,666214780 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 0,599785781 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 0,525500782 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 0,183358783 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 0,556928784 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 0,182500785 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 0,067298786 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 0,070140787 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 0,284750788 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 0,262000789 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 3,871130790 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 3,573630791 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 0,515500792 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 3,120296793 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 3,871130794 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 3,573630795 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 2,158630796 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 2,156130797 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 0,391000798 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 0,391000799 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 5,876130800 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 11,833850801 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 10,653850802 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 3,573630803 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 1,376130804 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 7,411130805 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 3,573630806 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 3,871130807 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 0,798630808 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 2,166130809 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 2,166130810 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 2,106130811 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 1,376130812 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

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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 3,871130814 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 0,498545815 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 0,517588816 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 0,625255817 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 3,491130818 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 0,421175819 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 0,611509820 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 1,045901821 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 0,057250822 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 0,408175823 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 0,282366824 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 0,295700825 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 0,508700826 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 0,509200827 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 0,509033828 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 0,437100829 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 0,028650830 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 0,028700831 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 0,029200832 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 0,057400833 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 0,058066834 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 0,056600835 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 0,140572836 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 0,129143837 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 0,140572838 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 0,261929839 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 0,109143840 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 0,105500841 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 0,105500842 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 0,109143843 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 0,230749844 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 0,272749845 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 0,390082846 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 0,149082847 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 1,460615848 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 1,346282849 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 1,448948850 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 1,284948851 W54798001 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,26 mg COMPR. ELIB. PREL. 0,26mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITAP-RF 10 0,283407 1,243593 0,141703 1,385297 0,255066 1,271934852 W60244001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0,283407 0,386259 0,141703 0,527963 0,255066 0,414600853 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 0,414934854 W54799002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 0,52 mg COMPR. ELIB. PREL. 0,52mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 0,566815 1,625185 0,283407 1,908593 0,510133 1,681867855 W60240001 N04BC05 PRAMIPEXOLUM * OPRYMEA 0,52mg COMPR. ELIB. PREL. 0,52mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0,566815 0,907518 0,283407 1,190926 0,510133 0,964200856 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 0,964200857 W54800002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 1,05 mg COMPR. ELIB. PREL. 1,05mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 1,144530 3,026470 0,572265 3,598735 1,030077 3,140923858 W60241001 N04BC05 PRAMIPEXOLUM * OPRYMEA 1,05mg COMPR. ELIB. PREL. 1,05mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 1,144530 0,838803 0,572265 1,411068 1,030077 0,953256859 W60243001 N04BC05 PRAMIPEXOLUM * OPRYMEA 2,10mg COMPR. ELIB. PREL. 2,10mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 2,289061 1,477272 1,144530 2,621803 2,060154 1,706179860 W54801002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 2,1 mg COMPR. ELIB. PREL. 2,1mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 2,289061 5,260272 1,144530 6,404803 2,060154 5,489179861 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 1,859179862 W54802002 N04BC05 PRAMIPEXOLUM * MIRAPEXIN 3,15 mg COMPR. ELIB. PREL. 3,15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 3,433592 4,746741 1,716796 6,463537 3,090232 5,090101863 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 5,090434864 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 0,371859865 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 0,039700866 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 0,039700867 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 0,025917868 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 0,034983869 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 0,082034870 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 0,064929871 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 0,463438872 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 0,089429873 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 0,064934874 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 0,082143875 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

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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 0,055250877 W60685003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0,523928 0,000000 0,261964 0,261964 0,471535 0,052393878 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 0,081200879 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 0,051286880 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 0,080572881 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 0,101429882 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 0,125215883 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 0,185939884 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 0,115284885 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 0,115284886 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 0,185939887 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 0,149970888 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 0,149970889 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 0,205367890 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 0,048500891 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 0,046889892 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 0,048500893 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 0,048500894 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 0,308833895 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 1,207500896 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 0,521858897 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 0,649643898 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 0,649643899 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 0,770000900 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 0,627858901 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 0,670358902 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 0,532191903 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 1,401072904 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 0,471786905 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 0,585000906 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 0,585000907 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 0,680358908 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 1,473929909 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 1,565715910 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 0,118000911 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 0,124358912 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 0,124358913 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 1,456786914 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 0,120715915 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 0,105322916 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 1,096048917 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 0,110800918 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 0,651381919 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 0,651381920 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 0,108250921 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 0,155000922 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 0,385600923 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 0,017200924 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 0,092267925 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 0,101701926 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 0,337034927 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 0,029067928 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 0,045534929 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 0,087051930 W55890001 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRLROMANIA 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 0,087051931 W55890002 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRLROMANIA 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 0,086951932 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 0,046034933 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 0,046217934 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 0,044700935 W55890003 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRLROMANIA 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 0,087051936 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 0,037284937 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 0,087051938 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

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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 0,357551940 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 0,043350941 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 0,043367942 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 0,357551943 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 0,332384944 W55889001 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRLROMANIA 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 0,062184945 W55889002 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRLROMANIA 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 0,061851946 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 0,049651947 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 0,061851948 W61220006 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 0,153499 0,034301 0,076749 0,111051 0,138149 0,049651949 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 0,150951950 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 0,150951951 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 0,411384952 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 0,108580953 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 0,382920954 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 0,469361955 W55730003 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml SOL. INJ./CONC. PT. SOL. PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 27,204000 0,000000 13,602000 13,602000 24,483600 2,720400956 W55730002 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA ** CEREBROLYSIN 215,2 mg/ml SOL. INJ./CONC. PT. SOL. PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML SOL. INJ./CONC. PT. SOL. PERF. PR/PRF 5 14,869000 3,801000 7,434500 11,235500 13,382100 5,287900957 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 0,055317958 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 0,055317959 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 5,903000960 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 1,327000961 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, SUSPENSIEP-RF 1 17,430000 10,970000 8,715000 19,685000 15,687000 12,713000962 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 PPPRF 1 93,420000 0,000000 46,710000 46,710000 84,078000 9,342000963 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 11,602000964 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 INHALATORPRF 30 2,233000 2,127333 1,116500 3,243833 2,009700 2,350633965 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 INHALATORPRF 30 2,233000 2,127333 1,116500 3,243833 2,009700 2,350633966 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 0,446600967 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 0,446600968 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 72,191200969 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 61,533000970 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 16,266000971 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 11,490000972 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 15,073000973 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 61,933000974 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 80,601200975 W61943001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/125 micrograme/doza SUSP. INHAL. PRESURIZATA 25micrograme/125micrograme/doz CIPLA EUROPE NV BELGIA CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS ÎNTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA PRF 1 81,330000 14,490000 40,665000 55,155000 73,197000 22,623000976 W61945001 R03AK06 SALMETEROLUM+FLUTICASONUM * SERROFLO 25 micrograme/250 micrograme/doza SUSP. INHAL. PRESURIZATA 25micrograme/250micrograme/doz CIPLA EUROPE NV BELGIA CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS ÎNTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA PRF 1 121,760000 0,000000 60,880000 60,880000 109,584000 12,176000977 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 12,366000978 W56427001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 160micrograme/4,5micrograme/in ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. P6L 1 67,286666 13,233334 33,643333 46,876667 60,557999 19,962001979 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 DOZEPRF 1 117,040000 0,000000 58,520000 58,520000 105,336000 11,704000980 W56428001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie PULB. DE INHAL. 320micrograme/9micrograme/inha ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. P6L 1 134,573333 18,326667 67,286666 85,613334 121,115999 31,784001981 W56426001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL. 80micrograme/4,5micrograme/inh ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL. P6L 1 67,286666 12,043334 33,643333 45,686667 60,557999 18,772001982 W62789001 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM) * SYMBICORT 160 micrograme/4,5 micrograme/inhalatie SUSP. DE INHALAT PRESURIZATA 160micrograme/4,5micrograme ASTRAZENECA AB SUEDIA CUTIE CU 1 PUNGA DIN FOLIE LAMINATA+1 DISPOZITIV DE INHALARE ALCATUIT DINTR-UN FLAC. PRESURIZAT,INCHIS CU O VALVA DOZATOARE SI ATASAT UNUI INDICATOR AL DOZELOR,INCLUS INTR-UN DIAPOZITIV INHALATOR DIN PLASTIC DE CULOARE ROSIE CU 120 ACTIONARI P6L 1 134,573333 11,436667 67,286666 78,723334 121,115999 24,894001983 W57995002 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER 100/6 micrograme pe doza SOL. DE INHALAT PRESURIZATA 100/6micrograme pe doza CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS IN DISPOZITIVUL DE ADMINISTRARE DIN PE CU CAPAC PROTECTOR DIN PLASTIC A 180 DOZE SOL. DE INHALATPRF 1 201,859999 16,370001 100,929999 117,300001 181,673999 36,556001984 W59645001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 125 micrograme/5 micrograme SUSP. INHAL. PRESURIZATA 125micrograme/5micrograme MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU 1 FLAC. DIN AL (INHALATOR) PREVAZUT CU VALVA DOZATOARE SI DISPOZITIV DE ADMINISTRARE DIN PP X 120 DOZE SUSP. DE INHALAT PRESURIZATA P6L 1 131,602500 28,117500 65,801250 93,918750 118,442250 41,277750985 W59644001 R03AK11 COMBINATII (FLUTICASONUM+FORMOTEROLUM) FLUTIFORM 50 micrograme/5 microgrameSUSP. INHAL. PRESURIZATA 50micrograme/5micrograme MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU 1 FLAC. DIN AL (INHALATOR) PREVAZUT CU VALVA DOZATOARE SI DISPOZITIV DE ADMINISTRARE DIN PP X 120 DOZE SUSP. DE INHALAT PRESURIZATA P6L 1 122,230000 0,000000 61,115000 61,115000 110,007000 12,223000986 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 0,794500987 W64767001 R03AL04 COMBINATII (INDACATEROLUM+GLICOPIRONIUM) ** ULTIBRO BREEZHALER 85 micrograme/43 micrograme CAPS. CU PULB. DE INHAL. 85micrograme/43micrograme NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 BLISTERE PERFORATE PA-AL-PVC/AL PENTRU ELIBERAREA UNEI UNITATI DOZATE X 1 CAPSULA CU PULBERE DE INHALAT + 1 INHALATOR PR/PRF 30 7,945000 0,000000 3,972500 3,972500 7,150500 0,794500988 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 22,904250989 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 22,850000990 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 20,643000991 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 21,911040992 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 19,902600993 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 17,685200994 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 16,971300995 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 8,392600996 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 7,915000997 W41591001 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE (R) 50 INHALER CFC - Free SUSP. INHAL. PRESURIZATA 50mcg/doza GLAXO WELLCOME UK LTD.MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE P-RF 1 16,754400 19,955600 8,377200 28,332800 15,078960 21,631040998 W12420003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 0,5 mg/2 ml SUSP. INHAL. PRIN NEBULIZATOR 0,5mg/2ml 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 2,451369999 W12419003 R03BA05 FLUTICASONUM PROPIONAT * FLIXOTIDE NEBULES 2 mg/2 ml SUSP. INHAL. PRIN NEBULIZATOR 2mg/2ml 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 6,6324731.000 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 10,6116251.001 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

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1.002 W64226001 R03BA08 CICLESONIDUM * ALVESCO 160 INHALER SOL. DE INHALAT PRESURIZATA 160micrograme/doza ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA PRF 1 90,310000 0,000000 45,155000 45,155000 81,279000 9,0310001.003 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 9,0310001.004 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 0,8905671.005 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 0,4040341.006 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 13,8070001.007 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 0,8569011.008 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 0,8569011.009 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 0,0331991.010 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 0,0148201.011 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 0,0256991.012 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 0,0938961.013 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 0,2582001.014 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 0,9969261.015 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 1,7290691.016 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 0,0870671.017 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 0,2165691.018 W58991005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,901035 0,091107 0,450517 0,541625 0,810931 0,1812111.019 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 0,0568581.020 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 1,1025151.021 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 0,0457001.022 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 0,0630001.023 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 0,1868001.024 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 1,9171581.025 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 1,0949301.026 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 1,8270731.027 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 0,0509341.028 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 0,0838581.029 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 0,1020731.030 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 1,9171581.031 W55198002 R03DX03 FENSPIRIDUM EURESPAL 80 mg COMPR. CU ELIBERARE PRELUNGITA 80mg 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 0,1124771.032 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 0,1381441.033 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 2,1450001.034 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 0,1213321.035 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 0,0370501.036 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 0,0357501.037 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 0,7049351.038 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 MLP-RF 1 2,793471 5,806529 1,396735 7,203265 2,514123 6,0858771.039 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 0,9400001.040 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 6,8774691.041 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 0,0889001.042 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 0,0591001.043 W58148003 R06AE09 LEVOCETIRIZINUM XYZAL PIC. ORALE, SOL. 5mg/ml UCB PHARMA GMBHGERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR P-6L 1 27,100000 0,000000 13,550000 13,550000 24,390000 2,7100001.044 W58334001 R06AE09 LEVOCETIRIZINUM ZENARO 0,5 mg/ml SIROP 0,5mg/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPAC DIN PP PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 200ML SIROP + 1 LINGURITA DOZATOARE DE 5ML P6L 1 25,080000 0,000000 12,540000 12,540000 22,572000 2,5080001.045 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 0,0263001.046 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 0,0382671.047 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 0,1777841.048 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 0,1404511.049 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 0,3224511.050 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 0,3221171.051 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 0,0375001.052 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 0,0417671.053 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 0,3221171.054 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 0,3224511.055 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 0,7853921.056 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 0,7853921.057 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 0,5831171.058 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 0,5831171.059 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 1,1200001.060 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 3,1100001.061 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 1,1200001.062 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 3,1100001.063 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 0,4960001.064 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

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Page 41: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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Val. maxima suportata de sistemul de

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Contributie maxima a

asiguratului / UT (pt. asiguratii care

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din pretul de referinta)

Val. maxima suportata de sistemul de

asigurari sociale de sanatate / UT (pt.

asiguratii care beneficiaza de

compensare 90% din pretul de referinta)

Contributie maxima a

asiguratului / UT (pt. asiguratii care

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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 1,4700011.066 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 1,4700011.067 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 3,2300011.068 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 3,2300011.069 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 4,4875001.070 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 4,4875001.071 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 1,5500001.072 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 0,8964021.073 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 14,1667001.074 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 3,8775001.075 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 1,4840001.076 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 0,6030001.077 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 1,0650001.078 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 0,5730001.079 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 0,5730001.080 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 0,4920001.081 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 26,6571001.082 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 2,4103271.083 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 7,0871001.084 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 0,5320001.085 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 1,5371001.086 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 1,5371001.087 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 9,0329701.088 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 9,0329701.089 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 1,9620001.090 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 1,8970001.091 W63546001 S01GX09 OLOPATADINUM OPATANOL 1mg/ml PIC. OFT., SOL. 1mg/ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML P-RF 1 19,120000 0,050000 9,560000 9,610000 17,208000 1,9620001.092 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 (2) se prescrie numai în etapa pregătitoare pentru colonoscopie; - Pentru medicamentele corespunzătoare DCI-urilor notate cu (#) regulile de prescriere sunt stabilite prin Contractul-cadru.

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) 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;

Pagina 18 din 18

Page 42: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

ANEXA 2c

Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0030008 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 0,1310009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,07960014 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 0,08253315 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 0,00000016 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 0,03326717 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 0,00000018 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 0,11780019 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 0,00000020 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 0,16510121 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 0,05326722 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 0,05360123 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 0,00060124 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 0,05326725 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 0,05326726 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 0,05360127 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 0,00000028 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 0,04460129 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 0,00000030 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 0,05393431 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 0,00000032 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 0,00000033 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 0,00000034 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 0,00000035 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 0,00000036 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 0,00000037 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 0,00000038 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 0,04873339 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 0,00000040 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 0,00000041 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 0,00000042 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 0,00000043 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 0,00000044 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

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

SECŢIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ CONFORMDCI-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

Pagina 1 din 39

Page 43: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

45 W59569003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mgCOMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,258399 0,258399 0,05326746 W59568003 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,191000 0,191000 0,00000047 W04260001 C07AB02 METOPROLOLUM BETALOC (R) ZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,258399 0,258399 0,22193448 W04262001 C07AB02 METOPROLOLUM BETALOC (R) ZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 0,207600 0,207600 0,17306649 W43226004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,227000 0,227000 0,00000050 W43227004 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 0,377666 0,377666 0,00000051 W04259001 C07AB02 METOPROLOLUM BETALOC SOL. INJ./PERF. 5mg/5ml ASTRAZENECA AB SUEDIA CUTIE X 5 FIOLE X 5 ML SOL.INJ. I.V./PERF. PR 5 3,368000 3,368000 0,00000052 W58764001 C07AB07 BISOPROLOLUM BOREZ 10 mg COMPR. FILM. 10 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,291999 0,291999 0,09066753 W60359002 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,291999 0,291999 0,52866754 W60569004 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,291999 0,291999 0,07366755 W58765001 C07AB07 BISOPROLOLUM BOREZ 2,5 mg COMPR. FILM. 2,5 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 0,255666 0,255666 0,00000056 W60357002 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,263599 0,263599 0,04973457 W60567004 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,219666 0,219666 0,00000058 W60358002 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,187320 0,187320 0,22268059 W60568004 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 0,187320 0,187320 0,03001360 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 0,239599 0,239599 0,43325861 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 0,239599 0,239599 0,14306762 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 0,239599 0,239599 0,20273463 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 0,199666 0,00000064 W58211001 C07AB12 NEBIVOLOLUM ** NEBIVOLOL TORRENT 5 mg COMPR. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L 30 0,239599 0,239599 0,20273465 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 0,239599 0,239599 0,19906766 W64800005 C07AB12 NEBIVOLOLUM ** NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA B.V. OLANDA CUTIE CU 3 BLIST. PVDC/AL X 10 COMPR. P6L 30 0,239599 0,239599 0,14306767 W59931001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,292333 0,292333 0,00000068 W12649001 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,272857 0,272857 0,00000069 W42058001 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,296000 0,296000 0,00000070 W42659001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,313713 0,313713 0,17328771 W53658001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,313713 0,313713 0,03978772 W53751001 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313713 0,313713 0,09195373 W58304001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,5 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,313713 0,313713 0,16228774 W63454001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,313713 0,313713 0,17328775 W12648002 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 0,348000 0,348000 0,02557176 W42059001 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,348000 0,348000 0,20300077 W42658001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,348000 0,348000 0,28566678 W53752001 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,348000 0,348000 0,20366679 W58305001 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,348000 0,348000 0,28700080 W59932001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,334333 0,334333 0,00000081 W63455001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,348000 0,348000 0,22866682 W41867002 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 0,196071 0,196071 0,00000083 W41912001 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 0,176666 0,176666 0,00000084 W42660001 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 0,211999 0,211999 0,03900185 W53663001 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,211999 0,211999 0,02850186 W53750001 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,194666 0,194666 0,00000087 W59930001 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 0,190000 0,190000 0,00000088 W63453001 C07AG02 CARVEDILOLUM CARVEDILOL SLAVIA 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 0,211999 0,211999 0,03900189 W58955007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,261428 0,261428 0,00000090 W58956007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,290000 0,290000 0,00000091 W58954007 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 0,182857 0,182857 0,00000092 W00775001 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148399 0,148399 0,00093493 W06860001 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,148399 0,148399 0,01010194 W00774002 C09AA01 CAPTOPRILUM CAPTOPRIL LAROPHARM 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,148399 0,148399 0,01660195 W43029001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,125000 0,125000 0,00000096 W06857001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,123666 0,123666 0,00000097 W08550001 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,124333 0,124333 0,00000098 W41981002 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,148399 0,148399 0,01426799 W53677002 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,125000 0,125000 0,000000

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Page 44: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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Contributie maxima a asiguratului / UT (pt. asiguratii care

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100 W53678001 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,145500 0,145500 0,000000101 W00777001 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,171999 0,171999 0,070334102 W06862001 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,171999 0,171999 0,031501103 W43028001 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,145500 0,145500 0,000000104 W42060001 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,164000 0,164000 0,000000105 W00776003 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,143333 0,143333 0,000000106 W12405001 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,210500 0,210500 0,000000107 W02920004 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,209666 0,209666 0,000000108 W02922001 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,210500 0,210500 0,000000109 W41447001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 0,200500 0,200500 0,000000110 W51276001 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,240600 0,240600 0,082257111 W53672002 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 0,210000 0,210000 0,000000112 W53672003 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 0,209800 0,209800 0,000000113 W53672004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 0,209900 0,209900 0,000000114 W53666002 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 0,210500 0,210500 0,000000115 W58491002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,209500 0,209500 0,000000116 W62035001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,210500 0,210500 0,000000117 W12199001 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,348000 0,348000 0,000000118 W02921003 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,348333 0,348333 0,000000119 W02923001 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,348000 0,348000 0,000000120 W51277001 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,417600 0,417600 0,118471121 W53674001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,348333 0,348333 0,000000122 W53674004 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 0,348200 0,348200 0,000000123 W56712001 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 0,348000 0,348000 0,000000124 W58492001 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,348000 0,348000 0,000000125 W62036001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L 20 0,348000 0,348000 0,000000126 W12198001 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 0,098000 0,098000 0,000000127 W02925001 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 0,098500 0,098500 0,000000128 W51275001 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 0,114000 0,114000 0,037428129 W12811003 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 0,098000 0,098000 0,000000130 W53673001 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,098666 0,098666 0,000000131 W58490002 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 0,095000 0,095000 0,000000132 W62034001 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L 20 0,098000 0,098000 0,000000133 W58233001 C09AA02 ENALAPRILUM ENAP 1,25 mg/ml SOL. INJ./PERF. 1,25mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.PR/PRF 5 3,374000 3,374000 0,000000134 W12794001 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,304399 0,304399 0,241601135 W42156001 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,304399 0,304399 0,261101136 W42593001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,253666 0,253666 0,000000137 W43054001 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,267666 0,267666 0,000000138 W53748003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,284666 0,284666 0,000000139 W53916002 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,304399 0,304399 0,131267140 W54841001 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,304399 0,304399 0,102386141 W54843001 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,325357 0,325357 0,000000142 W12793001 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,428400 0,428400 0,413266143 W42088001 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,428400 0,428400 0,396100144 W42594001 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 0,357000 0,357000 0,000000145 W53747003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,399000 0,399000 0,000000146 W53917002 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,428400 0,428400 0,426600147 W54840001 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,428400 0,428400 0,255171148 W43055002 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 0,428400 0,428400 0,023100149 W53918002 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1,432000 1,432000 0,000000150 W12795001 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 0,243600 0,243600 0,034733151 W43053001 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,203000 0,203000 0,000000152 W53746003 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 0,203333 0,203333 0,000000153 W54842001 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,243600 0,243600 0,033185154 W51933002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,240856 0,240856 0,010215

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tie cant. UT/

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(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

155 W64367002 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,240856 0,240856 0,010215156 W42940001 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,240856 0,240856 0,077144157 W42972001 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,240856 0,240856 0,077144158 W43524001 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,240856 0,240856 0,077358159 W54354001 C09AA05 RAMIPRILUM TRITACE 10 COMPR. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 0,240856 0,240856 0,248429160 W55273002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,200714 0,200714 0,000000161 W60133002 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,240856 0,240856 0,077144162 W60133005 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,240856 0,240856 0,077144163 W62447001 C09AA05 RAMIPRILUM TRITACE 10 mg COMPR. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,240856 0,240856 0,248429164 W62662001 C09AA05 RAMIPRILUM RAMIPRIL ATB 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,240856 0,240856 0,010144165 W64288002 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0,200714 0,200714 0,000000166 W51934002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 0,157500 0,157500 0,000000167 W64365002 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,157500 0,157500 0,000000168 W42939001 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,177333 0,177333 0,000000169 W42970001 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,181333 0,181333 0,000000170 W43522001 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,175000 0,175000 0,000000171 W54352003 C09AA05 RAMIPRILUM TRITACE(R) 2,5 COMPR. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,188400 0,188400 0,090528172 W60131006 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,181333 0,181333 0,000000173 W62451001 C09AA05 RAMIPRILUM TRITACE 2,5 mg COMPR. 2,5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL/ X 28 COMPR. P6L 28 0,188400 0,188400 0,090528174 W62660001 C09AA05 RAMIPRILUM RAMIPRIL ATB 2,5 mg COMPR. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,157000 0,157000 0,000000175 W51932002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 0,168428 0,168428 0,012643176 W64366002 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg TEVA B.V. OLANDA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. P6L 28 0,168428 0,168428 0,012643177 W42237001 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,168428 0,168428 0,092905178 W42971001 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 0,168428 0,168428 0,091905179 W43523001 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,168428 0,168428 0,083714180 W54353001 C09AA05 RAMIPRILUM TRITACE® 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 0,168428 0,168428 0,233714181 W55272005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 0,140357 0,140357 0,000000182 W60132003 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 0,168428 0,168428 0,092905183 W60132008 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 0,168428 0,168428 0,092905184 W62382001 C09AA05 RAMIPRILUM TRITACE 5 mg COMPR. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 0,168428 0,168428 0,233714185 W62661001 C09AA05 RAMIPRILUM RAMIPRIL ATB 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 0,168428 0,168428 0,012905186 W64287005 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC TRANSPARENT/AL X 28 COMPR. P6L 28 0,140357 0,140357 0,000000187 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 0,584325 0,584325 1,009603188 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 0,584325 0,584325 0,543175189 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 0,486938 0,000000190 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 0,584325 0,584325 0,007103191 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 0,584325 0,584325 0,166389192 W58950013 C09CA03 VALSARTANUM ** VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,584325 0,584325 0,166389193 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 0,516856 0,516856 2,051358194 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 0,516856 0,516856 1,146715195 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 0,430714 0,430714 0,000000196 W58948013 C09CA03 VALSARTANUM ** VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,430714 0,430714 0,000000197 W56931003 C09CA03 VALSARTANUM ** DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 0,370040 0,370040 0,824960198 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 0,308367 0,000000199 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 0,370040 0,370040 0,180674200 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 0,370040 0,370040 0,032102201 W58949013 C09CA03 VALSARTANUM ** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 0,370040 0,370040 0,032102202 W55631001 C09CA03 VALSARTANUM ** DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML ) P-6L 1 24,880000 24,880000 0,000000203 W55622005 C09CA06 CANDESARTANUM CILEXETIL ** TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L 28 0,638570 0,638570 0,480001204 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 0,532142 0,000000205 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 0,638570 0,638570 0,130430206 W58808002 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 16mg COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,638570 0,638570 0,791787207 W58874004 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,638570 0,638570 0,145763208 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 0,638570 0,638570 0,480001209 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 0,638570 0,638570 0,068096

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rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

210 W61496002 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN CILEXETIL MCC 16 mg COMPR. 16mg MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 0,638570 0,638570 0,480096211 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 0,638570 0,638570 0,273930212 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 0,638570 0,638570 0,091763213 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 0,638570 0,638570 0,225763214 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 1,192399 1,192399 0,186934215 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 1,192399 1,192399 0,656529216 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 0,993666 0,000000217 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 1,192399 1,192399 0,333601218 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 1,014285 0,000000219 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 1,192399 1,192399 0,280101220 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 0,457713 0,457713 0,101215221 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 0,381428 0,000000222 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 0,457713 0,457713 0,099620223 W58807002 C09CA06 CANDESARTANUM CILEXETIL ** ATACAND 8mg COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L 28 0,457713 0,457713 0,403001224 W58873004 C09CA06 CANDESARTANUM CILEXETIL ** CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 0,457713 0,457713 0,093953225 W59607002 C09CA06 CANDESARTANUM CILEXETIL ** CANDESARTAN LABORMED 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L 28 0,457713 0,457713 0,100858226 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 0,457713 0,457713 0,058620227 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 0,457713 0,457713 0,101620228 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 0,457713 0,457713 0,101215229 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 0,457713 0,457713 0,100953230 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 0,457713 0,457713 0,018953

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.

