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Page 1: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale
Page 2: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale
Page 3: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

ANEXA 1

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti

1 A02BA02 RANITIDINUM RANITIDIN ARENA 150mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 4,55 0,227500 0,194887 0,1753982 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 4,56 0,228000 0,194887 0,1753983 A02BA02 RANITIDINUM RANITIDIN COMPR. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,55 0,227500 0,194887 0,1753984 A02BA02 RANITIDINUM ZANTAC 150 mg COMPR. FILM. 150mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 10 COMPR. FILM. P-6L 20 7,01 0,350500 0,194887 0,1753985 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 4,56 0,228000 0,194887 0,1753986 A02BA02 RANITIDINUM RANITIDINA ATB 150 MG COMPR. FILM. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 4,55 0,227500 0,194887 0,1753987 A02BA02 RANITIDINUM RANITIDINA LPH 300 mg COMPR. FILM. 300mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 13,00 0,433333 0,389774 0,3507968 A02BA02 RANITIDINUM RANITIDINA ATB 300 mg COMPR. FILM. 300mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 8,66 0,433000 0,389774 0,3507969 A02BA02 RANITIDINUM ARNETIN SOL. INJ. 25mg/ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE X 2 ML P-RF 5 12,67 2,534000 1,678945 1,511050

10 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 8,89 0,296333 0,194887 0,17539811 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 5,86 0,195333 0,194887 0,17539812 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 9,45 0,337500 0,194887 0,17539813 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 7,72 0,257333 0,257333 0,23159914 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 12,31 0,410333 0,389774 0,35079615 A02BA03 FAMOTIDINUM QUAMATEL 20 mg PULB+SOLV. PT. SOL. INJ./PERF. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERFUZ. + 5 FIOLE DIN STCLA INCOLORA X 5 S/P-RF 5 24,64 4,928000 4,928000 4,43520016 A02BA04 NIZATIDINUM NIZATIDIN VIM SPECTRUM 150 mg CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 18,23 0,911500 0,194887 0,17539817 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 10 mg CAPS. GASTROREZ. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L 14 4,61 0,329285 0,323356 0,29102018 A02BC01 OMEPRAZOLUM ULTOP CAPS. GASTROREZ. 20mg KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ. P-6L 14 14,45 1,032142 0,646713 0,58204119 A02BC01 OMEPRAZOLUM OMEPRAZOL 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 14,45 1,032142 0,646713 0,58204120 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 20 12,80 0,640000 0,640000 0,57600021 A02BC01 OMEPRAZOLUM OMERAN 20 CAPS. GASTROREZ. 20mg EUROPHARM SA ROMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 28 21,42 0,765000 0,646713 0,58204122 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 22,68 0,756000 0,646713 0,58204123 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 22,53 0,751000 0,646713 0,58204124 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 22,02 0,734000 0,646713 0,58204125 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 20,85 0,695000 0,646713 0,58204126 A02BC01 OMEPRAZOLUM NOVOGAST 20 mg CAPS. GASTROREZ. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L 20 16,95 0,847500 0,646713 0,58204127 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10CAPS. GASTROREZ P-6L 10 6,49 0,649000 0,646713 0,58204128 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 22,16 0,738666 0,646713 0,58204129 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 8,07 0,576428 0,576428 0,51878530 A02BC01 OMEPRAZOLUM HELICID 20 CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 14 CAPS. GASTROREZ. P-6L 14 10,06 0,718571 0,646713 0,58204131 A02BC01 OMEPRAZOLUM HELICID 20 CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L 28 18,38 0,656428 0,646713 0,58204132 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 21,42 0,714000 0,646713 0,58204133 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mg CAPS. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ. P6L 28 8,94 0,319285 0,319285 0,28735634 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 14 10,71 0,765000 0,646713 0,58204135 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 28 21,42 0,765000 0,646713 0,58204136 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 28 21,42 0,765000 0,667574 0,60081637 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 14 10,71 0,765000 0,667574 0,60081638 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 16,95 0,847500 0,646713 0,58204139 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 18,38 0,656428 0,646713 0,58204140 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 18,38 0,656428 0,656428 0,59078541 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 8,03 1,147142 1,147142 1,032427

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 CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI

MODIFICARILE ULTERIOARE VALABILA INCEPAND CU 1 IANUARIE 2015

Pagina 1 din 27

Page 4: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti42 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mg CAPS. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L 14 12,76 0,911428 0,911428 0,82028543 A02BC01 OMEPRAZOLUM LOSEC MUPS 10 mg COMPR. GASTROREZ. 10mg ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID X 14 COMPR. GASTROREZ. P6L 14 33,19 2,370714 0,323356 0,29102044 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 14,45 0,516071 0,516071 0,46446345 A02BC01 OMEPRAZOLUM LOSEC MUPS 20 mg COMPR. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID X 7 COMPR. GASTROREZ. P6L 7 24,96 3,565714 0,646713 0,58204146 A02BC01 OMEPRAZOLUM OMEZ 40 mg PULB. PT. SOL. PERF. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF.S/P-RF 1 16,22 16,220000 14,597999 13,13819947 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF. 40mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 16,22 16,220000 14,597999 13,13819948 A02BC01 OMEPRAZOLUM HELICID 40 INF PULB. PT. SOL. PERF. FARA CONCENTRATIE ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. S/P-RF 1 16,22 16,220000 14,597999 13,13819949 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 6,56 0,468571 0,323356 0,29102050 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 13,13 0,937857 0,646713 0,58204151 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 11,36 0,811428 0,646713 0,58204152 A02BC03 LANSOPRAZOLUM LANZAP 30mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 20 16,66 0,833000 0,646713 0,58204153 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL. P-6L 30 25,07 0,835666 0,835666 0,75209954 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. X 15 CAPS. ELIB. PREL. P-6L 30 25,07 0,835666 0,835666 0,75209955 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 9,03 0,451500 0,417833 0,37604956 A03AA05 TRIMEBUTINUM TRIMEBUTIN 100 COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 11,12 0,370666 0,370665 0,33359857 A03AA05 TRIMEBUTINUM COLPERIN 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 11,12 0,370666 0,370665 0,33359858 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 17,13 0,571000 0,370665 0,33359859 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 33,61 1,120333 0,741334 0,66720060 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 36,01 1,800500 1,112002 1,00080161 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 12,05 12,050000 12,050000 10,84500062 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 10,05 10,050000 6,328125 5,69531263 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA ARENA 100 mg COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,42 0,221000 0,193837 0,17445364 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA FARMACOM 200 mg COMPR. 200 mg FARMACOM S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 8,54 0,427000 0,387675 0,34890765 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 4,01 0,100250 0,090225 0,08120266 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 5,67 0,141750 0,090225 0,08120267 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L 40 4,01 0,100250 0,090225 0,08120268 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 8,69 8,690000 8,690000 7,82100069 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 MLP-RF 5 13,22 2,644000 2,644000 2,37960070 A03FA03 DOMPERIDONUM MOTILIUM 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 12,31 1,231000 0,090225 0,08120271 A03FA03 DOMPERIDONUM OROPERIDYS 10 mg COMPR. ORODISPERSABILE 10mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP. P6L 30 25,07 0,835666 0,090225 0,08120272 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 124,28 1,242800 1,242800 1,11852073 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 71,49 1,429800 1,340850 1,20676574 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 68,77 1,375400 1,340850 1,20676575 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 55,47 0,924500 0,924500 0,83205076 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOCHOL 150 mg COMPR. 150mg ZAMBON S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-6L 60 54,19 0,903166 0,804510 0,72405977 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOCHOL 300 mg COMPR. 300mg ZAMBON S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 35,88 1,794000 1,609021 1,44811878 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 50 136,52 2,730400 2,681700 2,41353079 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 100 268,17 2,681700 2,681700 2,41353080 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 97,49 97,490000 67,042564 60,33830781 A06AD11 LACTULOSUM DUPHALAC (R) LICHID ORAL 66,7% ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 10,37 10,370000 6,957322 6,26158982 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 10,42 10,420000 10,169999 9,15299983 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 3,47 3,470000 3,389999 3,05099984 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 17,23 17,230000 16,949999 15,25499985 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 33,34 33,340000 33,340000 30,00600086 A06AD11 LACTULOSUM LACTULAK 660 mg/ml SOL. ORALA 660 mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L 1 6,73 6,730000 6,730000 6,05700087 A06AD11 LACTULOSUM LAEVOLAC 670mg/ml SOL. ORALA 670mg/ml FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA + DISPOZITIV DE CURGERE + MASURA CU GRADATII DE LA 5 ML LA 30 ML P-RF 1 3,57 3,570000 3,494307 3,14487688 A07AA02 NYSTATINUM NISTATINA COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 9,24 0,462000 0,461999 0,41579989 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 28,24 0,564800 0,564800 0,50832090 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 28,20 0,564000 0,564000 0,507600

Pagina 2 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti91 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 60 197,11 3,285166 1,611998 1,45079892 A07EC02 MESALAZINUM** PENTASA 500mg COMPR. ELIB. PREL. 500mg FERRING GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 100 143,02 1,430200 0,805999 0,72539993 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 67,24 0,672400 0,402998 0,36269894 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 100 120,94 1,209400 0,805999 0,72539995 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 73,85 1,477000 0,805999 0,72539996 A07EC02 MESALAZINUM** MESALAZINA DUO 400 mg COMPR. GASTROREZISTENTE 400mg DUO FARMACEUTICI S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 46,88 0,781333 0,644798 0,58031897 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 46,88 0,781333 0,644798 0,58031898 A07EC02 MESALAZINUM** MESALAZINA DUO 800 mg COMPR. GASTROREZISTENTE 800mg DUO FARMACEUTICI S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 89,05 1,484166 1,289599 1,16063999 A07EC02 MESALAZINUM** MESALAZINA DUO 800 mg COMPR. GASTROREZISTENTE 800mg DUO FARMACEUTICI S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 90 128,96 1,432888 1,289599 1,160639100 A07EC02 MESALAZINUM** MESALAZINA SOFARFARM 800 mg COMPR. GASTROREZISTENTE 800mg SOFARFARM S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 89,05 1,484166 1,289599 1,160639101 A07EC02 MESALAZINUM** MESALAZINA SOFARFARM 800 mg COMPR. GASTROREZISTENTE 800mg SOFARFARM S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 90 128,96 1,432888 1,289599 1,160639102 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 28 173,80 6,207142 6,207142 5,586427103 A07EC02 MESALAZINUM** SALOFALK 1 g SUPOZ. 1g DR. FALK PHARMA GMBH GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L 30 223,62 7,454000 6,207142 5,586427104 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 21,74 2,174000 1,551780 1,396602105 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 36,00 3,600000 3,103571 2,793213106 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 7 169,61 24,230000 24,230000 21,807000107 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,53 0,217666 0,181166 0,163049108 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,76 0,338000 0,338000 0,304200109 B01AC05 TICLOPIDINUM 1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 35,53 1,776500 0,602517 0,542265110 B01AC05 TICLOPIDINUM 1) IPATON COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P-RF 20 33,37 1,668500 0,602517 0,542265111 B02BA01 PHYTOMENADIONUM FITOMENADION 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 16,10 3,220000 3,220000 2,898000112 B03AA07 FERROSI SULFAS FERROGRADUMET (R) COMPR. ELIB. PREL. 105mg TEOFARMA SRL ITALIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 8,58 0,286000 0,286000 0,257400113 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 12,08 0,402666 0,232091 0,208881114 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 21,49 0,716333 0,644699 0,580229115 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FER ROMPHARM 50 mg/ml PIC. ORALE, SOL. 50mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 30 ML PIC. ORALE, SOL. P6L 1 8,78 8,780000 8,780000 7,902000116 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 8,81 8,810000 8,809999 7,928999117 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 ML P-6L 1 13,53 13,530000 8,809999 7,928999118 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 15,39 15,390000 8,809999 7,928999119 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 ML P-6L 1 10,06 10,060000 5,873333 5,285999120 B03AEN1 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 14,85 0,297000 0,297000 0,267300121 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 7,40 0,246666 0,246666 0,221999122 C01AA05 DIGOXINUM DIGOXIN 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 3,34 0,133600 0,133600 0,120240123 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 3,34 0,133600 0,133600 0,120240124 C01AA05 DIGOXINUM DIGOXIN 0,5 mg/2 ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. S/P-RF 5 7,97 1,594000 1,594000 1,434600125 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. S/P-RF 5 7,97 1,594000 1,594000 1,434600126 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 20 COMPR. P-RF 20 12,37 0,618500 0,617975 0,556177127 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 13,25 0,662500 0,617975 0,556177128 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 19,26 0,642000 0,617975 0,556177129 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 30,82 0,616400 0,616400 0,554760130 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8,03 0,401500 0,362325 0,326092131 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 36,25 0,362500 0,362325 0,326092132 C01BC03 PROPAFENONUM RYTMONORM (R) COMPR. FILM. 150mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 32,02 0,640400 0,362325 0,326092133 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. X 25 COMPR. FILM. P-RF 50 18,71 0,374200 0,362325 0,326092134 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 BLIST. X 20 COMPR. FILM. P-RF 20 7,49 0,374500 0,362325 0,326092135 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 34,95 0,349500 0,349500 0,314550136 C01BC03 PROPAFENONUM PROPAFENON SANDOZ 150 mg COMPR. FILM. 150mg HEXAL AG GERMANIA CUTIE X 5 BLIST. AL/PP X 10 COMPR. FILM. P-RF 50 18,09 0,361800 0,361800 0,325620137 C01BC03 PROPAFENONUM PROPANORM 300 mg COMPR. FILM. 300mg PRO. MED. CS PRAHA CEHIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 40,30 0,806000 0,724650 0,652185138 C01BC03 PROPAFENONUM RYTMONORM SOL. INJ. 70mg/20ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. P-RF 5 36,79 7,358000 7,358000 6,622200139 C01BD01 AMIODARONUM AMIODARONA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 9,01 0,300333 0,272333 0,245099

Pagina 3 din 27

Page 6: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti140 C01BD01 AMIODARONUM AMIODARONA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,33 0,244333 0,244333 0,219899141 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. DIVIZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 13,87 0,462333 0,272333 0,245099142 C01BD01 AMIODARONUM AMIOKORDIN SOL INJ. 150mg/3ml CN UNIFARM S.A. ROMANIA CUTIE X 5 FIOLE X 3ML SOLUTIE INJECTABILA PRF 5 18,49 3,698000 3,697999 3,328199143 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 11,42 0,190333 0,150805 0,135724144 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 3,87 0,193500 0,115256 0,103730145 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 18,47 1,847000 1,847000 1,662300146 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 15,30 15,300000 15,300000 13,770000147 C01DA08 ISOSORBIDI DINITRAS ISOSORBIDE DINITRATE 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 2,14 0,035666 0,035666 0,032099148 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 3,94 0,065666 0,065666 0,059099149 C01DA14 ISOSORBIDI MONONITRAS OLICARD 40 mg RETARD CAPS. ELIB. PREL. 40mg ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 12,02 0,601000 0,290010 0,261009150 C01DA14 ISOSORBIDI MONONITRAS MONO ROM SR 40 mg CAPS. ELIB. PREL. 40mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 20 11,86 0,593000 0,290010 0,261009151 C01DA14 ISOSORBIDI MONONITRAS MONO ROM SR 60 mg CAPS. ELIB. PREL. 60mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 20 18,49 0,924500 0,435016 0,391514152 C01DA14 ISOSORBIDI MONONITRAS MONONITRON (R) EP 60 mg COMPR. FILM. ELIB. PREL. 60mg ZENTIVA S.A ROMANIA CUTIE X 4 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 40 36,41 0,910250 0,435016 0,391514153 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 5 328,95 65,790000 55,530750 49,977675154 C01EA01 ALPROSTADILUM*** VASAPROSTAN 20 LIOF. PT. SOL. PERF. 20µg UCB PHARMA GMBH GERMANIA CUTIE X 10 FIOLE X 5 ML LIOF. PT. SOL. PERF. PRF 10 521,11 52,111000 52,111000 46,899900155 C01EB15 TRIMETAZIDINUM TRIMETAZIDIN VIM SPECTRUM 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 CAPS. P-6L 30 7,61 0,253666 0,253666 0,228299156 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 16,72 0,557333 0,443915 0,399523157 C01EB15 TRIMETAZIDINUM APSTAR 35 mg COMPR. ELIB. PREL. 35mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR/AL X 60 COMPR. ELIB. PREL. P6L 60 33,41 0,556833 0,443915 0,399523158 C01EB15 TRIMETAZIDINUM TRIMELUZINE 35 mg COMPR. ELIB. PREL. 35mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 60 COMPR. ELIB. PREL. P6L 60 26,64 0,444000 0,443915 0,399523159 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 16,56 0,552000 0,443915 0,399523160 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA TEVA 35 mg COMPR. ELIB. PREL. 35mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P6L 60 23,56 0,392666 0,392666 0,353399161 C01EB15 TRIMETAZIDINUM MODUXIN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 7,61 0,253666 0,253666 0,228299162 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 15,24 0,254000 0,253666 0,228299163 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 23,44 0,390666 0,253666 0,228299164 C01EB15 TRIMETAZIDINUM PREDUCTAL MR 35 mg COMPR. FILM. ELIB. MODIF. 35mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. FILM. ELIB. MODIF. P-6L 60 49,74 0,829000 0,443915 0,399523165 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 35 mg COMPR. FILM. ELIB. MODIF. 35mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. MODIF. P-6L 60 33,39 0,556500 0,443915 0,399523166 C01EB15 TRIMETAZIDINUM PREDUTRIM 20 mg/ml PIC. ORALE, SOL. 20mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 50 ML PIC. ORALE P6L 1 12,33 12,330000 12,330000 11,097000167 C02AB01 METHYLDOPUM DOPEGYT COMPR. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 26,73 0,534600 0,534600 0,481140168 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 12,00 0,240000 0,216642 0,194977169 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 12,34 0,246800 0,216642 0,194977170 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 12,33 0,246600 0,216642 0,194977171 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 4,18 0,167200 0,167200 0,150480172 C03BA11 INDAPAMIDUM SERDIMID 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 13,68 0,456000 0,319799 0,287819173 C03BA11 INDAPAMIDUM INDAPAMIDA SOPHARMA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SOPHARMA PLC BULGARIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 9,32 0,310666 0,310666 0,279599174 C03BA11 INDAPAMIDUM SERDIMID 2,5 mg COMPR. CU ELIB. PREL. 2,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. CU ELIB. PREL. P6L 30 15,07 0,502333 0,502333 0,452099175 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 13,30 0,443333 0,319799 0,287819176 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 2,5mg COMPR. CU ELIB. PRELUNGITA 2,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10COMPR. CU ELIB. PREL. P-6L 30 14,90 0,496666 0,496666 0,446999177 C03BA11 INDAPAMIDUM INDAPAMIDA MYLAN 1,5 mg COMPR. ELIB. PREL. 1,5 mg MYLAN S.A.S. FRANTA CUTIE CU BLIST DIN PVC/AL X 30 COMPR. ELIB. PREL. P-6L 30 12,60 0,420000 0,319799 0,287819178 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 21,05 0,701666 0,319799 0,287819179 C03BA11 INDAPAMIDUM INDAPAMID MCC 1,5 mg COMPR. ELIB. PREL. 1,5mg MAGISTRA C&C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 13,68 0,456000 0,319799 0,287819180 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 10,66 0,355333 0,319799 0,287819181 C03BA11 INDAPAMIDUM DIUREMID SR 1,5 mg COMPR. ELIB. PREL. 1,5mg GLENMARK PHARMACEUTICALS SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P-6L 30 13,68 0,456000 0,319799 0,287819182 C03BA11 INDAPAMIDUM INDAPAMIDA TEVA 1,5 mg COMPR. ELIB. PREL. 1,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-6L 30 13,31 0,443666 0,319799 0,287819183 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 13,68 0,456000 0,319799 0,287819184 C03BA11 INDAPAMIDUM INDAPAGAMMA 1,5 mg COMPR. ELIB. PREL. 1,5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. ELIB. PREL. P6L 30 12,62 0,420666 0,319799 0,287819185 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 15,07 0,502333 0,502333 0,452099186 C03BA11 INDAPAMIDUM INDAPAMID SR 1,5 mg LAROPHARM COMPR. FILM. ELIB. PREL. 1,5 mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 9,11 0,455500 0,319799 0,287819187 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 13,68 0,456000 0,319799 0,287819188 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 11,71 0,390333 0,319799 0,287819

Pagina 4 din 27

Page 7: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti189 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 13,16 0,438666 0,319799 0,287819190 C03BA11 INDAPAMIDUM INDAPAMIDA ACTAVIS 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. CU ELIB. PRELUNGITA P-6L 30 13,68 0,456000 0,319799 0,287819191 C03BA11 INDAPAMIDUM REDITENS SR 1.5 mg COMPR. FILM. ELIB. PREL. 1,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 13,68 0,456000 0,319799 0,287819192 C03BA11 INDAPAMIDUM INDAPEN SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg J & P PHARMA UK. LTD. MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. CU ELIB. PREL. P-6L 30 9,88 0,329333 0,319799 0,287819193 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 3,02 0,151000 0,151000 0,135900194 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,151000 0,135900195 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 6,02 0,301000 0,151250 0,136125196 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,04 0,152000 0,151250 0,136125197 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 6,02 0,301000 0,151250 0,136125198 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5,42 0,271000 0,151250 0,136125199 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 6,07 1,214000 1,214000 1,092600200 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 28,51 0,950333 0,950333 0,855299201 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 16,07 0,321400 0,237583 0,213824202 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 19,46 0,324333 0,237583 0,213824203 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 16,72 0,557333 0,475166 0,427649204 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 16,24 0,541333 0,475166 0,427649205 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,30 0,215000 0,215000 0,193500206 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 17,83 0,356600 0,237583 0,213824207 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 4,30 0,215000 0,215000 0,193500208 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 13,74 0,687000 0,475166 0,427649209 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 31,48 1,049333 1,049333 0,944399210 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 23,31 1,165500 1,049333 0,944399211 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 31,48 1,049333 1,049333 0,944399212 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 23,31 1,165500 1,049333 0,944399213 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 40 22,42 0,560500 0,417066 0,375359214 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 10,25 0,512500 0,417066 0,375359215 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 20,54 0,410800 0,410800 0,369720216 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 33,83 0,676600 0,625599 0,563039217 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 65,38 0,653800 0,625599 0,563039218 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 33,65 0,673000 0,625599 0,563039219 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 6,13 0,306500 0,306500 0,275850220 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. FILM. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 20 17,21 0,860500 0,417066 0,375359221 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 18,40 0,306666 0,306666 0,275999222 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 16,46 0,823000 0,625599 0,563039223 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 3,25 0,065000 0,030404 0,027363224 C07AA05 PROPRANOLOLUM PROPRANOLOL 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,10 0,082000 0,030404 0,027363225 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,98 0,099600 0,099600 0,089640226 C07AA05 PROPRANOLOLUM PROPRANOLOL 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,98 0,099600 0,099600 0,089640227 C07AA05 PROPRANOLOLUM PROPRANOLOL ARENA 40 mg COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,98 0,099600 0,099600 0,089640228 C07AA05 PROPRANOLOLUM HEMANGIOL 3,75 mg/ml SOL. ORALA 3,75 mg/ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON DIN STICLA BRUNA X 120ML SOLUTIE ORALA PR/PRF 1 1.067,99 1.067,990000 1,368203 1,231382229 C07AA07 SOTALOLUM SOTAGAMMA 160 COMPR. 160mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 100 58,44 0,584400 0,486472 0,437824230 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 11,17 0,558500 0,486472 0,437824231 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 26,93 0,538600 0,486472 0,437824232 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 54,63 0,546300 0,486472 0,437824233 C07AA07 SOTALOLUM DAROB (R) 80 mg COMPR. 80mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVP X 10 COMPR. P-6L 20 10,06 0,503000 0,243236 0,218912234 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 39,32 0,393200 0,243236 0,218912235 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 36,53 0,365300 0,243236 0,218912236 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 17,52 0,350400 0,243236 0,218912237 C07AB02 METOPROLOLUM BLOXAN COMPR. 100mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L 30 14,05 0,468333 0,284849 0,256364

Pagina 5 din 27

Page 8: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti238 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,94 0,364666 0,284849 0,256364239 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 6,56 0,328000 0,284849 0,256364240 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,12 0,237333 0,237333 0,213599241 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 100 mg COMPR. 100mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5,86 0,293000 0,284849 0,256364242 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9,49 0,316333 0,284849 0,256364243 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 15,12 0,504000 0,284849 0,256364244 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 7,38 0,369000 0,284849 0,256364245 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,01 0,233666 0,233666 0,210299246 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8,09 0,404500 0,284849 0,256364247 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 8,78 0,292666 0,284849 0,256364248 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 1,90 0,095000 0,071212 0,064090249 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 1,90 0,095000 0,071212 0,064090250 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2,85 0,095000 0,071212 0,064090251 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 2,85 0,095000 0,071212 0,064090252 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 50 mg COMPR. 50mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,51 0,175500 0,142424 0,128181253 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,27 0,175666 0,142424 0,128181254 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 3,51 0,175500 0,142424 0,128181255 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,75 0,158333 0,142424 0,128181256 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,27 0,175666 0,142424 0,128181257 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,06 0,235333 0,142424 0,128181258 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 3,45 0,172500 0,142424 0,128181259 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 5,27 0,175666 0,142424 0,128181260 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,51 0,175500 0,142424 0,128181261 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 4,39 0,146333 0,142424 0,128181262 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 11,12 0,556000 0,284849 0,256364263 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 9,09 0,303000 0,284849 0,256364264 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 5,24 0,174666 0,142424 0,128181265 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 25,70 0,856666 0,284849 0,256364266 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 15,69 0,523000 0,142424 0,128181267 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 22,71 0,757000 0,541214 0,487092268 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 8,14 0,271333 0,135303 0,121772269 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 13,59 0,453000 0,270607 0,243546270 C07AB03 ATENOLOLUM ATENOCOR 100 mg COMPR. 100mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,83 0,361000 0,361000 0,324900271 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,57 0,352333 0,352333 0,317099272 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 7,04 0,352000 0,352000 0,316800273 C07AB03 ATENOLOLUM ATENOLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6,26 0,313000 0,313000 0,281700274 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,93 0,196500 0,196500 0,176850275 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,90 0,196666 0,196666 0,176999276 C07AB03 ATENOLOLUM ATENOCOR 50 mg COMPR. 50mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,35 0,178333 0,178333 0,160499277 C07AB03 ATENOLOLUM ATENOLOL ARENA 50 MG COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,56 0,178000 0,178000 0,160200278 C07AB03 ATENOLOLUM ATENOLOL 100 mg MEDO COMPR. FILM. 100mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4,61 0,230500 0,230500 0,207450279 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 9,61 0,343214 0,343214 0,308892280 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 4 BLIST. AL/PVC X 7 COMPR. FILM. P-6L 28 14,84 0,530000 0,427274 0,384546281 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 15,89 0,529666 0,427274 0,384546282 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 10,60 0,530000 0,427274 0,384546283 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC X 7 COMPR. FILM. P-6L 14 7,41 0,529285 0,427274 0,384546284 C07AB07 BISOPROLOLUM BISOPROLOL LPH 10mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 18,12 0,604000 0,427274 0,384546285 C07AB07 BISOPROLOLUM BISOBLOCK 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 16,18 0,539333 0,427274 0,384546286 C07AB07 BISOPROLOLUM BISOPROLOL LPH 5mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 8,55 0,285000 0,213637 0,192273

Pagina 6 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti287 C07AB07 BISOPROLOLUM BISOBLOCK 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7,32 0,244000 0,213637 0,192273288 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 10,51 0,350333 0,350333 0,315299289 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 31,83 1,061000 0,427274 0,384546290 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 49,43 0,494300 0,427274 0,384546291 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 18,12 0,604000 0,427274 0,384546292 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 32,72 1,090666 0,427274 0,384546293 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 18,12 0,604000 0,427274 0,384546294 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 13,67 0,455666 0,427274 0,384546295 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 32,72 1,090666 0,427274 0,384546296 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 10,05 0,335000 0,335000 0,301500297 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 8,07 0,269000 0,106818 0,096136298 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 14,76 0,492000 0,106818 0,096136299 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 14,76 0,492000 0,106818 0,096136300 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 6,04 0,201333 0,106818 0,096136301 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 16,33 0,544333 0,213637 0,192273302 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 8,55 0,285000 0,213637 0,192273303 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-6L 100 25,01 0,250100 0,213637 0,192273304 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 22,31 0,743666 0,213637 0,192273305 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 8,55 0,285000 0,213637 0,192273306 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 7,87 0,262333 0,213637 0,192273307 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 22,31 0,743666 0,213637 0,192273308 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 6,04 0,201333 0,201333 0,181199309 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8,20 0,273333 0,273333 0,245999310 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 8,20 0,273333 0,273333 0,245999311 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 29,94 1,069285 0,315792 0,284212312 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 12,48 0,445714 0,315792 0,284212313 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 13,30 0,443333 0,315792 0,284212314 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 13,36 0,445333 0,315792 0,284212315 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 6,72 0,336000 0,315792 0,284212316 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 13,10 0,436666 0,315792 0,284212317 C07AG02 CARVEDILOLUM MIOCARVIL 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 13,36 0,445333 0,315792 0,284212318 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,2 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8,72 0,436000 0,315792 0,284212319 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 33,45 1,194642 0,631585 0,568426320 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 22,05 0,787500 0,631585 0,568426321 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 23,62 0,787333 0,631585 0,568426322 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 9,18 0,306000 0,306000 0,275400323 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 23,62 0,787333 0,631585 0,568426324 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 23,00 0,766666 0,631585 0,568426325 C07AG02 CARVEDILOLUM MIOCARVIL 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 23,62 0,787333 0,631585 0,568426326 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 15,72 0,786000 0,631585 0,568426327 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 9,18 0,306000 0,306000 0,275400328 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 16,46 0,587857 0,157896 0,142106329 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 6,44 0,230000 0,157896 0,142106330 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 6,89 0,229666 0,157896 0,142106331 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 6,25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 5,33 0,177666 0,157896 0,142106332 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 6,89 0,229666 0,157896 0,142106333 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 4,56 0,228000 0,157896 0,142106334 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 6,70 0,223333 0,157896 0,142106335 C07AG02 CARVEDILOLUM MIOCARVIL 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 6,89 0,229666 0,157896 0,142106

Pagina 7 din 27

Page 10: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti336 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 5,33 0,177666 0,157896 0,142106337 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 6,93 0,247500 0,247500 0,222750338 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 7,70 0,275000 0,275000 0,247500339 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 4,85 0,173214 0,157896 0,142106340 C08CA01 AMLODIPINUM AMLODIPINA TEVA 10 mg COMPR. 10 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 11,53 0,384333 0,384333 0,345899341 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 29,68 0,989333 0,578249 0,520424342 C08CA01 AMLODIPINUM AMLOHEXAL 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424343 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 19,26 0,642000 0,578249 0,520424344 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 13,13 0,437666 0,437666 0,393899345 C08CA01 AMLODIPINUM CARDILOPIN 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424346 C08CA01 AMLODIPINUM ALMACOR 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424347 C08CA01 AMLODIPINUM EPLODIN 10 mg COMPR. 10mg EXTRACTUMPHARMA UNGARIA CUTIE X 3 BLIST. PVC- PVDC/AL X 10 COMPR. P-6L 30 19,26 0,642000 0,578249 0,520424348 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 19,28 0,642666 0,578249 0,520424349 C08CA01 AMLODIPINUM STAMLO M 10 mg COMPR. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 14 COMPR. P-6L 28 14,67 0,523928 0,523928 0,471535350 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 19,31 0,643666 0,578249 0,520424351 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 19,31 0,643666 0,578249 0,520424352 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 7,38 0,246000 0,246000 0,221400353 C08CA01 AMLODIPINUM RECOTENS 10 mg COMPR. 10mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 14,05 0,468333 0,468333 0,421499354 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L 20 12,85 0,642500 0,578249 0,520424355 C08CA01 AMLODIPINUM AGEN 10 COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 8,49 0,283000 0,283000 0,254700356 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 12,85 0,642500 0,578249 0,520424357 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 8,49 0,283000 0,283000 0,254700358 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 12,87 0,643500 0,578249 0,520424359 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 19,28 0,642666 0,578249 0,520424360 C08CA01 AMLODIPINUM AMLODIPINA TEVA 5 mg COMPR. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 5,76 0,192000 0,192000 0,172800361 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 19,94 0,664666 0,289124 0,260211362 C08CA01 AMLODIPINUM AMLOHEXAL 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 11,37 0,379000 0,289124 0,260211363 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 11,40 0,380000 0,289124 0,260211364 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 7,81 0,260333 0,260333 0,234299365 C08CA01 AMLODIPINUM CARDILOPIN 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 30 11,37 0,379000 0,289124 0,260211366 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 11,36 0,378666 0,289124 0,260211367 C08CA01 AMLODIPINUM EPLODIN 5 mg COMPR. 5mg EXTRACTUMPHARMA UNGARIA CUTIE X 3 BLIST. PVC- PVDC/AL X 10 COMPR. P-6L 30 11,37 0,379000 0,289124 0,260211368 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 11,37 0,379000 0,289124 0,260211369 C08CA01 AMLODIPINUM STAMLO M 5 mg COMPR. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 14 COMPR. P-6L 28 8,75 0,312500 0,289124 0,260211370 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 10,82 0,360666 0,289124 0,260211371 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 10,82 0,360666 0,289124 0,260211372 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 5,25 0,175000 0,175000 0,157500373 C08CA01 AMLODIPINUM RECOTENS 5 mg COMPR. 5mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 7,63 0,254333 0,254333 0,228899374 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L 20 7,44 0,372000 0,289124 0,260211375 C08CA01 AMLODIPINUM AGEN 5 COMPR. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 4,10 0,136666 0,136666 0,122999376 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 7,58 0,379000 0,289124 0,260211377 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 5 mg COMPR. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 4,10 0,136666 0,136666 0,122999378 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 8,63 0,431500 0,289124 0,260211379 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 7,89 0,263000 0,263000 0,236700380 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 50,21 1,673666 0,578249 0,520424381 C08CA02 FELODIPINUM FELODIPIN AL 10 mg COMPR. ELIB. PREL. 10mg ALIUD PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 33,73 1,124333 0,578249 0,520424382 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 2,5mg ASTRAZENECA AB SUEDIA CUTIE 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 22,26 0,742000 0,144562 0,130105383 C08CA02 FELODIPINUM FELODIPIN AL 2,5 mg COMPR. ELIB. PREL. 2,5mg ALIUD PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 14,47 0,482333 0,144562 0,130105384 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 28,37 0,945666 0,289124 0,260211