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 0,0000002 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 0,0000003 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 0,4549574 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 0,0149335 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 0,4172666 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 0,4172667 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 0,0000008 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 0,2576009 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 0,00000011 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 0,00000012 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 0,93745713 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 0,0000002 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 0,0000003 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 5,7892154 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

2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

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

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

Pagina 5 din 39

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Contributie maxima a asiguratului / UT (pt. asiguratii care

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5 W61374009 J05AB04 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mgCOMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,071071 2,071071 0,0000006 W62522002 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF 30 2,950333 2,950333 0,0000007 W07518002 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 3,540399 3,540399 0,8399588 W63292001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL ZENTIVA 245 mg COMPR. FILM. 245 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. X 30 COMPR. FILM. PR 30 14,880799 14,880799 6,2808679 W60828015 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEÎD CU CAPAC CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM.PR 30 14,880799 14,880799 7,711867

10 W60828017 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEÎD CU PERETII ÎNGROSATI CU CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. PR 30 14,880799 14,880799 7,71186711 W62771001 J05AF07 TENOFOVIRUM DISOPROXIL **1 VIROFOB 245 mg COMPR. FILM. 245mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID CU CAPAC DIN PP X 30 COMPR. FILM. PR 30 14,880799 14,880799 12,59453412 W63256001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL MYLAN COMPR. FILM. 245mg MYLAN S.A.S FRANTA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM PR 30 14,880799 14,880799 6,28086713 W63499004 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL SANDOZ 245 mg COMPR. FILM. 245mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID X 30 COMPR. FILM. PR 30 14,880799 14,880799 7,59220114 W63769001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL ACCORD 245 mg COMPR. FILM. 245mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 14,880799 14,880799 7,59220115 W64012002 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL AUROBINDO 245 mg COMPR. FILM. 245mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 12,400666 12,400666 0,00000016 W51522001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 36,378000 36,378000 0,00000017 W64757001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. DIN PEID X 30 COMPR. PR 30 36,378000 36,378000 0,00000018 W51442002 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 12,696000 12,696000 25,25466619 W63932001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANDOZ 0,5 mg COMPR. FILM. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 5,23400020 W63777001 J05AF10 ENTECAVIRUM **1 ENTECAVIR GLENMARK 0,5 mg COMPR. FILM. 0,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 12,696000 12,696000 12,31700021 W63911001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 30 X 1 COMPR. FILM. PR 30 12,696000 12,696000 5,25366622 W63864001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 12,696000 12,696000 0,00000023 W63812002 J05AF10 ENTECAVIRUM **1 ENTECAVIR DR. REDDY'S 0,5 mg COMPR. FILM. 0,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 12,696000 12,696000 26,76900024 W63803001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 0,5 mg COMPR. FILM. 0,5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 12,696000 12,696000 8,88833325 W63755002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 10,580000 10,580000 0,00000026 W63755005 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X 30X1 COMPR. FILM.PR 30 10,580000 10,580000 0,00000027 W64007001 J05AF10 ENTECAVIRUM **1 ENTECAVIR AUROBINDO 0,5 mg COMPR. FILM. 0,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 22,99933328 W64330001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ZENTIVA K.S. 0,5 mg COMPR. FILM. 0,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 0,18433329 W64862001 J05AF10 ENTECAVIRUM **1 ENTECAVIR PHARMATHEN 0,5 mg COMPR. FILM. 0,5mg FLOMI FARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 5,21633330 W51443002 J05AF10 ENTECAVIRUM **1 BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 31,124400 31,124400 9,64260031 W63933001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANDOZ 1 mg COMPR. FILM. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 25,937000 25,937000 0,00000032 W63843001 J05AF10 ENTECAVIRUM **1 ENTECAVIR GLENMARK 1 mg COMPR. FILM. 1mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 31,124400 31,124400 8,65326633 W63912001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 30 X 1 COMPR. FILM. PR 30 28,233333 28,233333 0,00000034 W63865001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 1 mg COMPR. FILM. 1mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 31,124400 31,124400 1,48793335 W63813002 J05AF10 ENTECAVIRUM **1 ENTECAVIR DR. REDDY'S 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 31,124400 31,124400 11,27693336 W63814001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 1 mg COMPR. FILM. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 31,124400 31,124400 9,64160037 W63756002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 28,064666 28,064666 0,00000038 W63756005 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X 30X1 COMPR. FILM.PR 30 28,064666 28,064666 0,00000039 W64008001 J05AF10 ENTECAVIRUM **1 ENTECAVIR AUROBINDO 1 mg COMPR. FILM. 1mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 31,124400 31,124400 7,22260040 W64331001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ZENTIVA K.S. 1 mg COMPR. FILM. 1mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 31,124400 31,124400 1,97626641 W64863001 J05AF10 ENTECAVIRUM **1 ENTECAVIR PHARMATHEN 1 mg COMPR. FILM. 1mg FLOMI FARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 25,937666 25,937666 0,00000042 W51444001 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,05mg/ml SOL. ORALA 0,05mg/ml BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 210 ML SOL. ORALA + LINGURITA DOZATOARE PR 1 2.374,620000 2.374,620000 0,00000043 W62156001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN POLIETILENA DE INALTA DENSITATE (PEID) PREVAZUTE CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM.PR 28 2.640,848928 2.640,848928 0,00000044 W64756001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2.640,848928 2.640,848928 0,00000045 W62930001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 2.072,128928 2.072,128928 0,00000046 W64591001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME OLANDA CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 2.072,128928 2.072,128928 0,00000047 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 88,130000 88,130000 0,00000048 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 126,230400 126,230400 27,41960049 W61793001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 83,590000 83,590000 0,00000050 W61794001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 126,230400 126,230400 2,90960051 W55757002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 79,452000 79,452000 0,00000052 W62176005 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300µg/0,5ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 87,520000 87,520000 0,00000053 W64857002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 79,452000 79,452000 0,00000054 W55758002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 105,192000 105,192000 0,00000055 W64858002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 105,192000 105,192000 0,00000056 W62177005 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480µg/0,8ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,8 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 126,230400 126,230400 8,83960057 W51329001 L03AB04 INTERFERONUM ALFA 2A **1 ROFERON A SOL. INJ. 9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR 1 185,300000 185,300000 0,00000058 W59599002 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 18 milioane U.I. SOL. INJ. PEN MULTIDOZA 18 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 408,040000 408,040000 0,00000059 W59600001 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 30 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 628,000000 628,000000 0,000000

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(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

60 W60714001 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 100 µg PULB. + SOLV. PT. SOL. INJ. 100µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 706,330000 706,330000 0,00000061 W60715002 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 120 µg PULB. + SOLV. PT. SOL. INJ. 120µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 833,420000 833,420000 0,00000062 W60716002 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 150 µg PULB. + SOLV. PT. SOL. INJ. 150µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 1.024,070000 1.024,070000 0,00000063 W60713002 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 50 µg PULB. + SOLV. PT. SOL. INJ. 50µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 387,660000 387,660000 0,00000064 W08978004 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 744,040000 744,040000 0,00000065 W64393001 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 microrgrame/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180µg/0,5ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC PR 1 744,040000 744,040000 0,00000066 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

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

1 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 1,164200 0,0000002 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 1,225800 1,225800 0,0000003 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 0,0000004 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 PPP6L 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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 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 20,660000 20,660000 0,00000011 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 0,00000012 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 0,00000013 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 0,00300014 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 0,13100015 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 0,08800016 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 0,00000017 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 0,00000018 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 0,00000019 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

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

6. CIROZA BILIARA PRIMARA, COLANGITA SCLEROZANTA PRIMITIVA, HEPATITA CRONICA SI CIROZE DE ALTE ETIOLOGII CU COLESTAZA - G6

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

Pagina 7 din 39

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cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

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Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

20 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 0,08253321 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 0,00000022 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 0,03326723 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 0,00000024 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 0,11780025 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 0,00000026 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 0,16510127 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 0,00000028 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 0,00000029 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 5,78921530 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 5,45108431 W61374009 J05AB04 RIBAVIRINUM **1 RIBAVIRINA AUROBINDO 200 mgCOMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 2,071071 2,071071 0,00000032 W62522002 J05AF05 LAMIVUDINUM **1 LAMIVUDINA TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF 30 2,950333 2,950333 0,00000033 W07518002 J05AF05 LAMIVUDINUM **1 ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 3,540399 3,540399 0,83995834 W51522001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 36,378000 36,378000 0,00000035 W64757001 J05AF08 ADEFOVIRUM DIPIVOXILUM **1 HEPSERA COMPR. 10mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. DIN PEID X 30 COMPR. PR 30 36,378000 36,378000 0,00000036 W51442002 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,5mg COMPR. FILM. 0,5mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R 30 12,696000 12,696000 25,25466637 W63932001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANDOZ 0,5 mg COMPR. FILM. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 5,23400038 W63777001 J05AF10 ENTECAVIRUM **1 ENTECAVIR GLENMARK 0,5 mg COMPR. FILM. 0,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 12,696000 12,696000 12,31700039 W63911001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 30 X 1 COMPR. FILM. PR 30 12,696000 12,696000 5,25366640 W63864001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 0,5 mg COMPR. FILM. 0,5mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 12,696000 12,696000 0,00000041 W63812002 J05AF10 ENTECAVIRUM **1 ENTECAVIR DR. REDDY'S 0,5 mg COMPR. FILM. 0,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 12,696000 12,696000 26,76900042 W63803001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 0,5 mg COMPR. FILM. 0,5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 12,696000 12,696000 8,88833343 W63755002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 10,580000 10,580000 0,00000044 W63755005 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 0,5 mg COMPR. FILM. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X 30X1 COMPR. FILM.PR 30 10,580000 10,580000 0,00000045 W64007001 J05AF10 ENTECAVIRUM **1 ENTECAVIR AUROBINDO 0,5 mg COMPR. FILM. 0,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 22,99933346 W64330001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ZENTIVA K.S. 0,5 mg COMPR. FILM. 0,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 0,18433347 W64862001 J05AF10 ENTECAVIRUM **1 ENTECAVIR PHARMATHEN 0,5 mg COMPR. FILM. 0,5mg FLOMI FARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 12,696000 12,696000 5,21633348 W51443002 J05AF10 ENTECAVIRUM **1 BARACLUDE 1mg COMPR. FILM. 1mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA) P-RF/R 30 31,124400 31,124400 9,64260049 W63933001 J05AF10 ENTECAVIRUM **1 ENTECAVIR SANDOZ 1 mg COMPR. FILM. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 25,937000 25,937000 0,00000050 W63843001 J05AF10 ENTECAVIRUM **1 ENTECAVIR GLENMARK 1 mg COMPR. FILM. 1mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 31,124400 31,124400 8,65326651 W63912001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 30 X 1 COMPR. FILM. PR 30 28,233333 28,233333 0,00000052 W63865001 J05AF10 ENTECAVIRUM **1 ENTECAVIR MYLAN 1 mg COMPR. FILM. 1mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. (OPA/ALU/PVC-ALU) X 30 COMPR. FILM. PR 30 31,124400 31,124400 1,48793353 W63813002 J05AF10 ENTECAVIRUM **1 ENTECAVIR DR. REDDY'S 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 31,124400 31,124400 11,27693354 W63814001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ALVOGEN 1 mg COMPR. FILM. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 31,124400 31,124400 9,64160055 W63756002 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 28,064666 28,064666 0,00000056 W63756005 J05AF10 ENTECAVIRUM **1 ENTECAVIR TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X 30X1 COMPR. FILM.PR 30 28,064666 28,064666 0,00000057 W64008001 J05AF10 ENTECAVIRUM **1 ENTECAVIR AUROBINDO 1 mg COMPR. FILM. 1mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 31,124400 31,124400 7,22260058 W64331001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ZENTIVA K.S. 1 mg COMPR. FILM. 1mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 31,124400 31,124400 1,97626659 W64863001 J05AF10 ENTECAVIRUM **1 ENTECAVIR PHARMATHEN 1 mg COMPR. FILM. 1mg FLOMI FARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PR 30 25,937666 25,937666 0,00000060 W51444001 J05AF10 ENTECAVIRUM **1 BARACLUDE 0,05mg/ml SOL. ORALA 0,05mg/ml BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 210 ML SOL. ORALA + LINGURITA DOZATOARE PR 1 2.374,620000 2.374,620000 0,00000061 W62156001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 1 FLACON DIN POLIETILENA DE INALTA DENSITATE (PEID) PREVAZUTE CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM.PR 28 2.640,848928 2.640,848928 0,00000062 W64756001 J05AX65 COMBINATII (LEDIPASVIRUM+SOFOSBUVIRUM) **1 β HARVONI 90 mg/400 mg COMPR. FILM. 90mg/400mg GILEAD SCIENCES IRELAND UC IRLANDA CUTIE CU 1 FLAC. PEID PREVAZUT CU UN SISTEM DE INCHIDERE SECURIZAT PT. COPII X 28 COMPR. FILM. PR 28 2.640,848928 2.640,848928 0,00000063 W62930001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 2.072,128928 2.072,128928 0,00000064 W64591001 J05AX68 COMBINATII (ELBASVIRUM+GRAZOPREVIRUM) **1 β ZEPATIER 50 mg/100 mg COMPR. FILM. 50mg/100mg MERCK SHARP & DOHME OLANDA CUTIE X 2 CARDURI DIN CARTON X 2 BLISTERE AL/AL X 7 COMPRIMATE FILMATE (28 COMPRIMATE FILMATE ) PR 28 2.072,128928 2.072,128928 0,00000065 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 88,130000 88,130000 0,00000066 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 126,230400 126,230400 27,41960067 W61793001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 83,590000 83,590000 0,00000068 W61794001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 48 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 48MU/0,5 ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ. PR 1 126,230400 126,230400 2,90960069 W55757002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 79,452000 79,452000 0,00000070 W62176005 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300µg/0,5ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 87,520000 87,520000 0,00000071 W64857002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 79,452000 79,452000 0,00000072 W55758002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. P-RF 5 105,192000 105,192000 0,00000073 W64858002 L03AA02 FILGRASTIMUM (G-CSF) ** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml PFIZER EUROPE MA EEIG BELGIA CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF. PR 5 105,192000 105,192000 0,00000074 W62177005 L03AA02 FILGRASTIMUM (G-CSF) ** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480µg/0,8ml TEVA GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,8 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC PR 1 126,230400 126,230400 8,839600

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Page 50: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

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din pretul de referinta)

75 W51329001 L03AB04 INTERFERONUM ALFA 2A **1 ROFERON A SOL. INJ. 9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR 1 185,300000 185,300000 0,00000076 W59599002 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 18 milioane U.I. SOL. INJ. PEN MULTIDOZA 18 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 408,040000 408,040000 0,00000077 W59600001 L03AB05 INTERFERONUM ALFA 2B **1 INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA 30 milioane U.I. MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE P-RF/R 1 628,000000 628,000000 0,00000078 W60714001 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 100 µg PULB. + SOLV. PT. SOL. INJ. 100µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 706,330000 706,330000 0,00000079 W60715002 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 120 µg PULB. + SOLV. PT. SOL. INJ. 120µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 833,420000 833,420000 0,00000080 W60716002 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 150 µg PULB. + SOLV. PT. SOL. INJ. 150µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 1.024,070000 1.024,070000 0,00000081 W60713002 L03AB10 PEGINTERFERON ALFA-2B **1 PEGINTRON 50 µg PULB. + SOLV. PT. SOL. INJ. 50µg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT PR 1 387,660000 387,660000 0,00000082 W08978004 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 mcg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180mcg/0,5ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC P-RF/R 1 744,040000 744,040000 0,00000083 W64393001 L03AB11 PEGINTERFERON ALFA-2A **1 PEGASYS 180 microrgrame/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 180µg/0,5ml ROCHE REGISTRATION GMBH GERMANIA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC PR 1 744,040000 744,040000 0,00000084 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

Tratamentul se ini țiază de către medicul in specialitatea gastroenterologie sau boli infectioase

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,5056009 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. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF./INJ. S 5 15,354000 15,354000 0,00000011 W53092002 A04AA02 GRANISETRONUM ** GRANISETRON TEVA 3mg/3ml CONC. PT. SOL. PERF./INJ. 3mg/3ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3 ML CONC. PT. SOL. PERF./INJ. S 5 35,782000 35,782000 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 101,69000017 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 92,57000018 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 34,91000019 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 34,92000020 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 34,92000021 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 101,69000022 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 34,92000023 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 0,00000024 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 0,00000025 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 299,05800026 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 0,00000027 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 0,00000028 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 0,00000029 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 0,00000030 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 0,00000031 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 0,00000032 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 0,00000033 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 0,00000034 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 0,00000035 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 0,00000036 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 0,00000037 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 0,00000038 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 0,00000039 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

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

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compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

40 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 0,00000041 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 0,00000042 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 0,00000043 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 0,00000044 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 0,00000045 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 0,00000046 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 0,00000047 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 0,00000048 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 0,00000049 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 0,00000050 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 0,00000051 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 0,00000052 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 0,00000053 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 0,00000054 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 0,00000055 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 0,00000056 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 0,00000057 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 0,00000058 W58800001 G03HA01 CYPROTERONUM ** ANDROCUR COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF 50 2,237400 2,237400 0,00000059 W64041001 G03HA01 CYPROTERONUM ** ANDROCUR 50 mg COMPR. 50mg BAYER AG GERMANIA CUTIE CU 5 BLIST. AL/PVC X 10 COMPR. PRF 50 2,237400 2,237400 0,00000060 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 0,00000061 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 0,00000062 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 0,00000063 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 0,00000064 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 0,00000065 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 0,00000066 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 0,00000067 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 0,00000068 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 0,00000069 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 0,00000070 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 0,00000071 W03837002 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 2,623200 2,623200 0,74080072 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 2,186000 0,00000073 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 2,186000 0,00000074 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 2,186000 0,00000075 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 2,186000 0,00000076 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 2,186000 0,00000077 W08947008 J02AC03 VORICONAZOLUM ** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 14,358856 14,358856 43,58114478 W61017005 J02AC03 VORICONAZOLUM ** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 14,358856 14,358856 52,85471579 W61628005 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 11,965714 11,965714 0,00000080 W61628006 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 11,966000 11,966000 0,00000081 W61817001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 11,965714 11,965714 0,00000082 W62033006 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg COMPR. FILM. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 14,358856 14,358856 60,50714483 W64073003 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 14,358856 14,358856 71,69042984 W64073005 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 14,358856 14,358856 69,16007285 W64073008 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 14,358856 14,358856 67,89489486 W64072003 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 27,282857 27,282857 0,00000087 W64072005 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 24,856785 24,856785 0,00000088 W64072008 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 23,591607 23,591607 0,00000089 W62396001 J02AC03 VORICONAZOLUM ** VFEND 200mg PULB. + SOLV. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE 1 FLACON DIN STICLA TRANSPARENTA, CU CAPACITATEA DE 30 ML+1 PUNGA DE PERFUZIE DIN POLIPROPILENA A 50 ML+1 SERINA A 20 ML+1 ADAPTOR PT. FLACON PRF 1 329,844000 329,844000 83,16600090 W60659001 J02AC03 VORICONAZOLUM ** VORICONAZOL SANDOZ 200 mg PULB. PT. SOL. PERF. 200 mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA, CU CAPACIATEA DE 25 ML CARE CONTINE PULB. PT. SOL. PERF. PRF 1 274,870000 274,870000 0,00000091 W10489001 J02AC03 VORICONAZOLUM ** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 329,844000 329,844000 41,20600092 W61664001 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg PULB. PT. SOL. PERF. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU DOP DIN CAUCIUC CLOROBUTILIC, CAPAC DIN AL SI SIGILIU ROSU DIN PLASTIC CONTINAND PULB. PT. SOL. PERF. PRF 1 274,870000 274,870000 0,00000093 W62122001 J02AC03 VORICONAZOLUM ** VORICONAZOL FRESENIUS KABI 200 mg PULB. PT. SOL. PERF. 200mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA TIP I, CU CAPACITATEA DE 25 ML, CU PULBERE PT. SOL. PERF. PRF 1 329,844000 329,844000 41,20600094 W62814001 J02AC03 VORICONAZOLUM ** VORICONAZOL ACTAVIS 200 mg PULB. PT. SOL. PERF. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. PERF. PRF 1 329,844000 329,844000 21,646000

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Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

95 W62815001 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg PULB. PT. SOL. PERF. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA CU CAPCITATEA DE 25 ML CU PULB. PT. SOL. PERF. PRF 1 329,844000 329,844000 41,20600096 W41889001 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 1.546,390000 1.546,390000 0,00000097 W60913001 J02AC04 POSACONAZOLUM ** NOXAFIL 100mg COMPR. GASTROREZ. 100mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 144,731666 144,731666 0,00000098 W61578001 J02AC04 POSACONAZOLUM ** NOXAFIL 300mg CONC. PT. SOL. PERF. 300mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU UN FL X 16,7ML CONC. PT SOL PERF (18MG POSACONAZOL/ML) PR 1 1.491,710000 1.491,710000 0,00000099 W58194001 J02AC04 POSACONAZOLUM ** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.795,780000 2.795,780000 0,000000100 W06665001 J02AX04 CASPOFUNGINUM ** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 969,350000 969,350000 0,000000101 W63457001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ZENTIVA 50 mgPULB. PT. CONC. PT. SOL. PERF. 50mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 969,350000 969,350000 0,000000102 W63403001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA MYLAN 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONCENTRAT PT. SOL. PERF. PR 1 969,350000 969,350000 0,000000103 W63505001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ATB 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TIP I CU CAPACITATEA DE 10 ML, CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 969,350000 969,350000 0,000000104 W63508001 J02AX04 CASPOFUNGINUM ** DALVOCANS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 921,850000 921,850000 0,000000105 W63758001 J02AX04 CASPOFUNGINUM ** CASPOFUNGIN ACCORD 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE 50 MG PULB. PT. CONC. PT. SOL. PERF. PR 1 969,350000 969,350000 0,000000106 W64793001 J02AX04 CASPOFUNGINUM ** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 50 MG PULB. PTR. CONC. PTR. SOL. PERF. PR 1 969,350000 969,350000 0,000000107 W06670001 J02AX04 CASPOFUNGINUM ** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.243,540000 1.243,540000 0,000000108 W63458001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ZENTIVA 70 mgPULB. PT. CONC. PT. SOL. PERF. 70mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1.243,530000 1.243,530000 0,000000109 W63404001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA MYLAN 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONCENTRAT PT. SOL. PERF. PR 1 1.243,530000 1.243,530000 0,000000110 W63506001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA ATB 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA TIP I CU CAPACITATEA DE 10 ML, CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1.243,530000 1.243,530000 0,000000111 W63509001 J02AX04 CASPOFUNGINUM ** DALVOCANS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA DE TIP I, CU CAPACITATEA DE 10 ML CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.184,220000 1.184,220000 0,000000112 W63759001 J02AX04 CASPOFUNGINUM ** CASPOFUNGIN ACCORD 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE 70 MG PULB. PT. CONC. PT. SOL. PERF. PR 1 1.243,530000 1.243,530000 0,000000113 W64792001 J02AX04 CASPOFUNGINUM ** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME OLANDA CUTIE X 1 FLAC. X 70 MG PULB. PTR. CONC. PTR. SOL. PERF. PR 1 1.243,540000 1.243,540000 0,000000114 W62968001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA STADA 50 mg PULB. PT.CONC. PT. SOL. PERF. 50mg STADA M&D SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 969,350000 969,350000 0,000000115 W62969001 J02AX04 CASPOFUNGINUM ** CASPOFUNGINA STADA 70 mg PULB. PT.CONC. PT. SOL. PERF. 70mg STADA M&D SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. PERF. PR 1 1.243,480000 1.243,480000 0,000000116 W61708002 L01XX35ANAGRELIDUM ** THROMBOREDUCTIN 0,5 mg CAPS. 0,5mg AOP ORPHAN PHARMACEUTICALS AG AUSTRIA CUTIE CU 1 FLAC. DIN PE X 100 CAPS. PR 100 9,346800 9,346800 5,870500117 W64277002 L01XX35ANAGRELIDUM ** ANAGRELIDA ZENTIVA 0,5 mg CAPS. 0,5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9,346800 9,346800 0,792300118 W64255001 L01XX35ANAGRELIDUM ** ANAGRELIDA MYLAN 0,5 mg CAPS. 0,5mg MYLAN S.A.S FRANTA FLACON DIN PEID X 100 CAPS. PR 100 7,789000 7,789000 0,000000119 W64221001 L01XX35ANAGRELIDUM ** ANAGRELIDA DR. REDDY'S 0,5 mg CAPS. 0,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9,346800 9,346800 0,460100120 W64241001 L01XX35ANAGRELIDUM ** ANAGRELIDA ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9,346800 9,346800 0,460100121 W64564002 L01XX35ANAGRELIDUM ** GRENALVON 0,5 mg CAPS. 0,5mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9,346800 9,346800 0,460100122 W64656002 L01XX35ANAGRELIDUM ** ANAGRELIDA TEVA 0,5 mg CAPS. 0,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9,346800 9,346800 0,292500123 W64540001 L01XX35ANAGRELIDUM ** ANAGRELIDA TERAPIA 0,5 mg CAPS. 0,5mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9,346800 9,346800 0,460100124 W64672001 L01XX35ANAGRELIDUM ** ANAGRELIDA GLENMARK 0,5 mg CAPS. 0,5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 8,945600 8,945600 0,000000125 W64242001 L01XX35ANAGRELIDUM ** ANAGRELIDA ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 18,208300 18,208300 0,000000126 W64565001 L01XX35ANAGRELIDUM ** GRENALVON 1 mg CAPS. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. PEID X 42 CAPS. PR 42 19,170714 19,170714 0,000000127 W64565002 L01XX35ANAGRELIDUM ** GRENALVON 1 mg CAPS. 1mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 18,208300 18,208300 0,000000128 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 0,000000129 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 0,000000130 W59252003 N02AA01 MORPHYNUM SEVREDOL 10 mg COMPR. FILM. 10mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. PS 60 0,912500 0,912500 0,000000131 W59251003 N02AA01 MORPHYNUM SEVREDOL 20 mg COMPR. FILM. 20mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. PS 60 1,284500 1,284500 0,000000132 W12686002 N02AA01 MORPHYNUM VENDAL (R) RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 2,281333 2,281333 0,000000133 W12682002 N02AA01 MORPHYNUM VENDAL (R) RETARD 30 mg COMPR. FILM. ELIB. PREL. 30mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 0,731333 0,731333 0,000000134 W12684002 N02AA01 MORPHYNUM VENDAL (R) RETARD 60 mg COMPR. FILM. ELIB. PREL. 60mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-TS 30 1,415666 1,415666 0,000000135 W59797001 N02AA01 MORPHYNUM MORFINA ZENTIVA 20 mg/ml SOL. INJ. 20mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML P-TS 5 1,808000 1,808000 0,000000136 W55687009 N02AA05 OXYCODONUM OXIDOLOR 20 mg COMPR. ELIB. PREL. 20mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 1,263166 1,263166 0,000000137 W55688009 N02AA05 OXYCODONUM OXIDOLOR 40 mg COMPR. ELIB. PREL. 40mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 2,046833 2,046833 0,000000138 W59147002 N02AA05 OXYCODONUM OXICODONA SANDOZ 40 mg COMPR. ELIB. PREL. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL. PS 20 2,154500 2,154500 0,000000139 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 5,785000 5,785000 0,000000140 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 3,479666 3,479666 0,000000141 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 3,670000 3,670000 0,000000142 W44121001 N02AA08 DIHYDROCODEINUM DHC CONTINUS 120 mg COMPR. ELIB. PREL. 120mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 2,195714 2,195714 0,000000143 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 0,572500 0,000000144 W44120001 N02AA08 DIHYDROCODEINUM DHC CONTINUS 90 mg COMPR. ELIB. PREL. 90mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS 56 1,270535 1,270535 0,000000145 W42905002 N02AB02 PETHIDINUM MIALGIN (R) 100 mg/2 ml SOL. INJ. 50mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA X 2 ML P-TS 5 2,044000 2,044000 0,000000146 W58214001 N02AB03 FENTANYLUM ** LUNALDIN 100 micrograme COMPR. SUBLING. 100micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 21,290000 21,290000 0,000000147 W58215001 N02AB03 FENTANYLUM ** LUNALDIN 200 micrograme COMPR. SUBLING. 200micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 21,949000 21,949000 0,000000148 W58216001 N02AB03 FENTANYLUM ** LUNALDIN 300 micrograme COMPR. SUBLING. 300micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 23,095000 23,095000 0,000000149 W58217001 N02AB03 FENTANYLUM ** LUNALDIN 400 micrograme COMPR. SUBLING. 400micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 23,095000 23,095000 0,000000

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ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

150 W58218001 N02AB03 FENTANYLUM ** LUNALDIN 600 micrograme COMPR. SUBLING. 600micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 23,095000 23,095000 0,000000151 W58219001 N02AB03 FENTANYLUM ** LUNALDIN 800 micrograme COMPR. SUBLING. 800micrograme GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE PRF 10 23,095000 23,095000 0,000000152 W53503005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 100 mcg/h PLASTURE TRANSDERMIC 100mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 28,056000 28,056000 0,000000153 W53251003 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 100micrograme/h PLASTURE TRANSDERMIC 100micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC PS 5 27,480000 27,480000 0,000000154 W58004002 N02AB03 FENTANYLUM ** ALGOGESIC 100 micrograme/ora PLASTURE TRANSDERMIC 100micrograme/ora ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC PS 5 32,976000 32,976000 8,820000155 W54989004 N02AB03 FENTANYLUM ** DOLFORIN 100 micrograme/ORA PLASTURE TRANSDERMIC 100micrograme/ora GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 PLICURI DIN HÂRTIE/PET/AL/PAN X 1 PLASTURE TRANSDERMIC PS 5 32,976000 32,976000 8,398000156 W54989001 N02AB03 FENTANYLUM ** DOLFORIN 100 µg/ORA PLASTURE TRANSDERMIC 100µg/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 32,976000 32,976000 8,398000157 W53500005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 25 mcg/h PLASTURE TRANSDERMIC 25mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 9,150000 9,150000 0,000000158 W53248003 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 25micrograme/h PLASTURE TRANSDERMIC 25micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC PS 5 8,926000 8,926000 0,000000159 W58001002 N02AB03 FENTANYLUM ** ALGOGESIC 25 micrograme/ora PLASTURE TRANSDERMIC 25micrograme/ora ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC PS 5 10,711200 10,711200 2,300800160 W54985004 N02AB03 FENTANYLUM ** DOLFORIN 25 micrograme/ORA PLASTURE TRANSDERMIC 25micrograme/ora GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 PLICURI DIN HÂRTIE/PET/AL/PAN X 1 PLASTURE TRANSDERMIC PS 5 10,711200 10,711200 4,084800161 W54985001 N02AB03 FENTANYLUM ** DOLFORIN 25 µg/ORA PLASTURE TRANSDERMIC 25µg/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 10,711200 10,711200 4,084800162 W53501005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 50 mcg/h PLASTURE TRANSDERMIC 50mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 15,136000 15,136000 0,000000163 W53249003 N02AB03 FENTANYLUM ** FENTANYL ACTAVIS 50micrograme/h PLASTURE TRANSDERMIC 50micrograme/h ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC PS 5 15,136000 15,136000 0,000000164 W58002002 N02AB03 FENTANYLUM ** ALGOGESIC 50 micrograme/ora PLASTURE TRANSDERMIC 50micrograme/ora ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC PS 5 18,163200 18,163200 6,544800165 W54986004 N02AB03 FENTANYLUM ** DOLFORIN 50 micrograme/ORA PLASTURE TRANSDERMIC 50micrograme/ora GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 PLICURI DIN HÂRTIE/PET/AL/PAN X 1 PLASTURE TRANSDERMIC PS 5 18,163200 18,163200 7,066800166 W54986001 N02AB03 FENTANYLUM ** DOLFORIN 50 µg/ORA PLASTURE TRANSDERMIC 50µg/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 18,163200 18,163200 7,066800167 W53502005 N02AB03 FENTANYLUM ** FENTANYL TTS SANDOZ 75 mcg/h PLASTURE TRANSDERMIC 75mcg/h SANDOZ S.R.L. ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS 5 32,156000 32,156000 0,000000168 W58003002 N02AB03 FENTANYLUM ** ALGOGESIC 75 micrograme/ora PLASTURE TRANSDERMIC 75micrograme/ora ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC PS 5 33,782000 33,782000 0,000000169 W54987004 N02AB03 FENTANYLUM ** DOLFORIN 75 micrograme/ORA PLASTURE TRANSDERMIC 75micrograme/ora GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 PLICURI DIN HÂRTIE/PET/AL/PAN X 1 PLASTURE TRANSDERMIC PS 5 33,440000 33,440000 0,000000170 W54987001 N02AB03 FENTANYLUM ** DOLFORIN 75 µg/ORA PLASTURE TRANSDERMIC 75µg/ora GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC P-TS 5 33,440000 33,440000 0,000000171 W12691002 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,316000 0,316000 0,000000172 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,379200 0,379200 0,112300173 W60291001 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0,379200 0,379200 0,025800174 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,379200 0,379200 0,040800175 W42957001 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,379200 0,379200 0,025300176 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 0,667599 0,667599 0,021067177 W60236002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,663666 0,663666 0,000000178 W61448003 N02AX02 TRAMADOLUM MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,556333 0,556333 0,000000179 W63391001 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 0,667599 0,667599 0,002401180 W63391003 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. ELIB. PREL. 100mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 0,667599 0,667599 0,002401181 W58893002 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,863000 0,863000 0,000000182 W60237002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 0,952666 0,952666 0,000000183 W61449001 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,834000 0,834000 0,000000184 W61449003 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,833666 0,833666 0,000000185 W61449011 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 0,834000 0,834000 0,000000186 W61449013 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 0,833666 0,833666 0,000000187 W63389001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 0,864000 0,864000 0,000000188 W63389002 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PP/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 0,864000 0,864000 0,000000189 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,113000 1,113000 0,000000190 W61450003 N02AX02 TRAMADOLUM MABRON RETARD 200 mg COMPR. ELIB. PREL. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1,076000 1,076000 0,000000191 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 1,000399 1,000399 0,306934192 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1,291200 1,291200 0,435133193 W64091001 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 5 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 5 2,371200 2,371200 0,416800194 W64091002 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 100 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 100 2,371200 2,371200 0,060400195 W64091003 N02AX02 TRAMADOLUM TRAMADOL KALCEKS SOL INJ./PERF. 50mg/ml AS KALCEKS LETONIA CUTIE CU 2 TAVITE DIN PVC CU 10 FIOLE DIN STICLA TRANSPARENTA, CU PUNCT DE RUPERE, A CATE 2 ML SOL. INJ./PERF. PRF 10 2,371200 2,371200 0,418800196 W05961001 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 5 1,976000 1,976000 0,000000197 W05966001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 1,076000 1,076000 0,000000198 W05967001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 2,371200 2,371200 0,490800199 W05969001 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 1,218000 1,218000 0,000000200 W51921003 N07BC02 METHADONUM SINTALGON 2,5 mg COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-TS 50 0,533200 0,533200 0,000000201 W55533002 N07BC02 METHADONUM METADON BIOEEL 5 mg COMPR. 5mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 50 0,343000 0,343000 0,000000202 W60166003 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 CU SIGILIU DIN PE A 1000 ML CONC. PT. SOL. ORAL PS 1 404,950000 404,950000 0,000000203 W60166004 N07BC02 METHADONUM MISYO 10 mg/ml CONC. PT. SOL. ORALA 10mg/ml INN-FARM D.O.O. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII, A 1000 ML CONC. PT. SOL. ORALA PS 1 404,950000 404,950000 0,000000204 W01411002 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,208800 0,208800 0,001866

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205 W01409002 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,208800 0,208800 0,006800206 W01407004 R05DA04 CODEINUM CODEINA FOSFAT LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF 20 0,174000 0,174000 0,000000207 W54406001 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,199500 0,199500 0,000000208 W02408001 V03AC01 DEFEROXAMINUM ** 3) DESFERAL PULB. PT. SOL. INJ./PERF. 500mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF. PR 10 13,722000 13,722000 0,000000209 W51484001 V03AC03 DEFERASIROXUM ** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 28,887500 28,887500 0,000000210 W64440001 V03AC03 DEFERASIROXUM ** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 28,887500 28,887500 0,000000211 W51485001 V03AC03 DEFERASIROXUM ** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 51,852142 51,852142 0,000000212 W64441001 V03AC03 DEFERASIROXUM ** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 28 COMPR. DISP. (BLIST. PVC/PE/PVDC/AL) PR 28 51,852142 51,852142 0,000000213 W51486001 V03AC03 DEFERASIROXUM ** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 100,867500 100,867500 0,000000214 W64442001 V03AC03 DEFERASIROXUM ** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 28 COMPR. DISP. (BLIST. PVC/PE/PVDC/AL) PR 28 100,867500 100,867500 0,000000215 W63463001 V03AC03 DEFERASIROXUM ** EXJADE 180 mg COMPR. FILM. 180mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/ALU X 30 COMPR. FILM. PR 30 51,891000 51,891000 0,000000216 W64443001 V03AC03 DEFERASIROXUM ** EXJADE 180 mg COMPR. FILM. 180mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. PVC/PVDC/ALU X 30 COMPR. FILM. PR 30 51,891000 51,891000 0,000000217 W63464001 V03AC03 DEFERASIROXUM ** EXJADE 360 mg COMPR. FILM. 360mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/ALU X 30 COMPR. FILM. PR 30 101,419666 101,419666 0,000000218 W64444001 V03AC03 DEFERASIROXUM ** EXJADE 360 mg COMPR. FILM. 360mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU BLIST. PVC/PVDC/ALU X 30 COMPR. FILM. PR 30 101,419666 101,419666 0,000000

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

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0424009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 0,00000017 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 0,00000018 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 0,00000019 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 0,02036020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,19000026 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 0,14073327 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 0,00000028 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 0,00000029 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 0,00000030 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 0,15972031 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 0,00000032 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 0,00000033 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 0,00000034 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 0,00000035 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 0,00000036 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

9. EPILEPSIE - G11

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cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

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tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

37 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 0,06902038 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 0,06902039 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 0,11312040 W64666001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PP X 30 COMPR. ELIB. PREL. P-RF 30 0,380880 0,380880 0,11312041 W07649002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,292000 0,292000 0,00000042 W64668001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,292000 0,292000 0,00000043 W08325001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 2,026400 2,026400 0,00000044 W43170001 N03AG01 ACIDUM VALPROICUM + SARURI VALEPIL SIROP 200mg/5ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 100 ML SI O LINGURITA DOZATOARE DUBLA (2,5/5 ML)P-6L 1 17,230000 17,230000 0,00000045 W06972001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 19,410000 19,410000 0,00000046 W06972002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P-6L 1 19,410000 19,410000 0,00000047 W64489001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P6L 1 19,410000 19,410000 0,00000048 W64489002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P6L 1 19,410000 19,410000 0,00000049 W42997002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,927666 0,927666 0,00000050 W03925008 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 1,113199 1,113199 0,13822951 W42996002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1,862000 1,862000 0,00000052 W12304010 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 0,156785 0,156785 0,00000053 W42995002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,523000 0,523000 0,00000054 W09000001 N03AX09 LAMOTRIGINUM ** LAMICTAL 2 mg COMPR. DISP./MAST. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST. P-6L 30 0,009333 0,009333 0,00000055 W03929004 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. DISP./MAST. 5mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST. P-6L 30 0,027333 0,027333 0,00000056 W53160001 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 100 mg COMPR. FILM. 100mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 1,032166 1,032166 0,00000057 W58595007 N03AX11 TOPIRAMATUM ** TOPAMAX 100 mg COMPR. FILM. 100mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 1,238599 1,238599 0,25890158 W59849002 N03AX11 TOPIRAMATUM ** TOPILEX 100 mg COMPR. FILM. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 1,068333 1,068333 0,00000059 W64806001 N03AX11 TOPIRAMATUM ** TOPIRAMAT TEVA 100 mg COMPR. FILM. 100mg TEVA B.V. OLANDA CUTIE CU 6 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. PRF 60 1,032166 1,032166 0,00000060 W53158001 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 25 mg COMPR. FILM. 25mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 0,410833 0,410833 0,00000061 W58597007 N03AX11 TOPIRAMATUM ** TOPAMAX 25 mg COMPR. FILM. 25mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,492399 0,492399 0,10076762 W59847002 N03AX11 TOPIRAMATUM ** TOPILEX 25 mg COMPR. FILM. 25mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,410333 0,410333 0,00000063 W64802001 N03AX11 TOPIRAMATUM ** TOPIRAMAT TEVA 25 mg COMPR. FILM. 25mg TEVA B.V. OLANDA CUTIE CU 6 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. PRF 60 0,410833 0,410833 0,00000064 W53159001 N03AX11 TOPIRAMATUM ** TOPIRAMAT ACTAVIS 50 mg COMPR. FILM. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF 60 0,659333 0,659333 0,00000065 W58596007 N03AX11 TOPIRAMATUM ** TOPAMAX 50 mg COMPR. FILM. 50mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,791199 0,791199 0,03913466 W59848002 N03AX11 TOPIRAMATUM ** TOPILEX 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,680666 0,680666 0,00000067 W64804001 N03AX11 TOPIRAMATUM ** TOPIRAMAT TEVA 50 mg COMPR. FILM. 50mg TEVA B.V. OLANDA CUTIE CU 6 BLIST. AL/PVC-AL-OPA X 10 COMPR. FILM. PRF 60 0,659333 0,659333 0,00000068 W56688004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,157200 0,157200 0,00000069 W64281004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,157200 0,157200 0,00000070 W54332002 N03AX12 GABAPENTINUM ** GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,188640 0,188640 0,41852671 W60025001 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,188640 0,188640 0,24019372 W56689004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,471400 0,471400 0,00000073 W64282004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,471400 0,471400 0,00000074 W41589005 N03AX12 GABAPENTINUM ** GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,547200 0,547200 0,24910075 W42824001 N03AX12 GABAPENTINUM ** GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,547200 0,547200 0,87120076 W43540001 N03AX12 GABAPENTINUM ** GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,456000 0,456000 0,00000077 W54333001 N03AX12 GABAPENTINUM ** GRIMODIN 300 mg CAPS. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,547200 0,547200 0,05896678 W60026001 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,547200 0,547200 0,39796679 W64360001 N03AX12 GABAPENTINUM ** GABALEPT 300 mg CAPS. 300mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,456000 0,456000 0,00000080 W56690004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,629200 0,629200 0,00000081 W64283004 N03AX12 GABAPENTINUM ** GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,629200 0,629200 0,00000082 W41590005 N03AX12 GABAPENTINUM ** GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,729120 0,729120 0,52738083 W42825001 N03AX12 GABAPENTINUM ** GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 0,729120 0,729120 0,86028084 W43541001 N03AX12 GABAPENTINUM ** GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,607600 0,607600 0,00000085 W54334001 N03AX12 GABAPENTINUM ** GRIMODIN 400 mg CAPS. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,729120 0,729120 0,35371386 W60027001 N03AX12 GABAPENTINUM ** GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,729120 0,729120 0,45238087 W64361001 N03AX12 GABAPENTINUM ** GABALEPT 400 mg CAPS. 400mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,607600 0,607600 0,00000088 W42826001 N03AX12 GABAPENTINUM ** GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 2,295666 2,295666 0,00000089 W58650001 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TERAPIA 1000 mg COMPR. FILM. 1000 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMP.FILM. PRF 30 1,959000 1,959000 0,00000090 W57413002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACTAVIS 1000mg COMPR. FILM. 1000mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF 30 1,926000 1,926000 0,00000091 W58295002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. PRF 30 2,311200 2,311200 0,185800

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cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

92 W58649003 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF 30 0,702666 0,702666 0,00000093 W58294002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,843199 0,843199 0,13480194 W58258002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM TORRENT 750 mg COMPR. FILM. 750 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 2,256333 2,256333 0,00000095 W57149002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 1000 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 2,311200 2,311200 1,09080096 W57146002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 250 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 250mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 0,935333 0,935333 0,00000097 W57147002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 500 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 500mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 30 0,843199 0,843199 0,99946798 W57148004 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 750 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 750mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 60 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 60 2,707599 2,707599 0,32256799 W57729001 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACTAVIS GROUP 100mg/ml SOL. ORALA 100 mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLACON DIN STICLA BRUNA A 300ML PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 SERINGA PENTRU ADMINISTRARE ORALA A 10ML PRF 1 64,540000 64,540000 0,000000100 W65074001 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM ACCORD 100 mg/ml SOL. ORALA 100mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA BRUNA, O SERINGA DOZATOARE DE 10 ML CU UN ADAPTOR PT. SERINGA X 300 ML SOL. ORALA PR 1 64,540000 64,540000 0,000000101 W63613001 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 2,705000 2,705000 0,000000102 W63613003 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 2,436607 2,436607 0,000000103 W63613008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 2,705000 2,705000 0,000000104 W63613010 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 2,436607 2,436607 0,000000105 W41745001 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 0,889500 0,889500 0,516214106 W41745002 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 0,889500 0,889500 0,401928107 W62012001 N03AX16 PREGABALINUM ** PREGLENIX 150 mg CAPS. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,857142 0,857142 0,000000108 W62012003 N03AX16 PREGABALINUM ** PREGLENIX 150 mg CAPS. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,829107 0,829107 0,000000109 W62053001 N03AX16 PREGABALINUM ** PREGABALIN ZENTIVA 150 mg CAPS. 150mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,741250 0,741250 0,000000110 W62280006 N03AX16 PREGABALINUM ** PREGAMID 150 mg CAPS. 150mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,835666 0,835666 0,000000111 W62312005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 0,889500 0,889500 0,526666112 W62572001 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 0,889500 0,889500 2,109071113 W62572003 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 0,889500 0,889500 1,777821114 W62572008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,889500 0,889500 2,109071115 W62572011 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 150 mg CAPS. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,889500 0,889500 1,777821116 W62610001 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 0,765714 0,765714 0,000000117 W62610002 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 56 CPAS. PRF 56 0,741250 0,741250 0,000000118 W62880005 N03AX16 PREGABALINUM ** PREGABALINA DR. REDDY'S 150 mg CAPS. 150mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,889500 0,889500 1,777821119 W62901001 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ GMBH 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,741250 0,741250 0,000000120 W63186001 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,767142 0,767142 0,000000121 W63186004 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,742678 0,742678 0,000000122 W63186008 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0,767142 0,767142 0,000000123 W63186011 N03AX16 PREGABALINUM ** SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,742678 0,742678 0,000000124 W64907001 N03AX16 PREGABALINUM ** LYRICA 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0,889500 0,889500 0,516214125 W63615001 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 4,708571 4,708571 0,000000126 W63615003 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 4,385892 4,385892 0,000000127 W63615008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 4,708571 4,708571 0,000000128 W63615010 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 250 mg CAPS. 250mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 4,385892 4,385892 0,000000129 W41747001 N03AX16 PREGABALINUM ** LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 1,922785 1,922785 0,696500130 W62313005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 1,922785 1,922785 0,036215131 W62611001 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 300 mg CAPS. 300mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 1,741428 1,741428 0,000000132 W62883005 N03AX16 PREGABALINUM ** PREGABALINA DR. REDDY'S 300 mg CAPS. 300mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1,922785 1,922785 2,001143133 W63187001 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 1,743571 1,743571 0,000000134 W63187004 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,602321 1,602321 0,000000135 W63187008 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 1,743571 1,743571 0,000000136 W63187011 N03AX16 PREGABALINUM ** SIRANALEN 300 mg CAPS. 300mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1,602321 1,602321 0,000000137 W41743001 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF 14 0,776356 0,776356 0,315072138 W41743002 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF 56 0,776356 0,776356 0,278644139 W62011001 N03AX16 PREGABALINUM ** PREGLENIX 75 mg CAPS. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,760714 0,760714 0,000000140 W62011003 N03AX16 PREGABALINUM ** PREGLENIX 75 mg CAPS. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,736250 0,736250 0,000000141 W62052001 N03AX16 PREGABALINUM ** PREGABALIN ZENTIVA 75 mg CAPS. 75mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,648392 0,648392 0,000000142 W62278006 N03AX16 PREGABALINUM ** PREGAMID 75 mg CAPS. 75mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,776356 0,776356 0,140310143 W62311005 N03AX16 PREGABALINUM ** PREGABALINA AUROBINDO 75 mg CAPS. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 0,776356 0,776356 0,093477144 W62571001 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 CAPS. PRF 14 0,776356 0,776356 1,087215145 W62571003 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 0,776356 0,776356 0,935429146 W62571008 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,776356 0,776356 1,087215

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147 W62571011 N03AX16 PREGABALINUM ** PREGABALINA TERAPIA 75 mg CAPS. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,776356 0,776356 0,935429148 W62609001 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS. PRF 14 0,671428 0,671428 0,000000149 W62609002 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 56 CPAS. PRF 56 0,649464 0,649464 0,000000150 W62878005 N03AX16 PREGABALINUM ** PREGABALINA DR. REDDY'S 75 mg CAPS. 75mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,776356 0,776356 0,905965151 W62900001 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ GMBH 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,646964 0,646964 0,000000152 W63185001 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,671428 0,671428 0,000000153 W63185004 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,649464 0,649464 0,000000154 W63185008 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 14 CAPS. PRF 14 0,671428 0,671428 0,000000155 W63185011 N03AX16 PREGABALINUM ** SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,649464 0,649464 0,000000156 W64906002 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0,776356 0,776356 0,278644157 W64906001 N03AX16 PREGABALINUM ** LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0,776356 0,776356 0,315072158 W64181001 N03AX16 PREGABALINUM ** SIRANALEN 20 mg/ml SOL. ORALA 20mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 FLAC. PEID CONTINAND 473 ML SOL. ORALA, O SERINGA PT. ADMINISTRARE ORALA, UN ADAPTOR DIN PLASTIC ALB CARE SE ATASEAZA LA FLAC. PRIN IMPINGERE PRF 1 143,780000 143,780000 0,000000159 W51468002 N03AX17 STIRIPENTOLUM ** DIACOMIT 250mg CAPS. 250mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 13,365166 13,365166 0,000000160 W58592002 N03AX17 STIRIPENTOLUM ** DIACOMIT 500mg CAPS. 500mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 26,675833 26,675833 0,000000161 W51470002 N03AX17 STIRIPENTOLUM ** DIACOMIT 250mg PULB. PT. SUSP. ORALA 250mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 13,365166 13,365166 0,000000162 W51471002 N03AX17 STIRIPENTOLUM ** DIACOMIT 500mg PULB. PT. SUSP. ORALA 500mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 26,945333 26,945333 0,000000

10. BOALA PARKINSON - G12

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 0,0000002 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 0,0000003 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 0,0000004 W61590003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,435300 1,435300 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 W61591003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,364600 1,364600 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 0,00000017 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 0,00000018 W61592003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF 100 1,389240 1,389240 0,34466019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,25836023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,00000027 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 0,00000028 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 0,00000029 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 0,34874030 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 0,00714031 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 0,00000032 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

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

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tie cant. UT/

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(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