Pagina 8 din 27

Page 11: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti385 C08CA02 FELODIPINUM FELODIPIN AL 5 mg COMPR. ELIB. PREL. 5mg ALIUD PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 18,44 0,614666 0,289124 0,260211386 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 30,42 1,014000 0,578249 0,520424387 C08CA02 FELODIPINUM SISTAR 2,5 mg COMPR. FILM. ELIB. MODIF. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 14,47 0,482333 0,144562 0,130105388 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 18,43 0,614333 0,289124 0,260211389 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 42,57 1,419000 0,578249 0,520424390 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 30,52 1,017333 0,578249 0,520424391 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 16,47 0,549000 0,144562 0,130105392 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 26,66 0,888666 0,289124 0,260211393 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 15,69 0,523000 0,289124 0,260211394 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 29,88 1,067142 0,289124 0,260211395 C08CA05 NIFEDIPINUM NIFEDIPIN RETARD TERAPIA 20 mg COMPR. FILM. ELIB. PREL. 20mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 10,80 0,216000 0,192749 0,173474396 C08DA01 VERAPAMILUM VERAPAMIL ARENA 40 mg CAPS. 40mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 3,33 0,111000 0,094589 0,085130397 C08DA01 VERAPAMILUM VERAPAMIL ARENA 80 mg CAPS. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 5,96 0,198666 0,189180 0,170262398 C08DA01 VERAPAMILUM CORDAMIL 40 mg COMPR. FILM. 40mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 3,33 0,111000 0,094589 0,085130399 C08DA01 VERAPAMILUM VERAPAMIL AL 80 COMPR. FILM. 80mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L 100 21,02 0,210200 0,189180 0,170262400 C08DA01 VERAPAMILUM VERAPAMIL AL 80 COMPR. FILM. 80mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 10,51 0,210200 0,189180 0,170262401 C08DA01 VERAPAMILUM CORDAMIL 80 mg COMPR. FILM. 80mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 5,96 0,198666 0,189180 0,170262402 C08DA01 VERAPAMILUM ISOPTIN (R) 80 mg COMPR. FILM. 80mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 15,30 0,306000 0,189180 0,170262403 C08DA01 VERAPAMILUM ISOPTIN RR COMPR. FILM. ELIB. PREL. 240mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 19,91 0,995500 0,567540 0,510786404 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 11,82 0,236400 0,094589 0,085130405 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 17,32 0,346400 0,189180 0,170262406 C08DA01 VERAPAMILUM DILACORAN SOL INJ. 5mg/2ml ABBOTT PRODUCTS ROMANIA SRL ROMANIA CUTIE CU 5 FIOLE X 5MG/2ML PR/PRF 5 12,73 2,546000 2,546000 2,291400407 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 35,79 1,193000 0,805350 0,724815408 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 7,00 0,333333 0,333333 0,299999409 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 5,39 0,269500 0,268450 0,241605410 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5,39 0,269500 0,268450 0,241605411 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L 50 13,37 0,267400 0,267400 0,240660412 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 5,39 0,269500 0,268450 0,241605413 C08DB01 DILTIAZEMUM DILZEM 90 mg RETARD COMPR. FILM. ELIB. PREL. 90mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 15,38 0,512666 0,402675 0,362407414 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,41 0,113666 0,044550 0,040095415 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,10 0,136666 0,089100 0,080190416 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,089100 0,080190417 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 2,28 0,114000 0,089100 0,080190418 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,42 0,114000 0,089100 0,080190419 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,42 0,114000 0,089100 0,080190420 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,64 0,154666 0,089100 0,080190421 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,28 0,114000 0,089100 0,080190422 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 2,67 0,133500 0,133500 0,120150423 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6,67 0,222333 0,178200 0,160380424 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,87 0,193500 0,178200 0,160380425 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 2,67 0,133500 0,133500 0,120150426 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,50 0,150000 0,150000 0,135000427 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,93 0,131000 0,131000 0,117900428 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4,39 0,219500 0,178200 0,160380429 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,96 0,198000 0,178200 0,160380430 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 4,39 0,219500 0,178200 0,160380431 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 4,39 0,219500 0,178200 0,160380432 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 4,39 0,219500 0,178200 0,160380433 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 10,52 0,375714 0,178200 0,160380

Pagina 9 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti434 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 7,30 0,365000 0,178200 0,160380435 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6,87 0,229000 0,178200 0,160380436 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,25 0,225000 0,178200 0,160380437 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 22,02 0,220200 0,178200 0,160380438 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 4,10 0,205000 0,178200 0,160380439 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 4,39 0,219500 0,178200 0,160380440 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 7,94 0,397000 0,356400 0,320760441 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 20 mg COMPR. 20mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 10,18 0,509000 0,356400 0,320760442 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 8,75 0,437500 0,356400 0,320760443 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 7,94 0,397000 0,356400 0,320760444 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 17,12 0,611428 0,356400 0,320760445 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 11,11 0,555500 0,356400 0,320760446 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 11,12 0,370666 0,356400 0,320760447 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 16,43 0,328600 0,328600 0,295740448 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 7,92 0,396000 0,356400 0,320760449 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 7,94 0,397000 0,356400 0,320760450 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,67 0,183500 0,089100 0,080190451 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,67 0,183500 0,089100 0,080190452 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 3,67 0,183500 0,089100 0,080190453 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 7,87 0,281071 0,089100 0,080190454 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 3,84 0,192000 0,089100 0,080190455 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 3,93 0,196500 0,089100 0,080190456 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 5,58 0,186000 0,089100 0,080190457 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 5 mg COMPR. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 3,67 0,183500 0,089100 0,080190458 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 3,67 0,183500 0,089100 0,080190459 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 15,45 3,090000 3,090000 2,781000460 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 14,98 0,499333 0,178200 0,160380461 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10,74 0,537000 0,178200 0,160380462 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,31 0,343666 0,178200 0,160380463 C09AA03 LISINOPRILUM LISIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8,61 0,287000 0,178200 0,160380464 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14,44 0,481333 0,178200 0,160380465 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 12,87 0,429000 0,178200 0,160380466 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 11,96 0,398666 0,178200 0,160380467 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 15,47 0,552500 0,178200 0,160380468 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 8,75 0,312500 0,044550 0,040095469 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 23,11 0,770333 0,356400 0,320760470 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 15,65 0,782500 0,356400 0,320760471 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 15,05 0,501666 0,356400 0,320760472 C09AA03 LISINOPRILUM LISIGAMMA 20 mg COMPR. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 12,93 0,431000 0,356400 0,320760473 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 23,37 0,779000 0,356400 0,320760474 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 23,48 0,782666 0,356400 0,320760475 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 22,90 0,817857 0,356400 0,320760476 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 14,44 0,722000 0,356400 0,320760477 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 39,31 1,310333 0,712800 0,641520478 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7,64 0,254666 0,089100 0,080190479 C09AA03 LISINOPRILUM LISIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 6,50 0,216666 0,089100 0,080190480 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8,67 0,289000 0,089100 0,080190481 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 7,37 0,245666 0,089100 0,080190482 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 9,28 0,331428 0,089100 0,080190

Pagina 10 din 27

Page 13: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti483 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 9,23 0,329642 0,329642 0,296677484 C09AA05 RAMIPRILUM PIRAMIL 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 23,28 0,831428 0,712800 0,641520485 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 9,74 0,324666 0,324666 0,292199486 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 24,93 0,831000 0,712800 0,641520487 C09AA05 RAMIPRILUM HARTIL 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 9,21 0,328928 0,328928 0,296035488 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 9,23 0,329642 0,329642 0,296677489 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 14,19 0,506785 0,506785 0,456106490 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 9,49 0,338928 0,338928 0,305035491 C09AA05 RAMIPRILUM AMPRIGEN 10 mg COMPR. 10mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 24,04 0,801333 0,712800 0,641520492 C09AA05 RAMIPRILUM RAMIPRIL TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,296399493 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,296399494 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,296399495 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 4,65 0,166071 0,166071 0,149463496 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 9,37 0,334642 0,178200 0,160380497 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 4,87 0,162333 0,162333 0,146099498 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 10,02 0,334000 0,178200 0,160380499 C09AA05 RAMIPRILUM HARTIL 2,5 mg COMPR. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 4,62 0,165000 0,165000 0,148500500 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 4,65 0,166071 0,166071 0,149463501 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 7,15 0,255357 0,178200 0,160380502 C09AA05 RAMIPRILUM AMPRIGEN 2,5 mg COMPR. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 9,92 0,330666 0,178200 0,160380503 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 4,98 0,166000 0,166000 0,149400504 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 4,98 0,166000 0,166000 0,149400505 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 6,70 0,239285 0,239285 0,215356506 C09AA05 RAMIPRILUM PIRAMIL 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 10,17 0,363214 0,356400 0,320760507 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 7,18 0,239333 0,239333 0,215399508 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 10,85 0,361666 0,356400 0,320760509 C09AA05 RAMIPRILUM HARTIL 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 6,69 0,238928 0,238928 0,215035510 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 6,70 0,239285 0,239285 0,215356511 C09AA05 RAMIPRILUM TRITACE® 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 10,31 0,368214 0,356400 0,320760512 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 7,10 0,253571 0,253571 0,228213513 C09AA05 RAMIPRILUM AMPRIGEN 5 mg COMPR. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 10,75 0,358333 0,356400 0,320760514 C09AA05 RAMIPRILUM RAMIPRIL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,215399515 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,215399516 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,215399517 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 11,69 0,389666 0,118799 0,106919518 C09AA06 QUINAPRILUM ACCUPRO (R) 20 COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 16,75 0,558333 0,237599 0,213839519 C09AA06 QUINAPRILUM ACCUPRO (R) 5 COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 8,20 0,273333 0,059399 0,053459520 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 20,83 0,743928 0,118799 0,106919521 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 14,51 0,483666 0,118799 0,106919522 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 13,54 0,451333 0,118799 0,106919523 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg BRISTOL-MYERS SQUIBB UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 28,58 1,020714 0,237599 0,213839524 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 19,91 0,663666 0,237599 0,213839525 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 18,58 0,619333 0,237599 0,213839526 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 8,89 0,444500 0,412071 0,370863527 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 9,82 0,491000 0,412071 0,370863528 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL HL COMPR. 10mg/12.5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST.OPA-AL-PVC/AL A CATE 10 CAPS. P-6L 30 8,88 0,296000 0,296000 0,266400529 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL H COMPR. 10mg/25mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST.OPA-AL-PVC/AL A CATE 10 CAPS. P-6L 30 11,82 0,394000 0,394000 0,354600530 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 7,95 0,397500 0,397500 0,357750531 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 2,5 mg/12,5mg COMPR. 2,5mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 5,64 0,201428 0,201428 0,181285

Pagina 11 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti532 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) RAMIPRIL HCT-MEDOCHEMIE COMPR. 2,5mg/12,5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 13,27 0,442333 0,412071 0,370863533 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 2,5 PLUS COMPR. 2,5mg/12,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 8,67 0,309642 0,309642 0,278677534 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 12,82 0,457857 0,412071 0,370863535 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) RAMIPRIL HCT-MEDOCHEMIE COMPR. 5mg/25mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 20,15 0,671666 0,412071 0,370863536 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 19,72 0,704285 0,412071 0,370863537 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 39,38 1,312666 1,028324 0,925491538 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 33,41 1,113666 1,028324 0,925491539 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 33,41 1,113666 1,028324 0,925491540 C09CA01 LOSARTANUM LOZAP 100 COMPR. FILM. 100mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 14,38 0,479333 0,479333 0,431399541 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 32,76 1,170000 1,028324 0,925491542 C09CA01 LOSARTANUM LOSARTAN ZENTIVA 100 mg COMPR. FILM. 100mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 14,38 0,479333 0,479333 0,431399543 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 19,23 0,641000 0,514162 0,462745544 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 17,92 0,597333 0,514162 0,462745545 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 17,92 0,597333 0,514162 0,462745546 C09CA01 LOSARTANUM LOSARTAN FARMAL 50 mg COMPR. FILM. 50mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PE- PVDC/AL X 14 COMPR. FILM. P-6L 28 17,89 0,638928 0,514162 0,462745547 C09CA01 LOSARTANUM LOZAP 50 COMPR. FILM. 50mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 7,75 0,258333 0,258333 0,232499548 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 64,56 2,305714 0,514162 0,462745549 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 18,00 0,642857 0,514162 0,462745550 C09CA01 LOSARTANUM LOSARTAN ZENTIVA 50 mg COMPR. FILM. 50mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 7,75 0,258333 0,258333 0,232499551 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 8,75 0,312500 0,195731 0,176157552 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 10 mg COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 9,37 0,312333 0,195731 0,176157553 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 14 4,38 0,312857 0,195731 0,176157554 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 8,75 0,312500 0,195731 0,176157555 C10AA01 SIMVASTATINUM ZOCOR 10 mg COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 13,45 0,480357 0,195731 0,176157556 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 9,35 0,311666 0,195731 0,176157557 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 8,74 0,312142 0,195731 0,176157558 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 9,37 0,312333 0,195731 0,176157559 C10AA01 SIMVASTATINUM RANVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 4,24 0,302857 0,195731 0,176157560 C10AA01 SIMVASTATINUM RANVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 8,47 0,302500 0,195731 0,176157561 C10AA01 SIMVASTATINUM RANVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 9,37 0,312333 0,195731 0,176157562 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 10 mg COMPR. FILM. 10mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 3,98 0,142142 0,142142 0,127927563 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 4,01 0,143214 0,143214 0,128892564 C10AA01 SIMVASTATINUM SIMVASTATINA ALVOGEN 10 mg COMPR. FILM. 10mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 9,37 0,312333 0,195731 0,176157565 C10AA01 SIMVASTATINUM SIMGAL® 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 4,01 0,143214 0,143214 0,128892566 C10AA01 SIMVASTATINUM SIMVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 4,28 0,142666 0,142666 0,128399567 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 4,93 0,164333 0,164333 0,147899568 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 9,35 0,311666 0,195731 0,176157569 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 8,81 0,293666 0,195731 0,176157570 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 16,55 0,591071 0,391462 0,352315571 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 20 mg COMPR. FILM. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 17,75 0,591666 0,391462 0,352315572 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 16,56 0,591428 0,391462 0,352315573 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 14 8,27 0,590714 0,391462 0,352315574 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 14 12,74 0,910000 0,391462 0,352315575 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 25,45 0,908928 0,391462 0,352315576 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 17,69 0,589666 0,391462 0,352315577 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 16,55 0,591071 0,391462 0,352315578 C10AA01 SIMVASTATINUM SIMCOR 20 mg COMPR. FILM. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 17,73 0,591000 0,391462 0,352315579 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 17,73 0,591000 0,391462 0,352315580 C10AA01 SIMVASTATINUM RANVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 7,90 0,564285 0,391462 0,352315

Pagina 12 din 27

Page 15: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti581 C10AA01 SIMVASTATINUM RANVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 15,79 0,563928 0,391462 0,352315582 C10AA01 SIMVASTATINUM RANVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 14,05 0,468333 0,391462 0,352315583 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 20 mg COMPR. FILM. 20mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 6,58 0,235000 0,235000 0,211500584 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 6,63 0,236785 0,236785 0,213106585 C10AA01 SIMVASTATINUM SIMVASTATINA ALVOGEN 20 mg COMPR. FILM. 20mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 16,84 0,561333 0,391462 0,352315586 C10AA01 SIMVASTATINUM SIMGAL® 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 6,63 0,236785 0,236785 0,213106587 C10AA01 SIMVASTATINUM SIMVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 7,10 0,236666 0,236666 0,212999588 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 11,16 0,372000 0,372000 0,334800589 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 14,05 0,468333 0,391462 0,352315590 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 14,87 0,495666 0,391462 0,352315591 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 21,09 0,703000 0,587193 0,528473592 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 29,88 1,067142 0,782924 0,704631593 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 29,86 1,066428 0,782924 0,704631594 C10AA01 SIMVASTATINUM ZOCOR FORTE COMPR. FILM. 40mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 44,47 1,588214 0,782924 0,704631595 C10AA01 SIMVASTATINUM ZOCOR FORTE COMPR. FILM. 40mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 14 22,99 1,642142 0,782924 0,704631596 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 29,88 1,067142 0,782924 0,704631597 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 14 14,93 1,066428 0,782924 0,704631598 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 31,99 1,066333 0,782924 0,704631599 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 40 mg COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 31,99 1,066333 0,782924 0,704631600 C10AA01 SIMVASTATINUM SIMCOR 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 31,99 1,066333 0,782924 0,704631601 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 31,99 1,066333 0,782924 0,704631602 C10AA01 SIMVASTATINUM RANVOR 40 mg COMPR. FILM. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 15,01 1,072142 0,782924 0,704631603 C10AA01 SIMVASTATINUM RANVOR 40 mg COMPR. FILM. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 23,14 0,771333 0,771333 0,694199604 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 40 mg COMPR. FILM. 40mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 9,06 0,323571 0,323571 0,291213605 C10AA01 SIMVASTATINUM SIMVASTATINA ALVOGEN 40 mg COMPR. FILM. 40mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 23,14 0,771333 0,771333 0,694199606 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 9,12 0,325714 0,325714 0,293142607 C10AA01 SIMVASTATINUM SIMGAL® 40 mg COMPR. FILM. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 9,12 0,325714 0,325714 0,293142608 C10AA01 SIMVASTATINUM SIMVASTATINA TEVA 40 mg COMPR. FILM. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 9,77 0,325666 0,325666 0,293099609 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 17,72 0,590666 0,590666 0,531599610 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 23,11 0,770333 0,770333 0,693299611 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 25,79 0,859666 0,782924 0,704631612 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 80 mg COMPR. FILM. 80mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 56,17 1,872333 1,565849 1,409264613 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. X 10 COMPR. P-6L 100 67,59 0,675900 0,260974 0,234876614 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 14,44 1,444000 0,260974 0,234876615 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 20,79 0,693000 0,260974 0,234876616 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 25,87 0,862333 0,260974 0,234876617 C10AA02 LOVASTATINUM MEDOSTATIN 40 mg COMPR. 40mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 47,66 1,588666 0,521949 0,469754618 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 7 COMPR. P-6L 28 22,45 0,801785 0,391462 0,352315619 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 35,52 1,268571 0,782924 0,704631620 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26,89 0,896333 0,799949 0,719954621 C10AB05 FENOFIBRATUM FENOLIP 160 mg CAPS. 160mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 CAPS. P6L 30 26,44 0,881333 0,799949 0,719954622 C10AB05 FENOFIBRATUM LIPIVIM CAPS. PULB. MICRONIZATA 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26,43 0,881000 0,881000 0,792900623 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg LAB. FOURNIER S.A. FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 34,74 1,158000 0,724954 0,652458624 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. FILM. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 1 BLIST. PVC- PE-PVDC/AL X 10 COMPR. FILM. CU ELIB. MOD. P-6L 10 13,81 1,381000 0,799949 0,719954625 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. FILM. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. FILM. CU ELIB. MOD. P-6L 30 40,04 1,334666 0,799949 0,719954626 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 6,83 6,830000 6,455999 5,810399627 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 7,60 7,600000 6,185250 5,566725628 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 21,06 21,060000 2,061750 1,855575629 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 4,98 4,980000 2,061750 1,855575

Pagina 13 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti630 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 7,33 7,330000 6,185250 5,566725631 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 4,70 4,700000 4,700000 4,230000632 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 6,72 6,720000 6,185250 5,566725633 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 6,72 6,720000 6,185250 5,566725634 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA PRF 1 7,60 7,600000 6,185250 5,566725635 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 5,39 5,390000 2,061750 1,855575636 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 4,98 4,980000 2,061750 1,855575637 D07AA02 HYDROCORTISONUM HIDROCORTIZON 1% UNGUENT 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 7,40 7,400000 7,400000 6,660000638 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 7,40 7,400000 7,400000 6,660000639 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 5,96 5,960000 3,570000 3,213000640 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 5,96 5,960000 3,570000 3,213000641 G01AF04 MICONAZOLUM GYNOZOL 200 CAPS. VAG. 200mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI P-RF 6 5,96 0,993333 0,993333 0,893999642 G01AF04 MICONAZOLUM GYNOZOL 400 CAPS. VAG. 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI P-RF 3 5,72 1,906666 1,906666 1,715999643 G02AB03 ERGOMETRINUM MALEAT DE ERGOMETRINA 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 7,13 1,426000 1,426000 1,283400644 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 7,13 1,426000 1,426000 1,283400645 G03BA03 TESTOSTERONUM* UNDESTOR TESTOCAPS 40 mg CAPS. MOI 40mg N.V. ORGANON OLANDA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI P-RF 60 47,33 0,788833 0,788833 0,709949646 G03BA03 TESTOSTERONUM* ANDROGEL 50 mg GEL 50mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 30 PLICURI DIN FOLIE PET/AL/PE X 5 G GEL P-RF 30 223,35 7,445000 6,444749 5,800274647 G03BA03 TESTOSTERONUM* TESTIM 50 mg GEL TRANSDERMIC 50mg FERRING GMBH GERMANIA CUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMIC PR/PRF 30 183,34 6,111333 6,111333 5,500199648 G03BA03 TESTOSTERONUM* NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER PHARMA AG GERMANIA CUTIE X 1 FIOLA X 4 ML SOL. INJ. S/P-RF 1 452,72 452,720000 452,720000 407,448000649 G03CA03 ESTRADIOLUM* ESTREVA (R) GEL 0,1% LAB. THERAMEX MONACO CUTIE X 1 FLACON PE, INCHIS CU POMPA DOZATOARE X 50 G P-6L 1 29,40 29,400000 9,998190 8,998371650 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 16,61 16,610000 9,598263 8,638436651 G03CA03 ESTRADIOLUM* CLIMARA PLASTURE TRANSDERM. 50µg/24ore BAYER PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L 4 29,89 7,472500 7,472500 6,725250652 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 10,18 0,339333 0,189482 0,170533653 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 10,18 0,339333 0,189482 0,170533654 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 17,07 0,569000 0,378964 0,341067655 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 17,07 0,569000 0,378964 0,341067656 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 30,86 1,028666 0,757928 0,682135657 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 30,86 1,028666 0,757928 0,682135658 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVDC X 14 COMPR. ELIB. PREL. P-6L 28 46,49 1,660357 0,757928 0,682135659 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVDC X 14 COMPR. ELIB. PREL. P-6L 28 46,49 1,660357 0,757928 0,682135660 G04CAN1 DOXAZOSINUM KAMIREN XL 4 mg (vezi C02CA04) COMPR. FILM. ELIB. PREL. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 37,34 1,244666 0,757928 0,682135661 G04CAN1 DOXAZOSINUM KAMIREN XL 4 mg (vezi C02CA04) COMPR. FILM. ELIB. PREL. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 37,34 1,244666 0,757928 0,682135662 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,81 8,810000 8,282500 7,454250663 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 31,02 31,020000 31,020000 27,918000664 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 20,48 20,480000 16,565000 14,908500665 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 2,65 0,132500 0,087333 0,078599666 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,62 0,087333 0,087333 0,078599667 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,71 0,123666 0,087333 0,078599668 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 2,57 0,128500 0,087333 0,078599669 H02AB09 HYDROCORTISONUM* HYDROCORTISONE ROUSSEL COMPR. 10mg CN UNIFARM ROMANIA CUTIE X 1 FLAC. 25 COMPR. PRF 25 12,20 0,488000 0,488000 0,439200670 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 3,91 3,910000 3,527999 3,175199671 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 11,91 11,910000 11,910000 10,719000672 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 7,09 7,090000 3,527999 3,175199673 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HEMISUCCINAT SOL. INJ. I.V. 25mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B S/P-RF 5 21,33 4,266000 0,881999 0,793799674 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 4,01 0,401000 0,342900 0,308610675 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,00 0,350000 0,342900 0,308610676 J01AA02 DOXYCYCLINUM DOXICICLINA SANDOZ 100 mg CAPS. 100mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,61 0,361000 0,342900 0,308610677 J01AA02 DOXYCYCLINUM UNIDOX SOLUTAB COMPR. DISP. 100mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 BLIST. DIN AL/PVC X 10 COMPR.DISP. P-RF 10 6,83 0,683000 0,342900 0,308610678 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,95 0,297500 0,297500 0,267750

Pagina 14 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti679 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,93 0,346500 0,311849 0,280664680 J01CA04 AMOXICILLINUM OSPAMOX 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL-PVC/PVDC X 6 CAPS. P-RF/S 12 4,44 0,370000 0,311849 0,280664681 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,15 0,307500 0,307500 0,276750682 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5,86 0,586000 0,479374 0,431436683 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 5,92 0,592000 0,479374 0,431436684 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 8,81 0,440500 0,440500 0,396450685 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 5,69 0,569000 0,479374 0,431436686 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4,92 0,492000 0,479374 0,431436687 J01CA04 AMOXICILLINUM OSPAMOX 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 12 11,63 0,969166 0,958749 0,862874688 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 5,69 0,474166 0,474166 0,426749689 J01CA04 AMOXICILLINUM AMOXICILINA TERAPIA 1 g COMPR. PT. DISP. ORALA 1g TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 7 COMPR. PT. DISP. ORALA P-RF 21 19,41 0,924285 0,924285 0,831856690 J01CA04 AMOXICILLINUM DUOMOX 1000 mg COMPR. PT. DISPERSIE ORALA 1000mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 23,77 1,188500 0,958749 0,862874691 J01CA04 AMOXICILLINUM DUOMOX 250 mg COMPR. PT. DISPERSIE ORALA 250mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 10,12 0,506000 0,311849 0,280664692 J01CA04 AMOXICILLINUM DUOMOX 500 mg COMPR. PT. DISPERSIE ORALA 500mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 14,76 0,738000 0,479374 0,431436693 J01CA04 AMOXICILLINUM DUOMOX 750 mg COMPR. PT. DISPERSIE ORALA 750mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 19,75 0,987500 0,719061 0,647154694 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 5,73 5,730000 1,871099 1,683989695 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 4,55 4,550000 1,871099 1,683989696 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg/ 5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 20 G PULB. PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE PE, CU GRADATII PT. 1,25 P-RF 1 4,88 4,880000 3,742199 3,367979697 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 4,88 4,880000 3,742199 3,367979698 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 3,47 0,289166 0,289166 0,260249699 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN® 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. P-RF 12 6,10 0,508333 0,440718 0,396646700 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 2,62 0,218333 0,146906 0,132215701 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 8,63 8,630000 0,195874 0,176286702 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 5,39 5,390000 4,338799 3,904919703 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. S/P-RF 100 451,96 4,519600 4,338799 3,904919704 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,10 0,355000 0,296110 0,266499705 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,55 0,377500 0,296110 0,266499706 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,70 0,385000 0,296110 0,266499707 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 7,50 0,750000 0,592220 0,532998708 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 6,19 0,619000 0,592220 0,532998709 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 11,17 0,558500 0,558500 0,502650710 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 7,04 0,704000 0,592220 0,532998711 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 5,33 5,330000 5,117650 4,605885712 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 100 448,06 4,480600 4,480600 4,032540713 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 4,92 4,920000 2,558825 2,302942714 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 100 418,89 4,188900 2,558825 2,302942715 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S 100 418,89 4,188900 2,558825 2,302942716 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 4,92 4,920000 2,558825 2,302942717 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S 100 448,06 4,480600 4,480600 4,032540718 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 5,33 5,330000 5,117650 4,605885719 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN SR 1000 mg/62,5 mg COMPR. ELIB. PREL. 1000mg/62,5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU 7 BLIST. AL/PVC-AL X 4 COMPR. ELIB. PREL. P-RF 28 44,84 1,601428 1,548214 1,393392720 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 39,13 2,795000 1,354687 1,219218721 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 33,07 1,181071 0,774107 0,696696722 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500/125 mg COMPR. FILM. 500/125mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 10,83 0,773571 0,773571 0,696213723 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTO P-RF 14 15,32 1,094285 0,774107 0,696696724 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg COMPR. FILM. 500mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 9,95 0,710714 0,710714 0,639642725 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 625 mg COMPR. FILM. 625mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 14 COMPR. FILM. P-RF 14 28,06 2,004285 0,774107 0,696696726 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 18,97 1,355000 1,354687 1,219218727 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTO P-RF 14 26,35 1,882142 1,354687 1,219218

Pagina 15 din 27

Page 18: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti728 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM. 875mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 17,12 1,222857 1,222857 1,100571729 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 1000mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 25,07 1,790714 1,354687 1,219218730 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 625mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 16,53 1,180714 0,774107 0,696696731 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 156,25 mg/5 ml PULB. PT. SUSP. ORALA 125mg+31,25/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. CU PULB. PT. 100ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 14,90 14,900000 5,815178 5,233660732 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 11,69 11,690000 5,815178 5,233660733 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV FORTE 312,5mg/5ml PULB. PT. SUSP. ORALA 250mg+62,5mg/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 100 ML SUSP. P-RF 1 22,11 22,110000 11,630357 10,467321734 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. 35 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 6,46 6,460000 6,460000 5,814000735 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 12,93 12,930000 12,930000 11,637000736 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PEID CARE CONTINE PULB. PT. SUSP. ORALA PT. OBTINEREA A 35 ML SUSP. RECONSTITUITA + 1 SERINGA DE POLISTIREN CU GRADATII LA INTERVALE DE 0,5 ML PRF 1 6,47 6,470000 6,470000 5,823000737 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALA P-RF 1 9,95 9,950000 6,513000 5,861700738 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 9,95 9,950000 6,513000 5,861700739 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 19,89 19,890000 13,026000 11,723400740 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN (R) ES PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 34,30 34,300000 27,912857 25,121571741 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 24,02 24,020000 11,630357 10,467321742 J01DB01 CEFALEXINUM CEFALEXINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 11,91 0,595500 0,450900 0,405810743 J01DB01 CEFALEXINUM CEFALEXINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 12,02 0,601000 0,450900 0,405810744 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 CAPS. P-RF 12 7,15 0,595833 0,450900 0,405810745 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 250 mg CAPSULE CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 5,98 0,598000 0,450900 0,405810746 J01DB01 CEFALEXINUM CEFALEXINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 10,51 1,051000 0,901800 0,811620747 J01DB01 CEFALEXINUM CEFALEXINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 9,00 0,900000 0,900000 0,810000748 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 10,02 1,002000 0,901800 0,811620749 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 15,79 1,315833 1,315833 1,184249750 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 11,88 0,990000 0,901800 0,811620751 J01DB01 CEFALEXINUM KEFLEX (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 6,19 6,190000 5,136250 4,622625752 J01DB01 CEFALEXINUM OSPEXIN (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33 G GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA PP P-RF 1 7,61 7,610000 5,136250 4,622625753 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 125 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA GRAN. PT. SUSP. ORALA 125mg/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 6,93 6,930000 5,136250 4,622625754 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 10,48 10,480000 10,272500 9,245250755 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 9,65 9,650000 9,650000 8,685000756 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 9,63 9,630000 9,630000 8,667000757 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 18,55 1,855000 0,450900 0,405810758 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 13,45 1,345000 0,901800 0,811620759 J01DB05 CEFADROXILUM CEFORAN 500 mg CAPS. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 13,02 1,302000 0,901800 0,811620760 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 26,15 2,615000 1,803600 1,623240761 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 12,05 12,050000 5,136250 4,622625762 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 22,42 22,420000 10,272500 9,245250763 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 14,28 1,428000 1,355400 1,219860764 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 14,28 1,428000 1,355400 1,219860765 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 250 mg COMPR. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. PRF 10 10,80 1,080000 1,080000 0,972000766 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 30,12 3,012000 2,710800 2,439720767 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 30,12 3,012000 2,710800 2,439720768 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 500 mg COMPR. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. PRF 10 17,97 1,797000 1,797000 1,617300769 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 15,13 1,513000 1,324500 1,192050770 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 16,61 1,661000 1,355400 1,219860771 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 27,64 2,764000 2,710800 2,439720772 J01DC02 CEFUROXIMUM ZINNAT GRAN. PT. SUSP. ORALA 125mg/5ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU GRANULE PT 50 ML SUSP. ORALA + PAHAR MENZURA A 20 ML SI LINGURIT P-RF 1 19,41 19,410000 13,245000 11,920500773 J01DC02 CEFUROXIMUM AXYCEF (R) 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PULB. PT. 70 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 17,66 17,660000 17,660000 15,894000774 J01DC04 CEFACLORUM CECLODYNE 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 16,07 1,607000 0,677700 0,609930775 J01DC04 CEFACLORUM CEFACLOR ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 15,16 1,516000 0,677700 0,609930776 J01DC04 CEFACLORUM CLORACEF (R) 250 CAPS. 250mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 21,40 1,337500 0,677700 0,609930

Pagina 16 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti777 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250 mg CAPS. 250mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 13,81 0,920666 0,677700 0,609930778 J01DC04 CEFACLORUM CECLODYNE FORTE 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 29,55 2,955000 1,355400 1,219860779 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 28,55 1,784375 1,355400 1,219860780 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 27,89 2,789000 1,355400 1,219860781 J01DC04 CEFACLORUM CEFACLOR TERAPIA 500 mg CAPS. 500mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 32,67 2,178000 1,355400 1,219860782 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 26,19 2,619000 1,355400 1,219860783 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 35,79 3,579000 2,033100 1,829790784 J01DC04 CEFACLORUM CEFACLOR TERAPIA MR 375 COMPR. ELIB. PREL. 375mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. ELIB. PREL. P-RF 10 32,82 3,282000 1,016550 0,914895785 J01DC04 CEFACLORUM CEFACLOR TERAPIA MR 750 COMPR. ELIB. PREL. 750mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL. P-RF 10 55,59 5,559000 2,033100 1,829790786 J01DC04 CEFACLORUM CECLODYNE (R) MR 375 mg COMPR. FILM. ELIB. MODIF. 375mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 35,49 3,549000 1,016550 0,914895787 J01DC04 CEFACLORUM CECLODYNE (R) MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 46,90 4,690000 1,355400 1,219860788 J01DC04 CEFACLORUM CECLODYNE (R) MR 750 mg COMPR. FILM. ELIB. MODIF. 750mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 66,58 6,658000 2,033100 1,829790789 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 16,73 16,730000 9,933750 8,940375790 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 12,39 12,390000 9,933750 8,940375791 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 22,30 22,300000 19,867500 17,880750792 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. 100 ML SUSP. ORALA P-RF 1 29,74 29,740000 26,490000 23,841000793 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 33,16 33,160000 19,867500 17,880750794 J01DC04 CEFACLORUM CLORACEF (R) 125 PULB. PT. SUSP. ORALA 125mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE P-RF 1 11,90 11,900000 9,933750 8,940375795 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 9,09 9,090000 7,947000 7,152300796 J01DC04 CEFACLORUM CLORACEF (R) 250 PULB. PT. SUSP. ORALA 250mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE P-RF 1 21,40 21,400000 19,867500 17,880750797 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 16,53 16,530000 15,894000 14,304600798 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 21,56 2,156000 1,846462 1,661815799 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 34,77 3,477000 3,477000 3,129300800 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 55,99 11,198000 7,385850 6,647265801 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 10 101,25 10,125000 7,385850 6,647265802 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,72 0,386000 0,328950 0,296055803 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 7,40 0,370000 0,328950 0,296055804 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 7,04 0,352000 0,328950 0,296055805 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 7,72 0,386000 0,328950 0,296055806 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 4,76 4,760000 4,760000 4,284000807 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 10,48 10,480000 4,366125 3,929512808 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 7,09 0,354500 0,354500 0,319050809 J01FA01 ERYTHROMYCINUM ERITROMICINA 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,60 0,480000 0,419400 0,377460810 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 8,44 0,422000 0,419400 0,377460811 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 9,60 0,480000 0,419400 0,377460812 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200mg/5ml PULB. PT. SUSP. ORALA 200mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 30G + PULB. PT. 60 ML SUSP. ORALA + O LIGURITA DOZATOARE P-RF 1 11,46 11,460000 11,460000 10,314000813 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL. PRF 7 32,05 4,578571 2,097000 1,887300814 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF 6 29,37 4,895000 2,097000 1,887300815 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 28,57 2,040714 1,048500 0,943650816 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 16,69 1,192142 1,048500 0,943650817 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 14,67 1,047857 1,047857 0,943071818 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 16,69 1,192142 1,048500 0,943650819 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 11,34 0,810000 0,810000 0,729000820 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 11,36 0,811428 0,811428 0,730285821 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 10,20 0,728571 0,728571 0,655713822 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 32,62 2,330000 2,097000 1,887300823 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 32,08 2,291428 2,097000 1,887300824 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 32,62 2,330000 2,097000 1,887300825 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 43,35 2,167500 2,097000 1,887300