33 W53187006 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 2 mg COMPR. CU ELIB. PREL. 2mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF 28 1,158428 1,158428 0,21514334 W53189003 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 4 mg COMPR. CU ELIB. PREL. 4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF 28 2,240570 2,240570 0,28907235 W53190003 N04BC04 ROPINIROLUM ** REQUIP-MODUTAB 8 mg COMPR. CU ELIB. PREL. 8mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF 28 3,847713 3,847713 0,71657236 W56606002 N04BC04 ROPINIROLUM ** ROLPRYNA EP 2 mg COMPR. CU ELIBERARE PRELUNGITA 2 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF 28 0,965357 0,965357 0,00000037 W56607002 N04BC04 ROPINIROLUM ** ROLPRYNA EP 4 mg COMPR. CU ELIBERARE PRELUNGITA 4 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF 28 1,867142 1,867142 0,00000038 W56608002 N04BC04 ROPINIROLUM ** ROLPRYNA EP 8 mg COMPR. CU ELIBERARE PRELUNGITA 8 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL. PRF 28 3,206428 3,206428 0,00000039 W59634001 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 2 mg COMPR. ELIB. PREL. 2 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 0,965357 0,965357 0,00000040 W58902002 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 2 mg COMPR. ELIB. PREL. 2mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 0,965357 0,965357 0,00000041 W59635001 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 4 mg COMPR. ELIB. PREL. 4 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 1,867142 1,867142 0,00000042 W58903002 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 4 mg COMPR. ELIB. PREL. 4mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 1,867142 1,867142 0,00000043 W59636001 N04BC04 ROPINIROLUM ** ROPINIROL AUROBINDO 8 mg COMPR. ELIB. PREL. 8 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF 28 3,206428 3,206428 0,00000044 W58904002 N04BC04 ROPINIROLUM ** ROPINIROL ACTAVIS 8 mg COMPR. ELIB. PREL. 8mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF 28 3,206428 3,206428 0,00000045 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 0,390799 0,390799 0,01653446 W53525002 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 0,390799 0,390799 0,05853447 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 0,390799 0,390799 0,17586748 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 0,325666 0,325666 0,00000049 W60054001 N04BC05 PRAMIPEXOLUM ** PRAMIPEXOL ZENTIVA 0,7 mg COMPR. 0,7 mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 2,147333 2,147333 0,00000050 W53527002 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 2,033000 2,033000 0,00000051 W54713001 N04BC05 PRAMIPEXOLUM ** MEDOPEXOL 0,7 mg COMPR. 0,7mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,135666 2,135666 0,00000052 W55288001 N04BC05 PRAMIPEXOLUM ** GLEPARK 0,7 mg COMPR. 0,7mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 1,971666 1,971666 0,00000053 W54798001 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 0,26 mg COMPR. ELIB. PREL. 0,26mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 10 0,803599 0,803599 0,72340154 W60244001 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,26mg COMPR. ELIB. PREL. 0,26mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 0,669666 0,669666 0,00000055 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 0,670000 0,670000 0,00000056 W54799002 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 0,52 mg COMPR. ELIB. PREL. 0,52mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 1,769199 1,769199 0,42280157 W60240001 N04BC05 PRAMIPEXOLUM ** OPRYMEA 0,52mg COMPR. ELIB. PREL. 0,52mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 1,474333 1,474333 0,00000058 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 1,474333 1,474333 0,00000059 W54800002 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 1,05 mg COMPR. ELIB. PREL. 1,05mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 2,379999 2,379999 1,79100160 W60241001 N04BC05 PRAMIPEXOLUM ** OPRYMEA 1,05mg COMPR. ELIB. PREL. 1,05mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 1,983333 1,983333 0,00000061 W60243001 N04BC05 PRAMIPEXOLUM ** OPRYMEA 2,10mg COMPR. ELIB. PREL. 2,10mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 3,766333 3,766333 0,00000062 W54801002 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 2,1 mg COMPR. ELIB. PREL. 2,1mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 4,519599 4,519599 3,02973463 W60805002 N04BC05 PRAMIPEXOLUM ** CALMOLAN 2,1 mg COMPR. ELIB. PREL. 2,1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 3,919333 3,919333 0,00000064 W54802002 N04BC05 PRAMIPEXOLUM ** MIRAPEXIN 3,15 mg COMPR. ELIB. PREL. 3,15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P-RF 30 8,180333 8,180333 0,00000065 W62151001 N04BC05 PRAMIPEXOLUM ** OPRYMEA 3,15 mg COMPR. ELIB. PREL. 3,15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF 30 8,180666 8,180666 0,00000066 W61542003 N04BC09 ROTIGOTINUM ** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 8,400357 8,400357 0,00000067 W64036003 N04BC09 ROTIGOTINUM ** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 8,400357 8,400357 0,00000068 W61543003 N04BC09 ROTIGOTINUM ** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 12,040000 12,040000 0,00000069 W64037003 N04BC09 ROTIGOTINUM ** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 12,040000 12,040000 0,00000070 W61544003 N04BC09 ROTIGOTINUM ** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 15,257142 15,257142 0,00000071 W64038003 N04BC09 ROTIGOTINUM ** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 15,257142 15,257142 0,00000072 W61545003 N04BC09 ROTIGOTINUM ** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 18,166428 18,166428 0,00000073 W64039003 N04BC09 ROTIGOTINUM ** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h UCB PHARMA S.A. BELGIA CUTIE X 28 PLASTURI TRANSDERMICI PRF 28 18,166428 18,166428 0,00000074 W08952005 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 BLIST. DIN AL/PVC X 10 COMPR. P-6L 50 0,763800 0,763800 0,00000075 W08952003 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L 100 0,725300 0,725300 0,00000076 W62180001 N04BD02 RASAGILINUM ** RASAGILINA RATIOPHARM 1 mg COMPR. 1mg TEVA B.V. OLANDA CUTIE CU BLIST AL/AL X 30 COMPR. PRF 30 1,865599 1,865599 2,93573477 W62316004 N04BD02 RASAGILINUM ** RALAGO 1 mg COMPR. 1mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1,865599 1,865599 0,84640178 W62398003 N04BD02 RASAGILINUM ** RASAGILINA SANDOZ 1 mg COMPR. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 1,865599 1,865599 2,22406779 W62490012 N04BD02 RASAGILINUM ** RASAGILINA AUROBINDO 1 mg COMPR. 1mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 1,865599 1,865599 1,01373480 W62491006 N04BD02 RASAGILINUM ** RASAGILINA TORRENT 1 mg COMPR. 1mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 1,865599 1,865599 5,67773481 W62556004 N04BD02 RASAGILINUM ** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 1,865599 1,865599 1,12240182 W62556010 N04BD02 RASAGILINUM ** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 1,865599 1,865599 1,12240183 W62918002 N04BD02 RASAGILINUM ** RASAGILINA DR. REDDY'S 1 mg COMPR. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 1,554666 1,554666 0,00000084 W62766004 N04BD02 RASAGILINUM ** HIPERAVIA 1 mg COMPR. 1mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1,818333 1,818333 0,00000085 W62764003 N04BD02 RASAGILINUM ** RASAGILINA ZENTIVA 1 mg COMPR. 1mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. PRF 28 1,865599 1,865599 4,92297286 W62764004 N04BD02 RASAGILINUM ** RASAGILINA ZENTIVA 1 mg COMPR. 1mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1,865599 1,865599 1,13940187 W62982004 N04BD02 RASAGILINUM ** AZILECT 1mg COMPR. 1mg TEVA BV OLANDA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 1,865599 1,865599 3,306401

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ambalaj

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(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

88 W59891001 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 1,873333 1,873333 0,00000089 W59891002 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PRF 60 1,779166 1,779166 0,00000090 W59891003 N04BX02 ENTACAPONUM ** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 100 COMPR. FILM. PRF 100 1,687200 1,687200 0,00000091 W63027003 N04BX02 ENTACAPONUM ** ENTACAPONE TEVA COMPR. FILM. 200mg TEVA B.V. OLANDA CUTIE CU 1 FLAC. DIN PEID X 100 COMPR. FILM PRF 100 1,687200 1,687200 0,00000092 W63177002 N05AH02 CLOZAPINUM ** LEPONEX® 100 mg COMPR. 100mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 1,289800 1,289800 0,00000093 W63176002 N05AH02 CLOZAPINUM ** LEPONEX® 25 mg COMPR. 25mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 0,402400 0,402400 0,000000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

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 0,0300002 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 0,0000003 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 0,0163334 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 0,0260005 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 0,0000006 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 0,0000007 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 0,0000008 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

Tratamentul se initiaza de catre medicul in specialitatea neurologie

12. SCLEROZA MULTIPLA - G14

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0300007 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 0,0000008 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 0,0163339 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 0,00000011 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

Tratamentul se iniţiază de către medicul din specialitatea neurologie.

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 0,1597202 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0690209 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

11. MIASTENIA GRAVIS - G13

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

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Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

11 W64666001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 500 mg COMPR. ELIB. PREL. 500mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PP X 30 COMPR. ELIB. PREL. P-RF 30 0,380880 0,380880 0,11312012 W07649002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,292000 0,292000 0,00000013 W64668001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. GASTROREZ. 200mg SANOFI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L 40 0,292000 0,292000 0,00000014 W08325001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 2,026400 2,026400 0,00000015 W43170001 N03AG01 ACIDUM VALPROICUM + SARURI VALEPIL SIROP 200mg/5ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 100 ML SI O LINGURITA DOZATOARE DUBLA (2,5/5 ML)P-6L 1 17,230000 17,230000 0,00000016 W06972001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L 1 19,410000 19,410000 0,00000017 W06972002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P-6L 1 19,410000 19,410000 0,00000018 W64489001 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P6L 1 19,410000 19,410000 0,00000019 W64489002 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE SIROP 57,64mg/ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P6L 1 19,410000 19,410000 0,00000020 W42997002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,927666 0,927666 0,00000021 W03925008 N03AX09 LAMOTRIGINUM ** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 1,113199 1,113199 0,13822922 W42996002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 1,862000 1,862000 0,00000023 W12304010 N03AX09 LAMOTRIGINUM ** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 0,156785 0,156785 0,00000024 W42995002 N03AX09 LAMOTRIGINUM ** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,523000 0,523000 0,00000025 W09000001 N03AX09 LAMOTRIGINUM ** LAMICTAL 2 mg COMPR. DISP./MAST. 2mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST. P-6L 30 0,009333 0,009333 0,00000026 W03929004 N03AX09 LAMOTRIGINUM ** LAMICTAL 5 mg COMPR. DISP./MAST. 5mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST. P-6L 30 0,027333 0,027333 0,00000027 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 0,00000028 W52419001 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,176500 0,176500 0,00000029 W60383001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 0,281000 0,281000 0,00000030 W60384001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF 30 0,393000 0,393000 0,00000031 W56620001 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF 1 5,690000 5,690000 0,00000032 W61980001 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg/ml PIC. ORALE, SOL. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CARE CONTINE 10 ML PICATURI ORALE, SOL., PREVAZUT CU PICURATOR DIN PEJD PRF 1 6,828000 6,828000 0,40200033 W03427002 N05AD01 HALOPERIDOLUM HALOPERIDOL - RICHTER 2mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 FLAC. PICURATOR DIN STICLA BRUNA X 10 ML PICATURI ORALE, SOLUTIE P-RF 1 6,828000 6,828000 0,43200034 W61141001 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 50 mg/ml SOL. INJ. 50mg/ml GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF 5 8,902000 8,902000 0,00000035 W54845001 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/ml SOL. INJ. 5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 5 2,324000 2,324000 0,00000036 W44015001 N05AE03 SERTINDOL ** SERDOLECT 16 mg COMPR. FILM. 16mg H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 15,446071 15,446071 0,00000037 W44017001 N05AE03 SERTINDOL ** SERDOLECT 4 mg COMPR. FILM. 4mg H. LUNDBECK A/S DANEMARCA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 3,880666 3,880666 0,00000038 W59272007 N05AE04 ZIPRASIDONUM ** ZYPSILA 40 mg CAPS. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 60 2,935833 2,935833 0,00000039 W59273007 N05AE04 ZIPRASIDONUM ** ZYPSILA 60 mg CAPS. 60mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 60 4,436166 4,436166 0,00000040 W59274007 N05AE04 ZIPRASIDONUM ** ZYPSILA 80 mg CAPS. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 60 4,238500 4,238500 0,00000041 W03207001 N05AF01 FLUPENTIXOLUM ** FLUANXOL DEPOT SOL. INJ. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.P-RF 10 7,364000 7,364000 0,00000042 W12437003 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. DIN PEJD X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDER P-RF 50 0,377600 0,377600 0,00000043 W10638002 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL 20 mg/ml PIC. ORALE-SOL. 20mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 1 FLAC. + CAPAC SECURIZAT PT. COPII X 20 ML P-RF 1 30,830000 30,830000 0,00000044 W12431001 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL (R) DEPOT SOL. INJ. 200mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE X 1 ML P-RF 10 13,118000 13,118000 0,00000045 W13182005 N05AF05 ZUCLOPENTHIXOLUM ** CLOPIXOL ACUPHASE (R) SOL. INJ. 50mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 5 FIOLE X 1 ML P-RF 5 9,538000 9,538000 0,00000046 W63177002 N05AH02 CLOZAPINUM ** LEPONEX® 100 mg COMPR. 100mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 1,289800 1,289800 0,00000047 W63176002 N05AH02 CLOZAPINUM ** LEPONEX® 25 mg COMPR. 25mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 5 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. PRF 50 0,402400 0,402400 0,00000048 W52357003 N05AH03 OLANZAPINUM ** ZALASTA 10mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL) P-RF 28 0,706800 0,706800 0,00034249 W52354002 N05AH03 OLANZAPINUM ** ZALASTA 5mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL) P-RF 28 0,463928 0,463928 0,00000050 W08727002 N05AH03 OLANZAPINUM ** ZYPREXA 10 mg COMPR. FILM. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 0,706800 0,706800 6,47962851 W55022004 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,706800 0,706800 2,54284252 W55022005 N05AH03 OLANZAPINUM ** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,706800 0,706800 2,54120053 W55124004 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,589000 0,589000 0,00000054 W55883002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. FILM. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,706800 0,706800 0,00034255 W62411002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. FILM. 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,706800 0,706800 0,00034256 W64075002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. FILM. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,706800 0,706800 0,00034257 W55023004 N05AH03 OLANZAPINUM ** LAPOZAN 15 mg COMPR. FILM. 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 3,053570 3,053570 4,64821558 W08557001 N05AH03 OLANZAPINUM ** ZYPREXA 5 mg COMPR. FILM. 5mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF 28 0,470142 0,470142 3,31914359 W55021004 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 0,470142 0,470142 0,89092960 W55021005 N05AH03 OLANZAPINUM ** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,470142 0,470142 0,89085861 W55122004 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 0,392000 0,392000 0,00000062 W55882002 N05AH03 OLANZAPINUM ** BLOONIS 5 mg COMPR. FILM. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,467857 0,467857 0,00000063 W62412002 N05AH03 OLANZAPINUM ** BLOONIS 5 mg COMPR. FILM. 5mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,467857 0,467857 0,00000064 W64076002 N05AH03 OLANZAPINUM ** BLOONIS 5 mg COMPR. FILM. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 0,467857 0,467857 0,00000065 W54601004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,700000 0,700000 0,000000

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cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

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tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

66 W55884002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. ORODISPERSABILE 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,589285 0,589285 0,00000067 W56989003 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 10 mg COMPR. ORODISPERSABILE 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,706800 0,706800 2,68391468 W60951004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 10 mg COMPR. ORODISPERSABILE 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0,706800 0,706800 0,00034269 W62413002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. ORODISPERSABILE 10mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,589285 0,589285 0,00000070 W64077002 N05AH03 OLANZAPINUM ** BLOONIS 10 mg COMPR. ORODISPERSABILE 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,589285 0,589285 0,00000071 W54602004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,544642 2,544642 0,00000072 W55885002 N05AH03 OLANZAPINUM ** BLOONIS 15 mg COMPR. ORODISPERSABILE 15mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,570357 2,570357 0,00000073 W56902001 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 15 mg COMPR. ORODISPERSABILE 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,564642 2,564642 0,00000074 W60952004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 2,570357 2,570357 0,00000075 W62414002 N05AH03 OLANZAPINUM ** BLOONIS 15 mg COMPR. ORODISPERSABILE 15mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,570357 2,570357 0,00000076 W64078002 N05AH03 OLANZAPINUM ** BLOONIS 15 mg COMPR. ORODISPERSABILE 15mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,570357 2,570357 0,00000077 W54603004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 20 mg COMPR. ORODISPERSABILE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,882500 2,882500 0,00000078 W55886002 N05AH03 OLANZAPINUM ** BLOONIS 20 mg COMPR. ORODISPERSABILE 20mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,911785 2,911785 0,00000079 W56903001 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 20 mg COMPR. ORODISPERSABILE 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,445357 2,445357 0,00000080 W56991003 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 20 mg COMPR. ORODISPERSABILE 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,934428 2,934428 3,39485781 W60953004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 20 mg COMPR. ORODISPERSABILE 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 2,896071 2,896071 0,00000082 W62415002 N05AH03 OLANZAPINUM ** BLOONIS 20 mg COMPR. ORODISPERSABILE 20mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,911785 2,911785 0,00000083 W64079002 N05AH03 OLANZAPINUM ** BLOONIS 20 mg COMPR. ORODISPERSABILE 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 2,911785 2,911785 0,00000084 W54599004 N05AH03 OLANZAPINUM ** OLANZAPINA TERAPIA 5 mg COMPR. ORODISPERSABILE 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,465714 0,465714 0,00000085 W56900001 N05AH03 OLANZAPINUM ** OLANZAPINA ACTAVIS 5 mg COMPR. ORODISPERSABILE 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 0,391785 0,391785 0,00000086 W60950004 N05AH03 OLANZAPINUM ** OLANZAPINA AUROBINDO 5 mg COMPR. ORODISPERSABILE 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PEÎD//AL-PE X 28 COMPR. ORODISPERSABILE PRF 28 0,463928 0,463928 0,00000087 W56988003 N05AH03 OLANZAPINUM ** OLANZAPINA TORRENT 7,5 mg COMPR. ORODISPERSABILE 7,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 3,490357 3,490357 0,00000088 W53870001 N05AH03 OLANZAPINUM ** ZYPADHERA 210mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 210mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 210MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 646,270000 646,270000 0,00000089 W53871001 N05AH03 OLANZAPINUM ** ZYPADHERA 300mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 300mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 300MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 911,250000 911,250000 0,00000090 W53872001 N05AH03 OLANZAPINUM ** ZYPADHERA 405mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 405mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 405MG PULB. + 1 FLAC. X 3ML SOLVENT P-RF/R 1 1.221,790000 1.221,790000 0,00000091 W08559001 N05AH03 OLANZAPINUM ** ZYPREXA 10 mg PULB. PT. SOL. INJ. 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. X 10 MG PULB.PT.SOL.INJ. P-RF 1 21,820000 21,820000 0,00000092 W63007005 N05AH04 QUETIAPINUM ** NETIAPIN 150 mg COMPR. CU ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1,058000 1,058000 0,00000093 W58021004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 200 mg COMPR. CU ELIB. PREL. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,753999 0,753999 0,15983494 W63010005 N05AH04 QUETIAPINUM ** NETIAPIN 200 mg COMPR. CU ELIB. PREL. 200mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 0,753999 0,753999 0,53366795 W63282004 N05AH04 QUETIAPINUM ** UNIQUET 200 mg COMPR. CU ELIB. PREL. 200mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 0,734833 0,734833 0,00000096 W58022004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 300 mg COMPR. CU ELIB. PREL. 300mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,303500 1,303500 0,00000097 W63013005 N05AH04 QUETIAPINUM ** NETIAPIN 300 mg COMPR. CU ELIB. PREL. 300mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1,564200 1,564200 0,17296698 W63284004 N05AH04 QUETIAPINUM ** UNIQUET 300 mg COMPR. CU ELIB. PREL. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 1,532000 1,532000 0,00000099 W58023004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 400 mg COMPR. CU ELIB. PREL. 400mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. PREL. PRF 60 2,272166 2,272166 0,000000100 W63016005 N05AH04 QUETIAPINUM ** NETIAPIN 400 mg COMPR. CU ELIB. PREL. 400mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 2,075166 2,075166 0,000000101 W63286004 N05AH04 QUETIAPINUM ** UNIQUET 400 mg COMPR. CU ELIB. PREL. 400mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 2,490199 2,490199 0,010634102 W63004005 N05AH04 QUETIAPINUM ** NETIAPIN 50 mg COMPR. CU ELIB. PREL. 50mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 0,444399 0,444399 0,046934103 W63280009 N05AH04 QUETIAPINUM ** UNIQUET 50 mg COMPR. CU ELIB. PREL. 50mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ELIB. PREL. PRF 60 0,444399 0,444399 0,097934104 W63280004 N05AH04 QUETIAPINUM ** UNIQUET 50 mg COMPR. CU ELIB. PREL. 50mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 0,444399 0,444399 0,097934105 W55378001 N05AH04 QUETIAPINUM ** SEROQUEL XR 150 mg COMPR. ELIB. PREL. 150mg ASTRAZENECA UK LIMITED MAREA BRITANIE CUTIE CU 6 BLIST. PVC-PCTFE/AL X 10 COMPR. ELIB. PREL. P-RF 60 1,269600 1,269600 1,974733106 W59533007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 150 mg COMPR. ELIB. PREL. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,242833 1,242833 0,000000107 W61500004 N05AH04 QUETIAPINUM ** KVENTIAX EP 150 mg COMPR. ELIB. PREL. 150mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ELIB. PREL. PRF 60 1,269600 1,269600 0,098900108 W63039004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1,269600 1,269600 0,232900109 W63631004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 150 mg COMPR. ELIB. PREL. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 1,075666 1,075666 0,000000110 W58674007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 200 mg COMPR. ELIB. PREL. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,723166 0,723166 0,000000111 W61501004 N05AH04 QUETIAPINUM ** KVENTIAX EP 200 mg COMPR. ELIB. PREL. 200mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ELIB. PREL. PRF 60 0,753999 0,753999 1,070501112 W63040004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 200 mg COMPR. ELIB. PREL. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 0,628333 0,628333 0,000000113 W58675007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 300 mg COMPR. ELIB. PREL. 300mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 1,507666 1,507666 0,000000114 W61502004 N05AH04 QUETIAPINUM ** KVENTIAX EP 300 mg COMPR. ELIB. PREL. 300mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ELIB. PREL. PRF 60 1,564200 1,564200 1,030966115 W63041004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 300 mg COMPR. ELIB. PREL. 300mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 1,310166 1,310166 0,000000116 W58676007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 400 mg COMPR. ELIB. PREL. 400mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 2,160166 2,160166 0,000000117 W63042004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 2,490199 2,490199 0,075634118 W58673007 N05AH04 QUETIAPINUM ** QUETIAPINA TEVA 50 mg COMPR. ELIB. PREL. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,444399 0,444399 0,087434119 W61991007 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 50 mg COMPR. ELIB. PREL. 50mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. PRF 60 0,370333 0,370333 0,000000120 W62718004 N05AH04 QUETIAPINUM ** KVENTIAX EP 50 mg COMPR. ELIB. PREL. 50mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ELIB. PREL. PRF 60 0,444399 0,444399 0,036601

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121 W63038004 N05AH04 QUETIAPINUM ** QUETIAPINA ZENTIVA 50 mg COMPR. ELIB. PREL. 50mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PCTFE/AL X 60 COMPR. ELIB. PREL. PRF 60 0,444399 0,444399 0,019434122 W56922003 N05AH04 QUETIAPINUM ** Q MIND 100 mg COMPR. FILM. 100mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 0,890000 0,890000 0,000000123 W56924003 N05AH04 QUETIAPINUM ** Q MIND 200 mg COMPR. FILM. 200mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,491500 1,491500 0,000000124 W56925003 N05AH04 QUETIAPINUM ** Q MIND 300 mg COMPR. FILM. 300mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,839500 1,839500 0,000000125 W52894001 N05AH04 QUETIAPINUM ** SEROQUEL XR 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE DIN AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 0,444399 0,444399 0,286434126 W05759001 N05AL01 SULPIRIDUM EGLONYL (R) 50 mg CAPS. 50mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. X 15 CAPS. P-RF 30 0,286000 0,286000 0,000000127 W05759002 N05AL01 SULPIRIDUM EGLONYL 50 mg CAPS. 50mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE CU 1 BLIST. PVC/AL X 30 CAPS. PRF 30 0,286000 0,286000 0,000000128 W63528001 N05AL01 SULPIRIDUM EGLONYL 50 mg CAPS. 50mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. PRF 30 0,286000 0,286000 0,000000129 W63528002 N05AL01 SULPIRIDUM EGLONYL 50 mg CAPS. 50mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 30 CAPS. PRF 30 0,286000 0,286000 0,000000130 W63529001 N05AL01 SULPIRIDUM EGLONYL 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 12 COMPR. PRF 12 0,728333 0,728333 0,000000131 W55404001 N05AL05 AMISULPRIDUM ** AMISULPRIDA LPH 200 mg COMPR. 200mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 30 1,603000 1,603000 0,000000132 W55435001 N05AL05 AMISULPRIDUM ** MIDORA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 1,603000 1,603000 0,000000133 W63222003 N05AL05 AMISULPRIDUM ** AMISULPRIDA AUROBINDO 200 mg COMPR. 200mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF 30 1,586666 1,586666 0,000000134 W64420001 N05AL05 AMISULPRIDUM ** SOLIAN 200 mg COMPR. 200mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 1,903999 1,903999 0,450667135 W62189001 N05AL05 AMISULPRIDUM ** AKTIPROL 400 mg COMPR. 400mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 2,329666 2,329666 0,000000136 W62189004 N05AL05 AMISULPRIDUM ** AKTIPROL 400 mg COMPR. 400mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 2,329666 2,329666 0,000000137 W00321001 N05AL05 AMISULPRIDUM ** SOLIAN 200 mg COMPR. DIVIZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 1,903999 1,903999 0,450667138 W07071001 N05AL05 AMISULPRIDUM ** SOLIAN 400 mg COMPR. FILM. 400mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 2,795599 2,795599 0,702401139 W61038001 N05AL05 AMISULPRIDUM ** MIDORA 400 mg COMPR. FILM. 400mg TERAPIA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 2,513666 2,513666 0,000000140 W64419001 N05AL05 AMISULPRIDUM ** SOLIAN 400 mg COMPR. FILM. 400mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 2,795599 2,795599 0,702401141 W44037003 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,231666 0,231666 0,000000142 W56212003 N05AX08 RISPERIDONUM ** RISPEN 1 COMPR. FILM. 1mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,277999 0,277999 0,100801143 W58413001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 1 mg COMPR. FILM. 1mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,277999 0,277999 0,126501144 W56213003 N05AX08 RISPERIDONUM ** RISPEN 2 COMPR. FILM. 2 mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,325400 0,325400 0,000000145 W43840003 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 2 mg COMPR. FILM. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,273000 0,273000 0,000000146 W58414001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 2 mg COMPR. FILM. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,327600 0,327600 0,555900147 W43830002 N05AX08 RISPERIDONUM ** TORENDO 3 mg COMPR. FILM. 3mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,539199 0,539199 0,719801148 W43842003 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 3 mg COMPR. FILM. 3mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,449333 0,449333 0,000000149 W56214003 N05AX08 RISPERIDONUM ** RISPEN 3 COMPR. FILM. 3mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,534600 0,534600 0,000000150 W58415001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 3 mg COMPR. FILM. 3mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,539199 0,539199 0,892301151 W56215003 N05AX08 RISPERIDONUM ** RISPEN 4 COMPR. FILM. 4 mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 0,325400 0,325400 0,000000152 W43831002 N05AX08 RISPERIDONUM ** TORENDO 4 mg COMPR. FILM. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 0,327600 0,327600 1,403066153 W43845003 N05AX08 RISPERIDONUM ** RISPERIDONE TEVA 4 mg COMPR. FILM. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 0,273000 0,273000 0,000000154 W57800001 N05AX08 RISPERIDONUM ** RISPERIDONA MEDOCHEMIE 4 mg COMPR. FILM. 4mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. PRF 20 0,327600 0,327600 1,358900155 W58416001 N05AX08 RISPERIDONUM ** RISPERIDONA ARENA 4 mg COMPR. FILM. 4mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF 20 0,327600 0,327600 1,489400156 W43835001 N05AX08 RISPERIDONUM ** TORENDO Q-TAB 1 mg COMPR. ORODISPERSABILE 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 0,277999 0,277999 0,155001157 W43838001 N05AX08 RISPERIDONUM ** TORENDO Q-TAB 2 mg COMPR. ORODISPERSABILE 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 0,327600 0,327600 0,592733158 W13666002 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 25mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 392,850000 392,850000 0,000000159 W13667002 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 37,5 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 37,5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 532,870000 532,870000 0,000000160 W13833002 N05AX08 RISPERIDONUM ** RISPOLEPT CONSTA 50 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE S/P-RF 1 618,470000 618,470000 0,000000161 W08728003 N05AX08 RISPERIDONUM ** RISPOLEPT SOL. ORALA 1mg/ml JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 30 ML SOL. ORALA + 1 PIPETA P-RF 1 13,940000 13,940000 0,000000162 W41602002 N05AX12 ARIPIPRAZOLUM ** ABILIFY 10mg COMPR. 10mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR. P-RF 28 2,040399 2,040399 3,577101163 W61492003 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 10mg COMPR. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,040399 2,040399 1,638601164 W61843003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL GLENMARK 10 mg COMPR. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLSIT. OPA-AL-PVC/AL X 28 COMPR. PRF 28 2,040399 2,040399 1,896386165 W61847007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1,700333 1,700333 0,000000166 W61920003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 2,040399 2,040399 1,216601167 W61973001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL SANDOZ 10 mg COMPR. 10mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. ALU/ALU X 28 COMPR. PRF 28 2,040399 2,040399 1,467458168 W62212001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR. PRF 28 2,040399 2,040399 0,588172169 W62245006 N05AX12 ARIPIPRAZOLUM ** ARICOGAN 10 mg COMPR. 10mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,040399 2,040399 0,824267170 W62048001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 10 mg COMPR. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. PRF 28 2,040399 2,040399 1,256743171 W62250002 N05AX12 ARIPIPRAZOLUM ** ZYKALOR 10 mg COMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,040399 2,040399 0,978934172 W62259003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL STADA 10 mg COMPR. 10mg STADA M&D SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. PRF 28 2,040399 2,040399 4,768172173 W62123003 N05AX12 ARIPIPRAZOLUM ** LEMILVO 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,040399 2,040399 3,293601174 W41603004 N05AX12 ARIPIPRAZOLUM ** ABILIFY 15mg COMPR. 15mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 56 (X1) COMPR. P-RF 56 2,049428 2,049428 2,820036175 W61493003 N05AX12 ARIPIPRAZOLUM ** ARYZALERA 15mg COMPR. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,049428 2,049428 3,372238