Pagina 17 din 27

Page 20: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti826 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 53,31 2,665500 2,097000 1,887300827 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 24,62 1,758571 1,758571 1,582713828 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 32,62 2,330000 2,097000 1,887300829 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 22,16 1,582857 1,582857 1,424571830 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 33,15 4,735714 2,097000 1,887300831 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL. P-RF 5 36,43 7,286000 2,097000 1,887300832 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 28,09 4,012857 2,097000 1,887300833 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 39,14 39,140000 26,085000 23,476500834 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 24,48 24,480000 15,651000 14,085900835 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-RF 1 23,30 23,300000 15,651000 14,085900836 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 26,21 26,210000 15,651000 14,085900837 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 . ORALA P-RF 1 18,94 18,940000 15,651000 14,085900838 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 51,09 51,090000 51,090000 45,981000839 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 31,68 31,680000 31,302000 28,171800840 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 28,78 28,780000 28,780000 25,902000841 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 53,78 53,780000 25,576250 23,018625842 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 11,36 1,136000 1,136000 1,022400843 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 20,02 2,002000 1,189800 1,070820844 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 37,31 3,731000 0,237960 0,214164845 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 65,61 3,280500 0,237960 0,214164846 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 6,83 0,683000 0,594900 0,535410847 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 6,83 0,683000 0,594900 0,535410848 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 6,83 0,683000 0,594900 0,535410849 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 6,83 0,683000 0,594900 0,535410850 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 12,30 0,615000 0,594900 0,535410851 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 6,93 0,693000 0,594900 0,535410852 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 6,56 0,656000 0,594900 0,535410853 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 12,30 0,615000 0,594900 0,535410854 J01MA02 CIPROFLOXACINUM ALVEBAR 250 mg COMPR. FILM. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4,76 0,476000 0,476000 0,428400855 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 13,22 1,322000 1,189800 1,070820856 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 13,22 1,322000 1,189800 1,070820857 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 13,22 1,322000 1,189800 1,070820858 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 13,22 1,322000 1,189800 1,070820859 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 8,78 0,878000 0,878000 0,790200860 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 13,22 1,322000 1,189800 1,070820861 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 9,23 0,923000 0,923000 0,830700862 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 16,43 0,821500 0,821500 0,739350863 J01MA02 CIPROFLOXACINUM ALVEBAR 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 6,49 0,649000 0,594900 0,535410864 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 38,50 3,850000 1,784700 1,606230865 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 37,31 3,731000 1,784700 1,606230866 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 84,70 12,100000 2,379600 2,141640867 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 27,63 9,210000 1,189800 1,070820868 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 27,86 2,786000 1,189800 1,070820869 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 15,73 0,786500 0,786500 0,707850870 J01MA06 NORFLOXACINUM NORFLOX - 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 6,19 0,619000 0,619000 0,557100871 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 17,60 0,880000 0,786500 0,707850872 J01MA06 NORFLOXACINUM NOR QUIN 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-RF/S 20 17,60 0,880000 0,786500 0,707850873 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 17,60 0,880000 0,786500 0,707850874 J01MB02 ACIDUM NALIDIXICUM NALIXID 500 mg CAPS. 500mg ZENTIVA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 29,29 0,976333 0,976333 0,878699

Pagina 18 din 27

Page 21: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti875 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 7,72 0,257333 0,257333 0,231599876 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 7,72 0,257333 0,257333 0,231599877 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 7,09 0,354500 0,297187 0,267468878 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 7,09 0,354500 0,297187 0,267468879 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 12 100,25 8,354166 8,354166 7,518749880 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 9,11 9,110000 8,632083 7,768874881 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 98,29 8,190833 8,190833 7,371749882 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 8,91 8,910000 8,632083 7,768874883 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 48,92 4,892000 4,316041 3,884436884 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 48,37 4,837000 4,316041 3,884436885 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 20 278,47 13,923500 4,316041 3,884436886 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 25,61 6,402500 4,002642 3,602377887 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 82,66 5,166250 4,002642 3,602377888 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 9,43 4,715000 4,002642 3,602377889 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 31,51 4,501428 4,002642 3,602377890 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 28,51 4,072857 4,002642 3,602377891 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 9,94 9,940000 6,003963 5,403566892 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 25,08 25,080000 6,003963 5,403566893 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 18,86 18,860000 6,003963 5,403566894 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 14,58 14,580000 6,003963 5,403566895 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 6,59 6,590000 6,003963 5,403566896 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,68 9,680000 6,003963 5,403566897 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 8,20 8,200000 6,003963 5,403566898 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6,59 6,590000 6,003963 5,403566899 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,03 9,030000 6,003963 5,403566900 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 63,10 15,775000 6,003963 5,403566901 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 10,06 10,060000 6,003963 5,403566902 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 12,03 12,030000 6,003963 5,403566903 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 9,94 9,940000 6,003963 5,403566904 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 12,94 12,940000 6,003963 5,403566905 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 6,01 6,010000 6,003963 5,403566906 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 12,03 12,030000 6,003963 5,403566907 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 39,37 5,624285 5,624285 5,061856908 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 22,56 3,222857 2,001321 1,801188909 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 56,54 8,077142 2,001321 1,801188910 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 29,61 4,230000 2,001321 1,801188911 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 41,93 5,990000 2,001321 1,801188912 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 16,69 2,384285 2,001321 1,801188913 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 19,58 2,797142 2,001321 1,801188914 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 16,15 2,307142 2,001321 1,801188915 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15,76 2,251428 2,001321 1,801188916 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 19,12 2,731428 2,001321 1,801188917 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 22,56 3,222857 2,001321 1,801188918 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 14,02 2,002857 2,001321 1,801188919 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60 ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O PRF 1 31,71 31,710000 14,009249 12,608324920 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 45,82 45,820000 29,910937 26,919843921 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 20,23 1,011500 0,775350 0,697815922 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 21,42 1,071000 0,775350 0,697815923 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 21,42 1,071000 0,775350 0,697815

Pagina 19 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti924 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 19,48 1,948000 1,550700 1,395630925 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 17,15 0,857500 0,775350 0,697815926 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 17,23 0,861500 0,775350 0,697815927 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 13,81 0,690500 0,690500 0,621450928 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 17,23 0,861500 0,775350 0,697815929 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 17,23 0,861500 0,775350 0,697815930 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 27,18 2,718000 1,550700 1,395630931 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 5 282,97 56,594000 56,594000 50,934600932 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. P-6L 20 1,62 0,081000 0,079425 0,071482933 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MG CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 2,14 0,071333 0,071333 0,064199934 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 3,53 0,176500 0,158850 0,142965935 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ. P-6L 6 4,13 0,688333 0,380999 0,342899936 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 6,87 0,687000 0,380999 0,342899937 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 6,59 0,659000 0,380999 0,342899938 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 47,70 2,385000 0,476550 0,428895939 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 20,49 0,683000 0,238275 0,214447940 M01AB05 DICLOFENACUM TRATUL 50 mg CAPS. MOI GASTROREZ. 50mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI GASTROREZ. P-6L 30 6,39 0,213000 0,158850 0,142965941 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 8,54 0,427000 0,317700 0,285930942 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 3,93 0,393000 0,238275 0,214447943 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 6,56 0,656000 0,317700 0,285930944 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 8,55 0,427500 0,317700 0,285930945 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 6,56 0,328000 0,158850 0,142965946 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 4,25 0,212500 0,158850 0,142965947 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 2,27 0,113500 0,113500 0,102150948 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 2,34 0,234000 0,158850 0,142965949 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 5,72 0,190666 0,079425 0,071482950 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 2,65 0,132500 0,132500 0,119250951 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 3,98 0,132666 0,132666 0,119399952 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF 5 9,40 1,880000 1,210837 1,089753953 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 14,24 2,848000 1,453005 1,307704954 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 MLP-RF 5 6,10 1,220000 1,210837 1,089753955 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 4,05 0,810000 0,810000 0,729000956 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 3,94 0,656666 0,656666 0,590999957 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 5,47 1,094000 0,761999 0,685799958 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 6,95 0,695000 0,695000 0,625500959 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 6,38 0,638000 0,638000 0,574200960 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 3,64 0,606666 0,095249 0,085724961 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 6,01 0,601000 0,095249 0,085724962 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 9,45 0,945000 0,380999 0,342899963 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 6,75 0,337500 0,105899 0,095309964 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 10,14 0,507000 0,105899 0,095309965 M01AB15 KETOROLACUM TROMETHAMIN KETANOV SOL. INJ. 30mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML P-RF 10 24,75 2,475000 1,614450 1,453005966 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 19,61 1,961000 1,614450 1,453005967 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 22,71 1,135500 0,158850 0,142965968 M01AC02 TENOXICAMUM TENOXICAM LPH 20 mg CAPS. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 11,45 0,572500 0,451350 0,406215969 M01AC02 TENOXICAMUM TENOXICAM ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 14,11 0,705500 0,451350 0,406215970 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 6,35 0,635000 0,451350 0,406215971 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 5,44 5,440000 1,768500 1,591650972 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 15,44 0,772000 0,451350 0,406215

Pagina 20 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti973 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 7,70 0,770000 0,451350 0,406215974 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215975 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 15 mg COMPR. 15mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9,98 0,499000 0,451350 0,406215976 M01AC06 MELOXICAMUM RECOXA 15 COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 6,92 0,346000 0,346000 0,311400977 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 10,03 0,501500 0,451350 0,406215978 M01AC06 MELOXICAMUM VALZER 15 mg COMPR. 15mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215979 M01AC06 MELOXICAMUM NOFLAMEN 15 mg COMPR. 15mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 10 5,01 0,501000 0,451350 0,406215980 M01AC06 MELOXICAMUM NOFLAMEN 15 mg COMPR. 15mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. OPA-AL-PVC/AL X 20 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215981 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 10,03 0,501500 0,451350 0,406215982 M01AC06 MELOXICAMUM ASPIFLEX 15 mg COMPR. 15mg BMF PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215983 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 6,92 0,346000 0,346000 0,311400984 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 7,41 0,741000 0,225675 0,203107985 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 14,84 0,742000 0,225675 0,203107986 M01AC06 MELOXICAMUM MELOXICAM LPH 7,5 mg COMPR. 7,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107987 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 7,5 mg COMPR. 7,5mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107988 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 9,65 0,482500 0,225675 0,203107989 M01AC06 MELOXICAMUM VALZER 7,5mg COMPR. 7,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107990 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 9,65 0,482500 0,225675 0,203107991 M01AC06 MELOXICAMUM ASPIFLEX 7,5 mg COMPR. 7,5mg BMF PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107992 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 5,89 1,963333 1,768500 1,591650993 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 9,82 1,964000 1,768500 1,591650994 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 9,83 1,966000 1,768500 1,591650995 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 15,12 3,024000 1,768500 1,591650996 M01AC06 MELOXICAMUM MELOXICAM 15 mg SUPOZ. 15mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 9,46 1,576666 0,664200 0,597780997 M01AE03 KETOPROFENUM KETOPROFEN SR TERAPIA 100 MG CAPS. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 11,93 1,193000 0,494699 0,445229998 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 16,49 0,824500 0,742050 0,667845999 M01AE03 KETOPROFENUM KETONAL UNO CAPS. ELIB. PREL. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 26,32 1,316000 0,989399 0,8904591.000 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 15,13 1,513000 0,989399 0,8904591.001 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 15,02 0,751000 0,742050 0,6678451.002 M01AE03 KETOPROFENUM RUBIFEN 100 mg COMPR. FILM. 100 mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 9,03 0,451500 0,451500 0,4063501.003 M01AE03 KETOPROFENUM PROFENID (R) 100 mg COMPR. FILM. 100mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM. P-6L 30 13,20 0,440000 0,440000 0,3960001.004 M01AE03 KETOPROFENUM KETONAL FORTE 100 mg COMPR. FILM. 100mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. FILM. P-6L 20 11,62 0,581000 0,494699 0,4452291.005 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 7,89 0,394500 0,394500 0,3550501.006 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 7,15 0,357500 0,247349 0,2226141.007 M01AE03 KETOPROFENUM PROFENID (R) LP 200 mg COMPR. FILM. ELIB. PREL. 200mg LAB. AVENTIS FRANTA CUTIE X 1 BLIST X 14 COMPR. FILM. ELIB. PREL. P-6L 14 13,36 0,954285 0,954285 0,8588561.008 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 5,70 1,140000 1,138000 1,0242001.009 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 11,36 1,136000 1,136000 1,0224001.010 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 11,36 1,136000 1,136000 1,0224001.011 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 9,63 1,926000 1,138000 1,0242001.012 M01AE03 KETOPROFENUM RUBIFEN (R) 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE METALIZATE AL-PE X 3 SUPOZ. P-6L 6 4,10 0,683333 0,660583 0,5945241.013 M01AE03 KETOPROFENUM KETOMAG SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L 10 6,53 0,653000 0,653000 0,5877001.014 M04AA01 ALLOPURINOLUM* MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 8,23 0,164600 0,148399 0,1335591.015 M04AA01 ALLOPURINOLUM* MILURIT 300 mg COMPR. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 12,87 0,429000 0,429000 0,3861001.016 M04AC01 COLCHICINUM COLCHICINA COMPR. 1mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-RF 40 5,76 0,144000 0,144000 0,1296001.017 N02AD01 PENTAZOCINUM FORTRAL SOL. INJ. 30mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE X 1 ML SOL. INJ. P-RF 10 14,70 1,470000 1,368750 1,2318751.018 N02AD01 PENTAZOCINUM FORTRAL SOL. INJ. 30mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 50 FIOLE X 1 ML SOL. INJ. P-RF/S 50 66,75 1,335000 1,335000 1,2015001.019 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,61 0,280500 0,280500 0,2524501.020 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,82 0,291000 0,283348 0,2550131.021 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,85 0,385000 0,283348 0,255013

Pagina 21 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.022 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,67 0,383500 0,283348 0,2550131.023 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,67 0,383500 0,283348 0,2550131.024 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 9,00 0,450000 0,283348 0,2550131.025 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 3,85 0,385000 0,283348 0,2550131.026 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,61 0,280500 0,280500 0,2524501.027 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,67 0,383500 0,283348 0,2550131.028 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,67 0,383500 0,283348 0,2550131.029 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-RF 10 6,30 0,630000 0,566699 0,5100291.030 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 18,89 0,629666 0,566699 0,5100291.031 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 18,91 0,630333 0,566699 0,5100291.032 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 18,89 0,629666 0,566699 0,5100291.033 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 27,55 0,918333 0,850049 0,7650441.034 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 33,41 1,113666 0,850049 0,7650441.035 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 27,55 0,918333 0,850049 0,7650441.036 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 34,30 1,143333 1,133398 1,0200581.037 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF 30 10,65 0,355000 0,283348 0,2550131.038 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 9,69 0,969000 0,566699 0,5100291.039 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 22,03 2,203000 0,850049 0,7650441.040 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 41,57 1,385666 0,850049 0,7650441.041 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. ELIB. PREL. P-RF 10 28,18 2,818000 1,133398 1,0200581.042 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 53,20 1,773333 1,133398 1,0200581.043 N02AX02 TRAMADOLUM TRALGIT 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,283348 0,2550131.044 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,283348 0,2550131.045 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,283348 0,2550131.046 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 9,83 1,966000 1,629810 1,4668291.047 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 134,56 1,345600 1,345600 1,2110401.048 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 4,93 0,986000 0,814902 0,7334111.049 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 13,10 2,620000 1,629810 1,4668291.050 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 5,58 1,116000 1,116000 1,0044001.051 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 44,81 22,405000 9,929166 8,9362491.052 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 25,36 12,680000 4,964583 4,4681241.053 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 58,12 9,686666 9,686666 8,7179991.054 N02CC01 SUMATRIPTANUM* SUMACTA 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. PRF 2 20,02 10,010000 9,929166 8,9362491.055 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 58,12 9,686666 9,686666 8,7179991.056 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 41,45 6,908333 4,964583 4,4681241.057 N02CC01 SUMATRIPTANUM* SUMACTA 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. PRF 2 14,28 7,140000 4,964583 4,4681241.058 N02CC01 SUMATRIPTANUM* SUMACTA 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 41,47 6,911666 4,964583 4,4681241.059 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 17,38 0,347600 0,234866 0,2113791.060 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.061 N03AF01 CARBAMAZEPINUM CARBAVIM COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.062 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.063 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,96 0,248000 0,234866 0,2113791.064 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,50 0,225000 0,225000 0,2025001.065 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,96 0,248000 0,234866 0,2113791.066 N03AF01 CARBAMAZEPINUM FINLEPSIN COMPR. 200mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.067 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 26,26 0,525200 0,469733 0,4227591.068 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 10,51 0,525500 0,469733 0,4227591.069 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 15,16 0,303200 0,176149 0,1585341.070 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 20,62 0,412400 0,352299 0,317069

Pagina 22 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.071 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 36,53 0,730600 0,704599 0,6341391.072 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 20,68 0,413600 0,352299 0,3170691.073 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 36,59 0,731800 0,704599 0,6341391.074 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 19,17 0,383400 0,234866 0,2113791.075 N03AF01 CARBAMAZEPINUM FINLEPSIN 200 RETARD COMPR. FILM. ELIB. PREL. 200mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 12,43 0,248600 0,234866 0,2113791.076 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 25,35 0,845000 0,469733 0,4227591.077 N03AF01 CARBAMAZEPINUM FINLEPSIN 400 RETARD COMPR. FILM. ELIB. PREL. 400mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 25,27 0,505400 0,469733 0,4227591.078 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 22,51 22,510000 22,510000 20,2590001.079 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 7,20 0,144000 0,144000 0,1296001.080 N03AX12 GABAPENTINUM GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 60,61 0,606100 0,288282 0,2594531.081 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 33,34 0,555666 0,288282 0,2594531.082 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 22,54 0,450800 0,288282 0,2594531.083 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 43,63 0,436300 0,288282 0,2594531.084 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 23,56 0,392666 0,288282 0,2594531.085 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 21,80 0,436000 0,436000 0,3924001.086 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 133,56 1,335600 0,864853 0,7783671.087 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 65,96 1,319200 0,864853 0,7783671.088 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 133,09 1,330900 0,864853 0,7783671.089 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 63,62 1,060333 0,864853 0,7783671.090 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 47,92 0,958400 0,864853 0,7783671.091 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 91,03 0,910300 0,864853 0,7783671.092 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 51,89 0,864833 0,864833 0,7783491.093 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 28,81 0,576200 0,576200 0,5185801.094 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 175,18 1,751800 1,153140 1,0378261.095 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 72,72 1,454400 1,153140 1,0378261.096 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 169,16 1,691600 1,153140 1,0378261.097 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 85,96 1,432666 1,153140 1,0378261.098 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 400 mg CAPS. 400mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 64,12 1,282400 1,153140 1,0378261.099 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 400 mg CAPS. 400mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 121,79 1,217900 1,153140 1,0378261.100 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 64,86 1,081000 1,081000 0,9729001.101 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 65,21 2,173666 1,729711 1,5567391.102 N03AX12 GABAPENTINUM GRIMODIN 600 mg COMPR. FILM. 600mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 123,68 2,061333 1,729711 1,5567391.103 N03AX12 GABAPENTINUM GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 104,24 3,474666 2,306281 2,0756521.104 N03AX12 GABAPENTINUM GRIMODIN 800 mg COMPR. FILM. 800mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 197,38 3,289666 2,306281 2,0756521.105 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 3,24 0,162000 0,089699 0,0807291.106 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 7,72 0,257333 0,179399 0,1614591.107 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF 30 10,80 0,360000 0,358799 0,3229191.108 N05AD01 HALOPERIDOLUM HALDOL COMPR. 5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 17,94 0,717600 0,717600 0,6458401.109 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 5,39 5,390000 3,587998 3,2291981.110 N05AD01 HALOPERIDOLUM HALOPERIDOL 2 mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF 1 6,66 6,660000 3,587998 3,2291981.111 N05AD01 HALOPERIDOLUM HALOPERIDOL DECANOAT SOL. INJ. 50mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 44,52 8,904000 8,904000 8,0136001.112 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 12,48 2,496000 1,162619 1,0463571.113 N05BA01 DIAZEPAMUM DIAZEPAM RICHTER 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 1,99 0,099500 0,099500 0,0895501.114 N05BA01 DIAZEPAMUM DIAZEPAM COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4,01 0,133666 0,133666 0,1202991.115 N05BA01 DIAZEPAMUM DIAZEPAM LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2,08 0,104000 0,104000 0,0936001.116 N05BA01 DIAZEPAMUM DIAZEPAM 10 mg SOL. INJ. 10mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 11,53 2,306000 2,306000 2,0754001.117 N05BA01 DIAZEPAMUM DIAZEPAM 5 mg/ml SOL. INJ. 10mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 11,53 2,306000 2,306000 2,0754001.118 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 10 mg SOL. RECTALA 10mg/2,5ml DESITIN GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF 5 32,62 6,524000 6,524000 5,8716001.119 N05BA01 DIAZEPAMUM DIAZEPAM DESITIN (R) SOLUTIE RECTALA 5 mg SOL. RECTALA 5mg/2,5ml DESITIN GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF 5 25,99 5,198000 5,198000 4,678200

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

APP Ambalaj Prescriptie

cant/ambala

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Pret amanunt

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Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

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Val suportata CNAS/UT (RON) pt.

Adulti1.120 N05BA03 MEDAZEPAMUM* MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLISTERE PVC/AL X 10 COMPRIMATE P-RF 20 2,45 0,122500 0,122500 0,1102501.121 N05BA03 MEDAZEPAMUM* MEDAZEPAM ARENA 10mg COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 5 BLISTERE PVC/AL X 10 COMPRIMATE P-RF 50 5,61 0,112200 0,112200 0,1009801.122 N05BA03 MEDAZEPAMUM* MEDAZEPAM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 20 COMPR. P-RF 20 3,05 0,152500 0,123637 0,1112731.123 N05BA03 MEDAZEPAMUM* MEDAZEPAM LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2,47 0,123500 0,123500 0,1111501.124 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 6,70 0,134000 0,098909 0,0890181.125 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 2,14 0,107000 0,037091 0,0333811.126 N05BA08 BROMAZEPAMUM* LEXOTAN COMPR. 3mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,16 0,238666 0,074182 0,0667631.127 N05BA08 BROMAZEPAMUM* BROMAZEPAM LPH 3 mg COMPR. 3mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3,10 0,155000 0,074182 0,0667631.128 N05BA08 BROMAZEPAMUM* BROMAZEPAM SLAVIA 3 mg COMPR. 3mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 2,20 0,220000 0,074182 0,0667631.129 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 1,54 0,154000 0,074182 0,0667631.130 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 5,65 0,188333 0,061818 0,0556361.131 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 2,68 0,134000 0,061818 0,0556361.132 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 4,35 0,145000 0,061818 0,0556361.133 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 4,93 0,164333 0,061818 0,0556361.134 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 1,22 0,122000 0,061818 0,0556361.135 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 2,45 0,122500 0,061818 0,0556361.136 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 3,67 0,122333 0,061818 0,0556361.137 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 8,94 0,298000 0,123637 0,1112731.138 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 4,24 0,212000 0,123637 0,1112731.139 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 7,46 0,248666 0,123637 0,1112731.140 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 5,79 0,193000 0,123637 0,1112731.141 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 1,93 0,193000 0,123637 0,1112731.142 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 3,87 0,193500 0,123637 0,1112731.143 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 5,81 0,193666 0,123637 0,1112731.144 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 12,70 0,423333 0,247274 0,2225461.145 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM LPH (R) 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6,06 0,303000 0,247274 0,2225461.146 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 8,24 0,274666 0,247274 0,2225461.147 N05BA12 ALPRAZOLAMUM* FRONTIN 1mg COMPR. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-RF 30 12,60 0,420000 0,247274 0,2225461.148 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF 10 2,74 0,274000 0,247274 0,2225461.149 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 5,50 0,275000 0,247274 0,2225461.150 N05BA12 ALPRAZOLAMUM* ALPRAZOLAM ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 8,24 0,274666 0,247274 0,2225461.151 N05CD02 NITRAZEPAMUM* NITRAZEPAM LPH (R) 2,5 mg COMPR. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1,37 0,068500 0,054000 0,0486001.152 N05CD02 NITRAZEPAMUM* NITRAZEPAM LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1,57 0,078500 0,078500 0,0706501.153 N05CD02 NITRAZEPAMUM* NITRAZEPAM 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2,40 0,120000 0,108000 0,0972001.154 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 2,40 0,120000 0,108000 0,0972001.155 N05CF01 ZOPICLONUM* SONLAX 7,5 mg COMPR. FILM. 7,5 mg AS GRINDEKS LETONIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 10,06 0,503000 0,503000 0,4527001.156 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 15,50 0,775000 0,513900 0,4625101.157 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 4,13 0,413000 0,390000 0,3510001.158 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 8,27 0,413500 0,390000 0,3510001.159 N05CF02 ZOLPIDEMUM* ZOLPIDEM 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4,25 0,425000 0,390000 0,3510001.160 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 4,25 0,425000 0,390000 0,3510001.161 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 3,90 0,390000 0,390000 0,3510001.162 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 7,80 0,390000 0,390000 0,3510001.163 N05CF02 ZOLPIDEMUM* ZOLPIDEM AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 2,53 0,253000 0,253000 0,2277001.164 N05CF02 ZOLPIDEMUM* ZOLSANA 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 20 13,56 0,678000 0,195000 0,1755001.165 N05CF02 ZOLPIDEMUM* ONIRIA 10 mg/ml PIC. ORALE, SOL. 10mg/ml ITF PHARMA KERESKEDELMI ES SZOLGALTATO KFT. UNGARIA CUTIE CU 1 FLACON DIN STICLA BRUNA CU CAPACITATEA DE 30 ML CU PIC. ORALE, SOL.+PIPETA P-RF 1 60,41 60,410000 11,700000 10,5300001.166 N06AA04 CLOMIPRAMINUM* ANAFRANIL (R) 10 mg DRAJ. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 7,24 0,241333 0,122399 0,1101591.167 N06AA04 CLOMIPRAMINUM* ANAFRANIL (R) 25 mg DRAJ. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 14,31 0,477000 0,305999 0,2753991.168 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 15,01 0,300200 0,300200 0,270180

Pagina 24 din 27

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.169 N06AA12 DOXEPINUM* DOXEPIN 25 mg DRAJ. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 21,96 0,732000 0,305999 0,2753991.170 N06AB03 FLUOXETINUM* FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 CAPS. P-RF 14 11,28 0,805714 0,620999 0,5588991.171 N06AB03 FLUOXETINUM* FLUOXIN 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS. P-RF 28 22,06 0,787857 0,620999 0,5588991.172 N06AB03 FLUOXETINUM* MAGRILAN 20 mg CAPS. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 17,63 0,587666 0,587666 0,5288991.173 N06AB03 FLUOXETINUM* ROFLUXIN 20 mg CAPS. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,12 0,756000 0,620999 0,5588991.174 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 36,82 1,315000 0,620999 0,5588991.175 N06AB04 CITALOPRAMUM** LINISAN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 7,12 0,237333 0,237333 0,2135991.176 N06AB04 CITALOPRAMUM** DALSAN 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. FILM. P-RF 28 7,40 0,264285 0,264285 0,2378561.177 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 39,54 1,318000 0,620999 0,5588991.178 N06AB04 CITALOPRAMUM** DALSAN 20 mg COMPR. FILM. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. FILM. P-RF 28 10,72 0,382857 0,382857 0,3445711.179 N06AB04 CITALOPRAMUM** DALSAN 40 mg COMPR. FILM. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. FILM. P-RF 28 33,59 1,199642 1,199642 1,0796771.180 N06AB05 PAROXETINUM* ARKETIS COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 23,05 0,768333 0,620999 0,5588991.181 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 23,04 0,768000 0,620999 0,5588991.182 N06AB05 PAROXETINUM* SEROXAT 20 mg COMPR. FILM. 20mg SMITHKLINE BEECHAM MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 34,30 1,143333 0,620999 0,5588991.183 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 23,05 0,768333 0,620999 0,5588991.184 N06AB05 PAROXETINUM* PALUXETIL 20 mg COMPR. FILM. 20mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR.FILM. P-RF 30 20,48 0,682666 0,620999 0,5588991.185 N06AB05 PAROXETINUM* PALUXETIL 40 mg COMPR. FILM. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR.FILM. P-RF 30 36,77 1,225666 1,225666 1,1030991.186 N06AB06 SERTRALINUM* SERLIFT 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 35,28 1,260000 1,241999 1,1177991.187 N06AB06 SERTRALINUM* ASENTRA (R) COMPR. FILM. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 40,84 1,458571 1,241999 1,1177991.188 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 34,09 1,217500 1,217500 1,0957501.189 N06AB06 SERTRALINUM* XIMPROVE 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 35,28 1,260000 1,241999 1,1177991.190 N06AB06 SERTRALINUM* ZOLOFT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM. P-RF 28 68,51 2,446785 1,241999 1,1177991.191 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 36,52 1,217333 1,217333 1,0955991.192 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 35,28 1,260000 1,241999 1,1177991.193 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 37,64 1,254666 1,241999 1,1177991.194 N06AB06 SERTRALINUM* SERLIFT 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-RF 28 19,54 0,697857 0,620999 0,5588991.195 N06AB06 SERTRALINUM* ASENTRA (R) COMPR. FILM. 50mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM. P-RF 28 22,87 0,816785 0,620999 0,5588991.196 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 18,74 0,669285 0,620999 0,5588991.197 N06AB06 SERTRALINUM* XIMPROVE 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF 28 19,54 0,697857 0,620999 0,5588991.198 N06AB06 SERTRALINUM* ZOLOFT 50 mg COMPR. FILM. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM. P-RF 28 36,98 1,320714 0,620999 0,5588991.199 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 20,06 0,668666 0,620999 0,5588991.200 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 20,94 0,698000 0,620999 0,5588991.201 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 20,92 0,697333 0,620999 0,5588991.202 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 65,61 65,610000 14,903989 13,4135901.203 N06AB08 FLUVOXAMINUM* FEVARIN (R) 100 COMPR. FILM. 100mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF 30 48,83 1,627666 0,620999 0,5588991.204 N06AB08 FLUVOXAMINUM* FEVARIN (R) 50 COMPR. FILM. 50mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF 30 25,21 0,840333 0,310499 0,2794491.205 N06AX03 MIANSERINUM* MIANSERIN 10 COMPR. FILM. 10mg REMEDICA LTD. CIPRU CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF/S 100 46,70 0,467000 0,398248 0,3584231.206 N06AX03 MIANSERINUM* MIANSERIN 30 COMPR. FILM. 30mg REMEDICA LTD. CIPRU CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 26,06 1,303000 1,194751 1,0752751.207 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 82,15 2,738333 1,263833 1,1374491.208 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 24,62 0,820666 0,631916 0,5687241.209 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 37,92 1,264000 1,263833 1,1374491.210 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 36,01 1,200333 1,200333 1,0802991.211 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 13,91 0,463666 0,463666 0,4172991.212 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 63,52 2,117333 1,895749 1,7061741.213 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILEP-RF 30 24,62 0,820666 0,631916 0,5687241.214 N06AX11 MIRTAZAPINUM* MIRZATEN Q-TAB 30 mg COMPR. ORODISPERSABILE 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 30 COMPR. ORODISPERSABILE P-RF 30 37,92 1,264000 1,263833 1,1374491.215 N06AX11 MIRTAZAPINUM* MIRTAZAPINA BLUEFISH 30 mg COMPR. ORODISPERSABILE 30mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILEP-RF 30 37,92 1,264000 1,263833 1,1374491.216 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 30 mg COMPR. ORODISPERSABILE 30mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILEP-RF 30 38,11 1,270333 1,263833 1,1374491.217 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 37,90 1,263333 1,263333 1,136999

Pagina 25 din 27

Page 28: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.218 N06AX11 MIRTAZAPINUM* MIRTAZAPINA AUROBINDO 45 mg COMPR. ORODISPERSABILE 45mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILEP-RF 30 63,52 2,117333 1,895749 1,7061741.219 N06AX16 VENLAFAXINUM** IVRYX 150mg CAPS. ELIB. PREL. 150 mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 23,22 0,829285 0,829285 0,7463561.220 N06AX16 VENLAFAXINUM** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN ACLAR-PE-PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 58,69 2,096071 1,277856 1,1500701.221 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 40,87 1,362333 1,277856 1,1500701.222 N06AX16 VENLAFAXINUM** IVRYX 150mg CAPS. ELIB. PREL. 150 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 23,22 0,829285 0,829285 0,7463561.223 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 38,14 1,362142 1,277856 1,1500701.224 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 40,87 1,362333 1,277856 1,1500701.225 N06AX16 VENLAFAXINUM** FOBILESS 150 mg CAPS. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 40,87 1,362333 1,277856 1,1500701.226 N06AX16 VENLAFAXINUM** ADOXA EP 150 mg CAPS. ELIB. PREL. 150mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 40,87 1,362333 1,277856 1,1500701.227 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 23,11 0,825357 0,825357 0,7428211.228 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 40,71 1,357000 1,277856 1,1500701.229 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 40,87 1,362333 1,277856 1,1500701.230 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 40,87 1,362333 1,277856 1,1500701.231 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 17,24 0,574666 0,319464 0,2875171.232 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 24,04 0,801333 0,319464 0,2875171.233 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 17,89 0,638928 0,638928 0,5750351.234 N06AX16 VENLAFAXINUM** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN ACLAR-PE-PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 35,58 1,270714 0,638928 0,5750351.235 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 25,61 0,853666 0,638928 0,5750351.236 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 17,89 0,638928 0,638928 0,5750351.237 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 17,89 0,638928 0,638928 0,5750351.238 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 23,88 0,852857 0,638928 0,5750351.239 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 25,59 0,853000 0,638928 0,5750351.240 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 19,15 0,638333 0,638333 0,5744991.241 N06AX16 VENLAFAXINUM** ADOXA EP 75 mg CAPS. ELIB. PREL. 75mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 25,61 0,853666 0,638928 0,5750351.242 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 17,72 0,632857 0,632857 0,5695711.243 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 25,42 0,847333 0,638928 0,5750351.244 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 25,61 0,853666 0,638928 0,5750351.245 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 25,61 0,853666 0,638928 0,5750351.246 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 24,04 0,801333 0,319464 0,2875171.247 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 24,50 0,816666 0,425952 0,3833561.248 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 25,42 0,847333 0,638928 0,5750351.249 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 20,74 0,691333 0,691333 0,6221991.250 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 15,98 0,532666 0,532666 0,4793991.251 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 13,73 0,686500 0,686500 0,6178501.252 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 3,70 0,925000 0,594374 0,5349361.253 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 3,68 0,920000 0,594374 0,5349361.254 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 3,70 0,925000 0,594374 0,5349361.255 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P6L 4 3,68 0,920000 0,594374 0,5349361.256 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 6,22 3,110000 3,079166 2,7712491.257 P02CA03 ALBENDAZOLUM ESKAZOLE COMPR. 400mg GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 12 BLIST. PVC-PVDC/AL X 1 COMPR. P-RF 12 71,68 5,973333 5,973333 5,3759991.258 P02CA03 ALBENDAZOLUM DUADOR 200 mg COMPR. FILM. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. X 2 COMPR. FILM. P-RF 2 6,38 3,190000 3,079166 2,7712491.259 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 6,39 3,195000 3,079166 2,7712491.260 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 5,73 5,730000 3,813750 3,4323751.261 P02CA03 ALBENDAZOLUM VERMIGAL NOVO 400 mg SUSP. ORALA 400mg/10ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA P-RF 1 3,74 3,740000 3,740000 3,3660001.262 P02CE01 LEVAMISOLUM DECARIS 150 mg COMPR. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 COMPR. P-RF 1 3,42 3,420000 3,420000 3,0780001.263 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 3,42 3,420000 3,420000 3,0780001.264 P02CE01 LEVAMISOLUM DECARIS 50 mg COMPR. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. P-RF 2 3,02 1,510000 1,139988 1,0259891.265 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 3,02 1,510000 1,139988 1,0259891.266 R01AD01 BECLOMETASONUM* RINOCLENIL 100 SPRAY NAZ.,SUSP. 100mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON DIN PET X 30 ML SPRAY NAZ.,SUSP., PREVAZUT CU POMPA DOZATOARE P-RF 1 48,52 48,520000 42,718000 38,446200

Pagina 26 din 27

Page 29: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.267 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 8,92 8,920000 1,558800 1,4029201.268 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 10,51 10,510000 7,794000 7,0146001.269 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 6,81 6,810000 6,810000 6,1290001.270 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., "SP P-RF 1 101,96 101,960000 101,960000 91,7640001.271 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 39,48 39,480000 37,495000 33,7455001.272 R03BA02 BUDESONIDUM* FRENOLYN 200 PULB. INHAL. 200 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA X 1 INHALATOR X 200 DOZE P-RF 1 75,00 75,000000 74,990000 67,4910001.273 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 60,76 60,760000 37,495000 33,7455001.274 R03BA02 BUDESONIDUM* FRENOLYN 400 PULB. INHAL. 400 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA X 1 INHALATOR X 100 DOZE P-RF 1 84,20 84,200000 74,990000 67,4910001.275 R03BA02 BUDESONIDUM* FRENOLYN 400 PULB. INHAL. 400 mcg/doza MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 PUNGA X 1 INHALATOR X 200 DOZE P-RF 1 172,36 172,360000 149,980000 134,9820001.276 R03BA02 BUDESONIDUM* BUDIAIR 200 mcg SOL. DE INHALAT PRESURIZATA 200 mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA + VALVA DOZATOARE + DISPOZITIV DE ADMINISTRA P-RF 1 74,98 74,980000 74,980000 67,4820001.277 R03BA02 BUDESONIDUM* BUDIAIR 200 mcg JET SOL. DE INHALAT PRESURIZATA 200mcg/doza CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA = VALVA DOZATOARE + DISPOZITIV JET DE ACTION P-RF 1 74,98 74,980000 74,980000 67,4820001.278 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 12,60 12,600000 12,600000 11,3400001.279 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 3,05 3,050000 3,050000 2,7450001.280 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 3,56 0,712000 0,712000 0,6408001.281 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 9,38 0,234500 0,234500 0,2110501.282 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 13,98 0,349500 0,349500 0,3145501.283 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,01 0,200333 0,162250 0,1460251.284 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 5,13 0,205200 0,162250 0,1460251.285 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 3,02 0,151000 0,151000 0,1359001.286 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3,41 0,170500 0,162250 0,1460251.287 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 3,19 0,159500 0,159500 0,1435501.288 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 3,65 0,182500 0,162250 0,1460251.289 R06AB04 CHLORPHENAMINUM CLORFENIRAMIN COMPR. 4mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,31 0,115500 0,115499 0,1039491.290 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 21,16 1,058000 0,604687 0,5442181.291 R06AE07 CETIRIZINUM LETIZEN (R) 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 13,53 0,676500 0,604687 0,5442181.292 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 13,16 13,160000 12,093750 10,8843751.293 R06AX17 KETOTIFENUM H - KETOTIFEN COMPR. 1mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,65 0,182500 0,172500 0,1552501.294 R06AX17 KETOTIFENUM KETOTIFEN COMPR. 1mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,45 0,172500 0,172500 0,1552501.295 R06AX17 KETOTIFENUM KETOTIFEN LAROPHARM 1 mg COMPR. 1mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 3,45 0,172500 0,172500 0,1552501.296 R06AX17 KETOTIFENUM KETOTIFEN LPH® 1 mg COMPR. 1mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. PVC X 10 COMPR P6L 20 3,31 0,165500 0,165500 0,1489501.297 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 11,43 11,430000 11,430000 10,2870001.298 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 10,69 10,690000 9,421250 8,4791251.299 S01BC03 DICLOFENACUM UNICLOPHEN (R) 0,1% PICATURI OFT.-SOL. 0,1% UNIMED PHARMA LTD. SLOVACIA CUTIE X 1 FLACON DIN PE X 10 ML PIC. OFTALMICE, SOL., PREVAZUT CU PICURATOR P-6L 1 11,23 11,230000 11,230000 10,1070001.300 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 SIGURANTA P-6L 1 14,30 14,300000 9,421250 8,4791251.301 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 13,45 13,450000 13,450000 12,1050001.302 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 15,45 15,450000 13,950000 12,555000

NOTĂ:

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății și cu aprobarea comisiilor de la nivelul Caselor Județene de Asigurări de Sănătate; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (1) se efectueaza pentru pacienții cu intoleranță la acidum acetylsalicylicum.

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se inițiaza de medicul de specialitate in limita competenței și 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 efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății;

Pagina 27 din 27

Page 30: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

ANEXA 2

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti

1 A02BC02 PANTOPRAZOLUM CONTROLOC 20 mg COMPR. FILM. GASTROREZ. 20mg NYCOMED GMBH GERMANIA CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ. P-6L 30 34,83 1,161000 0,646713 0,3233562 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg COMPR. FILM. GASTROREZ. 40mg NYCOMED GMBH GERMANIA CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ. P-6L 30 55,68 1,856000 1,293427 0,6467133 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 31,62 1,129285 1,129285 0,5646424 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 6,38 0,227857 0,227857 0,1139285 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 22,06 0,787857 0,646713 0,3233566 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 21,88 0,729333 0,646713 0,3233567 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TEVA 20 mg COMPR. GASTROREZ. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 20,43 0,681000 0,646713 0,3233568 A02BC02 PANTOPRAZOLUM AZATOL 20 mg COMPR. GASTROREZ. 20mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ. P6L 28 22,57 0,806071 0,667574 0,3337879 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 23,39 0,779666 0,646713 0,323356

10 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 15,99 0,533000 0,533000 0,26650011 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 6,15 0,205000 0,205000 0,10250012 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 11,63 0,415357 0,415357 0,20767813 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 31,62 1,129285 1,129285 0,56464214 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 32,77 1,092333 1,092333 0,54616615 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TEVA 40 mg COMPR. GASTROREZ. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L 30 36,17 1,205666 1,205666 0,60283316 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 5,93 0,593000 0,593000 0,29650017 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 19,57 0,652333 0,652333 0,32616618 A02BC02 PANTOPRAZOLUM PANTOPRAZOL MACLEODS 40 mg COMPR. GASTROREZ. 40mg MACLEODS PHARMA UK LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. GASTROREZ. P6L 28 27,57 0,984642 0,984642 0,49232119 A02BC02 PANTOPRAZOLUM PANTOPRAZOL ATB 40 mg COMPR. GASTROREZ. 40mg ANTIBIOTICE SA ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ. P6L 30 32,77 1,092333 1,092333 0,54616620 A02BC02 PANTOPRAZOLUM AZATOL 40 mg COMPR. GASTROREZ. 40mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ. P6L 28 33,80 1,207142 1,207142 0,60357121 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 25,05 0,835000 0,835000 0,41750022 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 11,22 0,374000 0,374000 0,18700023 A02BC02 PANTOPRAZOLUM GESOFLUX 20 mg COMPR. GASTROREZISTENTE 20mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L 30 22,28 0,742666 0,646713 0,32335624 A02BC02 PANTOPRAZOLUM GESOFLUX 40 mg COMPR. GASTROREZISTENTE 40mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L 30 34,10 1,136666 1,136666 0,56833325 A02BC02 PANTOPRAZOLUM NOLPAZA 40 mg PULB. PT. SOL. INJ. 40mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. P-RF 1 19,31 19,310000 14,597999 7,29899926 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg PULB. PT. SOL. INJ. 40mg NYCOMED GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. S/P-RF 1 13,39 13,390000 13,390000 6,69500027 A02BC05 ESOMEPRAZOLUM EMANERA 20 mg CAPS. GASTROREZ. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 14 CAPS. GASTROREZ.P-6L 14 26,47 1,890714 0,862284 0,43114228 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 37,80 1,350000 0,862284 0,43114229 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 18,38 0,656428 0,656428 0,32821430 A02BC05 ESOMEPRAZOLUM MESOPRAL 20 mg CAPS. GASTROREZ. 20mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 51,23 1,829642 0,862284 0,43114231 A02BC05 ESOMEPRAZOLUM EMANERA 40 mg CAPS. GASTROREZ. 40mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 14 CAPS. GASTROREZ.P-6L 14 38,71 2,765000 1,724569 0,86228432 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 55,99 1,999642 1,724569 0,86228433 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 30,80 1,100000 1,100000 0,55000034 A02BC05 ESOMEPRAZOLUM MESOPRAL 40 mg CAPS. GASTROREZ. 40mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ. P6L 28 73,54 2,626428 1,724569 0,86228435 A02BC05 ESOMEPRAZOLUM NEXIUM 20 mg COMPR. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. X 7 COMPR. FILM. GASTROREZ. P-6L 14 39,41 2,815000 0,862284 0,43114236 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SANDOZ 20 mg COMPR. GASTROREZ. 20mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ. P-6L 14 30,17 2,155000 0,862284 0,43114237 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 20 mg COMPR. GASTROREZ. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. GASTROREZ. P6L 28 51,18 1,827857 0,862284 0,43114238 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TEVA 20 mg COMPR. GASTROREZ. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. GASTROREZ. P6L 14 18,94 1,352857 0,862284 0,43114239 A02BC05 ESOMEPRAZOLUM PRAGASTROL 20 mg COMPR. GASTROREZ. 20mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ. P6L 30 26,75 0,891666 0,862284 0,43114240 A02BC05 ESOMEPRAZOLUM NEXIUM 40 mg COMPR. GASTROREZ. 40mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. AL/PVC X 7 COMPR. FILM. GASTROREZ. P-6L 14 59,56 4,254285 1,724569 0,86228441 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SANDOZ 40 mg COMPR. GASTROREZ. 40mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ. P-6L 14 44,12 3,151428 1,724569 0,86228442 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TORRENT 40 mg COMPR. GASTROREZ. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. GASTROREZ. P6L 28 73,48 2,624285 1,724569 0,86228443 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TEVA 40 mg COMPR. GASTROREZ. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. GASTROREZ. P6L 14 26,58 1,898571 1,724569 0,86228444 A02BC05 ESOMEPRAZOLUM PRAGASTROL 40 mg COMPR. GASTROREZ. 40mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ. P6L 30 47,82 1,594000 1,594000 0,797000

SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU MODIFICARILE SI

COMPLETARILE ULTERIOARE VALABILA INCEPAND CU 01 IANUARIE 2015

Pagina 1 din 26

Page 31: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti45 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 26,47 1,890714 0,862284 0,43114246 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 38,71 2,765000 1,724569 0,86228447 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 28 174,25 6,223214 6,223214 3,11160748 A02BC05 ESOMEPRAZOLUM NEXIUM 40 mg PULB. PT. SOL. INJ./PERF. 40mg ASTRAZENECA AB SUEDIA CUTIE X 10 FLACOANE LIOF. PT. SOL. INJ./PERF. S/P-RF 10 297,47 29,747000 19,463995 9,73199749 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL SANDOZ 40 mg PULB. PT. SOL. INJ./PERF. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF.PRF 10 193,35 19,335000 19,335000 9,66750050 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL POLPHARMA 40 mg PULB. PT. SOL. PERF./INJ. 40mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CONTINAND PULB. PT. SOL. INJ./PERF. P6L 10 193,35 19,335000 19,335000 9,66750051 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 6,19 0,309500 0,309500 0,15475052 A02BX02 SUCRALFATUM VENTER COMPR. 1g KRKA D.D. SLOVENIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 15,95 0,319000 0,314250 0,15712553 A02BX05 BISMUTHI SUBCITRAS DE - NOL COMPR. FILM. 120mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 5 BLIST. AL/AL X 8 COMPR. FILM. P-6L 40 39,95 0,998750 0,314250 0,15712554 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 33,57 1,119000 1,119000 0,55950055 A06AD15 MACROGOLUM* 2) OLOPEG CONC. PT. SOL. ORALA FARA CONCENTRATIE CNP PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN PET X 500 ML CONC. PT. SOL. ORALA, INSOTIT DE UN RECIPIENT DOZATOR GRADAT PRF 1 44,15 44,150000 44,150000 22,07500056 A06AD15 MACROGOLUM* 2) OLOPEG CONC. PT. SOL. ORALA FARA CONCENTRATIE CNP PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN PET X 200 ML CONC. PT. SOL. ORALA, INSOTIT DE UN RECIPIENT DOZATOR GRADAT PRF 1 19,03 19,030000 18,002500 9,00125057 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM. P-RF 12 33,10 2,758333 2,646666 1,32333358 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF 36 91,26 2,535000 2,535000 1,26750059 A07AA11 RIFAXIMINUM NORMIX 100mg/5ml GRAN. PT. SUSP. ORALA 100mg/5ml ALFA WASSERMANN SPA ITALIA CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML P-RF 1 19,11 19,110000 15,880014 7,94000760 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 100 444,55 4,445500 4,048486 2,02424361 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 30 419,11 13,970333 12,145471 6,07273562 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 1 419,11 419,110000 383,830000 191,91500063 A07EA06 BUDESONIDUM** BUDENOFALK 2 mg/doza SPUMA RECTALA 2mg/doza DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FLAC. DIN AL X 2X14 DOZE X 1,2G SPUMA RECTALA, 2X (14 APLICATOARE PVC LUBREFIANTE SI 14 PU P-RF 2 744,14 372,070000 372,070000 186,03500064 A07XA04 RACECADOTRILUM HIDRASEC 100 mg CAPS. 100mg LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS. P-RF 20 43,59 2,179500 2,081306 1,04065365 A07XA04 RACECADOTRILUM HIDRASEC 10 mg PULB. PT. SOL. ORALA 10mg LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 1 G P-RF 16 41,04 2,565000 2,081306 1,04065366 A07XA04 RACECADOTRILUM HIDRASEC 30 mg PULB. PT. SOL. ORALA 30mg LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 3 G P-RF 16 39,13 2,445625 2,081306 1,04065367 A08AB01 ORLISTATUM**** XENICAL 120mg CAPS. 120mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 21 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF 21 92,03 4,382380 3,789970 1,89498568 A08AB01 ORLISTATUM**** XENICAL 120mg CAPS. 120mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF 84 301,77 3,592500 3,592500 1,79625069 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 33,62 0,672400 0,523333 0,26166670 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 22,97 0,765666 0,523333 0,26166671 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 31,40 1,046666 1,046666 0,52333372 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 34,01 1,133666 1,046666 0,52333373 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 68,47 2,282333 1,978474 0,98923774 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**# THIOSSEN 600 (vezi N07XN03) COMPR. FILM. 600mg AAA - PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 30 46,05 1,535000 1,535000 0,76750075 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 5 120,12 24,024000 24,024000 12,01200076 B01AB04 DALTEPARINUM**# FRAGMIN 10000 UI/0,4 ml SOL. INJ. 10000UI/0,4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. X 1 SERINGA X 0,4 ML SOL. INJ. S/P-RF 5 125,97 25,194000 23,768000 11,88400077 B01AB04 DALTEPARINUM**# FRAGMIN 12500 UI/0,5 ml SOL. INJ. 12500 UI/0,5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. X 1 SERINGA X 0,5 ML SOL. INJ. S/P-RF 5 170,87 34,174000 29,710000 14,85500078 B01AB04 DALTEPARINUM**# FRAGMIN15000 UI/0,6 ml SOL. INJ. 15000ui/0,6ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,6 ML SOL. INJ. S/P-RF 5 206,87 41,374000 35,652000 17,82600079 B01AB04 DALTEPARINUM**# FRAGMIN 18000 UI/0,72 ml SOL. INJ. 18000 UI/0,72ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. X 1 SERINGA X 0,72 ML SOL. INJ. S/P-RF 5 235,27 47,054000 42,782400 21,39120080 B01AB04 DALTEPARINUM**# FRAGMIN 2500 UI/0,2 ml SOL. INJ. 2500ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML S/P-RF 10 77,59 7,759000 5,942000 2,97100081 B01AB04 DALTEPARINUM**# FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML S/P-RF 10 142,16 14,216000 11,884000 5,94200082 B01AB04 DALTEPARINUM**# FRAGMIN 7500 UI/0,3 ml SOL. INJ. 7500ui/0,3ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,3 ML S/P-RF 10 202,99 20,299000 17,826000 8,91300083 B01AB05 ENOXAPARINUM**# CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti-Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ. PR/PRF 10 64,09 6,409000 5,942000 2,97100084 B01AB05 ENOXAPARINUM**# CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti-Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ. PR/PRF 10 118,84 11,884000 11,884000 5,94200085 B01AB05 ENOXAPARINUM**# CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti-Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. PR/PRF 10 144,45 14,445000 14,445000 7,22250086 B01AB05 ENOXAPARINUM**# CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML SOL. INJ. PR/PRF 2 40,14 20,070000 20,070000 10,03500087 B01AB05 ENOXAPARINUM**# CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml LABORATOIRE AVENTIS FRANTA CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU A PR/PRF 6 127,39 21,231666 21,231666 10,61583388 B01AB06 NADROPARINUM**# FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ. S/P-RF 10 64,25 6,425000 5,942000 2,97100089 B01AB06 NADROPARINUM**# FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ. S/P-RF 10 64,25 6,425000 5,942000 2,97100090 B01AB06 NADROPARINUM**# FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ. S/P-RF 10 81,89 8,189000 7,922664 3,96133291 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 81,89 8,189000 7,922664 3,96133292 B01AB06 NADROPARINUM**# FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ. S/P-RF 10 127,08 12,708000 11,884000 5,94200093 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 10 127,08 12,708000 11,884000 5,94200094 B01AB06 NADROPARINUM**# FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ. S/P-RF 10 154,38 15,438000 15,438000 7,71900095 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 10 154,38 15,438000 15,438000 7,719000

Pagina 2 din 26

Page 32: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti96 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 CULO PR/PRF 10 517,40 51,740000 33,954281 16,97714097 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 CULO PR/PRF 10 1.090,55 109,055000 67,908568 33,95428498 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 10 123,06 12,306000 5,942000 2,97100099 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. PR/PRF 10 155,09 15,509000 7,639712 3,819856100 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. PR/PRF 2 73,65 36,825000 8,488568 4,244284101 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. PR/PRF 2 98,32 49,160000 23,768000 11,884000102 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. PR/PRF 2 120,16 60,080000 30,558856 15,279428103 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 50 102,83 2,056600 1,747900 0,873950104 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 82,25 1,645000 1,645000 0,822500105 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 64,86 6,486000 6,486000 3,243000106 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 78,43 7,843000 6,825250 3,412625107 B01AC04 CLOPIDOGRELUM** PLAVIX 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 359,66 11,988666 9,640285 4,820142108 B01AC04 CLOPIDOGRELUM** CLOPIDOGREL TEVA 75 mg COMPR. FILM. 75 mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. AL/AL X 28 X 1 COMPR. FILM. P-RF 28 37,53 1,340357 1,340357 0,670178109 B01AC04 CLOPIDOGRELUM** ZYLLT COMPR. FILM. 75 mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA/AL/PVC-AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 1,340357 0,670178110 B01AC04 CLOPIDOGRELUM** PLAVIX 75mg COMPR. FILM. 75mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-RF 28 57,74 2,062142 2,062142 1,031071111 B01AC04 CLOPIDOGRELUM** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 COMPR. FILM. P-RF 30 17,86 0,595333 0,595333 0,297666112 B01AC04 CLOPIDOGRELUM** EGITROMB 75 mg COMPR. FILM. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 1,340000 0,670000113 B01AC04 CLOPIDOGRELUM** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 90 COMPR. FILM. P-RF 90 52,86 0,587333 0,587333 0,293666114 B01AC04 CLOPIDOGRELUM** CLOPIDOGREL MYLAN 75mg COMPR. FILM. 75mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM. P-RF 28 79,52 2,840000 2,410071 1,205035115 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 79,52 2,840000 2,410071 1,205035116 B01AC04 CLOPIDOGRELUM** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 1,340357 0,670178117 B01AC04 CLOPIDOGRELUM** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 1,340357 0,670178118 B01AC04 CLOPIDOGRELUM** PLAVOCORIN 75 mg COMPR. FILM. 75mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 1,340357 0,670178119 B01AC04 CLOPIDOGRELUM** CLOPIDOGREL ACTAVIS 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 1,340357 0,670178120 B01AC04 CLOPIDOGRELUM** DEFROZYP 75 mg COMPR. FILM. 75mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 1,340357 0,670178121 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 40,26 1,342000 1,342000 0,671000122 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 40,22 1,340666 1,340666 0,670333123 B01AC04 CLOPIDOGRELUM** MOYTOR 75 mg COMPR. FILM. 75mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PCTFE-PE-PVC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 1,340000 0,670000124 B01AC04 CLOPIDOGRELUM** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. P-RF 10 13,82 1,382000 1,382000 0,691000125 B01AC04 CLOPIDOGRELUM** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 60 COMPR. FILM. P-RF 60 76,22 1,270333 1,270333 0,635166126 B01AC04 CLOPIDOGRELUM** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-RF 90 114,32 1,270222 1,270222 0,635111127 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 51,97 1,732333 1,732333 0,866166128 B01AC04 CLOPIDOGRELUM** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 37,46 1,337857 1,337857 0,668928129 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 40,20 1,340000 1,340000 0,670000130 B01AC04 CLOPIDOGRELUM** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 30 COMPRIMATE FILMATEP-RF 30 17,18 0,572666 0,572666 0,286333131 B01AC04 CLOPIDOGRELUM** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINÂND 90 COMPRIMATE FILMATEP-RF 90 49,88 0,554222 0,554222 0,277111132 B01AC04 CLOPIDOGRELUM** CLOPIDOGREL POLIPHARMA 75 mg COMPR. FILM. 75mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P6L 30 40,22 1,340666 1,340666 0,670333133 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 16,02 0,572142 0,572142 0,286071134 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 58,12 1,162400 1,162400 0,581200135 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 84,93 1,698600 1,205035 0,602517136 B01AC30 COMBINATII (ACID ACETYLSALICYLICUM+DIPYRIDAMOLUM)**AGGRENOX CAPS. ELIB. MODIF. 25mg/200mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 60 CAPS. CU ELIB.MODIF. P-6L 60 52,85 0,880833 0,880833 0,440416137 B01AC30 COMBINATII (ACID ACETYLSALICYLICUM+DIPYRIDAMOLUM)**AGGRENOX 200mg/25mg CAPS. ELIB. MODIF. 25mg/200mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 60 CAPS. CU ELIB.MODIF. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII +DESICAN P-6L 60 52,85 0,880833 0,880833 0,440416138 B01AF01 RIVAROXABANUM XARELTO COMPR. FILM. 10mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X BLIST PVC/PVDC/AL X 10 COMPR. FILM. P-RF 10 116,07 11,607000 11,006333 5,503166139 B01AF01 RIVAROXABANUM XARELTO COMPR. FILM. 10mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X BLIST PVC/PVDC/AL X 30 COMPR. FILM. P-RF 30 330,19 11,006333 11,006333 5,503166140 B01AF01 RIVAROXABANUM XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM. P-RF 10 116,07 11,607000 11,006333 5,503166141 B01AF01 RIVAROXABANUM XARELTO 10mg COMPR. FILM. 10mg BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM. P-RF 30 330,19 11,006333 11,006333 5,503166142 B01AX05 FONDAPARINUX SODIUM**# ARIXTRA 2,5mg/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 2,5mg/0,5ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CU P-RF 10 187,06 18,706000 18,706000 9,353000143 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 10 187,06 18,706000 18,706000 9,353000144 B01AX05 FONDAPARINUX SODIUM**# ARIXTRA 7,5mg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 7,5mg/0,6ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CU P-RF 10 607,13 60,713000 56,117999 28,058999145 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 10 607,13 60,713000 46,765000 23,382500146 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 5 149,77 29,954000 29,954000 14,977000

Pagina 3 din 26

Page 33: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti147 C01EB17 IVABRADINUM** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 28 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 28 160,23 5,722500 3,272517 1,636258148 C01EB17 IVABRADINUM** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 240,27 4,290535 3,272517 1,636258149 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 56 260,36 4,649285 4,649285 2,324642150 C01EB17 IVABRADINUM** CORLENTOR 7,5mg COMPR. FILM. 7,5mg LES LAB. SERVIER FRANTA CUTIE X 28 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 28 160,23 5,722500 4,908776 2,454388151 C02AC05 MOXONIDINUM MOXOGAMMA 0,2 mg COMPR. FILM. 0,2mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 21,80 0,726666 0,726666 0,363333152 C02AC05 MOXONIDINUM PHYSIOTENS 0,2 COMPR. FILM. 0,2mg ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L 28 32,50 1,160714 0,866569 0,433284153 C02AC05 MOXONIDINUM MOXONIDINA MYLAN 0,2 mg COMPR. FILM. 0,2mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 13,24 0,472857 0,472857 0,236428154 C02AC05 MOXONIDINUM MOXOGAMMA 0,3 mg COMPR. FILM. 0,3mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 25,87 0,862333 0,862333 0,431166155 C02AC05 MOXONIDINUM MOXONIDINA MYLAN 0,3 mg COMPR. FILM. 0,3mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 20,22 0,722142 0,722142 0,361071156 C02AC05 MOXONIDINUM MOXOGAMMA 0,4 mg COMPR. FILM. 0,4mg WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 33,14 1,104666 1,104666 0,552333157 C02AC05 MOXONIDINUM PHYSIOTENS 0,4 COMPR. FILM. 0,4mg ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L 28 43,79 1,563928 1,563928 0,781964158 C02AC05 MOXONIDINUM MOXONIDINA MYLAN 0,4 mg COMPR. FILM. 0,4mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 26,58 0,949285 0,949285 0,474642159 C02AC06 RILMENIDINUM TENAXUM COMPR. 1mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 41,62 1,387333 1,299855 0,649927160 C02AC06 RILMENIDINUM RILMENIDINA TEVA 1 mg COMPR. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X BLISTERE AL/AL (FOLIE AL CFF FORMATA LA RECE/FOLIE AL ACOPERITA LA CALD CU UN STRAT DE LAC) X 30 COMPRIMATE P6L 30 27,94 0,931333 0,931333 0,465666161 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 30 185,59 6,186333 3,866458 1,933229162 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 30 185,59 6,186333 6,186333 3,093166163 C04AE02 NICERGOLINUM NICERIUM (R) 15 CAPS. ELIB. MODIF. 15mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF. P-6L 30 27,89 0,929666 0,540833 0,270416164 C04AE02 NICERGOLINUM NICERIUM (R) 30 UNO CAPS. ELIB. MODIF. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF. P-6L 30 51,38 1,712666 1,081666 0,540833165 C04AE02 NICERGOLINUM NICERGOLINA LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 13,45 0,448333 0,360555 0,180277166 C04AE02 NICERGOLINUM GRALIN 10 mg COMPR. FILM. 10mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM. P-6L 30 13,45 0,448333 0,360555 0,180277167 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 48,31 1,610333 1,081666 0,540833168 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 32,45 1,081666 1,081666 0,540833169 C04AE02 NICERGOLINUM GRALIN 30 mg COMPR. FILM. 30mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM. P-6L 30 32,45 1,081666 1,081666 0,540833170 C04AE02 NICERGOLINUM GRALIN 5 mg COMPR. FILM. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM. P-6L 30 6,76 0,225333 0,180277 0,090138171 C04AE02 NICERGOLINUM NICERIUM (R) 10 DRAJ. 10mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PVC X 25 DRAJ. P-6L 25 14,11 0,564400 0,360555 0,180277172 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-6L 30 32,39 1,079666 1,079666 0,539833173 C04AE02 NICERGOLINUM SINERGOLIN 30 DRAJ. 30mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ. P-6L 20 21,59 1,079500 1,079500 0,539750174 C04AX07 VINCAMINUM OXYBRAL SR 30 mg CAPS. ELIB. PREL. 30mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 CAPS. CU ELIB. PREL. P-6L 10 9,26 0,926000 0,926000 0,463000175 C04AX07 VINCAMINUM VINCAMINA DRAJ. 10mg BIOFARM SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 DRAJ. P-6L 20 6,72 0,336000 0,315500 0,157750176 C04AXN1 GINKGO BILOBA** BILOBIL INTENS 120 mg (vezi N06DX02) CAPS. 120mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 60 65,18 1,086333 1,086333 0,543166177 C04AXN1 GINKGO BILOBA** BILOBIL 40 mg (C04AXN1) CAPS. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS. P-6L 20 9,58 0,479000 0,379604 0,189802178 C04AXN1 GINKGO BILOBA** BILOBIL 40 mg (C04AXN1) CAPS. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. AL/PVC-PVDC X 10 CAPS. P-6L 60 27,50 0,458333 0,379604 0,189802179 C04AXN1 GINKGO BILOBA** BILOBIL FORTE (vezi C04AXN1) CAPS. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. AL/PVC X 10 CAPS. P-6L 60 45,29 0,754833 0,754833 0,377416180 C04AXN1 GINKGO BILOBA** GINGIUM 120mg (vezi N06DX02) COMPR. FILM. 120mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. P-6L 30 33,74 1,124666 1,124666 0,562333181 C04AXN1 GINKGO BILOBA** GINGIUM 40mg (vezi N06DX02 ) COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. P-6L 30 12,48 0,416000 0,379604 0,189802182 C04AXN1 GINKGO BILOBA** GINKGO BILOBA BIOFARM 40 mg (vezi N06DX02) COMPR. FILM. 40mg BIOFARM S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 12,30 0,410000 0,379604 0,189802183 C04AXN1 GINKGO BILOBA** GINKGO BILOBA BIOFARM 40 mg (vezi N06DX02) COMPR. FILM. 40mg BIOFARM S.A. ROMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 60 23,51 0,391833 0,379604 0,189802184 C04AXN1 GINKGO BILOBA** GINKGO BILOBA BIOFARM 40 mg (vezi N06DX02) COMPR. FILM. 40mg BIOFARM S.A. ROMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. P-6L 60 23,51 0,391833 0,379604 0,189802185 C04AXN1 GINKGO BILOBA** TANAKAN (EGB 761) (N06DX02) COMPR. FILM. 40mg IPSEN PHARMA FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 23,17 0,772333 0,379604 0,189802186 C04AXN1 GINKGO BILOBA** GINGIUM 80mg (vezi N06DX02) COMPR. FILM. 80mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PP X 10 COMPR. FILM. P-6L 30 23,51 0,783666 0,759208 0,379604187 C04AXN1 GINKGO BILOBA** GINKGO BILOBA BIOFARM 80 mg (vezi N06DX02) COMPR. FILM. 80mg BIOFARM S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 23,17 0,772333 0,759208 0,379604188 C04AXN1 GINKGO BILOBA** GINKGO BILOBA BIOFARM 80 mg (vezi N06DX02) COMPR. FILM. 80mg BIOFARM S.A. ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 60 44,84 0,747333 0,747333 0,373666189 C04AXN1 GINKGO BILOBA** TANAKAN (EGB 761) (C04AXN1) PICATURI ORALE-SOL. 40mg/ml BEAUFOUR IPSEN PHARMA FRANTA CUTIE X 1 FLACON DE STICLA BRUNA X 30 ML + 1 PIPETA DIN POLIETILENA P-6L 1 24,88 24,880000 24,880000 12,440000190 C04AXN1 GINKGO BILOBA** TANAKAN (EGB 761) (C04AXN1) PICATURI ORALE-SOL. 40mg/ml IPSEN PHARMA FRANTA CUTIE X 1 FLACON DE STICLA BRUNA X 30 ML + 1 PIPETA DIN POLIETILENA P-6L 1 24,88 24,880000 24,880000 12,440000191 C05CA53 DIOSMINUM (COMBINATII)** DETRALEX ( R ) COMPR. FILM. 500mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 26,39 0,879666 0,879666 0,439833192 C07AB12 NEBIVOLOLUM NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 34,55 1,233928 0,854549 0,427274193 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 23,20 0,773333 0,773333 0,386666194 C07AB12 NEBIVOLOLUM X-PRESSOL 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 27,09 0,903000 0,854549 0,427274195 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 24,87 0,829000 0,829000 0,414500196 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P-6L 28 22,80 0,814285 0,814285 0,407142197 C07AB12 NEBIVOLOLUM NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 24,44 0,814666 0,814666 0,407333