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176 W61844003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL GLENMARK 15 mg COMPR. 15mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLSIT. OPA-AL-PVC/AL X 28 COMPR. PRF 28 2,049428 2,049428 0,363786177 W61848007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 15 mg COMPR. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,049333 2,049333 0,000000178 W61921003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL AUROBINDO 15 mg COMPR. 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 2,049428 2,049428 1,349238179 W61974001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL SANDOZ 15 mg COMPR. 15mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. ALU/ALU X 28 COMPR. PRF 28 1,723928 1,723928 0,000000180 W62213002 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 15 mg COMPR. 15mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR. PRF 28 1,710357 1,710357 0,000000181 W62251002 N05AX12 ARIPIPRAZOLUM ** ZYKALOR 15 mg COMPR. 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,049428 2,049428 2,259905182 W62260003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL STADA 15 mg COMPR. 15mg STADA M&D SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. PRF 28 1,707857 1,707857 0,000000183 W62049001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 15 mg COMPR. 15mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. PRF 28 1,713214 1,713214 0,000000184 W62246006 N05AX12 ARIPIPRAZOLUM ** ARICOGAN 15 mg COMPR. 15mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 1,742000 1,742000 0,000000185 W62124003 N05AX12 ARIPIPRAZOLUM ** LEMILVO 15 mg COMPR. 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 2,049428 2,049428 0,752238186 W61849007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 20 mg COMPR. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 12,261666 12,261666 0,000000187 W61850007 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TEVA 30 mg COMPR. 30mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 12,261333 12,261333 0,000000188 W61718002 N05AX12 ARIPIPRAZOLUM ** ASTORET 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE PRF 28 2,040399 2,040399 1,309601189 W62050001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 10 mg COMPR. ORODISPERSABILE 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. ORODISPERSABILE PRF 28 2,040399 2,040399 1,256743190 W62131003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TORRENT 10 mg COMPR. ORODISPERSABILE 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE PRF 28 2,040399 2,040399 4,778886191 W62030003 N05AX12 ARIPIPRAZOLUM ** LEMILVO 10 mg COMPR. ORODISPERSABILE 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE ORODISPERSABILE PRF 30 2,040399 2,040399 4,295601192 W61719002 N05AX12 ARIPIPRAZOLUM ** ASTORET 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE PRF 28 2,049428 2,049428 1,468072193 W62051001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ZENTIVA 15 mg COMPR. ORODISPERSABILE 15mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. ORODISPERSABILE PRF 28 2,049428 2,049428 0,006286194 W62132003 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOL TORRENT 15 mg COMPR. ORODISPERSABILE 15mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE PRF 28 2,049428 2,049428 5,274857195 W62031003 N05AX12 ARIPIPRAZOLUM ** LEMILVO 15 mg COMPR. ORODISPERSABILE 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE ORODISPERSABILE PRF 30 2,049428 2,049428 3,088572196 W60305001 N05AX12 ARIPIPRAZOLUM ** ABILIFY MAINTENA 400mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 400mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE CU UN FL.X 400 MG PULB., UN FL. DE 2 ML CU SOLV., O SERINGA LUER-LOCK DE 3 ML CU AC HIPODERMIC SECURIZAT, O SERINGA JETABILA DE 3 ML CU VÂRF LUER-LOCK, UN ADAPTOR PENTRU FLACON, UN AC HIPODERMIC SECURIZAT SI UN AC HIPODERMIC SECURIZAT PT OBEZI PRF 1 1.021,710000 1.021,710000 0,000000197 W52520001 N05AX12 ARIPIPRAZOLUM ** ABILIFY 7,5mg/ml SOL. INJ. 7,5mg/ml OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1FLAC. X 1,3ML SOL.INJ P-RF 1 16,640000 16,640000 0,000000198 W52519002 N05AX12 ARIPIPRAZOLUM ** ABILIFY 1mg/ml SOL. ORALA 1mg/ml OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1 FLACON PET CU SISTEM DE INCHIDERE DIN PROPILENA SECURIZAT PENTRU COPII X 150ML + 1 MASURA DOZATOARE + 1 PICURATOR CALIBRAT DIN PROPILENA-POLIETILENA DE JOASA DENSITAT P-RF 1 123,100000 123,100000 0,000000199 W52104002 N05AX13 PALIPERIDONUM ** INVEGA 3mg COMPR. ELIB. PREL. 3mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL) P-RF 30 10,277199 10,277199 5,782134200 W65237002 N05AX13 PALIPERIDONUM ** PARNIDO 3 mg COMPR. ELIB. PREL. 3mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINAND 30 COMPRIMATE CU ELIBERARE PRELUNGITA PRF 30 8,564333 8,564333 0,000000201 W52105002 N05AX13 PALIPERIDONUM ** INVEGA 6mg COMPR. ELIB. PREL. 6mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIEX 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL) P-RF 30 10,892400 10,892400 5,874933202 W65238002 N05AX13 PALIPERIDONUM ** PARNIDO 6 mg COMPR. ELIB. PREL. 6mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINAND 30 COMPRIMATE CU ELIBERARE PRELUNGITA PRF 30 9,077000 9,077000 0,000000203 W52106002 N05AX13 PALIPERIDONUM ** INVEGA 9mg COMPR. ELIB. PREL. 9mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL) P-RF 30 14,704399 14,704399 3,441601204 W65239002 N05AX13 PALIPERIDONUM ** PARNIDO 9 mg COMPR. ELIB. PREL. 9mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONTINAND 30 COMPRIMATE CU ELIBERARE PRELUNGITA PRF 30 12,253666 12,253666 0,000000205 W57259001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 100mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1.390,760000 1.390,760000 0,000000206 W57260001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 150mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 2.050,730000 2.050,730000 0,000000207 W62903001 N05AX13 PALIPERIDONUM ** TREVICTA 175 mg SUSP. INJ. CU ELIB. PREL. 175mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 2.371,070000 2.371,070000 0,000000208 W62904001 N05AX13 PALIPERIDONUM ** TREVICTA 263 mg SUSP. INJ. CU ELIB. PREL. 263mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 3.046,750000 3.046,750000 0,000000209 W62905001 N05AX13 PALIPERIDONUM ** TREVICTA 350 mg SUSP. INJ. CU ELIB. PREL. 350mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 3.733,880000 3.733,880000 0,000000210 W57257001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 837,580000 837,580000 0,000000211 W62906001 N05AX13 PALIPERIDONUM ** TREVICTA 525 mg SUSP. INJ. CU ELIB. PREL. 525mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PRF 1 5.565,230000 5.565,230000 0,000000212 W57258001 N05AX13 PALIPERIDONUM ** XEPLION SUSP. INJ. CU ELIB. PREL. 75mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1.143,180000 1.143,180000 0,000000213 W43706001 N06AB04 CITALOPRAMUM ** LINISAN 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 1,440333 1,440333 0,000000214 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 0,615428 0,615428 0,204905215 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 0,649285 0,000000216 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 0,615428 0,615428 0,716000217 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 0,615428 0,615428 0,278857218 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 0,615428 0,615428 0,033905219 W55813002 N06AB10 ESCITALOPRAMUM ** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 0,615428 0,615428 0,206000220 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 0,552142 0,000000221 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 0,552500 0,000000222 W60685003 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF 28 0,523928 0,523928 0,000000223 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 0,615428 0,615428 0,196572224 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 0,512857 0,000000225 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 0,615428 0,615428 0,190286226 W59846001 N06AB10 ESCITALOPRAMUM ** ESCITALOPRAM TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 1,014285 1,014285 0,000000227 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 1,217142 1,217142 0,035000228 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 1,244000 1,244000 0,000000229 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 1,152833 0,000000230 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 1,152833 0,000000

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(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

231 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 1,244000 1,244000 0,000000232 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 0,679000 0,679000 0,000000233 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 0,679000 0,679000 0,000000234 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 0,485000 0,000000235 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 0,468888 0,000000236 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 0,485000 0,000000237 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 0,485000 0,000000238 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 0,562665 0,562665 0,182668239 W56742002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,700800 0,700800 1,220985240 W58756003 N06AX16 VENLAFAXINUM ** ELIFY EP 150 mg CAPS. ELIB. PREL. 150 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF 30 0,700800 0,700800 0,350533241 W64861002 N06AX16 VENLAFAXINUM ** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,700800 0,700800 1,220985242 W52122001 N06AX16 VENLAFAXINUM ** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,700800 0,700800 0,677414243 W52962005 N06AX16 VENLAFAXINUM ** ALVENTA 150mg CAPS. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,584000 0,584000 0,000000244 W54057002 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,700800 0,700800 0,200985245 W55396001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,700800 0,700800 0,677533246 W61609006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 150 mg CAPS. ELIB. PREL. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,700800 0,700800 0,002866247 W53268003 N06AX16 VENLAFAXINUM ** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,628000 0,628000 0,000000248 W55395001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,753600 0,753600 0,122066249 W56741002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,411600 0,411600 0,695185250 W58755003 N06AX16 VENLAFAXINUM ** ELIFY EP 75 mg CAPS. ELIB. PREL. 75 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 0,411600 0,411600 0,239066251 W64860002 N06AX16 VENLAFAXINUM ** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,411600 0,411600 0,695185252 W52123001 N06AX16 VENLAFAXINUM ** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 0,411600 0,411600 0,520542253 W52961005 N06AX16 VENLAFAXINUM ** ALVENTA 75 mg CAPS. ELIB. PREL. 75mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF 30 0,343000 0,343000 0,000000254 W53269003 N06AX16 VENLAFAXINUM ** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,411600 0,411600 0,286400255 W54056002 N06AX16 VENLAFAXINUM ** VENLAFAXINA ACTAVIS 75 mg CAPS. ELIB. PREL. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,411600 0,411600 0,280185256 W55397001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,411600 0,411600 0,514400257 W61608006 N06AX16 VENLAFAXINUM ** VENLAFAXINA AUROBINDO 75 mg CAPS. ELIB. PREL. 75mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,411600 0,411600 0,001400258 W55398001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 37,5 mg COMPR. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,753600 0,753600 0,122066259 W55399001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,892000 0,892000 0,000000260 W55400001 N06AX16 VENLAFAXINUM ** VENLAFAXINA ARENA 75 mg COMPR. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,411600 0,411600 0,514400261 W52959001 N06AX16 VENLAFAXINUM ** ARGOFAN 150 SR COMPR. ELIB. PREL. 150mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,700666 0,700666 0,000000262 W52958001 N06AX16 VENLAFAXINUM ** ARGOFAN 75 SR COMPR. ELIB. PREL. 75mg ZENTIVA A.S. SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-RF 30 0,411600 0,411600 0,000400263 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 1,252713 1,252713 0,526929264 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 1,094000 1,094000 0,000000265 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 1,221785 1,221785 0,000000266 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 1,221785 1,221785 0,000000267 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 1,252713 1,252713 0,089429268 W62305004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 30 mgCAPS. GASTROREZ. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,200000 1,200000 0,000000269 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 1,242500 1,242500 0,000000270 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 1,104333 1,104333 0,000000271 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 1,252713 1,252713 0,720501272 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 1,043928 1,043928 0,000000273 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 1,157142 1,157142 0,000000274 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 1,157142 1,157142 0,000000275 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 1,252500 1,252500 0,000000276 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 2,332142 2,332142 0,000000277 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 1,263856 1,263856 1,446144278 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 1,180000 0,000000279 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 1,243571 0,000000280 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 1,243571 0,000000281 W62007001 N06AX21 DULOXETINUM ** DULOXETINA DR. REDDY'S 60 mg CAPS. GASTROREZ. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ. PRF 28 1,263856 1,263856 1,337215282 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 1,207142 0,000000283 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 1,053214 0,000000284 W62306004 N06AX21 DULOXETINUM ** DULOXETINA AUROBINDO 60 mgCAPS. GASTROREZ. 60mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 30 CAPS. GASTROREZ. PRF 30 1,263856 1,263856 0,976477285 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 1,108000 0,000000

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Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

286 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 1,263856 1,263856 0,531810287 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 1,263856 1,263856 0,531810288 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 1,082500 0,000000289 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 1,263856 1,263856 0,035429290 W41829001 N06BA09 ATOMOXETINUM ** STRATTERA 10 mg CAPS. 10mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 13,640000 13,640000 0,000000291 W41830001 N06BA09 ATOMOXETINUM ** STRATTERA 18 mg CAPS. 18mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 7 14,210000 14,210000 0,000000292 W41831003 N06BA09 ATOMOXETINUM ** STRATTERA 25 mg CAPS. 25mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 13,262500 13,262500 0,000000293 W41832003 N06BA09 ATOMOXETINUM ** STRATTERA 40 mg CAPS. 40mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 13,262500 13,262500 0,000000294 W41833003 N06BA09 ATOMOXETINUM ** STRATTERA 60 mg CAPS. 60mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC-PE-PCTFE/AL X 7 CAPS. P-RF 28 13,262500 13,262500 0,000000295 W53076003 N06BA09 ATOMOXETINUM ** STRATTERA 80 mg CAPS. 80mg ELI LILLY AND COMPANY LTD. MAREA BRITANIE CUTIE X 4 BLIST. PCTFE-PE-PVC/AL X 7 CAPS. P-RF 28 16,623571 16,623571 0,000000296 W62268001 N06BA09 ATOMOXETINUM ** STRATTERA 4 mg/ml SOL. ORALA 4mg/ml ELI LILLY HOLDINGS LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA DE CULOARE BRUNA CU 100 ML SOL. ORALA+1 DISPOZITIV CARE CONTINE O SERINGA PT. ADMINISTRARE ORALA DE 10 ML GRADATA PT. FIECARE MILILITRU SI UN ADAPTOR PT. STICLA DIN PEJD PRF 1 213,250000 213,250000 0,000000

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

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,9080006 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 0,7953727 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 0,7951438 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 0,7222389 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 0,68567211 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 0,59423812 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 0,00771413 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 0,17890514 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 0,17890515 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 0,00000016 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 0,58200017 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 0,50057218 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 0,50092919 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 0,50073820 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 0,42159221 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 0,42167222 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 0,00000023 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 2,56300024 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 0,00000025 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 3,71585726 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 3,71585727 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 0,13485728 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 1,77700029 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 0,71628630 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 0,21789331 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 0,00000032 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 0,00000033 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 0,61875134 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 0,00000035 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 0,10410836 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 0,20400037 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 0,00000038 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

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

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39 W54542001 N06DA03 RIVASTIGMINUM ** NIMVASTID 6mg COMPR. ORODISPERSABILE 6mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 2,333571 2,333571 0,00000040 W59938005 N06DA03 RIVASTIGMINUM ** EXELON 13,3mg/24h PLASTURE TRANSDERMIC 13,3/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 10,123000 10,123000 0,00000041 W64475005 N06DA03 RIVASTIGMINUM ** EXELON 13,3 mg/24h PLASTURE TRANSDERMIC 13,3mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 10,123000 10,123000 0,00000042 W52347002 N06DA03 RIVASTIGMINUM ** EXELON 4,6mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 3,668400 3,668400 0,84226643 W60439002 N06DA03 RIVASTIGMINUM ** EVERTAS 4,6 mg/24 h PLASTURE TRANSDERMIC 4,6mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 3,057000 3,057000 0,00000044 W64473002 N06DA03 RIVASTIGMINUM ** EXELON 4,6 mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 3,668400 3,668400 0,84226645 W52348002 N06DA03 RIVASTIGMINUM ** EXELON 9,5mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 5,066799 5,066799 0,91386746 W60440002 N06DA03 RIVASTIGMINUM ** EVERTAS 9,5 mg/24 h PLASTURE TRANSDERMIC 9,5mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 4,222333 4,222333 0,00000047 W64474002 N06DA03 RIVASTIGMINUM ** EXELON 9,5 mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 5,066799 5,066799 0,91386748 W55333001 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA TEVA 2 mg/ml SOL. ORALA 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPACIT. 125ML X 120ML SOLUTIE ORALA, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII, CU O SERINGA DOZATOARE GRADATA DIN PP SI UN ADAPTOR DIN PE P-RF 1 317,240000 317,240000 0,00000049 W62196002 N06DA03 RIVASTIGMINUM ** RIVASTIGMINA SANDOZ 2mg/ml SOL. ORALA 2mg/ml SANDOZ GMBH AUSTRIA CUTIE CU FLAC. DIN STICLA BRUNA A 120 ML SOL.ORALA + SERINGA DOZATOARE PR 1 264,390000 264,390000 0,00000050 W57106004 N06DA04 GALANTAMINUM ** GALSYA 16 mg CAPS. ELIB. PREL. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,912000 1,912000 0,00000051 W57106013 N06DA04 GALANTAMINUM ** GALSYA 16 mg CAPS. ELIB. PREL. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,912000 1,912000 0,00000052 W57107004 N06DA04 GALANTAMINUM ** GALSYA 24 mg CAPS. ELIB. PREL. 24mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,912000 1,912000 0,00000053 W57107013 N06DA04 GALANTAMINUM ** GALSYA 24 mg CAPS. ELIB. PREL. 24mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,912000 1,912000 0,00000054 W57105004 N06DA04 GALANTAMINUM ** GALSYA 8 mg CAPS. ELIB. PREL. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,912000 1,912000 0,00000055 W57105013 N06DA04 GALANTAMINUM ** GALSYA 8 mg CAPS. ELIB. PREL. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,912000 1,912000 0,00000056 W41503001 N06DA04 GALANTAMINUM ** REMINYL (R) 4 mg/ml SOL. ORALA 4mg/ml JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 1 FLACON X 100 ML + 1 PIPETA DOZATOARE P-RF 1 126,970000 126,970000 0,00000057 W12136004 N06DX01 MEMANTINUM ** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R 56 0,595713 0,595713 1,53857258 W59688005 N06DX01 MEMANTINUM ** MEMANTINA TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. PR 56 0,595713 0,595713 0,09982259 W59817001 N06DX01 MEMANTINUM ** NEMDATINE 10mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 0,595713 0,595713 0,08678760 W59977004 N06DX01 MEMANTINUM ** MEMANTINA DR. REDDY'S 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,595713 0,595713 0,00553761 W60024003 N06DX01 MEMANTINUM ** MIRVEDOL 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,595713 0,595713 0,08946562 W60163004 N06DX01 MEMANTINUM ** MEMANTINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,571250 0,571250 0,00000063 W60183005 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,595713 0,595713 0,08267964 W60183015 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR 56 0,595713 0,595713 0,08267965 W60192007 N06DX01 MEMANTINUM ** MEMANTINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,595713 0,595713 0,09517966 W60251001 N06DX01 MEMANTINUM ** MARIXINO 10mg COMPR. FILM. 10mg CONSILIENT HEALTH LTD. IRLANDA CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE PR 56 0,595713 0,595713 0,05714467 W60436007 N06DX01 MEMANTINUM ** COGNOMEM 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,595713 0,595713 0,12589468 W60672010 N06DX01 MEMANTINUM ** MEMANTINA LANNACHER HEILMITTEL 10 mg COMPR. FILM. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 70 COMPR. FILM. PR 70 0,595713 0,595713 0,06614469 W61445005 N06DX01 MEMANTINUM ** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 0,595713 0,595713 0,12446570 W61445014 N06DX01 MEMANTINUM ** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 0,595713 0,595713 0,12446571 W61802002 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 0,496428 0,496428 0,00000072 W64525001 N06DX01 MEMANTINUM ** MARIXINO 10mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE PR 56 0,595713 0,595713 0,05714473 W59689005 N06DX01 MEMANTINUM ** MEMANTINA TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. PR 56 1,884428 1,884428 0,24128674 W59818001 N06DX01 MEMANTINUM ** NEMDATINE 20mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 1,635000 1,635000 0,00000075 W60184001 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PR 28 1,714285 1,714285 0,00000076 W60184009 N06DX01 MEMANTINUM ** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. PR 28 1,714285 1,714285 0,00000077 W60193002 N06DX01 MEMANTINUM ** MEMANTINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR 28 1,570357 1,570357 0,00000078 W60437007 N06DX01 MEMANTINUM ** COGNOMEM 20 mg COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 1,731785 1,731785 0,00000079 W61446005 N06DX01 MEMANTINUM ** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 1,884428 1,884428 0,28950080 W61446014 N06DX01 MEMANTINUM ** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 1,884428 1,884428 0,28950081 W61803002 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 1,570357 1,570357 0,00000082 W56770002 N06DX01 MEMANTINUM ** EBIXA 5mg/doza PICATURI ORALE - SOL. 5mg/doza H LUNDBECK A/S DANEMARCA CUTIE X 1 FLACON DIN STICLA BRUNA CU POMPA DOZATOARE X 50 ML SOLUTIE P-RF/R 1 122,136000 122,136000 26,36400083 W60646004 N06DX01 MEMANTINUM ** MEMANTINA TEVA 10 mg/ml SOL. ORALA 10 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA + SERINGA DOZATOARE A 50 ML SOL. ORALA PR 1 101,780000 101,780000 0,00000084 W60122002 N06DX01 MEMANTINUM ** MEMANTINA TORRENT 10 mg/ml SOL. ORALA 10mg/ml TORRENT PHARMA SRL ROMANIA CUTIE CU 1 FLAC. A 100 ML SOL. SOL. ORALA SI O POMPA DOZATOARE PR 1 193,030000 193,030000 0,000000

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

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 0,0000002 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 0,0000003 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

15. COLAGENOZE MAJORE (LUPUS ERITEMATOS SISTEMIC, SCLERODERMIE, POLI/DERMATOMIOZITA, VASCULITE SISTEMICE) - G 17

Pagina 25 din 39

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Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

4 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 0,0000005 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 0,0000006 W57242001 L04AA26 BELIMUMABUM **1 BENLYSTA PULB. PT. CONC. PT. SOL. PERF. 120 mg GLAXO GROUP LIMITED MAREA BRITANIE CUTIE CU 1 FL. DIN STICLA A 5ML X 120MG S 1 722,430000 722,430000 0,0000007 W57243001 L04AA26 BELIMUMABUM **1 BENLYSTA PULB. PT.CONC. PT.SOL. PERF. 400mg GLAXO GROUP LIMITED MAREA BRITANIE CUTIE CU 1 FL. DIN STICLA A 20ML X 400MG S 1 2.242,990000 2.242,990000 0,0000008 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 0,0000009 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 0,553166 0,000000

10 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 0,553166 0,000000

Tratamentul se iniţiază şi se monitorizează de către medicul în specialitatea reumatologie, nefrologie, boli infecţioase, pediatrie sau medicină internă.

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 W62233002 L01BA01 METHOTREXATUM NAMAXIR 10 mg SOL INJ. IN SERINGA PREUMPLUTA 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. PR 4 35,647500 35,647500 0,0000008 W63589007 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 2,25 ML, CARE CONTINE 1,5 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA PR 1 50,619000 50,619000 32,4610009 W63589010 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 2,25 ML, CARE CONTINE 2 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA PR 1 67,488000 67,488000 65,012000

10 W63589001 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 1 ML, CARE CONTINE 0,75 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA PR 1 33,720000 33,720000 30,80000011 W63589004 L01BA01 METHOTREXATUM METORTHRIT 10 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 10mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. DIN PVC/AL CU O SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU CAPACITATEA DE 1 ML, CARE CONTINE 1 ML SOL. INJ. SI UN AC STERIL PENTRU INJECTIE, PENTRU ADMINISTRARE SUBCUTANATA PR 1 42,777000 42,777000 5,93300012 W62235002 L01BA01 METHOTREXATUM NAMAXIR 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. PR 4 42,182500 42,182500 0,00000013 W62237002 L01BA01 METHOTREXATUM NAMAXIR 20 mg SOL INJ. IN SERINGA PREUMPLUTA 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,50 ML SOL. INJ. PR 4 56,240000 56,240000 0,00000014 W62239002 L01BA01 METHOTREXATUM NAMAXIR 25 mg SOL INJ. IN SERINGA PREUMPLUTA 25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. PR 4 70,310000 70,310000 0,00000015 W62232002 L01BA01 METHOTREXATUM NAMAXIR 7,5 mg SOL INJ. IN SERINGA PREUMPLUTA 7,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. PR 4 28,100000 28,100000 0,00000016 W58316007 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 50,619000 50,619000 33,31100017 W58316010 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 67,488000 67,488000 66,37200018 W58316001 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ PR 1 33,720000 33,720000 31,44000019 W58316004 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 42,777000 42,777000 6,44300020 W55460001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE WINTHROP 10mgCOMPR. FILM. 10mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 2,000666 2,000666 0,00000021 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 0,00000022 W55461001 L04AA13 LEFLUNOMIDUM ** LEFLUNOMIDE WINTHROP 20mgCOMPR. FILM. 20mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 3,390399 3,390399 0,40993423 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 0,40993424 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 0,00000025 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 0,00000026 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 0,00000027 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 0,00000028 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 0,00000029 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 0,00000030 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 0,00000031 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 0,00000032 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 0,00000033 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 0,37906634 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 0,00000035 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 0,00000036 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 0,00000037 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 0,00000038 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 0,00000039 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 0,00000040 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 0,00000041 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 0,00000042 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. POLIARTRITA REUMATOIDĂ, ARTROPATIA PSORIAZICĂ, PSORIAZIS CRONIC SEVER ŞI ARTRITA JUVENILĂ - G 18

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Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

43 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 0,00000044 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 0,00000045 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 0,00000046 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 0,00000047 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 0,00000048 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 0,553166 0,00000049 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 0,553166 0,000000

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,3790667 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 0,00000017 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 0,00000018 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 0,00000019 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 0,00000020 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

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 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

18. BOLI ENDOCRINE (GUŞĂ ENDEMICĂ, INSUFICIENŢĂ SUPRARENALĂ CRONICĂ, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARĂ, TUMORI NEUROENDOCRINE ŞI OSTEOPOROZĂ SEVERĂ) - G 22

17. SPONDILITA ANKILOZANTA - G 19

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

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

Pagina 27 din 39

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cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

13 W42956002 H01CB02 OCTREOTIDUM **1 SANDOSTATIN LAR 30 mg PULB.+SOLV. PT. SOL. INJ. 30mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC PR 1 2.715,000000 2.715,000000 0,00000014 W59079001 H01CB02 OCTREOTIDUM **1 SANDOSTATIN 0,1 mg/ml SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.PR 5 9,298000 9,298000 0,00000015 W58561001 H01CB03 LANREOTIDUM **1 SOMATULINE® PR 30 mg LIOF. PT. SOL. INJ. + SOLV. 30mg IPSEN PHARMA FRANTA CUTIE X 1 FLACON LIOF. + 1 FIOLA X 2 ML SOLV. + 1 SERINGA X 3 ML + 2 ACE S 1 1.674,330000 1.674,330000 0,00000016 W58628001 H01CB03 LANREOTIDUM **1 SOMATULINE AUTOGEL 120 mg SOL. INJ. IN SERINGA PREUMPLUTA 120mg IPSEN PHARMA FRANTA CUTIE CU 1 SERINGA PREUMPLUTA PE TEREFTALAT/AL/PE LAMINATA X 0,5 ML PREVAZUTA CU SIST. DE SIGURANTA AUTOMAT SI 1 AC DIN OTEL (1,2MMX20MM), TEACA DIN PLASTIC PT. AC (PEID) SI 1 OPRITOR PT. PISTON (BROMOBUTIL CAUCIUC) PR 1 4.905,410000 4.905,410000 0,00000017 W62193001 H01CB05 PASIREOTIDUM ** SIGNIFOR 20 mg PULB+SOLV. PT. SUSP. INJ. 20mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE 1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA PRF 1 11.353,760000 11.353,760000 0,00000018 W64454001 H01CB05 PASIREOTIDUM ** SIGNIFOR 20 mg PULB+SOLV. PT. SUSP. INJ. 20mg NOVARTIS EUROPHARM LTD. IRLANDA 1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA PRF 1 11.353,760000 11.353,760000 0,00000019 W62194001 H01CB05 PASIREOTIDUM ** SIGNIFOR 40 mg PULB+SOLV. PT. SUSP. INJ. 40mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE 1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA PRF 1 11.680,230000 11.680,230000 0,00000020 W64455001 H01CB05 PASIREOTIDUM ** SIGNIFOR 40 mg PULB+SOLV. PT. SUSP. INJ. 40mg NOVARTIS EUROPHARM LTD. IRLANDA 1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA PRF 1 11.680,230000 11.680,230000 0,00000021 W62195001 H01CB05 PASIREOTIDUM ** SIGNIFOR 60 mg PULB+SOLV. PT. SUSP. INJ. 60mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE 1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA PRF 1 12.182,390000 12.182,390000 0,00000022 W64456001 H01CB05 PASIREOTIDUM ** SIGNIFOR 60 mg PULB+SOLV. PT. SUSP. INJ. 60mg NOVARTIS EUROPHARM LTD. IRLANDA 1 FLAC. (DIN STICLA) DE CULOARE MARONIE, CU PULB. PT. SUSP. INJ. SI O SERINGA (DIN STICLA) PREUMPUTA, CU SOLVENT+1 ADAPTOR PT. FLAC. SI UN AC DE PROIECTAT PT. INJECTARE IN SIGURANTA PRF 1 12.182,390000 12.182,390000 0,00000023 W58524003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,3 mg SOL INJ. 0,3mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,3 MG PR 30 218,609666 218,609666 0,00000024 W64451003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,3 mg SOL INJ. 0,3mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,3 MG PR 30 218,609666 218,609666 0,00000025 W58526003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,6 mg SOL INJ. 0,6mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,6 MG PR 30 256,770666 256,770666 0,00000026 W64452003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,6 mg SOL INJ. 0,6mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,6 MG PR 30 256,770666 256,770666 0,00000027 W58527003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,9 mg SOL INJ. 0,9mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,9 MG PR 30 256,770666 256,770666 0,00000028 W64453003 H01CB05 PASIREOTIDUM ** SIGNIFOR 0,9 mg SOL INJ. 0,9mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,9 MG PR 30 256,770666 256,770666 0,00000029 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 0,424600 0,00000030 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 0,03000031 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 0,00000032 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 0,01633333 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 0,02600034 W44080001 H02AB09 HYDROCORTISONUM HYDROCORTISONE SUCCINAT SODIC LIOF. + SOLV. PT. SOL. INJ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 4,130000 4,130000 0,00000035 W58639001 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV. PR/PRF 1 12,530000 12,530000 0,00000036 W58638001 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 4,956000 4,956000 2,50400037 W51922003 H02AB09 HYDROCORTISONUM HIDROCORTIZON ZENTIVA 19.6mg/5ml SOL. INJ. 19,6mg/5ml ZENTIVA S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 1 ML SOL. A + 5 FIOLE DIN STICLA BRUNA CU CAPACITATEA DE 5ML (CU INEL DE RUPERE SAU PUNCT DE RUPERE) X 4 ML SOL. B S/P-RF 5 4,660000 4,660000 0,00000038 W57399003 H03AA01 LEVOTHYROXINUM EUTHYROX 100µg COMPR. 100µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,127900 0,127900 0,00000039 W57396003 H03AA01 LEVOTHYROXINUM EUTHYROX 25µg COMPR. 25µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,090400 0,090400 0,00000040 W57398002 H03AA01 LEVOTHYROXINUM EUTHYROX 50µg COMPR. 50µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 0,090400 0,090400 0,00000041 W61162002 H03AA01 LEVOTHYROXINUM ACCU-THYROX 100 micrograme/5 ml SOL. ORALA 100micrograme/5ml GALENICA S.A. GRECIA CUTIE CU 2 FLAC. DIN STICLA BRUNA CONTINAND 75 ML SOL. ORALA SI 1 SERINGA DOZATOARE DE 5 ML GRADATA LA 0,1 ML SI 1 ADAPTOR PT. FLACON SAU O LINGURITA DUBLA DIN PLASTIC DE 2,5/5 ML P6L 2 20,650000 20,650000 0,00000042 W61160002 H03AA01 LEVOTHYROXINUM ACCU-THYROX 25 micrograme/5 ml SOL. ORALA 25micrograme/5ml GALENICA S.A. GRECIA CUTIE CU 2 FLAC. DIN STICLA BRUNA CONTINAND 75 ML SOL. ORALA SI 1 SERINGA DOZATOARE DE 5 ML GRADATA LA 0,1 ML SI 1 ADAPTOR PT. FLACON SAU O LINGURITA DUBLA DIN PLASTIC DE 2,5/5 ML P6L 2 18,915000 18,915000 0,00000043 W61161002 H03AA01 LEVOTHYROXINUM ACCU-THYROX 50 micrograme/5 ml SOL. ORALA 50micrograme/5ml GALENICA S.A. GRECIA CUTIE CU 2 FLAC. DIN STICLA BRUNA CONTINAND 75 ML SOL. ORALA SI 1 SERINGA DOZATOARE DE 5 ML GRADATA LA 0,1 ML SI 1 ADAPTOR PT. FLACON SAU O LINGURITA DUBLA DIN PLASTIC DE 2,5/5 ML P6L 2 18,915000 18,915000 0,00000044 W03843004 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 0,134100 0,134100 0,00000045 W55488001 H05AA02 TERIPARATIDUM ** FORSTEO 20µg/80µl SOL. INJ. 20µg/80µl ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 ΜCG/80ΜCL) P-RF 1 1.519,630000 1.519,630000 0,00000046 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

Tratamentul se iniţiază de către medicul în specialitatea endocrinologie sau oncologie.

Pagina 28 din 39

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Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

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 0,0000002 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 0,0000003 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 0,0000004 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 299,0580005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 0,00000017 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 0,00000018 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 0,00000019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,00000027 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 0,00000028 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 0,00000029 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 0,00000030 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 0,00000031 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 0,00000032 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 0,00000033 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 0,00000034 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 0,00000035 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 0,00000036 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 0,00000037 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 0,00000038 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 0,00000039 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 0,00000040 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 0,00000041 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 0,00000042 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 0,00000043 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 0,00000044 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 0,00000045 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 0,00000046 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

19. BOALA WILSON - G23

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

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Contributie maxima a asiguratului / UT (pt. asiguratii care

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din pretul de referinta)

47 W54081003 C09CA04 IRBESARTANUM ** IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,466285 0,466285 0,35907248 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 0,466285 0,466285 0,10014349 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 0,466285 0,466285 0,12978650 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 0,466285 0,466285 0,73942951 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 0,466285 0,466285 0,16335752 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 0,652285 0,652285 0,20342953 W54082003 C09CA04 IRBESARTANUM ** IRBESARTAN TERAPIA 300 mg COMPR. FILM. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L 28 0,652285 0,652285 0,48021554 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 0,652285 0,652285 0,20342955 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 0,652285 0,652285 0,28057256 W60638002 C09CA04 IRBESARTANUM ** APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 0,652285 0,652285 0,94842957 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 0,03000058 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 0,00000059 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 0,01633360 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 0,02600061 W63199002 H05BX02 PARICALCITOLUM ** ZEMPLAR 1 microgram CAPS. MOI 1micrograme ABBVIE SPAIN S.L.U. SPANIA CUTIE CU 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI PRF 28 9,247500 9,247500 0,00000062 W60920002 H05BX02 PARICALCITOLUM ** ZEMPLAR 1µg CAPS. MOI 1µg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI P-RF 28 9,247500 9,247500 0,00000063 W60961001 H05BX02 PARICALCITOLUM ** ZEMPLAR SOL. INJ. 5 µg/ml ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 49,714000 49,714000 0,00000064 W63198001 H05BX02 PARICALCITOLUM ** ZEMPLAR 5 micrograme/ml SOL. INJ. 5micrograme/ml ABBVIE SPAIN S.L.U. SPANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA TIP I X 1 ML SOL. INJ.PR 5 49,714000 49,714000 0,00000065 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 0,00000066 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 0,00000067 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 0,00000068 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 0,00000069 W12240001 V06DDN1 COMBINATII (AMINOACIZI) ** KETOSTERIL COMPR. FILM. FARA CONCENTRATIE FRESENIUS KABI DEUTSCHLAND GMBH GERMANIA CUTIE X 5 BLIST. DIN PVC/AL X 20 COMPR. FILM. P-RF 100 2,393000 2,393000 0,000000

Tratamentul se initiaza de catre medicul in specialitatea nefrologie.

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 0,0000002 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 0,0000003 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 5,1700004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 0,00000017 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 0,00000018 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 0,00000019 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 11,02800020 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 0,00000021 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 4,43400022 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 1,41600023 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 1,39600024 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 0,00000025 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 0,00000026 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

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Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

27 W64597001 S01ED51 COMBINATII (TRAVOPROSTUM+TIMOLOLUM) DUOTRAV 40 micrograme/ml + 5mg/ml PIC. OFT.-SOL. 40µg/ml + 5mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE PRF 1 62,480000 62,480000 0,00000028 W59365001 S01EE01 LATANOPROSTUM SIFITAN 50 micrograme/ml PIC. OFT., SOL 50micrograme/ml NTC S.R.L. ITALIA CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 26,490000 26,490000 0,00000029 W56354001 S01EE01 LATANOPROSTUM ARULATAN 50 micrograme/ml PIC. OFT., SOL. 50micrograme/ml DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE CU 1 FLAC. PEJD CU DOP PICURATOR PEID X 2,5 ML PIC. OFT., SOL. P-6L 1 26,490000 26,490000 0,00000030 W59511003 S01EE01 LATANOPROSTUM MONOPOST 50 micrograme/ml PIC. OFT., SOL., IN RECIPIENT UNIDOZA 50micrograme/ml LABORATOIRES THEA FRANTA CUTIE CU 30 (6X5) RECIPIENTE UNIDOZA DIN PEID AMBALATE CATE 5 IN 6 PLICURI LAMINATE DIN PE-AL-COPOLIMER A CATE 0,2 MILILITRI PIC. OFT., SOL.P6L 30 1,665666 1,665666 0,00000031 W57240001 S01EE01 LATANOPROSTUM GLAUTAN 0,05 mg/ml PIC. OFT.,SOL. 0,05mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE CU 1 FLAC. PEJD CU CAPACITATEA DE 5 ML+PICURATOR DIN PEJD, CU CAPAC DE SIGURANTA DIN PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 26,490000 26,490000 0,00000032 W03937002 S01EE01 LATANOPROSTUM XALATAN (R) PICATURI OFT.-SOL. 50mcg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PICURATOR PE X 2,5 ML P-6L 1 27,470000 27,470000 0,00000033 W60652003 S01EE03 BIMATOPROSTUM BIMAGAN 0,3 mg/ml PIC. OFT., SOL 0,3 mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLACON ALB DIN PEJD CU PICURATOR DIN PEJD SI CAPAC CU INEL DE SIGURANTA DIN PEID X 3ML PICATURI OFTALMICE , SOLUTIE PRF 1 45,060000 45,060000 0,00000034 W61822003 S01EE03 BIMATOPROSTUM BIMAGAN 0,1 mg/ml PIC. OFT., SOL. 0,1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN FLACON DIN PEJD CU PICURATOR DIN PEJD SI CAPAC VERDE- ALBASTRUI DIN PEÎD A 3 ML PICATURI OFTALMICE, SOLUTIE PRF 1 50,820000 50,820000 2,86000035 W55458001 S01EE03 BIMATOPROSTUM LUMIGAN 0,1mg/ml PIC. OFT.,SOL. 0,1mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFT. SOL. P-RF 1 42,350000 42,350000 0,00000036 W60939001 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30mcg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 4ML PICATURI OFTALMICE, SOLUTIEPRF 1 74,630000 74,630000 0,00000037 W63545001 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30micrograme/ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 FLACON A 4ML X 2,5 ML DE TRAVOPROST, PICATURI OFTALMICE, SOLUTIE PRF 1 74,630000 74,630000 0,00000038 W64506001 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30micrograme/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 FLAC. A 4 ML X 2,5 ML DE TRAVOPROST, PICATURI OFTALMICE, SOLUTIE PRF 1 74,630000 74,630000 0,00000039 W61049001 S01EE04 TRAVOPROSTUM BONDULC 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. TRANSLUCID DIN PP CU CAPACITATEA DE 5 ML, PREVAZUT CU DOP PICURATOR TRANSPARENT DIN PEJD SI CAPAC DIN PEID A 2,5 ML PIC. OFT., SOL. P6L 1 32,830000 32,830000 0,00000040 W61045001 S01EE04 TRAVOPROSTUM TRAVOPROST ZENTIVA 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. TRANSLUCID DIN PP CU CAPACITATEA DE 5 ML, CU PICURATOR TRANSPARENT DIN PEJD A 2 ,5 ML PIC. OFT. SOL. P6L 1 38,230000 38,230000 0,000000

Tratamentul se iniţiază de către medicul în specialitatea oftalmologie.

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 0,0000002 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 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 0,00000017 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 0,03000018 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 0,00000019 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 0,01633320 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 0,02600021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,00000027 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

Tratamentul se iniţiază de către medicul în specialitatea dermatologie.

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 0,0000002 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

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Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

3 W64524002 A16AX06 MIGLUSTATUM **1 MIGLUSTAT ACCORD 100 mg CAPS. 100mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PE-PCTFE/AL X 84X1 PR 84 220,073928 220,073928 0,0000004 W63456001 A16AX10 ELIGLUSTAT **1 CERDELGA 84 mg CAPS. 84mg GENZYME EUROPE B.V., OLANDA CUTIE CU BLIST. DIN PETG/COC.PETG/PCTFE-ALUMINIU X 56 CAPS. PR 56 1.706,775000 1.706,775000 0,000000

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 0,0000002 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 0,0000003 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 0,0000004 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 0,1573005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,04228016 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 0,00000017 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 0,00000018 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 0,00000019 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 0,54400020 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 0,01400021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,06020025 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 0,00000026 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 0,85733427 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 0,85733428 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 0,00000029 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 0,00000030 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 0,00000031 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 0,00000032 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 4,91200033 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 0,00000034 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 1,46866635 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 1,74866636 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 1,74866637 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 1,22866638 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 1,74866639 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 0,68866640 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 4,91200041 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 0,00000042 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 0,00000043 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 0,00000044 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 0,00000045 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 0,00000046 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

După precizarea diagnosticului de către laboratoarele de specialitate, tratamentul se iniţiază de către medicul din specialitatea gastroenterologie, hematologie, neurologie, neurologie pediatrică şi pediatrie.

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

Pagina 32 din 39

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47 W64358002 J01FA10 AZITHROMYCINUM SUMAMED FORTE 200 mg/5 ml PULB. PT. SUSP. ORALA 200mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. DIN PEID CONTINAND PULB. PT. 30 ML SUSP. ORALA, O SERINGA PT. ADMINISTRARE ORALA DIN PE/PS SAU PP/PP SI O LINGURITA DOZATOARE PRF 1 33,300000 33,300000 0,00000048 W54037001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4,077000 4,077000 0,00000049 W54037002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 3,585000 3,585000 0,00000050 W44077004 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,621600 0,621600 0,09840051 W01273001 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,621600 0,621600 0,12240052 W01288001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,621600 0,621600 0,09840053 W01271002 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,621600 0,621600 0,12440054 W07862001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,621600 0,621600 0,13540055 W54038001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,621600 0,621600 0,09640056 W54038002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,621600 0,621600 0,05040057 W62110003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,518000 0,518000 0,00000058 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 0,909600 0,909600 0,33740059 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 0,909600 0,909600 0,05940060 W01289001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,909600 0,909600 0,48340061 W01272001 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,909600 0,909600 0,53440062 W07863001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 0,909600 0,909600 0,04840063 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,909600 0,909600 0,53440064 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 0,909600 0,909600 0,09840065 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 0,897500 0,897500 0,00000066 W62111003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,758000 0,758000 0,00000067 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 1,083000 1,083000 0,00000068 W54040001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,299600 1,299600 2,77740069 W57948001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 13,088571 13,088571 0,00000070 W63880001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 13,088571 13,088571 0,00000071 W57949001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 0,909600 0,909600 9,05040072 W63879001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 0,909600 0,909600 9,05040073 W01275002 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 2,984600 2,984600 0,00000074 W01275001 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-RF 5 3,581520 3,581520 0,07648075 W60268001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF. 100mg/10ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA PREVAZUTE CU INEL DE RUPERE X 10 ML PR 5 3,581520 3,581520 0,088480

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 511,8480012 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 0,0000003 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 0,0000004 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 277,8680015 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 0,0000006 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,5060007 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,5060008 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 0,0000009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 W64708001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA 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 PR 2 1.965,264000 1.965,264000 86,71100015 W59945002 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg/0,8ml ABBVIE LTD. MAREA BRITANIE 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 PR 2 1.965,264000 1.965,264000 86,711000

IMUNOSUPRESOARE SELECTIVE - G3125. BOALA CRONICA INFLAMATORIE INTESTINALA - G31a

Tratamentul se iniţiază de către medicul în specialitatea gastro-enterologie şi medicină internă.

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DET. APP AMBALAJ Pres

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tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

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cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

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tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

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 0,0000002 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 0,0000003 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 0,0000004 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 681,9680005 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 681,9680006 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 127,1310007 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 127,1310008 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 0,0000009 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 0,00000011 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 0,00000012 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 0,00000013 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 0,00000014 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 0,00000015 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 0,00000016 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 0,00000017 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 0,00000018 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 427,557500 427,557500 0,00000019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,00000027 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 511,84800128 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 0,00000029 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 0,00000030 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 277,86800131 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 0,00000032 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600033 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600034 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 0,00000035 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 0,00000036 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 0,00000037 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 0,00000038 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 0,00000039 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 0,00000040 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 0,00000041 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 0,00000042 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 0,00000043 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 0,00000044 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 0,00000045 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 0,00000046 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 0,00000047 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

26. POLIARTITRITA REUMATOIDA - G31b

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

Pagina 35 din 39

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Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

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 0,0000002 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 427,557500 427,557500 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 511,84800112 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 0,00000013 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 0,00000014 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 277,86800115 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 0,00000016 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600017 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600018 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 0,00000019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,00000027 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 0,00000028 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 0,00000029 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 0,00000030 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 0,0000002 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 427,557500 427,557500 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 511,84800112 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 0,00000013 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

27. ARTROPATIA PSORIAZICA - G31c

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

28. SPONDILITA ANKILOZANTA - G 31d

Pagina 36 din 39

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rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

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 277,86800115 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 0,00000016 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600017 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600018 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 0,00000019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,00000027 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 0,00000028 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 0,00000029 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 0,00000030 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 0,00000031 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

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

Pagina 37 din 39

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rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

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 0,0000002 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 0,0000003 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 427,557500 427,557500 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 0,00000012 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600013 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600014 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 0,00000015 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 0,00000016 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 0,00000017 W64708001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA 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 PR 2 1.965,264000 1.965,264000 86,71100018 W59945002 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg/0,8ml ABBVIE LTD. MAREA BRITANIE 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 PR 2 1.965,264000 1.965,264000 86,71100019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,0000002 W64809001 L04AB01 ETANERCEPTUM **1 ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PT. FLAC. + 8 TAMPOANE CU ALCOOL MEDICINAL PR 4 427,557500 427,557500 0,0000003 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 0,0000004 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 0,0000005 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 0,0000006 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 0,0000007 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 0,0000008 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 0,0000009 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 0,00000011 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 511,84800112 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 0,00000013 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 0,00000014 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 277,86800115 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 0,00000016 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,50600017 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 ALCOOLPR 2 1.965,264000 1.965,264000 1,506000

29. ARTRITA JUVENILA - G 31e

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

30. PSORIAZIS CRONIC SEVER (PLĂCI) - G 31f

Pagina 38 din 39

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Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari sociale de sanatate / UT

(pt. asiguratii care beneficiaza de

compensare 100% din pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

18 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 0,00000019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 W64708001 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg SOL. INJ. 40mg ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA 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 PR 2 1.965,264000 1.965,264000 86,71100025 W59945002 L04AB04 ADALIMUMABUM **1 HUMIRA 40 mg/0,80 ml SOL. INJ. 40mg/0,8ml ABBVIE LTD. MAREA BRITANIE 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 PR 2 1.965,264000 1.965,264000 86,71100026 W53884001 L04AC05 USTEKINUMAB **1 Ω STELARA 45 SOL. INJ. 45mg/0,5ml JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. X 0,5 SOL. INJ. P-RF/R 1 12.592,120000 12.592,120000 0,00000027 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 0,00000028 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 0,00000029 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 0,00000030 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 0,00000031 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 0,00000032 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 0,00000033 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 0,00000034 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 0,00000035 W62892001 L04AC13 IXEKIZUMABUM **1 TALTZ SOL INJ. IN STILOU PREUMPLUT 80mg ELI LILLY NEDERLAND BV OLANDA CUTIE CU 1 STILOU INJECTOR PREUMPLUT PR 1 4.187,990000 4.187,990000 0,000000

NOTA:

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (Ω) se efectuează în baza contractelor cost-volum încheiate. - Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (ß) se efectuează în baza contractelor cost-volum-rezultat încheiate;

Tratamentul se iniţiază de către medicul în specialitatea dermatologie.

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (5) se utilizează numai pentru cazurile fără răspuns terapeutic la prednisonum;

- 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;

Pagina 39 din 39

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ANEXA 2d

Nr c

rt.

Cod_

CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPTara det.