Pagina 4 din 26

Page 34: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti198 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 24,87 0,829000 0,829000 0,414500199 C07AB12 NEBIVOLOLUM NEBIVOLOL SANDOZ 5 mg COMPR. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 13,84 0,494285 0,494285 0,247142200 C07AB12 NEBIVOLOLUM NEBIVOLOL TERAPIA 5mg COMPR. 5mg TERAPIA S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L 28 22,65 0,808928 0,808928 0,404464201 C07AB12 NEBIVOLOLUM NEBIVOLOL TORRENT 5 mg COMPR. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L 30 24,59 0,819666 0,819666 0,409833202 C07AB12 NEBIVOLOLUM NEBICARD 5 mg COMPR. 5mg BIOFARM SP. ZO.O POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P6L 28 22,93 0,818928 0,818928 0,409464203 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 10 mg/6,25mg COMPR. FILM. 10 mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM. P-6L 30 29,46 0,982000 0,902749 0,451374204 C07BB07 COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 10 mg/6,25mg COMPR. FILM. 10 mg/6,25mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 30 29,46 0,982000 0,902749 0,451374205 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 26,29 0,876333 0,876333 0,438166206 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 26,29 0,876333 0,876333 0,438166207 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 29,46 0,982000 0,902749 0,451374208 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 29,46 0,982000 0,902749 0,451374209 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 12,80 0,914285 0,578249 0,289124210 C08CA13 LERCANIDIPINUM LERCANIDIPINA TEVA 10 mg COMPR. FILM. 10 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 26,92 0,448666 0,448666 0,224333211 C08CA13 LERCANIDIPINUM LERCANIDIPINA TEVA 10 mg COMPR. FILM. 10 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 21,09 0,703000 0,578249 0,289124212 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 16,18 0,539333 0,539333 0,269666213 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 40,07 0,667833 0,578249 0,289124214 C08CA13 LERCANIDIPINUM LERPIN 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 22,99 0,821071 0,578249 0,289124215 C08CA13 LERCANIDIPINUM KAPIDIN10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 13,45 0,448333 0,448333 0,224166216 C08CA13 LERCANIDIPINUM PEGFEL 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVCDC/AL X 28 COMPR. FILM. P -6L 28 21,76 0,777142 0,578249 0,289124217 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L 30 16,18 0,539333 0,539333 0,269666218 C08CA13 LERCANIDIPINUM LERCANIDIPINA ZENTIVA 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 13,45 0,448333 0,448333 0,224166219 C08CA13 LERCANIDIPINUM LERCANIDIPINA TEVA 20 mg COMPR. FILM. 20 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 43,54 0,725666 0,725666 0,362833220 C08CA13 LERCANIDIPINUM LERCANIDIPINA TEVA 20 mg COMPR. FILM. 20 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 32,91 1,097000 1,097000 0,548500221 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 26,96 0,898666 0,898666 0,449333222 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 64,75 1,079166 1,079166 0,539583223 C08CA13 LERCANIDIPINUM LERPIN 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 34,95 1,248214 1,156499 0,578249224 C08CA13 LERCANIDIPINUM PEGFEL 20 mg COMPR. FILM. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVCDC/AL X 28 COMPR. FILM. P -6L 28 33,98 1,213571 1,156499 0,578249225 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L 30 26,96 0,898666 0,898666 0,449333226 C09AA04 PERINDOPRILUM PRENESSA 2 mg COMPR. 2mg KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. DIN PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 13,44 0,448000 0,178200 0,089100227 C09AA04 PERINDOPRILUM PERINDOPRIL TEVA 4 mg COMPR. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST. PVC/VMCH-AL X 30 COMPR.P-6L 30 25,32 0,844000 0,356400 0,178200228 C09AA04 PERINDOPRILUM VIDOTIN 4 mg COMPR. 4mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 33,45 1,115000 0,356400 0,178200229 C09AA04 PERINDOPRILUM STOPRESS 4 mg COMPR. 4mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L 30 16,61 0,553666 0,356400 0,178200230 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 25,87 0,862333 0,356400 0,178200231 C09AA04 PERINDOPRILUM TREZEN 4 mg COMPR. 4mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 25,87 0,862333 0,356400 0,178200232 C09AA04 PERINDOPRILUM PRENESSA 4 mg COMPR. 4mg KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 26,87 0,895666 0,356400 0,178200233 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 26,90 0,896666 0,356400 0,178200234 C09AA04 PERINDOPRILUM PERINDOPRIL TEVA 8 mg COMPR. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST PVC/VMCH-AL X 30 COMPR. P-6L 30 49,00 1,633333 0,712800 0,356400235 C09AA04 PERINDOPRILUM VIDOTIN 8 mg COMPR. 8mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L 30 53,44 1,781333 0,712800 0,356400236 C09AA04 PERINDOPRILUM STOPRESS 8 mg COMPR. 8mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L 30 30,88 1,029333 0,712800 0,356400237 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 49,12 1,637333 0,712800 0,356400238 C09AA04 PERINDOPRILUM TREZEN 8 mg COMPR. 8mg TERAPIA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 49,12 1,637333 0,712800 0,356400239 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 54,01 1,800333 0,712800 0,356400240 C09AA04 PERINDOPRILUM PRENESSA 8 mg COMPR. 8mg KRKA POLSKA SP Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 49,45 1,648333 0,712800 0,356400241 C09AA04 PERINDOPRILUM PRESTARIUM 10 mg COMPR. FILM. 10 mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 63,61 2,120333 0,891000 0,445500242 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 42,77 1,425666 0,891000 0,445500243 C09AA04 PERINDOPRILUM PRESTARIUM 5 mg COMPR. FILM. 5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L 30 41,11 1,370333 0,445500 0,222750244 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 27,61 0,920333 0,445500 0,222750245 C09AA07 BENAZEPRILUM CIBACEN (R) 10 mg COMPR. FILM. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 43,66 1,559285 0,475199 0,237599246 C09AA07 BENAZEPRILUM CIBACEN (R) 20 mg COMPR. FILM. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 57,30 2,046428 0,950399 0,475199247 C09AA07 BENAZEPRILUM CIBACEN (R) 5 mg COMPR. FILM. 5mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 21,80 0,778571 0,237599 0,118799248 C09AA10 TRANDOLAPRILUM GOPTEN (R) 0,5 mg CAPS. 0,5mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 9,71 0,485500 0,089100 0,044550

Pagina 5 din 26

Page 35: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti249 C09AA10 TRANDOLAPRILUM GOPTEN (R) 2 mg CAPS. 2mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 28,09 1,003214 0,356400 0,178200250 C09AA10 TRANDOLAPRILUM GOPTEN (R) 4 mg CAPS. 4mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 46,79 1,671071 0,712800 0,356400251 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 44,47 1,588214 0,356400 0,178200252 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 19,69 0,703214 0,089100 0,044550253 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 2 mg/0,625 mg COMPR. 2 mg/0,625 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR. P6L 30 15,72 0,524000 0,524000 0,262000254 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 16,18 0,539333 0,539333 0,269666255 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg COMPR. 2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 16,18 0,539333 0,539333 0,269666256 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 16,18 0,539333 0,539333 0,269666257 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 4 mg/1,25 mg COMPR. 4 mg/1,25 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR. P6L 30 24,21 0,807000 0,807000 0,403500258 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 29,41 0,980333 0,824142 0,412071259 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PANINDORIL 4 mg/1,25 mg COMPR. 4mg/1, 25mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L 30 21,09 0,703000 0,703000 0,351500260 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg COMPR. 4mg/1,25mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L 30 29,41 0,980333 0,824142 0,412071261 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 29,41 0,980333 0,824142 0,412071262 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg COMPR. 8mg/2,5mg KRKA-POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 29,54 0,984666 0,824142 0,412071263 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 75,76 2,525333 0,824142 0,412071264 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 57,17 1,905666 0,824142 0,412071265 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 37,16 1,238666 0,824142 0,412071266 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 61,63 2,054333 0,824142 0,412071267 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRESTARIUM ARG PLUS 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 61,63 2,054333 0,824142 0,412071268 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 40,04 1,334666 0,824142 0,412071269 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 21,68 0,722666 0,722666 0,361333270 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 31,57 1,052333 0,824142 0,412071271 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 96,52 3,217333 3,217333 1,608666272 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 21,16 0,705333 0,705333 0,352666273 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 19,26 0,642000 0,500608 0,250304274 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 35,43 1,181000 1,001217 0,500608275 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 33,51 1,117000 0,723101 0,361550276 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg COMPR. CU ELIB. MODIF. 240mg/2mg ABBOTT GMBH & CO.KG GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 55,45 1,980357 1,887500 0,943750277 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg COMPR. CU ELIB. MODIF. 240mg/4mg ABBOTT GMBH & CO.KG GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF. P6L 28 72,69 2,596071 1,887500 0,943750278 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA COMPR.FILM.ELIB.MODIF. 180mg/2mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. FILM. CU ELIB. PREL. P-6L 28 52,85 1,887500 1,887500 0,943750279 C09CA03 VALSARTANUM VALSARTAN TEVA 160 mg CAPS. 160mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L 28 32,59 1,163928 1,163928 0,581964280 C09CA03 VALSARTANUM VALSARTAN TEVA 80 mg CAPS. 80mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L 28 20,26 0,723571 0,723571 0,361785281 C09CA03 VALSARTANUM WENZELL 160 mg COMPR. FILM. 160mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM. P-6L 28 66,00 2,357142 2,056648 1,028324282 C09CA03 VALSARTANUM WENZELL 160 mg COMPR. FILM. 160mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM. P-6L 30 70,74 2,358000 2,056648 1,028324283 C09CA03 VALSARTANUM VALSARGAMMA 160 mg COMPR. FILM. 160mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 33,91 1,130333 1,130333 0,565166284 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 28 116,60 4,164285 2,056648 1,028324285 C09CA03 VALSARTANUM VALSARTAN TORRENT 160 mg COMPR. FILM. 160mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 65,71 2,346785 2,056648 1,028324286 C09CA03 VALSARTANUM VALSACOR 160 mg COMPR. FILM. 160mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 32,85 1,173214 1,173214 0,586607287 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 66,00 2,357142 2,056648 1,028324288 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 22,79 0,813928 0,813928 0,406964289 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 32,82 1,172142 1,172142 0,586071290 C09CA03 VALSARTANUM VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 32,82 1,172142 1,172142 0,586071291 C09CA03 VALSARTANUM WAROTA 160 mg COMPR. FILM. 160mg ALKALOID - INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. P6L 30 33,16 1,105333 1,105333 0,552666292 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L 28 71,91 2,568214 0,514162 0,257081293 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 42,63 1,522500 0,514162 0,257081294 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 11,16 0,398571 0,398571 0,199285295 C09CA03 VALSARTANUM VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 11,16 0,398571 0,398571 0,199285296 C09CA03 VALSARTANUM WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM. P-6L 28 47,37 1,691785 1,028324 0,514162297 C09CA03 VALSARTANUM WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM. P-6L 30 50,79 1,693000 1,028324 0,514162298 C09CA03 VALSARTANUM VALSARGAMMA 80 mg COMPR. FILM. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 23,25 0,775000 0,775000 0,387500299 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 91,88 3,281428 1,028324 0,514162

Pagina 6 din 26

Page 36: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti300 C09CA03 VALSARTANUM VALSARTAN TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 47,00 1,678571 1,028324 0,514162301 C09CA03 VALSARTANUM VALSACOR 80 mg COMPR. FILM. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 28,84 1,030000 1,028324 0,514162302 C09CA03 VALSARTANUM AVASSAN 80 mg COMPR. FILM. 80mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 47,40 1,692857 1,028324 0,514162303 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 14,95 0,533928 0,533928 0,266964304 C09CA03 VALSARTANUM WAROTA 80 mg COMPR. FILM. 80mg ALKALOID - INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. P6L 30 32,48 1,082666 1,028324 0,514162305 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 18,18 0,649285 0,649285 0,324642306 C09CA03 VALSARTANUM VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 18,18 0,649285 0,649285 0,324642307 C09CA03 VALSARTANUM DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 160 ML SOL. ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PT. FLAC.+1 P-6L 1 41,42 41,420000 6,169946 3,084973308 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 16,18 0,577857 0,577857 0,288928309 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 26,19 0,935357 0,935357 0,467678310 C09CA04 IRBESARTANUM IRBESARTAN GALENICA 150 mg COMPR. FILM. 150 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 18,10 0,646428 0,646428 0,323214311 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 32,76 1,170000 1,028324 0,514162312 C09CA04 IRBESARTANUM IRBESARTAN WINTHROP 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 18,12 0,647142 0,647142 0,323571313 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 29,83 1,065357 1,028324 0,514162314 C09CA04 IRBESARTANUM IRBESARTAN SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 33,50 1,196428 1,028324 0,514162315 C09CA04 IRBESARTANUM IRPRESTAN 150 mg COMPR. FILM. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 23,08 0,769333 0,769333 0,384666316 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 37,35 1,333928 1,028324 0,514162317 C09CA04 IRBESARTANUM IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 21,54 0,769285 0,769285 0,384642318 C09CA04 IRBESARTANUM IRBESARTAN TORRENT 150 mg COMPR. FILM. 150mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 21,54 0,769285 0,769285 0,384642319 C09CA04 IRBESARTANUM ATOKKEN 150 mg COMPR. FILM. 150mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 24,01 0,857500 0,857500 0,428750320 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 18,12 0,647142 0,647142 0,323571321 C09CA04 IRBESARTANUM IRBESARTAN HF 150 mg COMPR. FILM. 150mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 23,08 0,769333 0,769333 0,384666322 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 32,76 1,170000 1,028324 0,514162323 C09CA04 IRBESARTANUM ATOKKEN 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 24,01 0,857500 0,857500 0,428750324 C09CA04 IRBESARTANUM IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 29,01 1,036071 1,036071 0,518035325 C09CA04 IRBESARTANUM IRBESARTAN GALENICA 300 mg COMPR. FILM. 300 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 29,43 1,051071 1,051071 0,525535326 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 43,20 1,542857 1,542857 0,771428327 C09CA04 IRBESARTANUM IRBESARTAN WINTHROP 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 29,32 1,047142 1,047142 0,523571328 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 38,87 1,388214 1,388214 0,694107329 C09CA04 IRBESARTANUM IRBESARTAN SANDOZ 300 mg COMPR. FILM. 300mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 64,85 2,316071 2,056648 1,028324330 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 60,27 2,152500 2,056648 1,028324331 C09CA04 IRBESARTANUM IRBESARTAN TORRENT 300 mg COMPR. FILM. 300mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 29,01 1,036071 1,036071 0,518035332 C09CA04 IRBESARTANUM ATOKKEN 300 mg COMPR. FILM. 300mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 31,00 1,107142 1,107142 0,553571333 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 29,32 1,047142 1,047142 0,523571334 C09CA04 IRBESARTANUM IRBESARTAN HF 300 mg COMPR. FILM. 300mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 31,09 1,036333 1,036333 0,518166335 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 43,20 1,542857 1,542857 0,771428336 C09CA04 IRBESARTANUM ATOKKEN 300 mg COMPR. FILM. 300mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 31,00 1,107142 1,107142 0,553571337 C09CA04 IRBESARTANUM IRBESARTAN TORRENT 75 mg COMPR. FILM. 75mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 16,18 0,577857 0,514162 0,257081338 C09CA04 IRBESARTANUM ATOKKEN 75 mg COMPR. FILM. 75mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 23,11 0,825357 0,514162 0,257081339 C09CA04 IRBESARTANUM ATOKKEN 75 mg COMPR. FILM. 75mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 23,11 0,825357 0,514162 0,257081340 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 66,74 2,383571 2,056648 1,028324341 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L 28 44,87 1,602500 1,602500 0,801250342 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL ZENTIVA 16 mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,497500343 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 26,95 0,962500 0,962500 0,481250344 C09CA06 CANDESARTANUM CILEXETIL HIPOSTYN 16 mg COMPR. 16mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 42,50 1,416666 1,416666 0,708333345 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 43,24 1,441333 1,441333 0,720666346 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN TORRENT 16 mg COMPR. 16mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 48,03 1,601000 1,601000 0,800500347 C09CA06 CANDESARTANUM CILEXETIL CLASTINOL 16 mg COMPR. 16mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 44,85 1,601785 1,601785 0,800892348 C09CA06 CANDESARTANUM CILEXETIL CANDEPOL 16 mg COMPR. 16mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. AL/PVC-PVDC X 28 COMPR. P6L 28 44,88 1,602857 1,602857 0,801428349 C09CA06 CANDESARTANUM CILEXETIL CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,497500350 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL TEVA 16 mg COMPR. 16mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/PVC-PVAC-AL-OPA X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,497500

Pagina 7 din 26

Page 37: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti351 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 41,42 1,479285 1,479285 0,739642352 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 29,28 0,976000 0,976000 0,488000353 C09CA06 CANDESARTANUM CILEXETIL CADEXYL 16 mg COMPR. 16mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 29,85 1,066071 1,066071 0,533035354 C09CA06 CANDESARTANUM CILEXETIL ATACAND 32 mg COMPR. 32mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. P-6L 28 117,40 4,192857 4,113297 2,056648355 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL ZENTIVA 32 mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 36,65 1,221666 1,221666 0,610833356 C09CA06 CANDESARTANUM CILEXETIL HIPOSTYN 32 mg COMPR. 32mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 71,36 2,378666 2,378666 1,189333357 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 81,75 2,725000 2,725000 1,362500358 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN TORRENT 32 mg COMPR. 32mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 81,75 2,725000 2,725000 1,362500359 C09CA06 CANDESARTANUM CILEXETIL CLASTINOL 32 mg COMPR. 32mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 69,33 2,476071 2,476071 1,238035360 C09CA06 CANDESARTANUM CILEXETIL CANDEPOL 32 mg COMPR. 32mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. AL/PVC-PVDC X 28 COMPR. P6L 28 76,32 2,725714 2,725714 1,362857361 C09CA06 CANDESARTANUM CILEXETIL CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 36,65 1,221666 1,221666 0,610833362 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL TEVA 32 mg COMPR. 32mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/PVC-PVAC-AL-OPA X 30 COMPR. P6L 30 36,65 1,221666 1,221666 0,610833363 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN LABORMED 32 mg COMPR. 32mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L 28 56,66 2,023571 2,023571 1,011785364 C09CA06 CANDESARTANUM CILEXETIL CADEXYL 32 mg COMPR. 32mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 36,65 1,308928 1,308928 0,654464365 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 56,10 2,003571 1,028324 0,514162366 C09CA06 CANDESARTANUM CILEXETIL TANDESAR 8 mg COMPR. 8mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L 28 36,46 1,302142 1,028324 0,514162367 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL ZENTIVA 8 mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 16,22 0,540666 0,540666 0,270333368 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 16,81 0,600357 0,600357 0,300178369 C09CA06 CANDESARTANUM CILEXETIL HIPOSTYN 8 mg COMPR. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 24,13 0,804333 0,804333 0,402166370 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 33,01 1,100333 1,028324 0,514162371 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN TORRENT 8 mg COMPR. 8mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 39,07 1,302333 1,028324 0,514162372 C09CA06 CANDESARTANUM CILEXETIL CLASTINOL 8 mg COMPR. 8mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 36,46 1,302142 1,028324 0,514162373 C09CA06 CANDESARTANUM CILEXETIL CANDEPOL 8 mg COMPR. 8mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. AL/PVC-PVDC X 28 COMPR. P6L 28 36,46 1,302142 1,028324 0,514162374 C09CA06 CANDESARTANUM CILEXETIL CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 16,22 0,540666 0,540666 0,270333375 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN CILEXETIL TEVA 8 mg COMPR. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/PVC-PVAC-AL-OPA X 30 COMPR. P6L 30 23,07 0,769000 0,769000 0,384500376 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 33,65 1,201785 1,028324 0,514162377 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 21,57 0,719000 0,719000 0,359500378 C09CA06 CANDESARTANUM CILEXETIL CADEXYL 8 mg COMPR. 8mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 16,22 0,579285 0,579285 0,289642379 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 40mg COMPR. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 39,46 1,409285 1,028324 0,514162380 C09CA07 TELMISARTANUM MICARDIS 40 mg COMPR. 40mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28 COMPR. ( BLIST. PA/AL/PVC) P-6L 28 60,70 2,167857 1,028324 0,514162381 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 39,46 1,409285 1,028324 0,514162382 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 17,20 0,573333 0,573333 0,286666383 C09CA07 TELMISARTANUM TELMISARTAN TEVA 40 mg COMPR. 40mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE 30X1 P6L 30 42,27 1,409000 1,028324 0,514162384 C09CA07 TELMISARTANUM TELMISARTAN RANBAXY 40 mg COMPR. 40mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR.P6L 28 39,46 1,409285 1,028324 0,514162385 C09CA07 TELMISARTANUM TELMA 40 mg COMPR. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 17,20 0,614285 0,614285 0,307142386 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 40 mg COMPR. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 28 COMPR. P6L 28 42,24 1,508571 1,028324 0,514162387 C09CA07 TELMISARTANUM TELMISARTAN DR. REDDY'S 40 mg COMPR. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P6L 28 17,20 0,614285 0,614285 0,307142388 C09CA07 TELMISARTANUM TELMISARTAN ACTAVIS 80mg COMPR. 80 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 52,99 1,892500 1,892500 0,946250389 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 77,42 2,765000 2,056648 1,028324390 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 52,99 1,892500 1,892500 0,946250391 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 28,09 0,936333 0,936333 0,468166392 C09CA07 TELMISARTANUM TELMISARTAN TEVA 80 mg COMPR. 80mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE 30X1 P6L 30 56,77 1,892333 1,892333 0,946166393 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 52,99 1,892500 1,892500 0,946250394 C09CA07 TELMISARTANUM TELMA 80 mg COMPR. 80mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 22,68 0,810000 0,810000 0,405000395 C09CA07 TELMISARTANUM TELMISARTAN TORRENT 80 mg COMPR. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 28 COMPR. P6L 28 56,53 2,018928 2,018928 1,009464396 C09CA07 TELMISARTANUM TELMISARTAN DR. REDDY'S 80 mg COMPR. 80mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P6L 28 28,09 1,003214 1,003214 0,501607397 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 39,46 1,409285 1,028324 0,514162398 C09CA07 TELMISARTANUM TANYDON 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 42,27 1,409000 1,028324 0,514162399 C09CA07 TELMISARTANUM TELMISARTAN EGIS 40 mg COMPR. FILM. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 39,63 1,415357 1,028324 0,514162400 C09CA07 TELMISARTANUM TELMOTENS 40mg COMPR. FILM. 40mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM. P6L 30 42,27 1,409000 1,028324 0,514162401 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 52,99 1,892500 1,892500 0,946250

Pagina 8 din 26

Page 38: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti402 C09CA07 TELMISARTANUM TANYDON 80 mg COMPR. FILM. 80mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 56,78 1,892666 1,892666 0,946333403 C09CA07 TELMISARTANUM TELMISARTAN EGIS 80 mg COMPR. FILM. 80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 52,98 1,892142 1,892142 0,946071404 C09CA07 TELMISARTANUM TELMOTENS 80mg COMPR. FILM. 80mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM. P6L 30 56,77 1,892333 1,892333 0,946166405 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) HYZAAR (R) 50 mg/12,5 mg COMPR. FILM. 50mg+12,5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 79,46 2,837857 0,966213 0,483106406 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LOSARTAN HCT FARMAL 50mg/12,5mg COMPR. FILM. 50mg/12,5mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PE PCDC/AL X 14 COMPR. FILM. P-6L 28 30,06 1,073571 0,966213 0,483106407 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA HL 100 mg/12,5 mg COMPR.FILM 100mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 29,31 1,046785 0,966213 0,483106408 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA H COMPR.FILM 50mg+ 12,50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 18,06 0,645000 0,645000 0,322500409 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 85,68 3,060000 0,966213 0,483106410 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 160 mg/25 mg COMPR. FILM. 160mg/25mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 136,15 4,862500 0,966213 0,483106411 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 320 mg/12,5 mg COMPR. FILM. 320mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 132,23 4,722500 0,966213 0,483106412 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 320 mg/25 mg COMPR. FILM. 320mg/25mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 150,44 5,372857 0,966213 0,483106413 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 73,85 2,637500 0,966213 0,483106414 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 39,26 1,402142 0,966213 0,483106415 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 55,40 1,978571 0,966213 0,483106416 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE WINTHROP 150mg/12,5mg COMPR. FILM 150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 20,39 0,728214 0,728214 0,364107417 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM 150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 20,39 0,728214 0,728214 0,364107418 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE WINTHROP 300mg/12,5mg COMPR. FILM 300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 33,70 1,203571 0,966213 0,483106419 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM 300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 33,70 1,203571 0,966213 0,483106420 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 26,49 0,946071 0,946071 0,473035421 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 150mg/12,5mg COMPR. FILM. 150mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 39,59 1,319666 0,966213 0,483106422 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 35,50 1,267857 0,966213 0,483106423 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L 28 35,50 1,267857 0,966213 0,483106424 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 39,26 1,402142 0,966213 0,483106425 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 26,36 0,941428 0,941428 0,470714426 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 26,36 0,941428 0,941428 0,470714427 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 300 mg/12,5 mg COMPR. FILM. 300 mg/12,5mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 51,49 1,838928 0,966213 0,483106428 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/12,5mg COMPR. FILM. 300mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 73,91 2,463666 0,966213 0,483106429 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 68,91 2,461071 0,966213 0,483106430 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM. 300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L 28 68,91 2,461071 0,966213 0,483106431 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 55,40 1,978571 0,966213 0,483106432 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 36,01 1,286071 0,966213 0,483106433 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 36,01 1,286071 0,966213 0,483106434 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg COMPR. FILM. 300mg/25mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 55,40 1,978571 0,966213 0,483106435 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/25mg COMPR. FILM. 300mg/25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM. P6L 30 73,91 2,463666 0,966213 0,483106436 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM. 300mg/25mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 68,91 2,461071 0,966213 0,483106437 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM. 300mg/25mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L 28 68,91 2,461071 0,966213 0,483106438 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 55,40 1,978571 0,966213 0,483106439 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 36,01 1,286071 0,966213 0,483106440 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 36,01 1,286071 0,966213 0,483106441 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN CILEXETIL/HIDROCLOROTIAZIDA ZENTIVA 16 mg/12,5 mg COMPR. 16mg/12,5mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 23,44 0,781333 0,781333 0,390666442 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 23,44 0,781333 0,781333 0,390666443 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN CILEXETIL/HIDROCLOROTIAZIDA ZENTIVA 8 mg/12,5 mgCOMPR. 8mg/12,5mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 14,05 0,468333 0,468333 0,234166444 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 14,05 0,468333 0,468333 0,234166445 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 43,24 1,544285 0,966213 0,483106446 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 56,77 1,892333 0,966213 0,483106447 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 73,02 2,434000 0,966213 0,483106448 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 53,68 1,917142 0,966213 0,483106449 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 77,42 2,765000 0,966213 0,483106450 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 28 104,85 3,744642 0,966213 0,483106451 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TANYDON HCT 80 mg/12,5 mg COMPR. 80mg/12,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 29,81 0,993666 0,966213 0,483106452 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 28 COMPR. P6L 28 35,00 1,250000 0,966213 0,483106

Pagina 9 din 26

Page 39: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti453 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 29,54 0,984666 0,966213 0,483106454 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 56,77 1,892333 0,966213 0,483106455 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg COMPR. 80mg/12,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 52,99 1,892500 0,966213 0,483106456 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg COMPR. 80mg/12,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L 28 52,99 1,892500 0,966213 0,483106457 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TANYDON HCT 80 mg/25 mg COMPR. 80mg/25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 29,81 0,993666 0,966213 0,483106458 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 41,71 1,390333 0,966213 0,483106459 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 73,02 2,434000 0,966213 0,483106460 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg COMPR. 80mg/25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 69,38 2,477857 0,966213 0,483106461 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg COMPR. 80mg/25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L 28 69,38 2,477857 0,966213 0,483106462 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 252,74 4,513214 4,162053 2,081026463 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 10mg/160mg COMPR. FILM. 10mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L 28 128,66 4,595000 4,162053 2,081026464 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 56 252,74 4,513214 4,162053 2,081026465 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 5mg/160mg COMPR. FILM. 5mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC ) P-6L 28 128,66 4,595000 4,162053 2,081026466 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L 56 214,81 3,835892 3,835892 1,917946467 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM) EXFORGE 5mg/80mg COMPR. FILM. 5mg/80mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/PVDC ) P-6L 28 113,26 4,045000 4,045000 2,022500468 C09DB02 COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA) 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 95,38 3,406428 1,879265 0,939632469 C09DB02 COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA) 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 28 104,50 3,732142 3,732142 1,866071470 C09DB02 COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA) 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 95,38 3,406428 3,382677 1,691338471 C09DX01 COMBINATII(AMLODIPINA+VALSARTAN+HIDROCHLOROTHIZIDA 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 28 117,40 4,192857 4,001532 2,000766472 C09DX01 COMBINATII(AMLODIPINA+VALSARTAN+HIDROCHLOROTHIZIDA EXFORGE HCT COMPR. FILM. 10mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 117,40 4,192857 4,192857 2,096428473 C09DX01 COMBINATII(AMLODIPINA+VALSARTAN+HIDROCHLOROTHIZIDA 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 28 117,40 4,192857 3,891902 1,945951474 C09DX01 COMBINATII(AMLODIPINA+VALSARTAN+HIDROCHLOROTHIZIDA EXFORGE HCT COMPR. FILM. 5mg/160mg/25 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF 28 117,40 4,192857 4,165979 2,082989475 C10AA04 FLUVASTATINUM LESCOL 20 mg CAPS. 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 15,98 0,570714 0,391462 0,195731476 C10AA04 FLUVASTATINUM LESCOL 40 mg CAPS. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. P-6L 28 29,09 1,038928 0,782924 0,391462477 C10AA04 FLUVASTATINUM LESCOL XL 80 mg COMPR. ELIB. PREL. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. ELIB. PREL. P-6L 28 46,24 1,651428 1,565849 0,782924478 C10AA05 ATORVASTATINUM AMICOR 10 mg COMPR. FILM. 10 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P6L 30 18,38 0,612666 0,587193 0,293596479 C10AA05 ATORVASTATINUM TORVALIPIN 10 mg COMPR. FILM. 10 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P-6L 30 16,75 0,558333 0,558333 0,279166480 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 41,50 1,383333 0,587193 0,293596481 C10AA05 ATORVASTATINUM TORVACARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 10,57 0,352333 0,352333 0,176166482 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 19,43 0,647666 0,587193 0,293596483 C10AA05 ATORVASTATINUM GLETOR 10 mg COMPR. FILM. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 21,14 0,704666 0,587193 0,293596484 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 21,05 0,701666 0,587193 0,293596485 C10AA05 ATORVASTATINUM ATORGAMMA 10 mg COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 16,75 0,558333 0,558333 0,279166486 C10AA05 ATORVASTATINUM TULIP 10 mg COMPR. FILM. 10mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 21,23 0,707666 0,587193 0,293596487 C10AA05 ATORVASTATINUM TULIP 10 mg COMPR. FILM. 10mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-6L 90 55,45 0,616111 0,587193 0,293596488 C10AA05 ATORVASTATINUM ATILEN 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 19,83 0,708214 0,587193 0,293596489 C10AA05 ATORVASTATINUM TORVAZIN 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 18,77 0,625666 0,587193 0,293596490 C10AA05 ATORVASTATINUM XAMARA 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 27,86 0,928666 0,587193 0,293596491 C10AA05 ATORVASTATINUM VOREDANIN 10 mg COMPR. FILM. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 19,43 0,647666 0,587193 0,293596492 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 10,57 0,352333 0,352333 0,176166493 C10AA05 ATORVASTATINUM ATORVASTATINA POLIPHARMA 10 mg COMPR. FILM. 10mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. X 10 COMPR. FILM. P6L 30 10,57 0,352333 0,352333 0,176166494 C10AA05 ATORVASTATINUM ATORVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 6,36 0,227142 0,227142 0,113571495 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 21,69 0,723000 0,587193 0,293596496 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 27,83 0,927666 0,587193 0,293596497 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 6,83 0,227666 0,227666 0,113833498 C10AA05 ATORVASTATINUM AMICOR 20 mg COMPR. FILM. 20 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P6L 30 26,90 0,896666 0,896666 0,448333499 C10AA05 ATORVASTATINUM TORVALIPIN 20 mg COMPR. FILM. 20 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P-6L 30 24,56 0,818666 0,818666 0,409333500 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 53,41 1,780333 1,174387 0,587193501 C10AA05 ATORVASTATINUM TORVACARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 15,82 0,527333 0,527333 0,263666502 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 29,45 0,981666 0,981666 0,490833503 C10AA05 ATORVASTATINUM GLETOR 20 mg COMPR. FILM. 20mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 31,51 1,050333 1,050333 0,525166

Pagina 10 din 26

Page 40: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti504 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 34,71 1,157000 1,157000 0,578500505 C10AA05 ATORVASTATINUM ATORGAMMA 20 mg COMPR. FILM. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 24,14 0,804666 0,804666 0,402333506 C10AA05 ATORVASTATINUM TULIP 20 mg COMPR. FILM. 20mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 30,65 1,021666 1,021666 0,510833507 C10AA05 ATORVASTATINUM TULIP 20 mg COMPR. FILM. 20mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-6L 90 79,50 0,883333 0,883333 0,441666508 C10AA05 ATORVASTATINUM ATILEN 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 31,37 1,120357 1,120357 0,560178509 C10AA05 ATORVASTATINUM TORVAZIN 20 mg COMPR. FILM. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 28,64 0,954666 0,954666 0,477333510 C10AA05 ATORVASTATINUM XAMARA 20 mg COMPR. FILM. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 34,71 1,157000 1,157000 0,578500511 C10AA05 ATORVASTATINUM VOREDANIN 20 mg COMPR. FILM. 20mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 29,45 0,981666 0,981666 0,490833512 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 15,82 0,527333 0,527333 0,263666513 C10AA05 ATORVASTATINUM ATORVASTATINA POLIPHARMA 20 mg COMPR. FILM. 20mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. X 10 COMPR. FILM. P6L 30 15,82 0,527333 0,527333 0,263666514 C10AA05 ATORVASTATINUM ATORVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 7,50 0,267857 0,267857 0,133928515 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 32,60 1,086666 1,086666 0,543333516 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 34,71 1,157000 1,157000 0,578500517 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 8,04 0,268000 0,268000 0,134000518 C10AA05 ATORVASTATINUM AMICOR 40 mg COMPR. FILM. 40 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN AL/AL X 14 COMPR. FILM. P6L 14 28,58 2,041428 2,041428 1,020714519 C10AA05 ATORVASTATINUM AMICOR 40 mg COMPR. FILM. 40 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P6L 30 59,26 1,975333 1,975333 0,987666520 C10AA05 ATORVASTATINUM TORVALIPIN 40 mg COMPR. FILM. 40 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P-6L 30 50,55 1,685000 1,685000 0,842500521 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 45,27 3,233571 2,348774 1,174387522 C10AA05 ATORVASTATINUM TORVACARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 32,68 1,089333 1,089333 0,544666523 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 25,86 1,847142 1,847142 0,923571524 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 53,61 1,787000 1,787000 0,893500525 C10AA05 ATORVASTATINUM GLETOR 40 mg COMPR. FILM. 40mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 63,06 2,102000 2,102000 1,051000526 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 56,69 1,889666 1,889666 0,944833527 C10AA05 ATORVASTATINUM ATORGAMMA 40 mg COMPR. FILM. 40mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 52,86 1,762000 1,762000 0,881000528 C10AA05 ATORVASTATINUM TULIP 40 mg COMPR. FILM. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 61,73 2,057666 2,057666 1,028833529 C10AA05 ATORVASTATINUM TULIP 40 mg COMPR. FILM. 40mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-6L 90 152,32 1,692444 1,692444 0,846222530 C10AA05 ATORVASTATINUM ATILEN 40 mg COMPR. FILM. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 58,84 2,101428 2,101428 1,050714531 C10AA05 ATORVASTATINUM TORVAZIN 40 mg COMPR. FILM. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 52,68 1,756000 1,756000 0,878000532 C10AA05 ATORVASTATINUM XAMARA 40 mg COMPR. FILM. 40mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 63,04 2,101333 2,101333 1,050666533 C10AA05 ATORVASTATINUM VOREDANIN 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 53,61 1,787000 1,787000 0,893500534 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 32,10 1,070000 1,070000 0,535000535 C10AA05 ATORVASTATINUM ATORVASTATINA POLIPHARMA 40 mg COMPR. FILM. 40mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. X 10 COMPR. FILM. P6L 30 32,68 1,089333 1,089333 0,544666536 C10AA05 ATORVASTATINUM ATORVASTATINA TEVA 40 mg COMPR. FILM. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 26,78 0,956428 0,956428 0,478214537 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 38,11 1,270333 1,270333 0,635166538 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 40 mg COMPR. FILM. 40mg TORRENT PHARMA S.R.L. GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 63,03 2,101000 2,101000 1,050500539 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 13,84 0,461333 0,461333 0,230666540 C10AA05 ATORVASTATINUM SORTIS 80 mg COMPR. FILM. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 72,66 5,190000 4,697549 2,348774541 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 30 101,21 3,373666 3,373666 1,686833542 C10AA05 ATORVASTATINUM ATILEN 80 mg COMPR. FILM. 80mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 94,46 3,373571 3,373571 1,686785543 C10AA05 ATORVASTATINUM XAMARA 80 mg COMPR. FILM. 80mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 101,21 3,373666 3,373666 1,686833544 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 44,03 1,467666 1,467666 0,733833545 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 50,04 1,668000 1,668000 0,834000546 C10AA05 ATORVASTATINUM ATORVASTATINA POLIPHARMA 80 mg COMPR. FILM. 80mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. X 10 COMPR. FILM. P6L 30 44,03 1,467666 1,467666 0,733833547 C10AA05 ATORVASTATINUM ATORVASTATINA TEVA 80 mg COMPR. FILM. 80mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L 28 38,25 1,366071 1,366071 0,683035548 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 42,62 1,420666 1,420666 0,710333549 C10AA05 ATORVASTATINUM ATORVASTATINA TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 101,20 3,373333 3,373333 1,686666550 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 22,20 0,740000 0,740000 0,370000551 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 42,24 1,408000 1,174387 0,587193552 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 105,02 3,750714 1,174387 0,587193553 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 24,08 0,802666 0,802666 0,401333554 C10AA07 ROSUVASTATINUM ROXARDIO 10 mg COMPR. FILM. 10mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 45,03 1,608214 1,174387 0,587193

Pagina 11 din 26

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti555 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 53,56 1,785333 1,174387 0,587193556 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 24,08 0,802666 0,802666 0,401333557 C10AA07 ROSUVASTATINUM TINTAROS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 39,44 1,408571 1,174387 0,587193558 C10AA07 ROSUVASTATINUM ROSUVASTATINA LABORMED 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 18,60 0,664285 0,664285 0,332142559 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 33,52 1,197142 1,174387 0,587193560 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 33,52 1,197142 1,174387 0,587193561 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 35,92 1,197333 1,174387 0,587193562 C10AA07 ROSUVASTATINUM ROVASTAMED 10mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 39,38 1,406428 1,174387 0,587193563 C10AA07 ROSUVASTATINUM STARCREST 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 18,60 0,664285 0,664285 0,332142564 C10AA07 ROSUVASTATINUM ROZUCOR 10 mg COMPR. FILM. 10mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 46,97 1,565666 1,174387 0,587193565 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 44,73 1,491000 1,174387 0,587193566 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 56,77 1,892333 1,892333 0,946166567 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 149,38 5,335000 2,348774 1,174387568 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 26,72 0,890666 0,890666 0,445333569 C10AA07 ROSUVASTATINUM ROXARDIO 20 mg COMPR. FILM. 20mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 80,72 2,882857 2,348774 1,174387570 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 92,43 3,081000 2,348774 1,174387571 C10AA07 ROSUVASTATINUM ROSTAT 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 34,30 1,143333 1,143333 0,571666572 C10AA07 ROSUVASTATINUM TINTAROS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 52,95 1,891071 1,891071 0,945535573 C10AA07 ROSUVASTATINUM ROSUVASTATINA LABORMED 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 18,61 0,664642 0,664642 0,332321574 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 48,16 1,720000 1,720000 0,860000575 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 48,16 1,720000 1,720000 0,860000576 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 51,61 1,720333 1,720333 0,860166577 C10AA07 ROSUVASTATINUM ROVASTAMED 20mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 52,92 1,890000 1,890000 0,945000578 C10AA07 ROSUVASTATINUM STARCREST 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 18,61 0,664642 0,664642 0,332321579 C10AA07 ROSUVASTATINUM ROZUCOR 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 60,39 2,013000 2,013000 1,006500580 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 53,68 1,789333 1,789333 0,894666581 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 50,56 1,685333 1,685333 0,842666582 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 30 109,71 3,657000 3,657000 1,828500583 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 58,69 1,956333 1,956333 0,978166584 C10AA07 ROSUVASTATINUM TINTAROS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 68,64 2,451428 2,451428 1,225714585 C10AA07 ROSUVASTATINUM ROSUVASTATINA LABORMED 40 mg COMPR. FILM. 40mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 36,03 1,286785 1,286785 0,643392586 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 75,14 2,683571 2,683571 1,341785587 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 75,14 2,683571 2,683571 1,341785588 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 72,25 2,408333 2,408333 1,204166589 C10AA07 ROSUVASTATINUM ROVASTAMED 40mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 68,58 2,449285 2,449285 1,224642590 C10AA07 ROSUVASTATINUM STARCREST 40 mg COMPR. FILM. 40mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 36,03 1,286785 1,286785 0,643392591 C10AA07 ROSUVASTATINUM ROZUCOR 40 mg COMPR. FILM. 40mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 78,60 2,620000 2,620000 1,310000592 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 72,22 2,407333 2,407333 1,203666593 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 91,37 3,263214 0,587193 0,293596594 C10AA07 ROSUVASTATINUM ROXARDIO 5 mg COMPR. FILM. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 32,48 1,160000 0,587193 0,293596595 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 50,55 1,685000 0,587193 0,293596596 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 22,34 0,744666 0,587193 0,293596597 C10AA07 ROSUVASTATINUM TINTAROS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. P6L 28 27,73 0,990357 0,587193 0,293596598 C10AA07 ROSUVASTATINUM ROSUVASTATINA LABORMED 5 mg COMPR. FILM. 5mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 18,58 0,663571 0,587193 0,293596599 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 62,54 2,233571 0,587193 0,293596600 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 62,54 2,233571 0,587193 0,293596601 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 29,72 0,990666 0,587193 0,293596602 C10AA07 ROSUVASTATINUM ROVASTAMED 5mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 27,70 0,989285 0,587193 0,293596603 C10AA07 ROSUVASTATINUM STARCREST 5 mg COMPR. FILM. 5mg LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 18,58 0,663571 0,587193 0,293596604 C10AA07 ROSUVASTATINUM ROZUCOR 5 mg COMPR. FILM. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 42,50 1,416666 0,587193 0,293596605 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 40,26 1,342000 0,587193 0,293596

Pagina 12 din 26

Page 42: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti606 C10AB02 BEZAFIBRATUM REGADRIN (R) B DRAJ. 200mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 5 BLIST. X 10 DRAJ. P-6L 50 28,55 0,571000 0,571000 0,285500607 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 70,92 2,364000 2,364000 1,182000608 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 28 100,04 3,572857 2,399592 1,199796609 C10AX09 EZETIMIBUM EZETROL (R) COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 14 95,45 6,817857 5,370797 2,685398610 C10AX09 EZETIMIBUM EZETROL (R) COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 28 180,99 6,463928 5,370797 2,685398611 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 30 128,33 4,277666 4,277666 2,138833612 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 81,46 2,715333 1,680249 0,840124613 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 55,75 1,858333 1,680249 0,840124614 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) ATORDAPIN 10 mg/10 mg COMPR. FILM. 10mg/10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 55,75 1,858333 1,680249 0,840124615 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) TORVALIPIN PLUS 10 mg/10 mg COMPR. FILM. 10mg/10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 55,17 1,839000 1,680249 0,840124616 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 71,34 2,378000 1,680249 0,840124617 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 48,82 1,627333 1,627333 0,813666618 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) TORVALIPIN PLUS 5mg/10mg COMPR. FILM. 10mg/5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 48,46 1,615333 1,615333 0,807666619 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) ATORDAPIN 10mg/5mg COMPR. FILM. 10mg/5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE X BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE FILMATEP6L 30 48,42 1,614000 1,614000 0,807000620 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 71,26 2,375333 1,680249 0,840124621 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 64,10 2,136666 1,680249 0,840124622 D01BA02 TERBINAFINUM LAMISIL (R) COMPR. 250mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. X 14 COMPR. P-RF 14 87,90 6,278571 1,178125 0,589062623 D01BA02 TERBINAFINUM TERBINARAN COMPR. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF 30 234,95 7,831666 1,178125 0,589062624 D01BA02 TERBINAFINUM TERBINARAN COMPR. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR. P-RF 28 107,44 3,837142 1,178125 0,589062625 D01BA02 TERBINAFINUM TERBINAFINE 250 mg COMPR. 250mg ACTAVIS GROUP HF ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 28 29,74 1,062142 1,062142 0,531071626 D01BA02 TERBINAFINUM TERBINAFINA SLAVIA 250mg COMPR. 250mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR. P-RF 14 18,21 1,300714 1,178125 0,589062627 D01BA02 TERBINAFINUM EXIFINE 250 mg COMPR. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 14 COMPR. P-RF 14 16,66 1,190000 1,178125 0,589062628 D01BA02 TERBINAFINUM TERBISIL 250 mg COMPR. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. P-RF 28 108,77 3,884642 1,178125 0,589062629 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 31,99 1,142500 1,142500 0,571250630 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM) XAMIOL 50 micrograme/ 0,5 mg/g GEL 0,5 mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE CU 1 FLAC. PEID X 15 G GEL P-RF 1 81,72 81,720000 56,234999 28,117499631 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 30 G GEL PRF 1 108,59 108,590000 56,234999 28,117499632 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 57,17 57,170000 56,234999 28,117499633 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 53,43 53,430000 53,430000 26,715000634 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 74,74 2,491333 2,491333 1,245666635 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g CREMA 20mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 11,94 11,940000 11,940000 5,970000636 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 11,94 11,940000 11,940000 5,970000637 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g UNGUENT 20mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 12,28 12,280000 11,940000 5,970000638 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 12,28 12,280000 11,940000 5,970000639 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA BORCAN X 500 G CREMA PRF 1 96,76 96,760000 96,760000 48,380000640 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 85,55 85,550000 45,803214 22,901607641 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 75,96 75,960000 75,960000 37,980000642 D06BB10 IMIQUIMODUM* ALDARA 5% CREMA 5% MEDA AB SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA P-RF 12 265,43 22,119166 22,119166 11,059583643 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) crema 0,1% CREMA 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 12,93 12,930000 12,407500 6,203750644 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) LIPOCREAM 0,1% CREMA 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 13,39 13,390000 12,407500 6,203750645 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID CRELO (R) 0,1% EMULSIE CUT. 0.1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON X 30 G P-RF 1 12,80 12,800000 12,407500 6,203750646 D07AB02 HYDROCORTISONUM BUTYRATUM LOCOID (R) SOL. CUT. 0,1% ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLACON PICURATOR DIN PP X 30 ML P-RF 1 11,23 11,230000 11,230000 5,615000647 D07AC13 MOMETASONUM ELOCOM CREMA 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 7,67 7,670000 7,670000 3,835000648 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 10,18 10,180000 7,670000 3,835000649 D07AC13 MOMETASONUM ELOCOM SOL. CUT. 1mg/g SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLACON DIN PEID X 20 ML SOL. CUTANATA P-RF 1 18,78 18,780000 10,226666 5,113333650 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 7,67 7,670000 7,670000 3,835000651 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 10,18 10,180000 7,670000 3,835000652 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 12,70 12,700000 11,879375 5,939687653 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g crema CREMA 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 24,16 24,160000 23,758750 11,879375654 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 20 G P-RF 1 15,75 15,750000 15,750000 7,875000655 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g EMULSIE CUT. 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 50 G P-RF 1 34,03 34,030000 34,030000 17,015000656 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g unguent UNGUENT 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 12,99 12,990000 11,879375 5,939687

Pagina 13 din 26

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti657 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g unguent UNGUENT 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT P-RF 1 24,16 24,160000 23,758750 11,879375658 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 10,31 10,310000 10,310000 5,155000659 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 10,31 10,310000 10,310000 5,155000660 D07AD01 CLOBETASOLUM* DERMOVATE 0,5 mg/g CREMA 0,5mg/g GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 TUB AL X 25 G CREMA P-RF 1 12,08 12,080000 6,354000 3,177000661 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 5,21 5,210000 5,210000 2,605000662 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 8,91 8,910000 6,354000 3,177000663 D07CA01 COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H CREMA FARA CONCENTRATIE LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 20,28 20,280000 20,280000 10,140000664 D07CA01 COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H CREMA FARA CONCENTRATIE LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 20,28 20,280000 20,280000 10,140000665 D07CC01 COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg pe gram LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 21,46 21,460000 21,460000 10,730000666 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 21,46 21,460000 21,460000 10,730000667 D07XC03 COMBINATII (MOMETASONUM + AC. SALICILICUM)ELOSALIC 1mg+5mg/gram UNGUENT 1mg+5mg/gram MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 45 G P-RF 1 47,00 47,000000 47,000000 23,500000668 D07XC03 COMBINATII (MOMETASONUM + AC. SALICILICUM)ELOSALIC 1mg+5mg/gram UNGUENT 1mg+5mg/gram MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 16,66 16,660000 15,915000 7,957500669 D10AD54 COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL GEL 0,05%/0,2% STIEFEL LABORATORIES IRELAND LTD. MAREA BRITANIE CUTIE X 1 TUB DIN AL X 30 G GEL P-RF 1 36,22 36,220000 36,220000 18,110000670 D10AX03 ACIDUM AZELAICUM SKINOREN CREMA 200mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 34,10 34,100000 29,535500 14,767750671 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB AL X 50 G GEL P-RF 1 46,69 46,690000 46,690000 23,345000672 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 53,29 1,776333 1,087166 0,543583673 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 33,09 1,103000 1,087166 0,543583674 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 64,28 2,142666 2,142666 1,071333675 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 38,11 3,175833 2,404332 1,202166676 G01AA51 COMBINATII POLYGYNAX CAPS. MOI VAG. FARA CONCENTRATIE LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. MOI VAG. P-RF 6 17,46 2,910000 2,404332 1,202166677 G01AA51 COMBINATII POLYGYNAX CAPS. MOI VAG. FARA CONCENTRATIE LAB. INNOTECH INT. FRANTA CUTIE X 2 BLIST. AL/PVC X 6 CAPS. MOI. VAG. P-RF 12 33,74 2,811666 2,404332 1,202166678 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 35,47 35,470000 35,470000 17,735000679 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 51,21 25,605000 17,092497 8,546248680 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 20,09 20,090000 10,255498 5,127749681 G01AF12 FENTICONAZOLUM LOMEXIN CREMA VAGINALA CREMA VAG. 2% RECORDATI SPA ITALIA CUTIE X 1 TUB AL + APLICATOR X 78 G CREMA P-RF 1 36,01 36,010000 26,664296 13,332148682 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 40,29 40,290000 1,709249 0,854624683 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 15,01 1,501000 1,109700 0,554850684 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON® CREMA FARA CONCENTRATIE ALFA WASSERMANN SPA ITALIA CUTIE X 1 TUB DIN AL X 30 G P-RF 1 9,63 9,630000 9,630000 4,815000685 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON CREMA VAG. FARA CONCENTRATIE ALFA WASSERMAN SPA ITALIA CUTIE X 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN POLIPROPILENA P-RF 1 12,87 12,870000 12,870000 6,435000686 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON OVULE 500mg/100mg ALFA WASSERMAN SPA ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULE P-RF 10 36,96 3,696000 1,109700 0,554850687 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON SOL. VAGINALA FARA CONCENTRATIE ALFA WASSERMAN SPA ITALIA CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE P-RF 5 21,99 4,398000 1,109700 0,554850688 G02CB03 CABERGOLINUM* DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 43,59 21,795000 8,262750 4,131375689 G02CB03 CABERGOLINUM* DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 123,74 15,467500 8,262750 4,131375690 G03AC03 LEVONORGESTRELUM***# MIRENA 20 mcg/24 h DISPOZITIV INTRAUTERIN 52mg BAYER SCHERING PHARMA AG FINLANDA CUTIE X 1 BLIST. X 1 DISP. PT. ADM. INTRAUTERINA + 1 INSERTOR P-RF 1 513,53 513,530000 513,530000 256,765000691 G03CA04 ESTRIOLUM* OVESTIN OVULE 0,5mg ORGANON NV OLANDA CUTIE X 3 FOLII X 5 OVULE P-RF 15 20,62 1,374666 1,374666 0,687333692 G03CA09 PROMESTRIENUM* COLPOTROPHINE (R) CAPS. MOI VAG. 10mg LAB. THERAMEX MONACO CUTIE X 1 BLIST. AL/PVC X 10 CAPS. MOI VAG. P-RF 10 12,08 1,208000 0,663539 0,331769693 G03CA09 PROMESTRIENUM* COLPOTROPHINE (R) CREMA VAG. 1% LAB. THERAMEX MONACO CUTIE X 1 TUB X 15 G P-RF 1 13,87 13,870000 9,953098 4,976549694 G03CX01 TIBOLONUM** LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 72,82 2,600714 2,600714 1,300357695 G03DA04 PROGESTERONUM* UTROGESTAN (R) 100 mg CAPS. MOI 100mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI P-6L 30 30,00 1,000000 0,644499 0,322249696 G03DA04 PROGESTERONUM* AREFAM 100 mg CAPS. MOI 100mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L 30 19,49 0,649666 0,644499 0,322249697 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 30,00 2,142857 1,288999 0,644499698 G03DA04 PROGESTERONUM* AREFAM 200 mg CAPS. MOI 200mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L 30 37,74 1,258000 1,258000 0,629000699 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 21,14 21,140000 18,800000 9,400000700 G03DA04 PROGESTERONUM* MASTOPROFEN 10 mg/g GEL 10mg/g ANTIBIOTICE SA ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GEL P6L 1 9,01 9,010000 9,010000 4,505000701 G03DB01 DYDROGESTERONUM* DUPHASTON 10 mg COMPR. FILM. 10mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 21,57 1,078500 1,078500 0,539250702 G03DC03 LYNESTRENOLUM* ORGAMETRIL 5 mg COMPR. 5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 30 COMPR. P-6L 30 9,12 0,304000 0,304000 0,152000703 G03FA17 COMBINATII** ANGELIQ COMPR. FILM. 1mg+2mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P6L 28 57,86 2,066428 2,066428 1,033214704 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 7,77 0,370000 0,370000 0,185000705 G03FB08 COMBINATII** FEMOSTON 2/10 COMPR. FILM. FARA CONCENTRATIE ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GAL P-RF 28 30,99 1,106785 0,554196 0,277098706 G03GA05 FOLLITROPINUM ALFA****# GONAL - f 75 UI (5,5 mcg) PULB. + SOLV. PT. SOL. INJ. 75UI SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. X 1 ML SOLV. P-RF/R 1 132,63 132,630000 121,376553 60,688276707 G03GA05 FOLLITROPINUM ALFA****# 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 1 132,63 132,630000 121,376553 60,688276

Pagina 14 din 26

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti708 G03GA05 FOLLITROPINUM ALFA****# 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 1 505,65 505,650000 485,506213 242,753106709 G03GA05 FOLLITROPINUM ALFA****# GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA P-RF/R 1 735,78 735,780000 728,259319 364,129659710 G03GA05 FOLLITROPINUM ALFA****# 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 1.384,42 1.384,420000 1.384,420000 692,210000711 G03GA06 FOLLITROPINUM BETA****# PUREGON 100UI/0,5ml SOL. INJ. 100UI/0,5ml N. V. ORGANON OLANDA CUTIE X 1 FLACON DIN STICLA X 0,5 ML SOL. INJ. PR/PRF 1 200,89 200,890000 161,835363 80,917681712 G03GA06 FOLLITROPINUM BETA****# PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS + 6 ACE PR/PRF 1 517,31 517,310000 485,312010 242,656005713 G03GA06 FOLLITROPINUM BETA****# 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 1.410,83 1.410,830000 1.410,830000 705,415000714 G03GA07 LUTROPINUM ALFA****# LUVERIS 75UI PULB+SOLV.PT.SOL.INJ 75UI SERONO EUROPE LTD. 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 1 146,72 146,720000 146,720000 73,360000715 G03GB02 CLOMIFENUM CLOSTILBEGYT COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. P-RF 10 17,07 1,707000 1,707000 0,853500716 G03XC01 RALOXIFENUM EVISTA 60mg COMPR. FILM. 60mg DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR)P-RF 28 124,97 4,463214 4,463214 2,231607717 G04BD04 OXYBUTYNINUM DRIPTANE ( R ) 5 mg COMPR. 5mg LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. P-6L 60 26,63 0,443833 0,443833 0,221916718 G04BD07 TOLTERODINUM**# UROFLOW 1 COMPR. FILM. 1mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 22,20 0,792857 0,553415 0,276707719 G04BD07 TOLTERODINUM**# UROFLOW 2 COMPR. FILM. 2mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 26,66 0,952142 0,952142 0,476071720 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 30 147,62 4,920666 4,427324 2,213662721 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 30 227,12 7,570666 4,427324 2,213662722 G04BD08 SOLIFENACINUM SUCCINATE**# SOLIFENACIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 147,45 4,915000 4,427324 2,213662723 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 83,61 2,787000 2,213662 1,106831724 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 30 183,34 6,111333 2,213662 1,106831725 G04BD08 SOLIFENACINUM SUCCINATE**# ASOLFENA 5 mg COMPR. FILM. 5mg KRKA, TOVARNA ZDRAVIL, D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 83,61 2,787000 2,213662 1,106831726 G04BD08 SOLIFENACINUM SUCCINATE**# SOLIFENACIN ACTAVIS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L 30 83,55 2,785000 2,213662 1,106831727 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 38,11 1,270333 0,830123 0,415061728 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 63,52 2,117333 1,660246 0,830123729 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 36,04 1,201333 1,201333 0,600666730 G04CA01 ALFUZOSINUM XATRAL SR 10 mg COMPR. ELIB. PREL. 10mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-6L 30 40,59 1,353000 1,353000 0,676500731 G04CA01 ALFUZOSINUM XATRAL LP 5 mg COMPR. FILM. ELIB. PREL. 5mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. FILM. ELIB. PREL. P-6L 28 15,72 0,561428 0,561428 0,280714732 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 36,34 1,211333 1,211333 0,605666733 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 21,00 0,700000 0,700000 0,350000734 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 26,93 0,897666 0,897666 0,448833735 G04CA02 TAMSULOSINUM TANYZ CAPS. ELIB. PREL. 0,4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 21,20 0,706666 0,706666 0,353333736 G04CA02 TAMSULOSINUM TAMSUNORM 0,4 mg CAPS. ELIB. PREL. 0,4mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-6L 30 22,96 0,765333 0,765333 0,382666737 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 26,93 0,897666 0,897666 0,448833738 G04CA02 TAMSULOSINUM TAMSULOSIN TEVA 400 µg COMPR. CU ELIB. PRELUNGITA 400 µg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. CU ELIB. PRELUNG. P6L 30 20,08 0,669333 0,669333 0,334666739 G04CA02 TAMSULOSINUM TANYZ 0,4 mg COMPR. ELIB. PREL. 0,4mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. CU ELIB. PREL. P6L 30 31,90 1,063333 1,063333 0,531666740 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 63,98 2,132666 1,515857 0,757928741 G04CB01 FINASTERIDUM* PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM. P-6L 14 33,27 2,376428 1,175357 0,587678742 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 64,36 2,298571 1,175357 0,587678743 G04CB01 FINASTERIDUM* TAREDOX 5 mg COMPR. FILM. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 32,91 1,175357 1,175357 0,587678744 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 32,91 1,175357 1,175357 0,587678745 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 95,62 3,187333 3,187333 1,593666746 H01AA02 TETRACOSACTIDUM SYNACHTEN DEPOT SUSP. INJ. 1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FIOLA DIN STICLA X 1 ML SUSP. INJ. S/P-RF 1 5,75 5,750000 5,750000 2,875000747 H01AC01 SOMATROPINUM***# ZOMACTON PULB. + SOLV. PT. SOL. INJ. 4mg (12ui) FERING GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV. P-RF 1 434,84 434,840000 396,484000 198,242000748 H01AC01 SOMATROPINUM***# GENOTROPIN (R) 16 ui (5,3 mg) PULB. + SOLV. PT. SOL. INJ. 5,3mg/ml (16ui) PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ. P-RF 1 555,63 555,630000 528,645333 264,322666749 H01AC01 SOMATROPINUM***# OMNITROPE 15mg/1,5ml SOL INJ. 15mg/1,5ml SANDOZ GMBH AUSTRIA CUTIE X 1 CARTUS X 1,5 ML SOL.INJ. PR/PRF 1 1.653,92 1.653,920000 1.486,815000 743,407500750 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 1 991,21 991,210000 991,210000 495,605000751 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 1 484,12 484,120000 484,120000 242,060000752 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 1 765,73 765,730000 765,730000 382,865000753 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 1.320,72 1.320,720000 991,210000 495,605000754 H01AC01 SOMATROPINUM***# NORDITROPIN FLEXPRO 10 mg/1,5 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 10mg/1,5 ml NOVO NORDISK A/S DANEMARCA CUTIE CU 1 STILOU INJECTOR (PEN) PREUMPLUT MULTI-DOZA ( CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ P-RF 1 1.726,64 1.726,640000 991,210000 495,605000755 H01AC01 SOMATROPINUM***# NORDITROPIN FLEXPRO 5 mg/1,5 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 5mg/1,5 ml NOVO NORDISK A/S DANEMARCA CUTIE CU 1 STILOU INJECTOR (PEN) PREUMPLUT MULTI-DOZA ( CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ P-RF 1 898,74 898,740000 495,605000 247,802500756 H01CC01 GANIRELIXUM***# ORGALUTRAN 0.25mg/0,5ml SOL. INJ. 0,25mg/0,5ml N. V. ORGANON OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT P-RF/R 1 176,88 176,880000 121,294606 60,647303757 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 7 845,15 120,735714 120,735714 60,367857758 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 47,78 0,955600 0,955600 0,477800

Pagina 15 din 26

Page 45: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti759 H02AB01 BETAMETHASONUM DIPROPHOS® SUSP. INJ. I.M. 7mg/ml MERCK SHARP & DOHME BELGIA CUTIE X 5 FIOLE X 1 ML P-RF 5 34,53 6,906000 6,906000 3,453000760 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 95,62 31,873333 31,873333 15,936666761 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 35,71 11,903333 6,981149 3,490574762 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 21,00 0,420000 0,303840 0,151920763 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 25,52 0,510400 0,510400 0,255200764 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 30,86 0,308600 0,151920 0,075960765 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 32,36 6,472000 6,472000 3,236000766 H05BA01 CALCITONINUM (SOMON) MIACALCIC (R) SOL. INJ. 50ui/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 34,46 6,892000 3,735000 1,867500767 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 50 728,96 14,579200 14,579200 7,289600768 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 33,18 2,765000 2,765000 1,382500769 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. ORALAP-RF 1 24,41 24,410000 22,692500 11,346250770 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 9,85 0,615625 0,615625 0,307812771 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 25,56 2,556000 1,397998 0,698999772 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 25,50 4,250000 3,494998 1,747499773 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS.P-RF 6 37,99 6,331666 3,494998 1,747499774 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 25,36 4,226666 1,747497 0,873748775 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 48,80 8,133333 3,494998 1,747499776 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM. P-RF 6 25,52 4,253333 3,494998 1,747499777 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR. FILM. P-RF 6 25,52 4,253333 3,494998 1,747499778 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 38,17 12,723333 6,989997 3,494998779 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 48,80 16,266666 6,989997 3,494998780 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 25,65 8,550000 6,989997 3,494998781 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 25,64 8,546666 6,989997 3,494998782 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 25,64 8,546666 6,989997 3,494998783 J01FA10 AZITHROMYCINUM ZITROCIN 500 mg COMPR. FILM. 500mg LABORMED PHARMA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 3 COMPR. FILM. P-RF 3 25,65 8,550000 6,989997 3,494998784 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 22,13 7,376666 6,989997 3,494998785 J01FA10 AZITHROMYCINUM AZATRIL 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF 3 21,26 7,086666 6,989997 3,494998786 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 25,64 8,546666 6,989997 3,494998787 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 44,61 14,870000 8,388000 4,194000788 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF 3 44,61 14,870000 8,388000 4,194000789 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PE CU PULB. PT. 15 ML SUSP. ORALA RECONSTITUITA + FLAC. CU SOLV. X 7,5 ML SOLV. P-RF 1 16,36 16,360000 16,360000 8,180000790 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 22,45 22,450000 13,911996 6,955998791 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA CCUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 34,36 34,360000 27,823993 13,911996792 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOAREP-RF 1 25,18 25,180000 20,868000 10,434000793 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOAREP-RF 1 48,58 48,580000 41,736000 20,868000794 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOAREP-RF 1 60,36 60,360000 52,170000 26,085000795 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 12,14 0,758750 0,736484 0,368242796 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 23,33 1,458125 1,458125 0,729062797 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 300 mg COMPR. FILM. 300mg MIP PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF 16 23,31 1,456875 1,456875 0,728437798 J01FF01 CLINDAMYCINUM CLINDAMYCIN - MIP 300 mg COMPR. FILM. 300mg MIP PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM. P-RF 30 54,01 1,800333 1,472968 0,736484799 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 52,16 3,260000 2,945937 1,472968800 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 95,84 3,194666 2,945937 1,472968801 J01MA12 LEVOFLOXACINUM FLERADAY 250 mg COMPR. FILM. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/PVDC - AL X 7 COMPR. FILM. PRF 7 17,40 2,485714 2,379600 1,189800802 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 17,41 2,487142 2,379600 1,189800803 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 26,78 3,825714 2,379600 1,189800804 J01MA12 LEVOFLOXACINUM LEVOTOR 250 mg COMPR. FILM. 250mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF 7 17,40 2,485714 2,379600 1,189800805 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA MACLEODS 250 mg COMPR. FILM. 250mg MACLEODS PHARMA UK LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 23,64 2,364000 2,364000 1,182000806 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 33,85 4,835714 4,759200 2,379600807 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 33,86 4,837142 4,759200 2,379600808 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 52,08 7,440000 4,759200 2,379600809 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 33,65 4,807142 4,759200 2,379600

Pagina 16 din 26

Page 46: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti810 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA MACLEODS 500 mg COMPR. FILM. 500mg MACLEODS PHARMA UK LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF 5 23,64 4,728000 4,728000 2,364000811 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA MACLEODS 500 mg COMPR. FILM. 500mg MACLEODS PHARMA UK LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 41,93 4,193000 4,193000 2,096500812 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 74,08 14,816000 4,759200 2,379600813 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 40,26 8,052000 4,759200 2,379600814 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF 5 55,17 11,034000 4,759200 2,379600815 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 46,22 9,244000 4,759200 2,379600816 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 50,70 10,140000 4,759200 2,379600817 J02AC02 ITRACONAZOLUM* ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS.P-RF 15 76,92 5,128000 5,128000 2,564000818 J02AC02 ITRACONAZOLUM* ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 1,752000819 J02AC02 ITRACONAZOLUM* OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 1,752000820 J02AC02 ITRACONAZOLUM* MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 52,55 3,503333 3,503333 1,751666821 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 52,56 3,504000 3,504000 1,752000822 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 56,95 5,695000 5,168979 2,584489823 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 37,01 3,701000 3,701000 1,850500824 J05AB15 BRIVUDINUM*# BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF 7 332,58 47,511428 47,511428 23,755714825 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 26,13 0,522600 0,522600 0,261300826 L02AE02 LEUPRORELINUM***# LUCRIN DEPOT 11,25mg LIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL. 11,25mg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA + 2 ACE SI TA S/P-RF 1 610,41 610,410000 610,410000 305,205000827 L02AE02 LEUPRORELINUM***# LUCRIN DEPOT 3,75mg LIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL. 3,75mg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA SI TAMPON IMB S/P-RF 1 237,99 237,990000 214,191000 107,095500828 L02AE02 LEUPRORELINUM***# LUCRIN DEPOT 11,25mg PULB. PT. SUSP. INJ. CU ELIB. PREL. 11,25mg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(23G 1½)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%. PR/PRF 1 610,41 610,410000 610,410000 305,205000829 L02AE02 LEUPRORELINUM***# LUCRIN DEPOT 3,75mg PULB. PT. SUSP. INJ. CU ELIB. PREL. 3,75mg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(22G 1½)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%. PR/PRF 1 237,99 237,990000 214,191000 107,095500830 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 1 436,52 436,520000 402,272492 201,136246831 L02AE04 TRIPTORELINUM***# DIPHERELINE 0,1 mg LIOF. + 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 7 134,62 19,231428 5,711755 2,855877832 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 1.184,81 1.184,810000 642,573007 321,286503833 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 1 440,58 440,580000 440,580000 220,290000834 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 28 630,48 22,517142 0,765375 0,382687835 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,569974 0,284987836 M01AC01 PIROXICAMUM PIROXSAL 20 mg COMPR. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST.PVC/ AL X 10 COMPR. P-6L 20 2,63 0,131500 0,131500 0,065750837 M01AC01 PIROXICAMUM FLAMEXIN COMPR. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L 30 29,01 0,967000 0,902700 0,451350838 M01AC01 PIROXICAMUM FLAMEXIN COMPR. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR. P-6L 10 17,58 1,758000 0,902700 0,451350839 M01AC01 PIROXICAMUM PIROXICAM LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,13 0,156500 0,156500 0,078250840 M01AC01 PIROXICAMUM PIROXICAM ARENA 20 MG COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,47 0,123500 0,123500 0,061750841 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 4,44 0,222000 0,222000 0,111000842 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 1 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 10 20,80 2,080000 0,902700 0,451350843 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 2 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 20 39,37 1,968500 0,902700 0,451350844 M01AC01 PIROXICAMUM FLAMEXIN COMPR. EFF. 20mg CHIESI FARMACEUTICI SPA ITALIA CUTIE X 3 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L 30 48,42 1,614000 0,902700 0,451350845 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 27,37 1,368500 0,902700 0,451350846 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 11,77 2,354000 2,354000 1,177000847 M01AC01 PIROXICAMUM PIROXICAM ATB 20 mg SUPOZ. 20 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC X 3 SUPOZ. P6L 6 4,44 0,740000 0,740000 0,370000848 M01AC01 PIROXICAMUM PIROXICAM ATB 20 mg SUPOZ. 20 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC X 6 SUPOZ. P6L 6 4,44 0,740000 0,740000 0,370000849 M01AC01 PIROXICAMUM PIROXICAM SINTOFARM 20 mg SUPOZ. 20mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L 10 7,32 0,732000 0,732000 0,366000850 M01AC05 LORNOXICAMUM XEFO RAPID 8 mg COMPR. FILM. 8mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 10 9,37 0,937000 0,601799 0,300899851 M01AC05 LORNOXICAMUM XEFO 8 mg/ 2 ml PULB. + SOLV. PT. SOL. INJ. 8mg/2ml NYCOMED AUSTRIA GMBH AUSTRIA CUTIE CU 10 FLAC. DIN STICLA BRUNA CU PULB. PT. SOL. INJ. + 10 FIOLE DIN STICLA INCOLORA X 2 ML SOLV PRF 10 137,31 13,731000 1,178998 0,589499852 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 14,05 1,405000 0,494699 0,247349853 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 16,81 0,840500 0,494699 0,247349854 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 30,51 6,102000 2,276000 1,138000855 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 19,83 3,966000 2,276000 1,138000856 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 38,32 3,832000 2,276000 1,138000857 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 52,14 1,738000 1,629749 0,814874858 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 95,62 1,593666 1,593666 0,796833859 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 63,57 2,119000 0,965212 0,482606860 M01AH01 CELECOXIBUM ALGOXIB 100 mg CAPS. 100mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 27,27 0,909000 0,909000 0,454500