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 100% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

1 W02902002 A03AD02 DROTAVERINUM NO - SPA 40 mg/2 ml SOL. INJ. 40mg/2ml CHINOIN PHARMACEUTICAL AND CHEMICAL WORKS CO. LTD. UNGARIA CUTIE X 25 FIOLE X 2ML SOL. INJ. P-RF 25 1,071200 1,071200 0,0000002 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 0,0000003 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 0,0000004 W01509001 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,394500 0,394500 0,0000005 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 0,0000006 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 0,0000007 W43285003 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA 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. PRF 5 2,672000 2,672000 0,0000008 W43285004 A03DA02 COMBINATII ALGIFEN SOLUTIE INJECTABILA SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA 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. PRF 10 2,673000 2,673000 0,0000009 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 0,00000011 W63100001 A06AD65 COMBINATII CLENSIA PULB. PT. SUSP. ORALAFARA CONCENTRATIE ALFA WASSERMANN S.R.L.ROMANIA CUTIE CU 8 PLICURI (4 PLICURI A (MARI) + 4 PLICURI B (MICI)) DIN HARTIE-AL-PE CARE CONTIN PULB. PT. SOL. ORALA, CORESP. UNEI SINGURE CURE DE TRATAMENT PRF 4 14,747500 14,747500 0,00000012 W64825001 A06AD65 COMBINATII CLENSIA PULB. PT. SUSP. ORALAFARA CONCENTRATIE ALFASIGMA ROMANIA S.R.L. ROMANIA CUTIE CU 8 PLICURI (4 PLICURI A (MARI) + 4 PLICURI B (MICI)) DIN HARTIE-AL-PE CARE CONTIN PULB. PT. SOL. ORALA, CORESP. UNEI SINGURE CURE DE TRATAMENT PRF 4 14,747500 14,747500 0,00000013 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 0,00000014 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 0,00000015 W60620001 A11CA01 RETINOLUM VITAMINA A FORTE BIOFARM 50000 UICAPS. MOI 50000ui BIOFARM SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. MOIP6L 30 0,200333 0,200333 0,00000016 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 0,00000017 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 0,00000018 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 0,00000019 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 0,00000020 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 0,00000021 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 0,00000022 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 0,00000023 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 0,00000024 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 0,00000025 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 0,00000026 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 0,00000027 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 0,00000028 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 0,00000029 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 0,01056030 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 0,00000031 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 0,00000032 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 0,00000033 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 0,00000034 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 0,00000035 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 0,00000036 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 0,00000037 W60986001 A11GA01 ACIDUM ASCORBICUM VITAMEDI-C 750 mg/5ml SOL INJ. 750mg/5ml PASCOE PHARMAZEUTISCHE PRAPARATE GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ.PR 5 2,584800 2,584800 2,94320038 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 2,94320039 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 0,00000040 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 0,00000041 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 0,00000042 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 0,00000043 W57681001 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU 94mg/ml SOL. INJ. 94mg/ml B. BRAUN MELSUNGEN AGGERMANIA CUTIE X 20 FIOLE DIN PEJD X 10 ML SOL. INJ.P-RF 20 0,921500 0,921500 0,00000044 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 2,37020045 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 0,00000046 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

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREȚUL DE REFERINȚĂ - CONFORM DCI-URILOR, ALTELE DECÂT CELE DIN SUBLISTELE A, B, SUBLISTA C SECŢIUNEA C1 ŞI SUBLISTA D, CORESPUNZĂTOARE MEDICAMENTELOR, DE CARE BENEFICIAZĂ COPIII PÂNĂ LA 18 ANI, TINERII DE LA 18 LA 26 DE ANI DACĂ SUNT

ELEVI, UCENICI SAU STUDENŢI, DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LEHUZE, ÎN TRATAMENTUL AMBULATORIU,DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,

VALABILĂ ÎNCEPÂND CU 01 IANUARIE 2019

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Contributie maxima a asiguratului / UT (pt. asiguratii care

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47 W61535001 A16AXN1 DIVERSE ACTOVEGIN 200 mg/5 ml SOL. INJ. 200mg/5ml TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE X 5 ML SOL. INJ. PR 5 22,902000 22,902000 0,00000048 W57392002 B02BX01 ETAMSYLATUM ETAMSILAT ZENTIVA 250mg SOL. INJ. 250mg/2ml ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. P-RF 5 1,466000 1,466000 0,00000049 W00831001 B02BX02 CARBAZOCHROMI SALICYLAS ADRENOSTAZIN SOL. INJ. 0,3mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 5 ML P-RF 5 2,776000 2,776000 0,00000050 W14063001 B03AA03 FERROSI GLUCONAS ASCOFER COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 20 COMPR. P-6L 20 0,421500 0,421500 0,00000051 W01714003 B03AD02 COMBINATII FERRETAB 50 mg+0,5 mg CAPS. ELIB. PREL. 50mg+0,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,269666 0,269666 0,00000052 W01714005 B03AD02 COMBINATII FERRETAB 50 mg+0,5 mg CAPS. ELIB. PREL. 50mg+0,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P6L 100 0,270100 0,270100 0,00000053 W01714004 B03AD02 COMBINATII FERRETAB (R) CAPS. ELIB. PREL. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. AL/PVC X 20 CAPS. ELIB. PREL. P-6L 100 0,270100 0,270100 0,00000054 W01713001 B03AD03 COMBINATII TARDYFERON FOL (R) DRAJ. ELIB. PREL. FARA CONCENTRATIE LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L 30 0,488000 0,488000 0,00000055 W63335001 B03AD03 COMBINATII (FERROSI SULFAS+ACIDUM FOLICUM) FERROLA 37 mg + 0,8 mg COMPR. GASTROREZ. 37mg+0,8mg WÖRWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. GASTROREZ.P6L 30 0,373333 0,373333 0,00000056 W51229001 B03AD04 COMBINATII MALTOFER FOL COMPR. MAST. 100mg/0,35mg VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MAST. P-6L 30 0,650333 0,650333 0,00000057 W12102002 B03AE01 COMBINATII (CYANCOBALAMINUM+FERROSI SULFAS+ACIDUM FOLICUM) FERRO - FOLGAMMA (R) CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. MOI P6L 50 0,373200 0,373200 0,00000058 W60902001 B03AE10 COMBINATII TOT'HEMA SOL. ORALA FARA CONCENTRATIE LABORATOIRE INNOTECH INTERNATIONAL FRANTA CUTIE X 20 FIOLE X 10 ML P-6L 20 0,933000 0,933000 0,00000059 W56761001 B03BA01 CYANOCOBALAMINUM VITAMINA B12 ZENTIVA 50µg/ml SOL. INJ. 50µg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. P-RF 5 1,522000 1,522000 0,00000060 W62871001 C01EA01 ALPROSTADILUM ** ALPROSTADIL "REMEDIA" 500 µg CONC. PT. SOL. PERF. 500µg FARMACEUTICA REMEDIA DISTRIBUTION&LOGISTICS S.R.L.ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE DE CULOARE GALBENA, A CÂTE 1 ML CONCENTRAT PENTRU SOL. PERF. PR 5 349,070000 349,070000 0,00000061 W56319001 C05AA01 COMBINATII HEMORZON SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOFORMATE PVC X 3 SUPOZ. P-6L 6 1,271666 1,271666 0,00000062 W01826001 C05AA01 COMBINATII HEMORZON UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-6L 1 13,640000 13,640000 0,00000063 W61499001 C05AA08 COMBINATII ULTRAPROCT SUPOZITOARE SUPOZ. FARA CONCENTRATIE BAYER PHARMA AG GERMANIA CUTIE X 2 FOLII AL/PE X 5 SUPOZ. P-RF 10 1,399000 1,399000 0,00000064 W63894001 C05AA08 COMBINATII ULTRAPROCT SUPOZITOARE SUPOZ. FARA CONCENTRATIE BAYER AG GERMANIA CUTIE CU 2 FOLII AL/PE X 5 SUPOZ. PRF 10 1,399000 1,399000 0,00000065 W61498002 C05AA08 COMBINATII ULTRAPROCT UNGUENT RECTAL UNGUENT RECTAL FARA CONCENTRATIE BAYER PHARMA AG GERMANIA CUTIE X 1 TUB AL X 30 G + 1 CANULA PEJD P-RF 1 33,440000 33,440000 0,00000066 W63895002 C05AA08 COMBINATII ULTRAPROCT UNGUENT RECTAL UNGUENT RECTAL FARA CONCENTRATIE BAYER AG GERMANIA CUTIE X 1 TUB AL X 30 G + 1 CANULA PEJD PRF 1 33,440000 33,440000 0,00000067 W54548001 C05AD01 COMBINATII DOXIPROCT UNGUENT RECTAL FARA CONCENTRATIE OM PHARMA S.A. PORTUGALIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT RECTAL + CANULA APLICATOAREP-6L 1 22,820000 22,820000 0,00000068 W00727001 C05BX01 CALCII DOBESILAS DOXILEK CAPS. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC. X 10 CAPS. P-6L 30 0,781333 0,781333 0,00000069 W63052001 C05CA54 TROXERUTINUM (COMBINATII) GINKOR FORT CAPS. FARA CONCENTRATIE TONIPHARM FRANTA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 0,928000 0,928000 0,00000070 W57953002 C08CA06 NIMODIPINUM NIMOTOP 30 mg COMPR. FILM. 30mg BAYER PHARMA AG GERMANIA CUTIE CU 10 BLIST. AL/PP X 10 COMPR. FILM. P-RF 100 0,724300 0,724300 0,00000071 W63888002 C08CA06 NIMODIPINUM NIMOTOP 30 mg COMPR. FILM. 30mg BAYER AG GERMANIA CUTIE CU 10 BLIST. AL/PP X 10 COMPR. FILM. P-RF 100 0,724300 0,724300 0,00000072 W57954003 C08CA06 NIMODIPINUM NIMOTOP® SOL. PERF. 10mg/50ml BAYER PHARMA AG GERMANIA CUTIE X 5 CUTII X 1 FLACON DIN STICLA DE CULOARE BRUNA X 50 ML + 1 PERFUZOR DIN POLIETILENA S 5 30,384000 30,384000 0,00000073 W63887002 C08CA06 NIMODIPINUM NIMOTOP 10 mg/50 ml SOL. PERF. 10mg/50ml BAYER AG GERMANIA AMBALAJ MULTIPLU (FOLIE DE PLASTIC ETICHETATA) CU 5 CUTII A CÂTE 1 FLAC. DIN STICLA, TIP II, DE CULOARE BRUNA A 50 ML SOL. PERF. SI CÂTE 1 PERFUZOR DIN PE PR 5 30,384000 30,384000 0,00000074 W63893001 D01AC05 ISOCONAZOLUM TRAVOGEN CREMA 10mg/1g BAYER AG GERMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA PRF 1 12,130000 12,130000 0,00000075 W61428004 D01AC05 ISOCONAZOLUM TRAVOGEN CREMA 10mg/1g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA PRF 1 18,210000 18,210000 0,00000076 W63893002 D01AC05 ISOCONAZOLUM TRAVOGEN CREMA 10mg/1g BAYER AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA PRF 1 18,210000 18,210000 0,00000077 W61428003 D01AC05 ISOCONAZOLUM TRAVOGEN 10mg/g CREMA 10mg/g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA PRF 1 12,130000 12,130000 0,00000078 W41982001 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA 2% TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB PEJD X 15 G P-RF 1 3,650000 3,650000 0,00000079 W57514001 D01AC08 KETOCONAZOLUM NIZORAL 20 mg/g CREMA 20mg/g JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 4,380000 4,380000 1,24000080 W01868001 D05AXN1 COMBINATII ASORIAN SOL. CUT. FARA CONCENTRATIE BIOFARM SA ROMANIA CUTIE X 1 FLACON X 100 ML P-RF 1 11,110000 11,110000 0,00000081 W03176001 D07AC04 FLUOCINOLONI ACETONIDUM FLUOCINOLON ACETONID LAROPHARM 0,25 mg/g UNGUENT 0,25mg/g LAROPHARM SRL ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 8,070000 8,070000 0,00000082 W01894001 D07CB01 COMBINATII NIDOFLOR CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 10,910000 10,910000 0,00000083 W61211001 D07CC02 COMBINATII FLUOCINOLON N ATB 0,25 mg/5 mg/g UNGUENT 0,25mg/5mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 18 G UNG. PRF 1 8,950000 8,950000 0,00000084 W13665001 D07XB02 COMBINATII TRIAMCINOLON S ATB 1 mg/30 mg/g CREMA 1mg/30mg/g ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 9,740000 9,740000 0,00000085 W57647001 D07XC01 COMBINATII DIPROSALIC SOL. CUT. 0,64mg+20mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR P-RF 1 6,610000 6,610000 0,00000086 W57646001 D07XC01 COMBINATII DIPROSALIC UNGUENT 0,64 mg+30 mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 3,610000 3,610000 0,00000087 W54922001 D07XC01 COMBINATII (BETAMETHASONUM+ACIDUM SALICYLICUM) SAL-EKARZIN 0,50 mg/30 mg pe gram UNGUENT 0,50mg/30mg pe gram ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB AL X 15 G UNGUENT P-RF 1 7,630000 7,630000 0,00000088 W60851005 D07XC04 COMBINATII TRAVOCORT CREMA 10mg/1mg/1g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 27,260000 27,260000 0,00000089 W63892001 D07XC04 COMBINATII TRAVOCORT CREMA 10mg/1mg/1g BAYER AG GERMANIA CUTIE CU 1 TUB DIN AL X 30 G CREMA P6L 1 27,260000 27,260000 0,00000090 W02981001 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 30 ML SOL. CUT. P-RF 1 8,820000 8,820000 0,00000091 W02981002 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 100 ML SOL. CUT. P-RF 1 22,940000 22,940000 0,00000092 W63161001 D10AF52 COMBINATII ZINERYT 40 mg/12 mg/ml PULB. + SOLV. SOL. CUT. 40mg/12mg/ml LEO PHARMA A/S DANEMARCA CUTIE CU 1 FLAC. DIN PEÎD, CU APLICATOR SI CAPAC DIN PP CARE CONTINE PULBERE CUTANATA SI 1 FLAC. DIN PEÎD, CU APLICATOR SI CAPAC DIN PP CARE CONTINE SOLVENT, PENTRU 30 ML SOLUTIE CUTANATA PRF 1 28,540000 28,540000 0,00000093 W63162001 D11AH01 TACROLIMUSUM PROTOPIC 0,03% UNGUENT 0,03% LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB X 10 G PR 1 37,960000 37,960000 0,00000094 W63163001 D11AH01 TACROLIMUSUM PROTOPIC 0,1% UNGUENT 0,1% LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB X 10 G PR 1 42,140000 42,140000 0,00000095 W57974002 D11AH02 PIMECROLIMUS ELIDEL 1% (10mg/g) CREMA 10mg/g MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 TUB AL X 30 G CREMA P-RF 1 117,440000 117,440000 0,00000096 W08847001 G01AF01 METRONIDAZOLUM FLAGYL OVULE 500mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST. X 5 OVULE P-RF 10 0,921000 0,921000 0,00000097 W63536001 G01AF01 METRONIDAZOLUM FLAGYL 500 mg OVULE 500mg SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PE/PVC X 5 OVULE P-RF 10 0,921000 0,921000 0,00000098 W51916001 G01AX12 CICLOPIROXUM DAFNEGIN OVULE 100mg POLICHEM SA LUXEMBURGCUTIE X 1 FOLIE. TERMOSUDATA DIN PVC/PE X 6 OVULE + 6 APLICATOARE DIN PE P-6L 6 6,320000 6,320000 0,00000099 W01963001 G01BDN1 COMBINATII TERGYNAN COMPR. VAG. FARA CONCENTRATIE LAB. BOUCHARA-RECORDATI FRANTA CUTIE X 1 FOLIE HARTIE/PE/AL/PE X 10 COMPR. VAG.P-RF 10 2,752000 2,752000 0,000000100 W61424001 G03AC06 MEDROXYPROGESTERONUM SAYANA 104 mg SUSP. INJ. IN SERINGA PREUMPLUTA 104mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU O SERINGA PREUMPLUTA DE UNICA FOLOSINTA CU AC DE DIMENSIUNEA 26G, 3/8, DIN STICLA INCOLORA, CU CAPAC SI PISTON DIN CAUCIUC BROMOBUTILIC, CARE CONTINE 0,65 ML SUSPENSIE INJECTABILA PRF 1 85,700000 85,700000 0,000000101 W13497004 G03GA01 GONADOTROPHINUM CHORIONICUM PREGNYL 5000 LIOF. + SOLV. PT. SOL. INJ. 5000ui/ml NV ORGANON OLANDA CUTIE CU 1 FIOLA CU CAPACITATEA DE 2 ML, DIN STICLA INCOLORA, CU PUNCT DE RUPERE, TIP OPC, CONTINÂND PULB. PT. SOL. INJ. SI 1 FIOLA CU CAPACITATEA DE 1 ML, DIN STICLA INCOLORA, CU PUNCT DE RUPERE, TIP OPC, CONTINÂND SOLV. PT. SOL. INJ. S/P-RF 1 15,820000 15,820000 0,000000102 W63441001 G03GA01 GONADOTROPHINUM CHORIONICUM PREGNYL 5000 UI PULB+SOLV. PT. SOL. INJ. 5000UI/ml MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLACON, DIN STICLA INCOLORA, CONTINÂND PULBERE SI 1 FLACON, DIN STICLA INCOLORA, CONTINÂND SOLVENT PENTRU SOL. INJ. PRF 1 15,820000 15,820000 0,000000

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103 W53997001 G03GA02 MENOTROPINUM MENOPUR LIOF. + SOLV. PT. SOL. INJ. FARA CONCENTRATIE FERRING GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU LIOF. + 10 FIOLE X 1 ML SOLV. PT. SOL. INJ. S/P-RF 10 82,249000 82,249000 0,000000104 W62732003 G03GA02 MENOTROPINUM MERIOFERT 150 UI PULB+SOLV. PT. SOL. INJ. 150UI LABORATOIRES GENEVRIER SA FRANTA CUTIE CU 10 SETURI CARE CONTIN: FLACOANE CU PULB. PT. SOL. INJ. SI FIOLE CU SOLVENT PT. SOL. INJ. PR 10 159,313000 159,313000 0,000000105 W62731003 G03GA02 MENOTROPINUM MERIOFERT 75 UI PULB+SOLV. PT. SOL. INJ. 75UI LABORATOIRES GENEVRIER SA FRANTA CUTIE CU 10 SETURI CARE CONTIN: FLACOANE CU PULB. PT. SOL. INJ. SI FIOLE CU SOLVENT PT. SOL. INJ. PR 10 82,191000 82,191000 0,000000106 W60841001 G03GA02 MENOTROPINUM MENOPUR 1200 UI PULB. SI SOLV. PT. SOL. INJ. 1200UI FERRING GMBH GERMANIA CUTIE CU 1 FLAC. CU PULBERE PENTRU SOL. INJ., 2 SERINGI PRE-UMPLUTE CU SOLV. PENTRU RECONSTITUIRE, 1 AC PENTRU RECONSTITUIRE, 18 TAMPOANE CU ALCOOL MEDICINAL SI 18 SERINGI DE UNICA FOLOSINTA PENTRU ADMIN., GRADATE ÎN UNITATI FSH/LH CU ACE PRE-FIXATE PR 1 1.399,040000 1.399,040000 0,000000107 W60840001 G03GA02 MENOTROPINUM MENOPUR 600 UI PULB. SI SOLV. PT. SOL. INJ. 600UI FERRING GMBH GERMANIA CUTIE CU 1 FLAC. CU PULBERE PENTRU SOL. INJ., 1 SERINGA PRE-UMPLUTA CU SOLV. PENTRU RECONSTITUIRE, 1 AC PENTRU RECONSTITUIRE, 9 TAMPOANE CU ALCOOL MEDICINAL SI 9 SERINGI DE UNICA FOLOSINTA PENTRU ADMIN., GRADATE ÎN UNITATI FSH/LH CU ACE PRE-FIXATE PR 1 729,990000 729,990000 0,000000108 W51620001 G04BCN1 COMBINATII URALYT-U GRANULE FARA CONCENTRATIE MADAUS GMBH GERMANIA CUTIE X 1 FLAC. PP X 280 G GRANULE + 1 LINGURITA DOZATOARE + 1 CALENDAR DE CONTROL + HARTIE INDICATO P-6L 1 59,060000 59,060000 0,000000109 W57400001 H01AC03 MECASERMINUM **1 INCRELEX 10mg/ml SOL. INJ. 10mg/ml IPSEN PHARMA FRANTA CUTIE X 1 FLAC X 4ML SOL. INJ. PR 1 2.875,810000 2.875,810000 0,000000110 W10690001 H03AA03 COMBINATII NOVOTHYRAL (R) 100 COMPR. 100mcg+20mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 0,316300 0,316300 0,000000111 W53787001 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 1 24,194640 24,194640 3,375360112 W53787002 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 10 24,032000 24,032000 0,000000113 W53787003 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF 50 20,925000 20,925000 0,000000114 W53787004 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF. 1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S 100 20,162200 20,162200 0,000000115 W60633001 J01EB05 SULFAFURAZOLUM SULFAFURAZOL ARENA 500 mg COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,690500 0,690500 0,000000116 W62087001 J01GB03 GENTAMICINUM GENTAMICINA EIPICO 40 mg/ml SOL INJ. 40mg/ml E.I.P.I.CO MED S.R.L. ROMANIA CUTIE CU 3 FLAC. DIN STICLA TIP I INCOLORA CU CAPACITATEA DE 2,5 ML, CONTINAND 2 ML SOL. INJ. PRF 3 0,723333 0,723333 0,000000117 W03308001 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 40mg/ml KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 0,778000 0,778000 0,000000118 W03309001 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTOSLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 0,867999 0,867999 0,178001119 W08121001 J01GB03 GENTAMICINUM PAN - GENTAMICINE SOL.INJ. 80mg/2ml LAB. PANPHARMA FRANTA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 0,867999 0,867999 0,167001120 W52501003 J01XB01 COLISTINUM COLISTINA ATB 1.000.000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, ÎNCHISE CU DOP DIN CAUCIUC HALOBUTILIC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC FLIP-OFF DIN POLIPROPILENA, CONTINÂND PULB. PENTRU SOL. INJ./PERF. S 10 23,142000 23,142000 0,000000121 W08947008 J02AC03 VORICONAZOLUM ** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 14,358856 14,358856 43,581144122 W61017005 J02AC03 VORICONAZOLUM ** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 14,358856 14,358856 52,854715123 W61628005 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 11,965714 11,965714 0,000000124 W61628006 J02AC03 VORICONAZOLUM ** VORICONAZOL ZENTIVA 200 mg COMPR. FILM. 200mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 11,966000 11,966000 0,000000125 W61817001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 11,965714 11,965714 0,000000126 W62033006 J02AC03 VORICONAZOLUM ** VORAMOL 200 mg COMPR. FILM. 200mg ALVOGEN IPCO S.AR.L. LUXEMBURGCUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 14,358856 14,358856 60,507144127 W64073003 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 14,358856 14,358856 71,690429128 W64073005 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 14,358856 14,358856 69,160072129 W64073008 J02AC03 VORICONAZOLUM ** VERRIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 14,358856 14,358856 67,894894130 W64072003 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 COMPR. FILM. PRF 14 27,282857 27,282857 0,000000131 W64072005 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 24,856785 24,856785 0,000000132 W64072008 J02AC03 VORICONAZOLUM ** VERRIA 50 mg COMPR. FILM. 50mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PRF 56 23,591607 23,591607 0,000000133 W41889001 J02AC03 VORICONAZOLUM ** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR P-RF 1 1.546,390000 1.546,390000 0,000000134 W04988001 M01AA01 PHENYLBUTAZONUM FENILBUTAZONA 250 mg SUPOZ. 250mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 1,146000 1,146000 0,000000135 W59221003 M01AB55 COMBINATII TRATUL PLUS CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,574666 0,574666 0,000000136 W59221004 M01AB55 COMBINATII TRATUL PLUS CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 50 0,545200 0,545200 0,000000137 W60619003 M01AB55 COMBINATII NEODOLPASSE 0,30 mg+0,12 mg/ml SOL. PERF. 0,30mg+0,12mg/ml FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 250 ML SOL. PERF. PR 10 23,931000 23,931000 0,000000138 W64231003 M01AB55 COMBINATII NEODOLPASSE 0,30 mg+0,12 mg/ml SOL. PERF. 0,30mg+0,12mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 250 ML SOL. PERF. PR 10 23,931000 23,931000 0,000000139 W61549003 M01AB55 COMBINATII (DICLOFENACUM+OMEPRAZOLUM) DICLOPRAM 75 mg/20 mg CAPS. ELIB. MODIF. 75mg/20mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. ELIB. MODIFICATA P6L 30 1,666000 1,666000 0,000000140 W61549005 M01AB55 COMBINATII (DICLOFENACUM+OMEPRAZOLUM) DICLOPRAM 75 mg/20 mg CAPS. ELIB. MODIF. 75mg/20mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 CAPS. ELIB. MODIFICATA P6L 60 1,582333 1,582333 0,000000141 W14016001 M01AB55 COMBINATII (PARACETAMOLUM+DICLOFENACUM) ACECLOFEN SUPOZ. 500mg+50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL/PE X 3 SUPOZ. P-6L 6 1,091666 1,091666 0,000000142 W02034002 M01AB55 DICLOFENACUM+MISOPROSTOLUM ARTHROTEC 75 COMPR. GASTROREZ. 75mg+0,200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL X 10 COMPR. GASTROREZ. P-6L 20 1,561000 1,561000 0,000000143 W61050001 M01AE01 IBUPROFENUM CALMOLIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6L 20 0,202500 0,202500 0,000000144 W13106001 M01AE01 IBUPROFENUM PADUDEN (R) SR 300 mg CAPS. ELIB. PREL. 300mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL. P-6L 10 1,530000 1,530000 0,000000145 W62191001 M01AE01 IBUPROFENUM BRUFEN RETARD 800 mg COMPR. ELIB. PREL. 800mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. CU ELIB. PREL. P6L 30 0,661666 0,661666 0,000000146 W60142001 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 0,205000 0,205000 0,000000147 W62192002 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P6L 30 0,243000 0,243000 0,056333148 W62192005 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,243000 0,243000 0,056333149 W60143001 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 600 COMPR. FILM. 600mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 0,400000 0,400000 0,000000150 W63757001 M01AE01 IBUPROFENUM IBUPROFEN B. BRAUN 400 mg SOL. PERF. 400mg B. BRAUN MELSUNGEN AGGERMANIA CUTIE CU 10 FLAC. PEJD PREVAZUTE CU INCHIDERE TIP TWINCAP (CAPAC CU DOUA PORTURI DE ACCES) A CATE 100 ML PRF 10 16,504000 16,504000 0,000000151 W63800001 M01AE01 IBUPROFENUM IBUPROFEN B. BRAUN 600 mg SOL. PERF. 600mg B. BRAUN MELSUNGEN AGGERMANIA CUTIE CU 10 FLAC. DIN PEJD PREVAZUTE CU INCHIDERE TIP TWINCAP (CAPAC CU DOUA PORTURI DE ACCES) X 100 ML PRF 10 22,280000 22,280000 0,000000152 W60584001 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CU CAPAC DIN PP SI O SERINGA DOZATOARE (GRADATA) DIN PEJD PRF 1 7,290000 7,290000 0,000000153 W60584002 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CU CAPAC DIN PE SI O SERINGA DOZATOARE (GRADATA) DIN PEJD PRF 1 7,290000 7,290000 0,000000154 W64400001 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC DIN STICLA BRUNA X 100 ML SUSP. ORALA, CONSTITUIT DIN CAPAC INTERN SI CAPAC EXTERN DIN PP, PREVAZUT CU ADAPTOR PT. SERINGA DIN PE SI O SERINGA DOZATOARE PE/PS GRADATA LA FIECARE 0,25 ML, PT. MASURAREA VOLUMELOR PANA LA 6 ML PRF 1 7,290000 7,290000 0,000000155 W64400002 M01AE01 IBUPROFENUM ALGIN BABY 100 mg/5 ml SUSP. ORALA 100mg/5ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CONSTITUIT DIN CAPAC INTERN DIN PE SI CAPAC EXTERN DIN PP, PREVAZUT CU ADAPTOR PT. SERINGA DIN PE SI O SERINGA DOZATOARE PE/PS GRADATA LA FIECARE 0,25 ML, PT. MASURAREA VOLUMELOR PANA LA 6 ML PRF 1 7,290000 7,290000 0,000000156 W62190001 M01AE01 IBUPROFENUM BRUFEN 20 mg/ml SUSP. ORALA 20mg/ml BGP PRODUCTS AB SUEDIA CUTIE CU 1 FLAC. DIN PET DE CULOARE BRUNA CU CAPAC DIN AL SI SIGILIU DIN PEJD + SERINGA DOZATOARE DIN PP DE 5 ML, A 100 ML SUSP. ORALA P6L 1 8,748000 8,748000 1,342000157 W04449002 M01AE02 NAPROXENUM REUXEN 250 mg COMPR. 250mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,790500 0,790500 0,000000158 W62812002 M01AE02 NAPROXENUM NAPROXEN AUROBINDO 250 mg COMPR. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 10 0,700000 0,700000 0,000000

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Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 100% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