Pagina 17 din 26

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti861 M01AH01 CELECOXIBUM ACLEXA 100 mg CAPS. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 27,27 0,909000 0,909000 0,454500862 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 27,12 0,904000 0,904000 0,452000863 M01AH01 CELECOXIBUM CELETOR 100 mg CAPS. 100mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 42,68 1,422666 0,965212 0,482606864 M01AH01 CELECOXIBUM CALIDEM 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA/OLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 42,74 1,424666 0,965212 0,482606865 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 33,03 3,303000 1,930424 0,965212866 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 94,10 3,136666 1,930424 0,965212867 M01AH01 CELECOXIBUM ALGOXIB 200 mg CAPS. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 49,22 1,640666 1,640666 0,820333868 M01AH01 CELECOXIBUM ACLEXA 200 mg CAPS. 200mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 49,22 1,640666 1,640666 0,820333869 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 200 mg CAPS. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 49,21 1,640333 1,640333 0,820166870 M01AH01 CELECOXIBUM CELETOR 200 mg CAPS. 200mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 64,33 2,144333 1,930424 0,965212871 M01AH01 CELECOXIBUM CALIDEM 200 mg CAPS. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA/OLANDA CUTIE CU BLIST. PVC/AL X 10 CAPS. PRF 10 22,17 2,217000 1,930424 0,965212872 M01AH01 CELECOXIBUM CALIDEM 200 mg CAPS. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA/OLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 64,40 2,146666 1,930424 0,965212873 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 35,09 5,012857 3,860849 1,930424874 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X2 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 28 128,69 4,596071 3,860849 1,930424875 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 67,83 4,845000 3,860849 1,930424876 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 67,83 4,845000 3,860849 1,930424877 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 86,14 3,076428 0,965212 0,482606878 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 55,68 3,977142 1,930424 0,965212879 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 28 105,76 3,777142 1,930424 0,965212880 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 55,68 3,977142 1,930424 0,965212881 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 59,15 4,225000 2,895636 1,447818882 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 30,54 4,362857 2,895636 1,447818883 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 59,15 4,225000 2,895636 1,447818884 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 28 112,36 4,012857 2,895636 1,447818885 M01AX05 GLUCOSAMINUM CARTIFLEX 625 mg CAPS. 625 mg TERAPIA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/PVDC/AL X 10 (6 BLIST. X 10) CAPS. P6L 60 41,65 0,694166 0,694166 0,347083886 M01AX05 GLUCOSAMINUM GLUCOZAMINA PHARMATAXIS 1250 mg COMPR. EFF. 1250mg PHARMATAXIS LTD CIPRU CUTIE CU 3 TUBURI DIN PP CU DOP PP X 10 COMPR. EFF. P6L 30 42,05 1,401666 1,388332 0,694166887 M01AX05 GLUCOSAMINUM SLIDEFLEX 1178mg COMPR. FILM. 1178mg BLUE BIO PHARMACEUTICALS LIMITED IRLANDA CUTIE CU BLIST. DIN PVC/PVDC/AL X 30 COMPR. FILM. P6L 30 41,65 1,388333 1,388332 0,694166888 M01AX05 GLUCOSAMINUM DONA 1500 mg PULB. PT. SOL. ORALA 1500mg ROTTAPHARM SPA ITALIA CUTIE X 20 PLICURI UNIDOZA CU PULB. P-6L 20 43,20 2,160000 1,388332 0,694166889 M01AX17 NIMESULIDUM LEMESIL COMPR. 100mg ANFARM HELLAS S.A. PHARMACEUTICALSGRECIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,72 0,486000 0,486000 0,243000890 M01AX17 NIMESULIDUM NIMESULID 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4,87 0,487000 0,487000 0,243500891 M01AX17 NIMESULIDUM NIMESULID SLAVIA COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 7,24 0,724000 0,724000 0,362000892 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8,20 0,410000 0,410000 0,205000893 M01AX17 NIMESULIDUM APONIL COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 4,51 0,451000 0,451000 0,225500894 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 4,78 0,478000 0,478000 0,239000895 M01AX17 NIMESULIDUM NIMESULID FARMEX 100 mg COMPR. 100mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 7,20 0,720000 0,720000 0,360000896 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 20,37 0,407400 0,321719 0,160859897 M03BX01 BACLOFENUM LIORESAL (R) COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 33,50 0,670000 0,670000 0,335000898 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 48,27 12,067500 9,675000 4,837500899 M05BA04 ACIDUM ALENDRONICUM* RANOS 70 mg COMPR. 70mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. DIN PAO-PVC-AL/AL X 4 COMPR. P-6L 4 47,66 11,915000 9,675000 4,837500900 M05BA04 ACIDUM ALENDRONICUM* ACID ALENDRONIC AUROBINDO 70 mg COMPR. 70mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR. P6L 4 24,04 6,010000 6,010000 3,005000901 M05BA04 ACIDUM ALENDRONICUM* FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 37,13 18,565000 9,675000 4,837500902 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 12,82 6,410000 6,410000 3,205000903 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 12 131,92 10,993333 9,675000 4,837500904 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 24,78 12,390000 9,675000 4,837500905 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 47,97 11,992500 9,675000 4,837500906 M05BA06 ACIDUM IBANDRONICUM* ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 61,42 61,420000 41,464285 20,732142907 M05BA06 ACIDUM IBANDRONICUM* BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-6L 1 89,74 89,740000 41,464285 20,732142908 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 47,51 47,510000 41,464285 20,732142909 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 71,46 71,460000 41,464285 20,732142910 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 38,80 38,800000 38,800000 19,400000911 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 52,90 52,900000 41,464285 20,732142

Pagina 18 din 26

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti912 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 38,80 38,800000 38,800000 19,400000913 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 1 239,77 239,770000 239,770000 119,885000914 M05BA06 ACIDUM IBANDRONICUM* ACID IBANDRONIC TEVA 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. SI UN AC DE INJECTAREP6L 1 283,25 283,250000 267,246000 133,623000915 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 1 271,45 271,450000 267,246000 133,623000916 M05BA06 ACIDUM IBANDRONICUM* BONVIVA 3mg/3ml SOL. INJ. IN SERINGA PREUMPLUTA 1mg/1ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC P-6L 1 424,57 424,570000 267,246000 133,623000917 M05BA06 ACIDUM IBANDRONICUM* ACID IBANDRONIC ALVOGEN 3 mg SOL.INJ. IN SERINGA PREUMPLUTA 3 mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE X 3 ML SOL.INJ.PR/PRF 1 182,83 182,830000 182,830000 91,415000918 M05BA07 ACIDUM RISEDRONICUM* RISENDROS 35 mg COMPR. FILM. 35mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 14,31 3,577500 3,577500 1,788750919 M05BA07 ACIDUM RISEDRONICUM* RISEDRONAT TEVA 35 mg COMPR. FILM. 35mg TEVA PHARMACEUTICALS SRL ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 45,27 11,317500 9,675000 4,837500920 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 36,50 9,125000 9,125000 4,562500921 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 45,27 11,317500 9,675000 4,837500922 M05BA07 ACIDUM RISEDRONICUM* ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 65,83 16,457500 9,675000 4,837500923 M05BA07 ACIDUM RISEDRONICUM* RISEDRONAT SODIC SANDOZ 35 mg COMPR. FILM. 35mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 4 COMPR. FILM. P6L 4 28,38 7,095000 7,095000 3,547500924 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 14,31 3,577500 3,577500 1,788750925 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 14,31 3,577500 3,577500 1,788750926 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 43,00 10,750000 9,675000 4,837500927 M05BA07 ACIDUM RISEDRONICUM* ACTONEL 75 mg COMPR. FILM. 75mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P-6L 2 66,39 33,195000 20,732142 10,366071928 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 66,39 33,195000 20,732142 10,366071929 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 89,84 22,460000 9,675000 4,837500930 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 47,30 23,650000 9,675000 4,837500931 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.) P-6L 2 47,30 23,650000 9,675000 4,837500932 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)* FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.) P-6L 4 89,84 22,460000 9,675000 4,837500933 M05BX03 STRONTIUM RANELATUM* OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 14 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA P-RF 14 104,74 7,481428 6,547142 3,273571934 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 28 174,60 6,235714 6,235714 3,117857935 N02AA05 OXYCODONUM*# OXYCONTIN 10 mg COMPR. CU ELIB. MODIF. 10 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 64,10 1,068333 0,473131 0,236565936 N02AA05 OXYCODONUM*# OXYCONTIN 20 mg COMPR. CU ELIB. MODIF. 20 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 121,02 2,017000 0,946263 0,473131937 N02AA05 OXYCODONUM*# OXYCONTIN 40 mg COMPR. CU ELIB. MODIF. 40 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 172,88 2,881333 1,892531 0,946265938 N02AA05 OXYCODONUM*# OXYCONTIN 80 mg COMPR. CU ELIB. MODIF. 80mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 309,83 5,163833 3,785062 1,892531939 N02AA05 OXYCODONUM*# RELTEBON 10 mg COMPR. CU ELIB. PREL. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 43,09 0,718166 0,473131 0,236565940 N02AA05 OXYCODONUM*# RELTEBON 20 mg COMPR. CU ELIB. PREL. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 78,60 1,310000 0,946263 0,473131941 N02AA05 OXYCODONUM*# RELTEBON 40 mg COMPR. CU ELIB. PREL. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 118,39 1,973166 1,892531 0,946265942 N02AA05 OXYCODONUM*# RELTEBON 80 mg COMPR. CU ELIB. PREL. 80mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 201,30 3,355000 3,355000 1,677500943 N02AA05 OXYCODONUM*# OXIDOLOR 10 mg COMPR. ELIB. PREL. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 43,09 0,718166 0,473131 0,236565944 N02AA05 OXYCODONUM*# ALNAGON 10 mg COMPR. ELIB. PREL. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. ELIB. PREL. P-RF 56 48,27 0,861964 0,473131 0,236565945 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 78,65 1,310833 0,946263 0,473131946 N02AA05 OXYCODONUM*# ALNAGON 20 mg COMPR. ELIB. PREL. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. ELIB. PREL. P-RF 56 88,08 1,572857 0,946263 0,473131947 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 60 118,50 1,975000 1,892531 0,946265948 N02AA05 OXYCODONUM*# ALNAGON 40 mg COMPR. ELIB. PREL. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. ELIB. PREL. P-RF 56 132,72 2,370000 1,892531 0,946265949 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 47,40 2,370000 1,892531 0,946265950 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 20 139,36 6,968000 2,838798 1,419399951 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 60 201,38 3,356333 3,356333 1,678166952 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 80,55 4,027500 3,785062 1,892531953 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 56 128,54 2,295357 1,504445 0,752222954 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 29,34 0,523928 0,523928 0,261964955 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 56 101,69 1,815892 1,128334 0,564167956 N02AX52 COMBINATII DORETA 37,5mg/325mg COMPR. FILM. 37,5mg/325mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 10 7,89 0,789000 0,702074 0,351037957 N02AX52 COMBINATII 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 15,58 0,779000 0,702074 0,351037958 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 3 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 30 34,76 1,158666 0,702074 0,351037959 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 10 12,14 1,214000 0,702074 0,351037960 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 20 23,96 1,198000 0,702074 0,351037961 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 3 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 30 34,76 1,158666 0,702074 0,351037962 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 10 12,14 1,214000 0,702074 0,351037

Pagina 19 din 26

Page 49: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti963 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 5 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF 50 57,78 1,155600 0,702074 0,351037964 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 5 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 50 57,78 1,155600 0,702074 0,351037965 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM ZALDIAR (R) COMPR. FILM. 37,5mg+325mg GRUNENTHAL GMBH GERMANIA CUTIE X 2 BLIST. PP OPAC/AL X 10 COMPR. FILM. P-RF 20 23,96 1,198000 0,702074 0,351037966 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 23,34 0,778000 0,702074 0,351037967 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 11,71 0,780666 0,702074 0,351037968 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) PADOLTEN 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg S.C.TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 7,89 0,789000 0,702074 0,351037969 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) PADOLTEN 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg S.C.TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 15,59 0,779500 0,702074 0,351037970 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) LINEROL 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 7,90 0,790000 0,702074 0,351037971 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) LINEROL 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM. P-RF 20 15,59 0,779500 0,702074 0,351037972 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) LINEROL 37,5 mg/325 mg COMPR. FILM. 37,5mg/325mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P-RF 30 23,36 0,778666 0,702074 0,351037973 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM) DORETA 75 mg/650 mg COMPR. FILM. 75 mg/650 mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF 10 15,78 1,578000 0,702074 0,351037974 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 31,14 1,557000 0,702074 0,351037975 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 6,89 0,137800 0,067904 0,033952976 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 6,56 0,218666 0,218666 0,109333977 N03AX16 PREGABALINUM**# LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 76,16 5,440000 5,189139 2,594569978 N03AX16 PREGABALINUM**# LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 288,91 5,159107 5,159107 2,579553979 N03AX16 PREGABALINUM**# LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 422,67 7,547678 7,547678 3,773839980 N03AX16 PREGABALINUM**# LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 114,28 8,162857 8,162857 4,081428981 N03AX16 PREGABALINUM**# LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 53,71 3,836428 2,594569 1,297284982 N03AX16 PREGABALINUM**# LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 193,52 3,455714 2,594569 1,297284983 N04AA02 BIPERIDENUM AKINETON 2 mg COMPR. 2mg DESMA GMBH GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 10,57 0,211400 0,211400 0,105700984 N04BC05 PRAMIPEXOLUM* OPRYMEA 0,088mg COMPR. 0,088mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 19,75 0,658333 0,135126 0,067563985 N04BC05 PRAMIPEXOLUM* MIPARKAN 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 17,43 0,581000 0,276395 0,138197986 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 17,43 0,581000 0,276395 0,138197987 N04BC05 PRAMIPEXOLUM* MIRAPEXIN 0,18 mg COMPR. 0,18mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 49,77 1,659000 0,276395 0,138197988 N04BC05 PRAMIPEXOLUM* OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 17,70 0,590000 0,276395 0,138197989 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL TEVA 0,18mg COMPR. 0,18mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 33,41 1,113666 0,276395 0,138197990 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL SANDOZ 0,18 mg COMPR. 0,18mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF/R 30 33,42 1,114000 0,276395 0,138197991 N04BC05 PRAMIPEXOLUM* MEDOPEXOL 0,18 mg COMPR. 0,18mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 27,83 0,927666 0,276395 0,138197992 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 14,88 0,496000 0,276395 0,138197993 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL RANBAXY 0,18 mg COMPR. 0,18mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC X 30 COMPR. P-RF 30 30,86 1,028666 0,276395 0,138197994 N04BC05 PRAMIPEXOLUM* MIGLASEN 0,18 mg COMPR. 0,18mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 14,87 0,495666 0,276395 0,138197995 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL TORRENT 0,18 mg COMPR. 0,18mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 17,72 0,590666 0,276395 0,138197996 N04BC05 PRAMIPEXOLUM* PRAXITAB 0,18mg COMPR. 0,18mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 25,30 0,843333 0,276395 0,138197997 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL AUROBINDO 0,18 mg COMPR. 0,18mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 23,56 0,785333 0,276395 0,138197998 N04BC05 PRAMIPEXOLUM* MIGLASEN 0,18 mg COMPR. 0,18mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 14,87 0,495666 0,276395 0,138197999 N04BC05 PRAMIPEXOLUM* PRAMIPEXOLE ACCORD 0,35mg COMPR. 0,35mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 48,92 1,630666 0,537435 0,2687171.000 N04BC05 PRAMIPEXOLUM* MIPARKAN 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 60,97 2,032333 1,074870 0,5374351.001 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL AUROBINDO 0,7 mg COMPR. 0,7 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 83,51 2,783666 1,074870 0,5374351.002 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 60,97 2,032333 1,074870 0,5374351.003 N04BC05 PRAMIPEXOLUM* MIRAPEXIN 0,7 mg COMPR. 0,7mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 167,86 5,595333 1,074870 0,5374351.004 N04BC05 PRAMIPEXOLUM* OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 73,16 2,438666 1,074870 0,5374351.005 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL TEVA 0,7mg COMPR. 0,7mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 115,05 3,835000 1,074870 0,5374351.006 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL SANDOZ 0,7 mg COMPR. 0,7mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF/R 30 115,05 3,835000 1,074870 0,5374351.007 N04BC05 PRAMIPEXOLUM* MEDOPEXOL 0,7 mg COMPR. 0,7mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 99,54 3,318000 1,074870 0,5374351.008 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 72,02 2,400666 1,074870 0,5374351.009 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL RANBAXY 0,7 mg COMPR. 0,7mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC X 30 COMPR. P-RF 30 106,21 3,540333 1,074870 0,5374351.010 N04BC05 PRAMIPEXOLUM* MIGLASEN 0,7 mg COMPR. 0,7mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 72,03 2,401000 1,074870 0,5374351.011 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL TORRENT 0,7 mg COMPR. 0,7mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 73,14 2,438000 1,074870 0,5374351.012 N04BC05 PRAMIPEXOLUM* PRAXITAB 0,7 mg COMPR. 0,7mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 90,45 3,015000 1,074870 0,5374351.013 N04BC05 PRAMIPEXOLUM* MIGLASEN 0,7 mg COMPR. 0,7mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 72,03 2,401000 1,074870 0,537435

Pagina 20 din 26

Page 50: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.014 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. P-RF 10 58,12 5,812000 0,399237 0,1996181.015 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 61,20 2,040000 0,399237 0,1996181.016 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 17,09 1,709000 0,399237 0,1996181.017 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. P-RF 30 314,07 10,469000 0,798475 0,3992371.018 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 30 112,50 3,750000 0,798475 0,3992371.019 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 94,24 3,141333 0,798475 0,3992371.020 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. P-RF 30 650,35 21,678333 1,612305 0,8061521.021 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 30 160,92 5,364000 1,612305 0,8061521.022 N04BC05 PRAMIPEXOLUM* OPRYMEA 1,57mg COMPR. ELIB. PREL. 1,57mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 241,13 8,037666 2,410781 1,2053901.023 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 30 274,79 9,159666 3,224611 1,6123051.024 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. P-RF 30 1.229,85 40,995000 3,224611 1,6123051.025 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 30 229,34 7,644666 3,224611 1,6123051.026 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. P-RF 30 1.809,33 60,311000 4,836917 2,4184581.027 N04BC08 PIRIBEDILUM** PRONORAN 50 mg DRAJ. ELIB. PREL. 50mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL. P-RF 30 28,69 0,956333 0,956333 0,4781661.028 N05AL03 TIAPRIDUM TIAPRIDAL (R) 100 mg COMPR. 100mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 9,23 0,461500 0,461500 0,2307501.029 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 17,75 0,295833 0,295833 0,1479161.030 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 10,82 0,180333 0,156020 0,0780101.031 N06AA21 MAPROTILINUM* LUDIOMIL® 10 mg COMPR. FILM. 10mg AMDIPHARM LIMITED IRLANDA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 12,47 0,249400 0,244799 0,1223991.032 N06AA21 MAPROTILINUM* LUDIOMIL® 25 mg COMPR. FILM. 25mg AMDIPHARM LIMITED IRLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 8,83 0,294333 0,294333 0,1471661.033 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 22,51 0,750333 0,750333 0,3751661.034 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 90,38 3,227857 1,241999 0,6209991.035 N06AB10 ESCITALOPRAMUM** ESCITIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 25,01 0,893214 0,893214 0,4466071.036 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM-TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 22,51 0,750333 0,750333 0,3751661.037 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 27,57 0,984642 0,984642 0,4923211.038 N06AB10 ESCITALOPRAMUM** ESLOREX 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 22,57 0,752333 0,752333 0,3761661.039 N06AB10 ESCITALOPRAMUM** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 21,06 0,752142 0,752142 0,3760711.040 N06AB10 ESCITALOPRAMUM** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. PRF 14 12,68 0,905714 0,905714 0,4528571.041 N06AB10 ESCITALOPRAMUM** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PRF 28 25,27 0,902500 0,902500 0,4512501.042 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 21,00 0,750000 0,750000 0,3750001.043 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 22,57 0,752333 0,752333 0,3761661.044 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 21,00 0,750000 0,750000 0,3750001.045 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 32,82 1,172142 1,172142 0,5860711.046 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM-TEVA 15 mg COMPR. FILM. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 33,77 1,125666 1,125666 0,5628331.047 N06AB10 ESCITALOPRAMUM** ELICEA 15 mg COMPR. FILM. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 39,57 1,319000 1,319000 0,6595001.048 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM-TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 43,57 1,452333 1,452333 0,7261661.049 N06AB10 ESCITALOPRAMUM** SERODEPS 20mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 36,70 1,310714 1,310714 0,6553571.050 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 63,52 2,268571 2,268571 1,1342851.051 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 42,56 1,520000 1,520000 0,7600001.052 N06AB10 ESCITALOPRAMUM** ELICEA 20 mg COMPR. FILM. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 45,60 1,520000 1,520000 0,7600001.053 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 10 mg COMPR. ORODISPERSABILE 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 21,06 0,752142 0,752142 0,3760711.054 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 10 mg COMPR. ORODISPERSABILE 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 21,06 0,752142 0,752142 0,3760711.055 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE PRF 30 27,00 0,900000 0,900000 0,4500001.056 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 15 mg COMPR. ORODISPERSABILE 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 36,95 1,319642 1,319642 0,6598211.057 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 15 mg COMPR. ORODISPERSABILE 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 36,95 1,319642 1,319642 0,6598211.058 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 20 mg COMPR. ORODISPERSABILE 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 42,56 1,520000 1,520000 0,7600001.059 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 20 mg COMPR. ORODISPERSABILE 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 42,56 1,520000 1,520000 0,7600001.060 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM TEVA 20 mg COMPR. ORODISPERSABILE 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE PRF 30 47,18 1,572666 1,572666 0,7863331.061 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 24,95 1,247500 1,103207 0,5516031.062 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 63,31 1,055166 1,055166 0,5275831.063 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 63,31 1,055166 1,055166 0,5275831.064 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 24,95 1,247500 1,103207 0,551603

Pagina 21 din 26

Page 51: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.065 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 18,71 0,623666 0,551603 0,2758011.066 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 18,71 0,623666 0,551603 0,2758011.067 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 63,54 2,118000 2,118000 1,0590001.068 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 22,65 0,755000 0,755000 0,3775001.069 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 63,54 0,706000 0,706000 0,3530001.070 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 22,65 0,755000 0,755000 0,3775001.071 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 22,65 0,755000 0,755000 0,3775001.072 N06AX14 TIANEPTINUM** COAXIL (R) DRAJ. 12,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 33,74 1,124666 0,755000 0,3775001.073 N06AX21 DULOXETINUM** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 105,39 3,763928 3,336830 1,6684151.074 N06AX21 DULOXETINUM** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 178,89 6,388928 6,388928 3,1944641.075 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 71,94 3,597000 3,597000 1,7985001.076 N06BX18 VINPOCETINUM VINPOCETINA VIM SPECTRUM 5 mg CAPS. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L 50 10,29 0,205800 0,205800 0,1029001.077 N06BX18 VINPOCETINUM CAVINTON(R) FORTE COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-6L 30 14,45 0,481666 0,411600 0,2058001.078 N06BX18 VINPOCETINUM VICEBROL COMPR. 5mg BMF PHARM S.R.L. ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10,29 0,205800 0,205800 0,1029001.079 N06BX18 VINPOCETINUM CAVINTON(R) COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-6L 50 15,82 0,316400 0,205800 0,1029001.080 N06DX02 GINKGO BILOBA** GINKGO BILOBA BIOFARM 40 mg (vezi C04AXN1) COMPR. FILM. 40mg BIOFARM S.A. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. P-6L 30 12,30 0,410000 0,379604 0,1898021.081 N07CA01 BETAHISTINUM VERTIMED 16 mg COMPR. 16mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L 30 19,17 0,639000 0,385200 0,1926001.082 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 16,84 0,561333 0,385200 0,1926001.083 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 15,96 0,266000 0,266000 0,1330001.084 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 34,85 0,580833 0,577800 0,2889001.085 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 35,79 0,596500 0,577800 0,2889001.086 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 20 18,35 0,917500 0,577800 0,2889001.087 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 5 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 50 39,78 0,795600 0,577800 0,2889001.088 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P-6L 20 27,97 1,398500 0,577800 0,2889001.089 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L 30 19,81 0,660333 0,577800 0,2889001.090 N07CA01 BETAHISTINUM VERTIMED 24 mg COMPR. 24mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 60 COMPR. P6L 60 38,37 0,639500 0,577800 0,2889001.091 N07CA01 BETAHISTINUM VESTIBO 24 mg COMPR. 24mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 13,53 0,451000 0,451000 0,2255001.092 N07CA01 BETAHISTINUM MARBETA 24 mg COMPR. 24mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 60 34,85 0,580833 0,577800 0,2889001.093 N07CA01 BETAHISTINUM BETAHISTIN MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 6 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 60 35,76 0,596000 0,577800 0,2889001.094 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 32,40 0,540000 0,540000 0,2700001.095 N07CA01 BETAHISTINUM EMPERIN 8 mg COMPR. 8 mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 100 COMPR. P6L 100 19,24 0,192400 0,192400 0,0962001.096 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 30 9,58 0,319333 0,192600 0,0963001.097 N07CA01 BETAHISTINUM BETASERC 8 mg COMPR. 8mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 29,63 0,296300 0,192600 0,0963001.098 N07CA01 BETAHISTINUM BETAHISTINA LPH 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 9,58 0,319333 0,192600 0,0963001.099 N07CA01 BETAHISTINUM BETAHISTIN MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 10 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 100 19,26 0,192600 0,192600 0,0963001.100 N07CA01 BETAHISTINUM VERTIMED 8 mg COMPR. 8mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L 30 7,15 0,238333 0,192600 0,0963001.101 N07CA01 BETAHISTINUM MARBETA 8 mg COMPR. 8mg MEDREG S.R.O. REPUBLICA CEHA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 100 19,26 0,192600 0,192600 0,0963001.102 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 28,74 0,319333 0,192600 0,0963001.103 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 17,32 0,173200 0,173200 0,0866001.104 N07CA01 BETAHISTINUM ACUVER 8 mg/doza SOL. ORALA 8mg/doza CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 60 ML SOL. ORALA P-6L 1 38,11 38,110000 14,445014 7,2225071.105 N07CA01 BETAHISTINUM ACUVER 8 mg/doza SOL. ORALA 8mg/doza CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 120 ML SOL. ORALA P-6L 1 70,00 70,000000 28,890028 14,4450141.106 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 76,16 1,586666 1,586666 0,7933331.107 N07XN03 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**# THIOCTACID (R) 600 HR (vezi A16AX01) COMPR. FILM. 600mg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 30 COMPR. FILM. P-6L 30 68,47 2,282333 1,978474 0,9892371.108 N07XN03 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**# THIOCTACID (R) 600 HR (vezi A16AX01) COMPR. FILM. 600mg MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 FLAC. X 100 COMPR. FILM. P-6L 100 212,63 2,126300 1,978474 0,9892371.109 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA** CEREBROLYSIN® SOL. INJ./PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 MLPR/PRF 5 124,46 24,892000 24,892000 12,4460001.110 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA** CEREBROLYSIN® SOL. INJ./PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML PR/PRF 5 86,41 17,282000 14,863999 7,4319991.111 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA** CEREBROLYSIN® SOL. INJ./PERF. 215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 1 MLPR/PRF 10 39,22 3,922000 2,972800 1,4864001.112 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL® COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 31,39 0,523166 0,523166 0,2615831.113 R01AD05 BUDESONIDUM* RHINOCORT AQUA 32 micrograme/doza SPRAY NAZAL SUSP. 32micrograme/doza ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SPRAY NAZAL, SUSP. ECHIVALENT CU 120 DOZE, PREVAZUT CU POM PRF 1 25,27 25,270000 25,270000 12,6350001.114 R01AD08 FLUTICASONUM* FLIXONASE 0,05g/100g SPRAY NAZAL SUSP. 0,05g/100g GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON X 120 DOZE, PREVAZUT CU POMPA DOZATOARE P-RF 1 30,65 30,650000 30,650000 15,3250001.115 R01AD09 MOMETASONUM* KALMENTE 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID PREVAZUT CU POMPA DOZATOARE SI APLICATOR NAZAL CARE CONTINE SPRAY NAZAL, SUSP. PT. 140 PULVERIZARI PRF 1 31,77 31,770000 30,174999 15,087499

Pagina 22 din 26

Page 52: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.116 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 25,39 25,390000 25,390000 12,6950001.117 R01AD09 MOMETASONUM* MOMETAZONA TEVA 50 micrograme/doza SPRAY NAZ.,SUSP. 50µg/doza TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN PEID, CU POMPA DOZATOARE DIN PP SI SISTEM DE ACTIONARE X 140 DOZE SPRAY NAZAL, PRF 1 31,77 31,770000 30,174999 15,0874991.118 R01AD09 MOMETASONUM* NASONEX 50mcg/doza SPRAY NAZAL SUSP. 50mcg/doza MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON PP X 140 DOZE P-RF 1 47,31 47,310000 30,174999 15,0874991.119 R03AC04 FENOTEROLUM BEROTEC N - 100 mcg SOL. DE INHALAT PRESURIZATA 100mcg/doza BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE SOL. DE INHALAT PRESURIZATAP-6L 1 16,66 16,660000 16,660000 8,3300001.120 R03AC18 INDACATEROLUM**# ONBREZ BREEZHALER 150 µg CAPS. CU PULB.INHAL. 150 µg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIECU BLIST. DIN PA/AL/PVC X 30 CAPSULE (3 BIST X10)+ UN INHALATOR PRF 30 125,82 4,194000 2,621250 1,3106251.121 R03AC18 INDACATEROLUM**# ONBREZ BREEZHALER 300 µg CAPS. CU PULB.INHAL. 300 µg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PA/AL/PVC X 30 CAPSULE (1 BLIST. X10)+ UN INHALATORPRF 30 125,82 4,194000 4,194000 2,0970001.122 R03AK03 COMBINATII (FENOTEROLUM + IPRATROPIUM)* BERODUAL (R) N AEROSOL SOL. INHAL. 0,020mg+0,050mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLACON PRESURIZAT DIN OTEL X 200 DOZE SOLUTIE DE INHALAT PRESURIZATA P-6L 1 40,29 40,290000 40,290000 20,1450001.123 R03AK06 SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/100 PULB. INHAL. 50mg/100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 1DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L 1 103,09 103,090000 42,053400 21,0267001.124 R03AK06 SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/250 PULB. INHAL. 50mg/250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL.P-6L 1 133,50 133,500000 105,133500 52,5667501.125 R03AK06 SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/500 PULB. INHAL. 50mg/500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL. P-6L 1 175,51 175,510000 175,510000 87,7550001.126 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 P6L 1 103,09 103,090000 42,053400 21,0267001.127 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 P6L 1 133,50 133,500000 105,133500 52,5667501.128 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 P6L 1 175,51 175,510000 175,510000 87,7550001.129 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 1 164,30 164,300000 105,133500 52,5667501.130 R03AK06 SALMETEROLUM+FLUTICASONUM* SERETIDE 25 mcg/250 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/250mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA P-6L 1 233,63 233,630000 210,267000 105,1335001.131 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 1 122,59 122,590000 42,053400 21,0267001.132 R03AK07 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER 100/6 micrograme pe doza SOL. DE INHALAT PRESURIZATA 100/6micrograme pe doza CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS IN DISPOZITIVUL DE ADMINISTRARE DIN PE CU CAPAC PROTECTOR DIN PLASTIC A 180 DOZE SOL. DE INHALAT PRF 1 237,38 237,380000 237,380000 118,6900001.133 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 1 120,12 120,120000 117,012500 58,5062501.134 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 1 227,81 227,810000 227,810000 113,9050001.135 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 95,11 95,110000 58,506250 29,2531251.136 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 DOZEP-RF 1 40,65 40,650000 31,258800 15,6294001.137 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 DOZEP-RF 1 84,46 84,460000 78,147000 39,0735001.138 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 DOZEP-RF 1 137,24 137,240000 137,240000 68,6200001.139 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 44,60 44,600000 39,073500 19,5367501.140 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 DOZATOAREP-RF 1 36,40 36,400000 31,258800 15,6294001.141 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 27,04 2,704000 1,041958 0,5209791.142 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 79,09 7,909000 4,167838 2,0839191.143 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 57,33 57,330000 44,984999 22,4924991.144 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 81,74 81,740000 81,740000 40,8700001.145 R03BA08 CICLESONIDUM* ALVESCO 160 INHALER SOL. DE INHALAT PRESURIZATA 160µg/doza NYCOMED GMBH GERMANIA CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATAP-RF 1 124,79 124,790000 124,790000 62,3950001.146 R03BA08 CICLESONIDUM* ALVESCO 80 INHALER SOL. DE INHALAT PRESURIZATA 80µg/doza NYCOMED GMBH GERMANIA CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATAP-RF 1 112,34 112,340000 74,881250 37,4406251.147 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 30 164,34 5,478000 5,478000 2,7390001.148 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 MED PRF 1 171,62 171,620000 166,160000 83,0800001.149 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 INHALATORPRF 30 154,18 5,139333 5,139333 2,5696661.150 R03DA05 AMINOPHYLLINUM MIOFILIN 100 mg CAPS. 100mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 3,62 0,181000 0,166544 0,0832721.151 R03DA05 AMINOPHYLLINUM AMINOFILINA EEL COMPR. 100mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF 50 6,78 0,135600 0,135600 0,0678001.152 R03DA05 AMINOPHYLLINUM AMINOFILINA ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-RF 40 6,95 0,173750 0,166544 0,0832721.153 R03DA05 AMINOPHYLLINUM AMINOFILINA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,72 0,386000 0,333090 0,1665451.154 R03DA05 AMINOPHYLLINUM MIOFILIN 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 11,82 2,364000 2,364000 1,1820001.155 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 11,82 2,364000 2,364000 1,1820001.156 R03DC03 MONTELUKASTUM* ASTHATOR 10 mg COMPR. 10 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 61,93 2,211785 1,876785 0,9383921.157 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L 14 76,80 5,485714 1,876785 0,9383921.158 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L 28 80,14 2,862142 1,876785 0,9383921.159 R03DC03 MONTELUKASTUM* MONTELUKAST TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. FILM. P6L 28 82,04 2,930000 1,876785 0,9383921.160 R03DC03 MONTELUKASTUM* MONTELUKAST TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM. P6L 30 87,90 2,930000 1,876785 0,9383921.161 R03DC03 MONTELUKASTUM* SPIROKAST 10 mg COMPR. FILM. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. NY/AL/PVC-AL (FARA INDICAREA ZILELOR SAPTAMANII) X 28 COMPR. FILM.P6L 28 42,11 1,503928 1,503928 0,7519641.162 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 52,34 1,744666 1,744666 0,8723331.163 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 63,22 2,257857 1,876785 0,9383921.164 R03DC03 MONTELUKASTUM* ASTMASAN 10 mg COMPR. FILM. 10mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 77,66 2,773571 1,876785 0,9383921.165 R03DC03 MONTELUKASTUM* MONTELUKAST ALVOGEN 10 mg COMPR. FILM. 10mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 63,22 2,257857 1,876785 0,9383921.166 R03DC03 MONTELUKASTUM* STANGEN 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. FILM.P6L 28 63,22 2,257857 1,876785 0,938392