159 W04450002 M01AE02 NAPROXENUM REUXEN 500 mg COMPR. 500mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,598800 0,598800 0,660700160 W62813002 M01AE02 NAPROXENUM NAPROXEN AUROBINDO 500 mg COMPR. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 10 0,499000 0,499000 0,000000161 W59074001 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L 10 1,055000 1,055000 0,000000162 W59074002 M01AE02 NAPROXENUM NALDOREX 275 mg COMPR. FILM. 275mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P6L 20 0,902000 0,902000 0,000000163 W59075001 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L 10 1,511400 1,511400 0,075600164 W59075002 M01AE02 NAPROXENUM NALDOREX 550 mg COMPR. FILM. 550mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P6L 20 1,259500 1,259500 0,000000165 W00167001 M01AG01 ACIDUM MEFENAMICUM VIDAN COMPR. FILM. 500mg VIANEX SA GRECIA CUTIE X 3 BLIST. AL/PVC X 8 COMPR. FILM. P-6L 24 0,385000 0,385000 0,000000166 W41953001 M01AH04 PARECOXIBUM DYNASTAT 40mg PULB. PT. SOL. INJ. 40mg PFIZER LIMITED MAREA BRITANIE CUTIE X 10 FLAC. X 40 MG PULB. PT. SOL. INJ. S/P-RF 10 31,727000 31,727000 0,000000167 W01212002 M03BB03 CHLORZOXAZONUM CLORZOXAZON 250 mg COMPR. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,242000 0,242000 0,000000168 W60375001 M03BB03 CHLORZOXAZONUM CLORZOXAZONA ARENA 250 mg COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,225000 0,225000 0,000000169 W54833001 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0,530666 0,530666 0,000000170 W54832001 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,266000 0,266000 0,000000171 W63146001 M09AX01 ACIDUM HIALURONICUM HYALGAN 20 mg/2 ml SOL. INJ. IN SERINGA PREUMPLUTA 20mg/2ml ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA, CU DOP DIN ELASTOMER SI OPRITOR X 2 ML SOL. INJ. PRF 1 133,230000 133,230000 0,000000172 W58624003 N02AA59 COMBINATII ( PARACETAMOLUM + CODEINUM) ULTRACOD 500 mg/30 mg COMPR. 500 mg/30 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF 30 0,835800 0,835800 0,350533173 W51721001 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) PARADOREN 500mg/30mg COMPR. 500mg+30mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,696500 0,696500 0,000000174 W51722001 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) PARADOREN 500mg/60mg COMPR. 500mg+60mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 1,082500 1,082500 0,000000175 W61948001 N02AA59 COMBINATII (IBUPROFENUM+CODEINUM)BRUFEN PLUS 400 mg/30 mg COMPR. FILM. 400mg/30mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. AL/PVDC-PVC/PVDC X 30 COMPR. FILM. PRF 30 1,075000 1,075000 0,000000176 W42786002 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN (R) 500 mg COMPR. 500mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,405000 0,405000 0,045500177 W41738001 N02BB02 METAMIZOLUM NATRIUM ALINDOR COMPR. 500mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,405000 0,405000 0,045500178 W08988002 N02BB02 METAMIZOLUM NATRIUM SINTOCALMIN COMPR. 500mg SINTOFARM SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,360500 0,360500 0,000000179 W08609001 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN COMPR. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,405000 0,405000 0,041000180 W53162001 N02BB02 METAMIZOLUM NATRIUM ALGOBLOCK COMPR. 500mg BIOFARM S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,337500 0,337500 0,000000181 W42786004 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN 500 mg COMPR. 500mg ZENTIVA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 0,405000 0,405000 0,041333182 W57650001 N02BB02 METAMIZOLUM NATRIUM ALGOZONE 500mg COMPR. 500mg LABORMED PHARMA S.A. ROMANIA CUTIE X 2 BLIST.PVC-PVDC/AL A CATE 10 COMPR. P-RF 20 0,371500 0,371500 0,000000183 W63055002 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg COMPR. 500mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 20 COMPR. PRF 20 0,391500 0,391500 0,000000184 W60645004 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg/ml PIC. ORALE, SOL.500mg/ml TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 100 ML PIC. ORALE, SOL. P6L 1 29,910000 29,910000 0,000000185 W61617002 N02BB02 METAMIZOLUM NATRIUM LOCAMIN 500 mg/ml PIC. ORALE, SOL.500mg/ml STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD SI CAPAC DIN PEID/PP SECURIZAT PT. COPII X 50 ML PIC. ORALE,SOL. P6L 1 31,370000 31,370000 0,000000186 W42787003 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN (R) 1 g/2 ml SOL. INJ. 1g/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ.P-RF 5 1,292000 1,292000 0,000000187 W42787002 N02BB02 METAMIZOLUM NATRIUM ALGOCALMIN 1 g/2 ml SOL. INJ. 1g/2ml ZENTIVA S.A. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA, CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE ALB SI UN INEL (GALBEN) PE GATUL FIOLEI X 2 ML SOL. INJ. P-RF 10 1,279000 1,279000 0,000000188 W57866001 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN 300 mg SUPOZ. 300mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE, OPACE DIN PVC X 6 SUPOZ. PRF 12 1,320000 1,320000 0,000000189 W62161001 N05CD08 MIDAZOLAMUM MIDAZOLAM AGUETTANT 5 mg/ml SOL INJ. 5mg/ml HYPERICUM S.R.L. ROMANIA CUTIE CU 10 FIOLE X 10 ML SOL. INJ. PRF 10 26,256000 26,256000 0,000000190 W12614002 N05CD13 CINOLAZEPAMUM GERODORM (R) COMPR. 40mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF 30 0,803333 0,803333 0,000000191 W63237002 N05CD13 CINOLAZEPAMUM GERODORM 40 mg COMPR. 40mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. AL/PVDC-PVC X 10 COMPR. PRF 30 0,803333 0,803333 0,000000192 W43107002 N06BA04 METHYLFENIDATUM ** CONCERTA 18 mg COMPR. FILM. ELIB. PREL. 18mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 2,376000 2,376000 0,000000193 W43108002 N06BA04 METHYLFENIDATUM ** CONCERTA 36 mg COMPR. FILM. ELIB. PREL. 36mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 4,487000 4,487000 0,000000194 W43109002 N06BA04 METHYLFENIDATUM ** CONCERTA 54 mg COMPR. FILM. ELIB. PREL. 54mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS 30 6,405666 6,405666 0,000000195 W58095001 N06BX02 PYRITINOLUM ENCEPHABOL 100 mg DRAJ. 100mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 0,544600 0,544600 0,000000196 W58096001 N06BX02 PYRITINOLUM ENCEPHABOL 200 mg DRAJ. 200mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 1,282000 1,282000 0,000000197 W59741001 N06BX02 PYRITINOLUM ENCEPHABOL 80,5 mg/5 ml SUSP. ORALA 80,5mg/5ml MERCK KGAA GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 200 ML + 1 LINGURITA DOZATOARE DIN PP ALBA, CU GRADATII LA 1,25 ML, 2,5 ML, 5 ML P6L 1 44,350000 44,350000 0,000000198 W08294002 N07CA02 CINNARIZINUM CINARIZINA ARENA 25 mg CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. P-6L 40 0,090250 0,090250 0,000000199 W10590001 N07CA02 CINNARIZINUM STUGERON 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. P-6L 40 0,098599 0,098599 0,093151200 W13160002 N07CA02 CINNARIZINUM CINARIZINA LAROPHARM 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 3 BLIST. X 20 COMPR. P-6L 60 0,082166 0,082166 0,000000201 W05792001 P01AX08 TENONITROZOLUM ATRICAN 250 mg CAPS. MOI GASTROREZ. 250mg LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. MOI GASTROREZ.P-RF 8 1,520000 1,520000 0,000000202 W57359001 R01AD07 TIXOCORTOLUM PIVALONE 0,9mg/pulverizare SPRAY NAZAL SUSPENSIE 0,9mg/pulverizare PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLACON X 10 ML + POMPA DOZATOARE + APLICATOR NAZAL P-RF 1 11,460000 11,460000 0,000000203 W59773001 R01ADN1 COMBINATII (BETAMETHASONUM+TETRYZOLINUM) BIORINIL SPRAY NAZ.,SUSP. 0,5 mg/1 mg/ ml THEA FARMA SPA ITALIA CUTIE X 1 FLACON X 10 ML SPRAY NAZAL, SUSP. PREVAZUT CU NEBULIZATOR P-RF 1 28,260000 28,260000 0,000000204 W64698004 R01BA52 COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE) AERINAZE 2,5mg/120mg COMPR. ELIB. MODIF. 2,5mg/120mg MERCK SHARP & DOHME OLANDA CUTIE CU 10 COMPR. ELIB. MODIF. (BLIST.PCTFE/PVC/AL) PRF 10 2,273000 2,273000 0,000000205 W59831004 R01BA52 COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE) AERINAZE (vezi R06AX27) 2,5mg/120mg COMPR. FILM. ELIB. MODIF. 2,5mg/120mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 10 COMPR.FILM.ELIB.MODIF. ( BLIST.PCTFE/PVC/AL) P-RF 10 2,273000 2,273000 0,000000206 W62181001 R01BA52 COMBINATII (LORATADINUM+PSEUDOEFEDRINUM) CLARINASE 5 mg/120 mg COMPR. ELIB. MODIF. 5mg/120mg BAYER S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 COMPR. ELIB. MODIF. P-6L 7 1,445714 1,445714 0,000000207 W02941002 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA ARENA COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,341666 0,341666 0,000000208 W60632001 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA ZENTIVA 50 mg/ mlSOL. INJ. 50mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ PRF 5 1,618000 1,618000 0,000000209 W06666001 R05CB01 ACETYLCYSTEINUM ACC INJECT 300mg/3ml SOL. INJ./ SOL. PT. INHALAT PRIN NEBULIZATOR 300mg/3ml HEXAL AG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. PR 5 1,648000 1,648000 0,000000210 W53020001 R05CB01 ACETYLCYSTEINUM FLUIMUCIL 2% PEDIATRIC SOL. ORALA 2% ZAMBON S.P.A. ITALIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SOL. ORALA + MASURA DOZATOARE (5 SI 10 ML) P-RF 1 14,350000 14,350000 0,000000211 W53016001 R05CB01 ACETYLCYSTEINUM FLUIMUCIL SOL.INJ./INHAL.NEBULIZ./INSTILATIE ENDOTRAHEOBRON. 300mg/3ml ZAMBON S.P.A. ITALIA CUTIE X 5 FIOLE DIN STICLA X 3 ML SOL.INJ/SOL.PT.INHALAT PRIN NEBULIZATOR/SOL.PT.INSTILATIE ENDOTRAH PR 5 1,800000 1,800000 0,000000212 W61935001 R05CB03 CARBOCISTEINUM RHINATHIOL 100mg/5ml pentru copii SIROP 100 mg/5 ml SANOFI-AVENTIS OTC FRANTA CUTIE X 1 FLACON DIN STICLA INCOLORA X 125 ML SIROP + LINGURITA DOZATOARE P-RF 1 9,920000 9,920000 0,000000213 W63537001 R05CB03 CARBOCISTEINUM RHINATHIOL 100 mg/5 ml PENTRU COPII SIROP 100 mg/5 ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA DE TIP III X 125 ML SIROP + LINGURITA DOZATOARE DE 5 ML PRF 1 9,920000 9,920000 0,000000214 W61759001 R05CB03 CARBOCISTEINUM TRECID 100 mg/5 ml SIROP 100mg/5ml BIOFARM S.A. ROMANIA CUTIE CU 1 FLAC DIN STICLA BRUNA CU CAPAC DIN PE SI O MASURA DOZATOARE DIN PP CU GRADATII CUPRINSE INTRE 2,5-20 ML, A 100 ML SIROP PRF 1 4,250000 4,250000 0,000000

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rt.

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPTara det.

APP Ambalaj Pres

crip

tie cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 100% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

215 W07656001 R05CB03 CARBOCISTEINUM FLUIDOL 100mg/5ml SOL. ORALA 100mg/5ml TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PVC X 100 ML SIROP + LINGURITA DUBLA GRADATA LA 2,5 SI 5 ML P-RF 1 4,380000 4,380000 0,000000216 W52326001 R06AD02 PROMETHAZINUM ROMERGAN SIROP 5mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 ML SIROP + MASURA DOZATOARE P-RF 1 3,050000 3,050000 0,000000217 W13788001 R06AE05 MECLOZINUM EMETOSTOP COMPR. 30mg SPECIFAR SA GRECIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,391000 0,391000 0,000000218 W61193001 R06AX02 CYPROHEPTADINUM CIPROHEPTADINA ARENA 4 mg COMPR. 4mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,178333 0,178333 0,000000219 W62182001 R06AX13 LORATADINUM CLARITINE SIROP 1mg/ml BAYER S.R.L. ROMANIA CUTIE X 1 FLACON X 120 ML + LINGURITA DOZATOAREP-6L 1 13,440000 13,440000 3,770000220 W52861001 R06AX13 LORATADINUM LORATADINA BIOFARM 5mg/5ml SIROP 5mg/5ml BIOFARM S.A. ROMANIA CUTIE CU UN FLACON DIN STICLA BRUNA X 100ML SIROP SI O MASURA DOZATOARE DIN PE, PREVAZUTA CU GRADATII DE LA 2,5 LA 20ML P6L 1 7,730000 7,730000 0,000000221 W58299002 R06AX13 LORATADINUM LORATADINA LEK 5mg/5ml SUSP. ORALA 5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC CU FILET DIN PEID X 120 ML SUSP. ORALA + LINGURITA DOZATOAREP6L 1 11,200000 11,200000 0,000000222 W13143001 S01AA01 CHLORAMPHENICOLUM SIFICETINA PULB. + SOLV. PT. SOL. OFT. 4mg/ml S.I.F.I. SPA ITALIA CUTIE X 1 FLAC. STICLA BRUNA X 5 ML SOLV. + O PUNGA X UN REZERVOR CU PULB. + UN PICURATOR P-RF 1 21,090000 21,090000 0,000000223 W61153001 S01AA13 ACIDUM FUSIDICUM FUCITHALMIC 10mg/g GEL OFT. 10mg/g AMDIPHARM LIMITEDIRLANDA CUTIE X 1 TUB AL CU CANULA APLICATOARE X 5 G GEL OFTALMIC P-6L 1 14,190000 14,190000 0,000000224 W41624001 S01AA24 KANAMYCINUM KANAMICINA SULFAT 1% UNG. OFT. 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL X 6 G P-RF 1 7,000000 7,000000 0,000000225 W59768001 S01BA07 FLUOROMETHOLONUM FLUMETOL S 2 mg/ml PICATURI OFT.SUSP. 2mg/ml THEA FARMA SPA ITALIA CUTIE X 1 FLACON PEJD X 10ML PIC. OFT. SUSP.P-RF 1 33,860000 33,860000 0,000000226 W03615001 S01BC01 INDOMETACINUM INDOCOLLYRE (R) 0,1% PICATURI OFT.-SOL. 0,1% LAB. CHAUVIN FRANTA CUTIE X 1 FLACON PICURATOR DIN POLIETILENA X 5 ML P-6L 1 15,250000 15,250000 0,000000227 W02268001 S02CA05 COMBINATII OTIS-T PICATURI AURICULARE-SOL. FARA CONCENTRATIE TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PE X 10 ML PIC. AURICULARE, SOL. P-RF 1 4,440000 4,440000 0,980000228 W10587001 S02CA05 COMBINATII SOLUTIE AURICULARA CU CLORAMFENICOL SI FLUOCINOLON SOL. AURICULARA FARA CONCENTRATIE BIOFARM SA ROMANIA CUTIE X 1 FLAC DIN STICLA BRUNA+APLICATOR TIP PIPETA X 10 ML SOL. AURICULARA P-RF 1 3,700000 3,700000 0,000000

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

Page 86: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

ANEXA 2eN

r crt

.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

crip

tie

cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 20% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 20%

din pretul de referinta)

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 0,6183402 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 0,2041703 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 0,2051704 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 0,2041705 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 0,2041706 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 0,2041707 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 0,1996708 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 0,2048369 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 0,26850311 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 0,17040012 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 0,32438413 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 0,22506714 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 0,34560015 W54839001 A02BA03 FAMOTIDINUM QUAMATEL 20 mg PULB+SOLV. PT. SOL. INJ./PERF. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA CU PULBERE PENTRU SOLUTIE INJ./PERF. + 5 FIOLE DIN STICLA INCOLORA X 5ML SOLV. PENTRU UZ PARENTERAL S/P-RF 5 4,110000 0,000000 0,822000 3,28800016 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 0,25720017 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 0,27496518 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 0,60693319 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 0,60693320 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 0,60693321 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 0,60693322 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 0,39313423 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 0,32426724 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 0,32426725 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 0,32426726 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 1,02220027 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 1,72430028 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 10,52800029 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 9,58805030 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 0,45842631 W58243002 A03FA03 DOMPERIDONUM OROPERIDYS 10 mg COMPR. ORODISPERSABILE 10mg PIERRE FABRE MEDICAMENT FRANTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP. P6L 30 0,112874 0,588792 0,022574 0,67909232 W61966003 A03FA03 DOMPERIDONUM DOMOTIL 10 mg COMPR. ORODISPERSABILE 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE P6L 30 0,112874 0,367459 0,022574 0,45775933 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 0,33813334 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 0,33813335 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 0,52780036 W59722004 C01EB15 TRIMETAZIDINUM MODUXIN MR 35 mg COMPR. ELIB. PREL. 35mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. CU ELIB. PRELUNG. P6L 30 0,422666 0,000000 0,084533 0,33813337 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 0,22902938 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 0,31769639 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 0,42001140 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 1,22503441 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 0,76070042 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 0,75203443 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 0,21217244 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 0,74453345 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 0,74320046 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 0,29280047 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

SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR 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

Pagina 1 din 3

Page 87: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

Nr c

rt.

Cod

_CIM

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Pres

crip

tie

cant. UT/

ambalaj

Pret de referinta / UT

(RON)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 100%

din pretul de referinta)

Val. maxima suportata de sistemul de asigurari

sociale de sanatate / UT (pt. asiguratii care

beneficiaza de compensare 20% din

pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

beneficiaza de compensare 20%

din pretul de referinta)

48 W58770010 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90 ** TEVOCOR 1000 mg CAPS. MOI 1000 mg TEVA PHARMACEUTICALS S.R.L.ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. PRF 30 1,445333 0,000000 0,289066 1,15626749 W13986001 C10AX06 ACID OMEGA-3-ESTERI ETILICI 90 ** OMACOR (R) CAPS. MOI 1000mg PRONOVA BIOPHARMA NORGE A.S. NORVEGIA FALC. DIN PEID X 28 CAPS. MOI P-RF 28 1,639981 0,583947 0,327996 1,89593250 W00040001 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 2,199000 13,751000 0,439800 15,51020051 W53041001 D06BB03 ACICLOVIRUM ACICLOVIR TIS 50mg/g CREMA 50mg/g TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB DIN PEJD X 15 G CREMA P-RF 1 4,950000 0,000000 0,990000 3,96000052 W55128001 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA P-RF 1 6,597000 0,733000 1,319400 6,01060053 W58038001 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 6,597000 0,733000 1,319400 6,01060054 W60557002 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA PRF 1 6,597000 1,713000 1,319400 6,99060055 W55128002 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA P-RF 1 2,199000 3,691000 0,439800 5,45020056 W60557001 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA PRF 1 2,199000 3,241000 0,439800 5,00020057 W58038002 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL A 5 G CREMA PRF 1 2,199000 5,131000 0,439800 6,89020058 W64229001 D06BB03 ACICLOVIRUM ACEVIREX 50 mg/g CREMA 50mg/g THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU 1 TUB DIN AL X 5 G CREMA PRF 1 2,199000 20,801000 0,439800 22,56020059 W08119001 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 6,564000 0,000000 1,312800 5,25120060 W05099002 M01AC01 PIROXICAMUM PIROXSAL 20 mg COMPR. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST.PVC/ AL X 10 COMPR. P-6L 20 0,143500 0,000000 0,028700 0,11480061 W12442003 M01AC01 PIROXICAMUM FLAMEXIN COMPR. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L 30 0,341100 0,650566 0,068220 0,92344662 W05092002 M01AC01 PIROXICAMUM PIROXICAM LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST., PVC/AL X 20 COMPR. P-6L 20 0,242500 0,000000 0,048500 0,19400063 W53944002 M01AC01 PIROXICAMUM PIROXICAM ARENA 20 MG COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,135000 0,000000 0,027000 0,10800064 W59471001 M01AC01 PIROXICAMUM PIROXICAM HELCOR 20 mg COMPR. 20mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,233500 0,000000 0,046700 0,18680065 W12441001 M01AC01 PIROXICAMUM FLAMEXIN (R) PULB. PT. SOL. ORALA 20mg/plic CHIESI FARMACEUTICI SPA ITALIA CUTIE X 20 PLICURI DUBLU COMPARTIMENTAT X 3 G PULB. PT. SOL. ORALA P-6L 20 0,341100 1,074900 0,068220 1,34778066 W05080001 M01AC01 PIROXICAMUM HOTEMIN SOL. INJ. 20mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 BLIST. C-PET/PE X 5 FIOLE X 1 ML SOL. INJ. P-RF 5 2,068000 0,258000 0,413600 1,91240067 W09001001 M01AC01 PIROXICAMUM PIROXICAM SINTOFARM 20 mg SUPOZ. 20mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L 10 0,770000 0,000000 0,154000 0,61600068 W08513001 M01AX17 NIMESULIDUM LEMESIL COMPR. 100mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,370856 0,046644 0,074171 0,34332969 W08886001 M01AX17 NIMESULIDUM NIMESULID 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,370856 0,047144 0,074171 0,34382970 W42589001 M01AX17 NIMESULIDUM NIMESULID SLAVIA COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0,370856 0,047144 0,074171 0,34382971 W43252002 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,370856 0,045144 0,074171 0,34182972 W43252001 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,370856 0,045144 0,074171 0,34182973 W51945001 M01AX17 NIMESULIDUM NIMESULID ARENA 100 mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0,370856 0,047144 0,074171 0,34382974 W63141001 M01AX17 NIMESULIDUM AULIN 100 mg COMPR. 100mg ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU BLIST. AL/PVC X 10 COMPR. PRF 10 0,370856 0,265144 0,074171 0,56182975 W63142009 M01AX17 NIMESULIDUM AULIN 100 mg GRAN. PT. SUSP. ORALA 100mg/plic ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU 15 PLICURI DIN AL/HÂRTIE/PE SAU AL/HÂRTIE/PE/FOLIE SURLYN A CÂTE 2 G GRANULE PENTRU SUSPENSIE ORALA PRF 15 0,370856 0,263810 0,074171 0,56049576 W61456002 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 10 0,370856 0,047144 0,074171 0,34382977 W61456003 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 30 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 30 0,370856 0,046144 0,074171 0,34282978 W55441001 M05BA06 ACIDUM IBANDRONICUM OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC.UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P-6L 1 25,947000 7,233000 5,189400 27,99060079 W56947001 M05BA06 ACIDUM IBANDRONICUM QUODIXOR 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P-6L 1 21,020000 0,000000 4,204000 16,81600080 W57485004 M05BA06 ACIDUM IBANDRONICUM OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM. P6L 1 23,500000 0,000000 4,700000 18,80000081 W58574001 M05BA06 ACIDUM IBANDRONICUM ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L 1 25,947000 2,883000 5,189400 23,64060082 W60664001 M05BA06 ACIDUM IBANDRONICUM ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P6L 1 25,947000 3,773000 5,189400 24,53060083 W63021001 M05BA06 ACIDUM IBANDRONICUM ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 21,530000 0,000000 4,306000 17,22400084 W57932001 M05BA06 ACIDUM IBANDRONICUM OSSICA 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE P6L 1 73,800000 35,770000 14,760000 94,81000085 W61791001 M05BA06 ACIDUM IBANDRONICUM ACID IBANDRONIC ACCORD 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE PR/PRF 1 73,800000 32,410000 14,760000 91,45000086 W57484001 M05BA06 ACIDUM IBANDRONICUM OSAGRAND 3 mg/3 ml SOL. INJ. 3mg/3ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ. P6L 1 73,800000 36,590000 14,760000 95,63000087 W42094003 M05BX03 STRONTIUM RANELATUM OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 28 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF 28 5,318214 0,000000 1,063642 4,25457288 W51336001 N03AE01 CLONAZEPAMUM RIVOTRIL COMPR. 0,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR. P-RF 50 0,068501 0,080699 0,013700 0,13550089 W55375001 N03AE01 CLONAZEPAMUM RIVOTRIL 2 mg COMPR. 2mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-RF 30 0,207000 0,000000 0,041400 0,16560090 W52016002 N06BX03 PIRACETAMUM PIRACETAM ARENA 400 mg CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,107718 0,277615 0,021543 0,36379091 W08467001 N06BX03 PIRACETAMUM PIRACETAM FARMEX 400 mg COMPR. 400mg FARMEX COMPANY SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,107718 0,009032 0,021543 0,09520792 W05045001 N06BX03 PIRACETAMUM PIRACETAM MCC 400mg COMPR. 400mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,107718 0,061782 0,021543 0,14795793 W54455002 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mgCOMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 4 BLIST. PVC/AL X 10 COMPR. P-6L 40 0,107718 0,062282 0,021543 0,14845794 W60657001 N06BX03 PIRACETAMUM PIRACETAM LAROPHARM 400 mg COMPR. 400mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,107718 0,221282 0,021543 0,30745795 W57920002 N06BX03 PIRACETAMUM PIRACETAM HELCOR 400mg COMPR. FILM. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,107718 0,020782 0,021543 0,10695796 W60618001 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 400 mg COMPR. FILM. 400mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. FILM.P6L 20 0,107718 0,084282 0,021543 0,17045797 W57090002 N06BX03 PIRACETAMUM NOOTROPIL 800 mg COMPR. FILM. 800mg U.C.B. PHARMA S.A. BELGIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. FILM.P6L 90 0,215438 0,143228 0,043087 0,31557998 W57921001 N06BX03 PIRACETAMUM PIRACETAM HELCOR 800mg COMPR. FILM. 800mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 20 0,215438 0,017062 0,043087 0,18941399 W60617001 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 800 mg COMPR. FILM. 800mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. FILM.P6L 20 0,215438 0,017062 0,043087 0,189413100 W42904001 N06BX03 PIRACETAMUM MEMOTAL1 g/5 ml SOL. INJ. 1g/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 1,960000 0,000000 0,392000 1,568000101 W63143001 R05CB15 ERDOSTEINUM ** ERDOMED 300 mg CAPS. 300mg ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 10 1,667000 0,000000 0,333400 1,333600102 W63144001 R05CB15 ERDOSTEINUM ** ERDOMED 175 mg/5 ml PULB. PT. SUSP. ORALA 175mg/5ml ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA A 50 G PULB. PT. OBTINEREA A 100 ML SUSP. ORALA + 1 MASURA DOZATOARE DIN PP P-6L 1 25,150000 0,000000 5,030000 20,120000

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Page 88: Casa Naţională de Asigurări de Sănătate medicamentelor A-B-C1-C3 … · 39 w62376001 a06ad11 lactulosum duphalac® lichid oral 66,7% bgp products b.v. olanda flacon din peid

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Contributie maxima a asiguratului / UT (pt. asiguratii care

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Val. maxima suportata de sistemul de asigurari

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pretul de referinta)

Contributie maxima a asiguratului / UT (pt. asiguratii care

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NOTĂ:

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (**) se efectuează pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătăţii.

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) 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

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