Pagina 23 din 26

Page 53: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.167 R03DC03 MONTELUKASTUM* SOLOK 10 mg COMPR. FILM. 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 63,10 2,253571 1,876785 0,9383921.168 R03DC03 MONTELUKASTUM* MONART 10 mg COMPR. FILM. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 28 COMPR. FILM. P6L 28 52,55 1,876785 1,876785 0,9383921.169 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 64,30 2,296428 1,876785 0,9383921.170 R03DC03 MONTELUKASTUM* MONTELUKAST CHIESI 10 mg COMPR. FILM. 10mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 44,73 1,597500 1,597500 0,7987501.171 R03DC03 MONTELUKASTUM* MONTELUKAST ABBOTT 10 mg COMPR. FILM. 10mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 67,75 2,419642 1,876785 0,9383921.172 R03DC03 MONTELUKASTUM* MONTELUKAST POLIPHARMA 10 mg COMPR. FILM. 10mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 BLIST. OPA/AL/PVC/AL X 7 COMPR. FILM. P6L 28 52,55 1,876785 1,876785 0,9383921.173 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 44,47 1,588214 1,511428 0,7557141.174 R03DC03 MONTELUKASTUM* SINGULAIR COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P-RF 28 94,51 3,375357 1,511428 0,7557141.175 R03DC03 MONTELUKASTUM* SINGULAIR COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 7 COMPR. MAST. P-RF 14 83,04 5,931428 1,511428 0,7557141.176 R03DC03 MONTELUKASTUM* MONTELUKAST TEVA 4 mg COMPR. MAST. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L 28 42,84 1,530000 1,511428 0,7557141.177 R03DC03 MONTELUKASTUM* MONTELUKAST TEVA 4 mg COMPR. MAST. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L 30 45,90 1,530000 1,511428 0,7557141.178 R03DC03 MONTELUKASTUM* SPIROKAST 4 mg COMPR. MAST. 4mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. NY/AL/PVC-AL (FARA INDICAREA ZILELOR SAPTAMANII) X 28 COMPR. MAST. P6L 28 29,97 1,070357 1,070357 0,5351781.179 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 41,75 1,391666 1,391666 0,6958331.180 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 42,84 1,530000 1,511428 0,7557141.181 R03DC03 MONTELUKASTUM* MONTELUKAST ALVOGEN 4 mg COMPR. MAST. 4mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE P6L 28 42,84 1,530000 1,511428 0,7557141.182 R03DC03 MONTELUKASTUM* STANGEN 4 mg COMPR. MAST. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST.P6L 28 42,84 1,530000 1,511428 0,7557141.183 R03DC03 MONTELUKASTUM* SOLOK 4 mg COMPR. MAST. 4mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PAPVC/AL X 28 COMPR. MAST. P6L 28 42,32 1,511428 1,511428 0,7557141.184 R03DC03 MONTELUKASTUM* MONART 4 mg COMPR. MAST. 4mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST. P6L 28 42,32 1,511428 1,511428 0,7557141.185 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 48,83 1,743928 1,511428 0,7557141.186 R03DC03 MONTELUKASTUM* MONTELUKAST CHIESI 4 mg COMPR. MAST. 4mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. MAST. P-6L 28 27,73 0,990357 0,990357 0,4951781.187 R03DC03 MONTELUKASTUM* MONTELUKAST ABBOTT 4 mg COMPR. MAST. 4mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 42,84 1,530000 1,511428 0,7557141.188 R03DC03 MONTELUKASTUM* ASTMASAN 4 mg COMPR. MAST. 4mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 17,20 0,614285 0,614285 0,3071421.189 R03DC03 MONTELUKASTUM* MONTELUKAST POLIPHARMA 4 mg COMPR. MAST. 4mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 BLIST. OPA/AL/PVC/AL X 7 COMPR. MAST. P6L 28 42,84 1,530000 1,511428 0,7557141.190 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 55,28 1,974285 1,889284 0,9446421.191 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 14 76,63 5,473571 1,889284 0,9446421.192 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 79,92 2,854285 1,889284 0,9446421.193 R03DC03 MONTELUKASTUM* MONTELUKAST TEVA 5 mg COMPR. MAST. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L 28 53,46 1,909285 1,889284 0,9446421.194 R03DC03 MONTELUKASTUM* MONTELUKAST TEVA 5 mg COMPR. MAST. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L 30 57,27 1,909000 1,889284 0,9446421.195 R03DC03 MONTELUKASTUM* SPIROKAST 5 mg COMPR. MAST. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. NY/AL/PVC-AL (FARA INDICAREA ZILELOR SAPTAMANII) X 28 COMPR. MAST. P6L 28 36,31 1,296785 1,296785 0,6483921.196 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 47,72 1,590666 1,590666 0,7953331.197 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 53,46 1,909285 1,889284 0,9446421.198 R03DC03 MONTELUKASTUM* MONTELUKAST ALVOGEN 5 mg COMPR. MAST. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE P6L 28 53,46 1,909285 1,889284 0,9446421.199 R03DC03 MONTELUKASTUM* STANGEN 5 mg COMPR. MAST. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST.P6L 28 53,46 1,909285 1,889284 0,9446421.200 R03DC03 MONTELUKASTUM* SOLOK 5 mg COMPR. MAST. 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA/PVC/AL X 28 COMPR. MAST. P6L 28 53,25 1,901785 1,889284 0,9446421.201 R03DC03 MONTELUKASTUM* MONART 5 mg COMPR. MAST. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST. P6L 28 53,46 1,909285 1,889284 0,9446421.202 R03DC03 MONTELUKASTUM* MONTELUKAST CHIESI 5 mg COMPR. MAST. 5mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. MAST. P-6L 28 34,30 1,225000 1,225000 0,6125001.203 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 60,94 2,176428 1,889284 0,9446421.204 R03DC03 MONTELUKASTUM* MONTELUKAST ABBOTT 5 mg COMPR. MAST. 5mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 53,46 1,909285 1,889284 0,9446421.205 R03DC03 MONTELUKASTUM* ASTMASAN 5 mg COMPR. MAST. 5mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 21,20 0,757142 0,757142 0,3785711.206 R03DC03 MONTELUKASTUM* MONTELUKAST POLIPHARMA 5 mg COMPR. MAST. 5mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 BLIST. OPA/AL/PVC/AL X 7 COMPR. MAST. P6L 28 53,41 1,907500 1,889284 0,9446421.207 R03DC03 MONTELUKASTUM* ASTMASAN 4 mg GRANULE 4mg SANDOZ S.R.L. ROMANIA CUTIE CU 28 PLICURI PET/AL/PE CONTINAND GRANULE P6L 28 77,86 2,780714 1,511428 0,7557141.208 R03DC03 MONTELUKASTUM* SINGULAIR 4 mg GRANULE 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 79,47 2,838214 1,511428 0,7557141.209 R03DX03 FENSPIRIDUM EURESPAL 80 mg COMPR. CU ELIBERARE PRELUNGITA 80mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.CU ELIBERARE PRELUGITA P-6L 30 28,09 0,936333 0,936333 0,4681661.210 R03DX03 FENSPIRIDUM EURESPAL 2 mg/ml SIROP 2mg/ml LES LAB. SERVIER IND. FRANTA CUTIE X 1 FLACON PVC DE CULOARE BRUNA X 150 ML P-6L 1 20,02 20,020000 20,019999 10,0099991.211 R05CB15 ERDOSTEINUM** ERDOMED 300 mg CAPS. 300mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 10 15,81 1,581000 1,581000 0,7905001.212 R05CB15 ERDOSTEINUM** ERDOMED 225 mg GRAN. PT. SUSP. ORALA 225mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE CU 20 PLICURI UNIDOZA DIN HARTIE AL/PE P-6L 20 33,14 1,657000 1,303562 0,6517811.213 R05CB15 ERDOSTEINUM** ERDOMED 175 mg/5 ml PULB. PT. SUSP. ORALA 175mg/5ml CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA A 50 G PULB. PT. OBTINEREA A 100 ML SUSP. ORALA + 1 MASURA DOZATOA P-6L 1 24,95 24,950000 24,950000 12,4750001.214 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE 20 mg COMPR. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 6,78 0,339000 0,339000 0,1695001.215 R05DA09 DEXTROMETHORPHANUM HUMEX SIROP 0,1% LAB. URGO SA FRANTA CUTIE X 1 FLACON X 125 ML SIROP + O MASURA DOZATOARE PENTRU MASURAREA VOLUMELOR 2,5ML; 5ML; 7,5ML; 15ML P-RF 1 8,46 8,460000 8,460000 4,2300001.216 R05DA09 DEXTROMETHORPHANUM HUMEX 0,133 g/100 ml SIROP 0,13% LAB. URGO SA FRANTA CUTIE X 1 FLACON X 200 ML + O MASURA DOZATOARE DIN POLIPROPILENA P-RF 1 10,82 10,820000 9,283183 4,6415911.217 R05DA09 DEXTROMETHORPHANUM ROFEDEX SIROP 15mg/5ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOAREP-RF 1 5,27 5,270000 5,270000 2,635000

Pagina 24 din 26

Page 54: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.218 R05DA09 DEXTROMETHORPHANUM HUMISEC pentru adulti 20mg/15 ml SIROP 20mg/15 ml LAB. URGO SA FRANTA CUTIE X 1 FLACON X 200 ML + O MASURA DOZATOARE DIN POLIPROPILENA P-RF 1 10,82 10,820000 9,283183 4,6415911.219 R05DA09 DEXTROMETHORPHANUM HUMISEC 5mg/5ml SIROP 5mg/5ml LAB. URGO SA FRANTA CUTIE X 1 FLACON X 125 ML SIROP + O MASURA DOZATOARE PENTRU MASURAREA VOLUMELOR 2,5ML; 5ML; 7,5ML; 15ML P-RF 1 8,46 8,460000 4,362396 2,1811981.220 R05DA09 DEXTROMETHORPHANUM TUSSIN 6,5mg/5ml SIROP 6,5mg/5ml ROPHARMA S.A. ROMANIA CUTIE X 1 FLAC. X 115ML SIROP + O LINGURITA DOZATOARE GRADATA LA 1,25ML; 2,5ML SI 5 ML P-RF 1 7,87 7,870000 5,217428 2,6087141.221 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 8,61 8,610000 2,617438 1,3087191.222 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 8,61 8,610000 5,234876 2,6174381.223 R06AE09 LEVOCETIRIZINUM XYZAL (R) COMPR. FILM. 5mg U.C.B. GMBH GERMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 16,92 1,692000 1,209375 0,6046871.224 R06AE09 LEVOCETIRIZINUM XYZAL (R) COMPR. FILM. 5mg U.C.B. GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 42,17 1,405666 1,209375 0,6046871.225 R06AE09 LEVOCETIRIZINUM CEZERA 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL CU 30 COMPR. FILM. P-6L 30 28,34 0,944666 0,944666 0,4723331.226 R06AE09 LEVOCETIRIZINUM LEVOCETIRIZINA SANDOZ 5 mg COMPR. FILM. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 10,99 1,099000 1,099000 0,5495001.227 R06AE09 LEVOCETIRIZINUM CETIZAL 5 mg COMPR. FILM. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 7,27 0,727000 0,727000 0,3635001.228 R06AE09 LEVOCETIRIZINUM LEVOCETIRIZINA ACTAVIS 5 mg COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 10 6,41 0,641000 0,641000 0,3205001.229 R06AE09 LEVOCETIRIZINUM ZENARO 5 mg COMPR. FILM. 5mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR/AL X 20 COMPR. FILM. P6L 20 12,80 0,640000 0,640000 0,3200001.230 R06AE09 LEVOCETIRIZINUM XYZAL PIC. ORALE, SOL. 5mg/ml UCB PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR P-6L 1 36,23 36,230000 24,187500 12,0937501.231 R06AE09 LEVOCETIRIZINUM ZENARO 0,5 mg/ml SIROP 0,5mg/ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 200 ML SIROP + 1 LINGURITA DOZATOARE DE 5 ML GRADATA LA 2,5 ML S P6L 1 23,91 23,910000 23,910000 11,9550001.232 R06AX26 FEXOFENADINUM TELFAST® 120 mg COMPR. FILM. 120mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 COMPR.FILM. P-6L 10 10,80 1,080000 0,820916 0,4104581.233 R06AX27 DESLORATADINUM DYNID 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 25,42 0,847333 0,820916 0,4104581.234 R06AX27 DESLORATADINUM DESLORATADINA ACTAVIS COMPR. FILM. 5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 10 PRF 10 9,35 0,935000 0,820916 0,4104581.235 R06AX27 DESLORATADINUM DESLORATADINA ACTAVIS COMPR. FILM. 5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X30 PRF 30 28,06 0,935333 0,820916 0,4104581.236 R06AX27 DESLORATADINUM DESLORATADINA SANDOZ 5 mg COMPR. FILM. 5 mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. NON UNIDOZA OPA-AL-PVC/AL X 30 COMPR.FILM. P6L 30 10,51 0,350333 0,350333 0,1751661.237 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 25,45 0,848333 0,820916 0,4104581.238 R06AX27 DESLORATADINUM DESLORATADINA RATIOPHARM COMPR. FILM. 5mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN PVC/PVDC/AL X 30 COMPRIMATE FILMATEPRF 30 35,44 1,181333 0,820916 0,4104581.239 R06AX27 DESLORATADINUM DESLORATADINA ALVOGEN 5 mg COMPR. FILM. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 35,44 1,181333 0,820916 0,4104581.240 R06AX27 DESLORATADINUM DESLORATADINA TERAPIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. PCTFE-PVC/AL X 30 COMPR. FILM. P6L 30 25,45 0,848333 0,820916 0,4104581.241 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 16,01 0,533666 0,533666 0,2668331.242 R06AX27 DESLORATADINUM DESLORATADINA TEVA COMPR. FILM. 5mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN OPA/AL/PVC - AL X 30 COMPR. FILM. PRF 30 28,46 0,948666 0,820916 0,4104581.243 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 10 8,21 0,821000 0,820916 0,4104581.244 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 30 24,62 0,820666 0,820666 0,4103331.245 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 28,55 0,951666 0,410458 0,2052291.246 R06AX27 DESLORATADINUM DESLORATADINA TEVA 5 mg COMPR. ORODISPERSABILE 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/HARTIE-PET-AL X 30 COMPR. ORODISPERSABILE P6L 30 19,94 0,664666 0,664666 0,3323331.247 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. ORODISPERSABILE 5mg MERCK SHARP&DOHME LTD. MAREA BRITANIE CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF 30 28,55 0,951666 0,820916 0,4104581.248 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 13,31 13,310000 12,000000 6,0000001.249 R06AX27 DESLORATADINUM DESLORATADINA ALVOGEN 0,5 mg/ml SOL. ORALA 0,5mg/ml ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 1 FLAC. DIN STICLA BRUNA A 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOAR P6L 1 13,31 13,310000 12,000000 6,0000001.250 R06AX27 DESLORATADINUM DYNID 0,5 mg/ml SOL. ORALA 0,5mg/ml GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOARE ( SERINGA DOZATOARE ARE GRADATII DE 2,5 ML SI 5 ML; LINGURITA DOZATOARE ARE CAPACITATEA DE 2,5 ML SI 5 ML P6L 1 13,31 13,310000 12,000000 6,0000001.251 R06AX27 DESLORATADINUM DESLORATADINA TEVA 0,5 mg/ml SOL. ORALA 0,5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA + 1 LINGURA DOZATOARE DIN PEID GRADATA LA DOZE DE 2,5 ML SI 5 ML X 120 M P6L 1 13,31 13,310000 12,000000 6,0000001.252 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 16,73 16,730000 12,000000 6,0000001.253 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 10,88 10,880000 10,880000 5,4400001.254 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 4,71 4,710000 4,710000 2,3550001.255 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 4,08 4,080000 4,080000 2,0400001.256 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 11,31 11,310000 4,080000 2,0400001.257 S01AA12 TOBRAMYCINUM TOBREX 2 X PICATURI OFT.-SOL. 0,3% ALCON COUVREUR NV BELGIA CUTIE X 1 FLAC. PEID CU PICURATOR DIN PEID X 5 ML P-RF 1 20,80 20,800000 4,080000 2,0400001.258 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 8,64 8,640000 3,060000 1,5300001.259 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 14,18 14,180000 14,180000 7,0900001.260 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 MLP-RF 15 28,94 1,929333 1,251059 0,6255291.261 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 APLICATORP-RF 1 32,50 32,500000 20,850997 10,4254981.262 S01AX11 OFLOXACINUM FLOXAL (R) PICATURI OFT.-SOL. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PICATURI OFT., SOL. P-RF 1 14,45 14,450000 11,302500 5,6512501.263 S01AX11 OFLOXACINUM FLOXAL (R) UNG. OFT. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 TUB DIN AL PREVAZUT CU APLICATOR X 3 G P-RF 1 15,38 15,380000 15,380000 7,6900001.264 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 10,12 10,120000 9,107999 4,5539991.265 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 5,55 5,550000 4,553999 2,2769991.266 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 8,55 8,550000 4,553999 2,2769991.267 S01BA06 BETAMETHASONUM OPHTAMESONE SOL. OFT. 0,1% DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML P-RF 1 4,50 4,500000 4,500000 2,2500001.268 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 31,39 31,390000 11,920500 5,960250

Pagina 25 din 26

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

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit.

a) si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.269 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 51,31 2,565500 0,715230 0,3576151.270 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 12,53 12,530000 11,920500 5,9602501.271 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 10,00 10,000000 10,000000 5,0000001.272 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 15,39 15,390000 11,920500 5,9602501.273 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 13,07 13,070000 8,344350 4,1721751.274 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 30,49 30,490000 30,490000 15,2450001.275 S01XA02 RETINOLUM OCULOTECT GEL OFT. 10mg/g NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 TUB X 10 G GEL. OFT. P-6L 1 16,43 16,430000 16,430000 8,215000

NOTĂ:

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (2) se prescrie numai in 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 inițiaza de medicul de specialitate in limita competenței și 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 efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății; - Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sănătății și cu aprobarea comisiilor de la nivelul Caselor Județene de Asigurări de Sănătate; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Casei Nationale de Asigurari de Sanatate;

Pagina 26 din 26

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

1 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,53 0,217666 0,217666 0,2176662 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,76 0,338000 0,338000 0,3380003 C01AA05 DIGOXINUM DIGOXIN 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 3,34 0,133600 0,133600 0,1336004 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 3,34 0,133600 0,133600 0,1336005 C01AA05 DIGOXINUM DIGOXIN 0,5 mg/2 ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. S/P-RF 5 7,97 1,594000 1,594000 1,5940006 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. S/P-RF 5 7,97 1,594000 1,594000 1,5940007 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 4,18 0,167200 0,167200 0,1672008 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 3,02 0,151000 0,151000 0,1510009 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,151000 0,151000

10 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 6,02 0,301000 0,181200 0,18120011 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,04 0,152000 0,152000 0,15200012 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 6,02 0,301000 0,181200 0,18120013 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5,42 0,271000 0,181200 0,18120014 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 6,07 1,214000 1,214000 1,21400015 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 28,51 0,950333 0,950333 0,95033316 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 16,07 0,321400 0,258000 0,25800017 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 19,46 0,324333 0,258000 0,25800018 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 16,72 0,557333 0,557333 0,55733319 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 16,24 0,541333 0,541333 0,54133320 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,30 0,215000 0,215000 0,21500021 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 17,83 0,356600 0,258000 0,25800022 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 4,30 0,215000 0,215000 0,21500023 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 13,74 0,687000 0,649599 0,64959924 C07AB02 METOPROLOLUM BLOXAN COMPR. 100mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L 30 14,05 0,468333 0,280399 0,28039925 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,94 0,364666 0,280399 0,28039926 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 6,56 0,328000 0,280399 0,28039927 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,12 0,237333 0,237333 0,23733328 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 100 mg COMPR. 100mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5,86 0,293000 0,280399 0,28039929 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9,49 0,316333 0,280399 0,28039930 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 15,12 0,504000 0,280399 0,28039931 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 7,38 0,369000 0,280399 0,28039932 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,01 0,233666 0,233666 0,23366633 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8,09 0,404500 0,280399 0,28039934 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 8,78 0,292666 0,280399 0,28039935 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 1,90 0,095000 0,095000 0,09500036 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 1,90 0,095000 0,095000 0,09500037 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2,85 0,095000 0,095000 0,09500038 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 2,85 0,095000 0,095000 0,095000

ANEXA 3

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

DCI-urilor UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI PENTRU CARE DECONTAREA SE FACE PE BAZA PROTOCOALELOR TERAPEUTICE CU MONITORIZAREA PRESCRIERII ŞI CONSUMULUI PRIN COMISIILE PARITARE; MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE

DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOAREVALABILĂ ÎNCEPÂND CU 01 IANUARIE 2015

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

Pagina 1 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

39 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 50 mg COMPR. 50mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,51 0,175500 0,175500 0,17550040 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,27 0,175666 0,175599 0,17559941 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 3,51 0,175500 0,175500 0,17550042 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,75 0,158333 0,158333 0,15833343 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,27 0,175666 0,175599 0,17559944 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,06 0,235333 0,175599 0,17559945 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 3,45 0,172500 0,172500 0,17250046 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 5,27 0,175666 0,175599 0,17559947 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,51 0,175500 0,175500 0,17550048 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 4,39 0,146333 0,146333 0,14633349 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 11,12 0,556000 0,280399 0,28039950 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 9,09 0,303000 0,280399 0,28039951 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 5,24 0,174666 0,174666 0,17466652 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 25,70 0,856666 0,280399 0,28039953 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 15,69 0,523000 0,175599 0,17559954 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 22,71 0,757000 0,757000 0,75700055 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 8,14 0,271333 0,271333 0,27133356 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 13,59 0,453000 0,453000 0,45300057 C07AB02 METOPROLOLUM BETALOC SOL. INJ. 5mg/5ml ASTRAZENECA AB SUEDIA CUTIE X 5 FIOLE X 5 ML SOL.INJ. I.V./PERF. S 5 22,16 4,432000 4,432000 4,43200058 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 10,51 0,350333 0,350333 0,35033359 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 32,72 1,090666 0,402000 0,40200060 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 32,72 1,090666 0,402000 0,40200061 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 10,05 0,335000 0,335000 0,33500062 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 8,07 0,269000 0,241599 0,24159963 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 14,76 0,492000 0,241599 0,24159964 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 14,76 0,492000 0,241599 0,24159965 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 6,04 0,201333 0,201333 0,20133366 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 22,31 0,743666 0,241599 0,24159967 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 22,31 0,743666 0,241599 0,24159968 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 6,04 0,201333 0,201333 0,20133369 C07AB12 NEBIVOLOLUM** NEBILET (R) COMPR. 5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 34,55 1,233928 0,593142 0,59314270 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 23,20 0,773333 0,593142 0,59314271 C07AB12 NEBIVOLOLUM** X-PRESSOL 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 27,09 0,903000 0,593142 0,59314272 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 24,87 0,829000 0,593142 0,59314273 C07AB12 NEBIVOLOLUM** NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P-6L 28 22,80 0,814285 0,593142 0,59314274 C07AB12 NEBIVOLOLUM** NEBIVOLOL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 24,44 0,814666 0,593142 0,59314275 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 24,87 0,829000 0,593142 0,59314276 C07AB12 NEBIVOLOLUM** NEBIVOLOL SANDOZ 5 mg COMPR. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L 28 13,84 0,494285 0,494285 0,49428577 C07AB12 NEBIVOLOLUM** NEBIVOLOL TERAPIA 5mg COMPR. 5mg TERAPIA S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L 28 22,65 0,808928 0,593142 0,59314278 C07AB12 NEBIVOLOLUM** NEBIVOLOL TORRENT 5 mg COMPR. 5mg TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L 30 24,59 0,819666 0,593142 0,59314279 C07AB12 NEBIVOLOLUM** NEBICARD 5 mg COMPR. 5mg BIOFARM SP. ZO.O POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P6L 28 22,93 0,818928 0,593142 0,59314280 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8,20 0,273333 0,273333 0,27333381 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 8,20 0,273333 0,273333 0,27333382 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 29,94 1,069285 0,297000 0,29700083 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 12,48 0,445714 0,297000 0,29700084 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 13,30 0,443333 0,297000 0,29700085 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 13,36 0,445333 0,297000 0,29700086 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 6,72 0,336000 0,297000 0,29700087 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 13,10 0,436666 0,297000 0,29700088 C07AG02 CARVEDILOLUM MIOCARVIL 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 13,36 0,445333 0,297000 0,297000

Pagina 2 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

89 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,2 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8,72 0,436000 0,297000 0,29700090 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 33,45 1,194642 0,330000 0,33000091 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 22,05 0,787500 0,330000 0,33000092 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 23,62 0,787333 0,330000 0,33000093 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 9,18 0,306000 0,306000 0,30600094 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 23,62 0,787333 0,330000 0,33000095 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 23,00 0,766666 0,330000 0,33000096 C07AG02 CARVEDILOLUM MIOCARVIL 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 23,62 0,787333 0,330000 0,33000097 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 15,72 0,786000 0,330000 0,33000098 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 9,18 0,306000 0,306000 0,30600099 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 16,46 0,587857 0,207856 0,207856100 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 6,44 0,230000 0,207856 0,207856101 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 6,89 0,229666 0,207856 0,207856102 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 6,25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 5,33 0,177666 0,177666 0,177666103 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 6,89 0,229666 0,207856 0,207856104 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 4,56 0,228000 0,207856 0,207856105 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 6,70 0,223333 0,207856 0,207856106 C07AG02 CARVEDILOLUM MIOCARVIL 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 6,89 0,229666 0,207856 0,207856107 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 5,33 0,177666 0,177666 0,177666108 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 6,93 0,247500 0,247500 0,247500109 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 7,70 0,275000 0,275000 0,275000110 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 4,85 0,173214 0,173214 0,173214111 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,41 0,113666 0,113666 0,113666112 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,10 0,136666 0,136666 0,136666113 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,136800 0,136800114 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 2,28 0,114000 0,114000 0,114000115 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,42 0,114000 0,114000 0,114000116 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,42 0,114000 0,114000 0,114000117 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,64 0,154666 0,136800 0,136800118 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,28 0,114000 0,114000 0,114000119 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 2,67 0,133500 0,133500 0,133500120 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6,67 0,222333 0,157200 0,157200121 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,87 0,193500 0,157200 0,157200122 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 2,67 0,133500 0,133500 0,133500123 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,50 0,150000 0,150000 0,150000124 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,93 0,131000 0,131000 0,131000125 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4,39 0,219500 0,219500 0,219500126 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,96 0,198000 0,198000 0,198000127 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 4,39 0,219500 0,219500 0,219500128 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 4,39 0,219500 0,219500 0,219500129 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 4,39 0,219500 0,219500 0,219500130 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 10,52 0,375714 0,237600 0,237600131 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 7,30 0,365000 0,237600 0,237600132 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6,87 0,229000 0,229000 0,229000133 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,25 0,225000 0,225000 0,225000134 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 22,02 0,220200 0,220200 0,220200135 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 4,10 0,205000 0,205000 0,205000136 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 4,39 0,219500 0,219500 0,219500137 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 7,94 0,397000 0,394320 0,394320138 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 20 mg COMPR. 20mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 10,18 0,509000 0,394320 0,394320

Pagina 3 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

139 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 8,75 0,437500 0,394320 0,394320140 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 7,94 0,397000 0,394320 0,394320141 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 17,12 0,611428 0,394320 0,394320142 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 11,11 0,555500 0,394320 0,394320143 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 11,12 0,370666 0,370666 0,370666144 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 16,43 0,328600 0,328600 0,328600145 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 7,92 0,396000 0,394320 0,394320146 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 7,94 0,397000 0,394320 0,394320147 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,67 0,183500 0,183500 0,183500148 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,67 0,183500 0,183500 0,183500149 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 3,67 0,183500 0,183500 0,183500150 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 7,87 0,281071 0,220200 0,220200151 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 3,84 0,192000 0,192000 0,192000152 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 3,93 0,196500 0,196500 0,196500153 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 5,58 0,186000 0,186000 0,186000154 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 5 mg COMPR. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 3,67 0,183500 0,183500 0,183500155 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 3,67 0,183500 0,183500 0,183500156 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 15,45 3,090000 3,090000 3,090000157 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 14,98 0,499333 0,344400 0,344400158 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10,74 0,537000 0,344400 0,344400159 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,31 0,343666 0,343666 0,343666160 C09AA03 LISINOPRILUM LISIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8,61 0,287000 0,287000 0,287000161 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14,44 0,481333 0,344400 0,344400162 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 12,87 0,429000 0,344400 0,344400163 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 11,96 0,398666 0,344400 0,344400164 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 15,47 0,552500 0,344400 0,344400165 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 8,75 0,312500 0,312500 0,312500166 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 23,11 0,770333 0,517200 0,517200167 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 15,65 0,782500 0,517200 0,517200168 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 15,05 0,501666 0,501666 0,501666169 C09AA03 LISINOPRILUM LISIGAMMA 20 mg COMPR. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 12,93 0,431000 0,431000 0,431000170 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 23,37 0,779000 0,517200 0,517200171 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 23,48 0,782666 0,517200 0,517200172 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 22,90 0,817857 0,517200 0,517200173 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 14,44 0,722000 0,517200 0,517200174 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 39,31 1,310333 1,310333 1,310333175 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7,64 0,254666 0,254666 0,254666176 C09AA03 LISINOPRILUM LISIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 6,50 0,216666 0,216666 0,216666177 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8,67 0,289000 0,259999 0,259999178 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 7,37 0,245666 0,245666 0,245666179 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 9,28 0,331428 0,259999 0,259999180 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 9,23 0,329642 0,329642 0,329642181 C09AA05 RAMIPRILUM PIRAMIL 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 23,28 0,831428 0,389599 0,389599182 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 9,74 0,324666 0,324666 0,324666183 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 24,93 0,831000 0,389599 0,389599184 C09AA05 RAMIPRILUM HARTIL 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 9,21 0,328928 0,328928 0,328928185 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 9,23 0,329642 0,329642 0,329642186 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 14,19 0,506785 0,389599 0,389599187 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 9,49 0,338928 0,338928 0,338928188 C09AA05 RAMIPRILUM AMPRIGEN 10 mg COMPR. 10mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 24,04 0,801333 0,389599 0,389599

Pagina 4 din 45

Page 60: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

189 C09AA05 RAMIPRILUM RAMIPRIL TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,329333190 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,329333191 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,329333192 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 4,65 0,166071 0,166071 0,166071193 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 9,37 0,334642 0,194799 0,194799194 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 4,87 0,162333 0,162333 0,162333195 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 10,02 0,334000 0,194799 0,194799196 C09AA05 RAMIPRILUM HARTIL 2,5 mg COMPR. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 4,62 0,165000 0,165000 0,165000197 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 4,65 0,166071 0,166071 0,166071198 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 7,15 0,255357 0,194799 0,194799199 C09AA05 RAMIPRILUM AMPRIGEN 2,5 mg COMPR. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 9,92 0,330666 0,194799 0,194799200 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 4,98 0,166000 0,166000 0,166000201 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 4,98 0,166000 0,166000 0,166000202 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 6,70 0,239285 0,239285 0,239285203 C09AA05 RAMIPRILUM PIRAMIL 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 10,17 0,363214 0,286713 0,286713204 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 7,18 0,239333 0,239333 0,239333205 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 10,85 0,361666 0,286713 0,286713206 C09AA05 RAMIPRILUM HARTIL 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 6,69 0,238928 0,238928 0,238928207 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 6,70 0,239285 0,239285 0,239285208 C09AA05 RAMIPRILUM TRITACE® 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 10,31 0,368214 0,286713 0,286713209 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 7,10 0,253571 0,253571 0,253571210 C09AA05 RAMIPRILUM AMPRIGEN 5 mg COMPR. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 10,75 0,358333 0,286713 0,286713211 C09AA05 RAMIPRILUM RAMIPRIL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,239333212 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,239333213 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,239333214 C09CA03 VALSARTANUM** VALSARTAN TEVA 160 mg CAPS. 160mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L 28 32,59 1,163928 0,976713 0,976713215 C09CA03 VALSARTANUM** VALSARTAN TEVA 80 mg CAPS. 80mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L 28 20,26 0,723571 0,640713 0,640713216 C09CA03 VALSARTANUM** WENZELL 160 mg COMPR. FILM. 160mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM. P-6L 28 66,00 2,357142 0,976713 0,976713217 C09CA03 VALSARTANUM** WENZELL 160 mg COMPR. FILM. 160mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM. P-6L 30 70,74 2,358000 0,976713 0,976713218 C09CA03 VALSARTANUM** VALSARGAMMA 160 mg COMPR. FILM. 160mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 33,91 1,130333 0,976713 0,976713219 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 28 116,60 4,164285 0,976713 0,976713220 C09CA03 VALSARTANUM** VALSARTAN TORRENT 160 mg COMPR. FILM. 160mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 65,71 2,346785 0,976713 0,976713221 C09CA03 VALSARTANUM** VALSACOR 160 mg COMPR. FILM. 160mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 32,85 1,173214 0,976713 0,976713222 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 66,00 2,357142 0,976713 0,976713223 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 22,79 0,813928 0,813928 0,813928224 C09CA03 VALSARTANUM** VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 32,82 1,172142 0,976713 0,976713225 C09CA03 VALSARTANUM** VAPRESS 160 mg COMPR. FILM. 160mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 32,82 1,172142 0,976713 0,976713226 C09CA03 VALSARTANUM** WAROTA 160 mg COMPR. FILM. 160mg ALKALOID - INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. P6L 30 33,16 1,105333 0,976713 0,976713227 C09CA03 VALSARTANUM** DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L 28 71,91 2,568214 0,478285 0,478285228 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 42,63 1,522500 0,478285 0,478285229 C09CA03 VALSARTANUM** VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 11,16 0,398571 0,398571 0,398571230 C09CA03 VALSARTANUM** VAPRESS 40 mg COMPR. FILM. 40mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 11,16 0,398571 0,398571 0,398571231 C09CA03 VALSARTANUM** WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM. P-6L 28 47,37 1,691785 0,640713 0,640713232 C09CA03 VALSARTANUM** WENZELL 80 mg COMPR. FILM. 80mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM. P-6L 30 50,79 1,693000 0,640713 0,640713233 C09CA03 VALSARTANUM** VALSARGAMMA 80 mg COMPR. FILM. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 23,25 0,775000 0,640713 0,640713234 C09CA03 VALSARTANUM** DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L 28 91,88 3,281428 0,640713 0,640713235 C09CA03 VALSARTANUM** VALSARTAN TORRENT 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 47,00 1,678571 0,640713 0,640713236 C09CA03 VALSARTANUM** VALSACOR 80 mg COMPR. FILM. 80mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 28,84 1,030000 0,640713 0,640713237 C09CA03 VALSARTANUM** AVASSAN 80 mg COMPR. FILM. 80mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 47,40 1,692857 0,640713 0,640713238 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 14,95 0,533928 0,533928 0,533928

Pagina 5 din 45

Page 61: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

239 C09CA03 VALSARTANUM** WAROTA 80 mg COMPR. FILM. 80mg ALKALOID - INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. P6L 30 32,48 1,082666 0,640713 0,640713240 C09CA03 VALSARTANUM** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 18,18 0,649285 0,640713 0,640713241 C09CA03 VALSARTANUM** VAPRESS 80 mg COMPR. FILM. 80mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L 28 18,18 0,649285 0,640713 0,640713242 C09CA03 VALSARTANUM** DIOVAN 3 mg/ml SOL. ORALA 3mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 160 ML SOL. ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PT. FLAC.+1 P-6L 1 41,42 41,420000 41,420000 41,420000243 C09CA06 CANDESARTANUM CILEXETIL** ATACAND COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 66,74 2,383571 1,155000 1,155000244 C09CA06 CANDESARTANUM CILEXETIL** TANDESAR 16 mg COMPR. 16mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L 28 44,87 1,602500 1,155000 1,155000245 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN CILEXETIL ZENTIVA 16 mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,995000246 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 26,95 0,962500 0,962500 0,962500247 C09CA06 CANDESARTANUM CILEXETIL** HIPOSTYN 16 mg COMPR. 16mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 42,50 1,416666 1,155000 1,155000248 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 43,24 1,441333 1,155000 1,155000249 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN TORRENT 16 mg COMPR. 16mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 48,03 1,601000 1,155000 1,155000250 C09CA06 CANDESARTANUM CILEXETIL** CLASTINOL 16 mg COMPR. 16mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 44,85 1,601785 1,155000 1,155000251 C09CA06 CANDESARTANUM CILEXETIL** CANDEPOL 16 mg COMPR. 16mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. AL/PVC-PVDC X 28 COMPR. P6L 28 44,88 1,602857 1,155000 1,155000252 C09CA06 CANDESARTANUM CILEXETIL** CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,995000253 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN CILEXETIL TEVA 16 mg COMPR. 16mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/PVC-PVAC-AL-OPA X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,995000254 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 41,42 1,479285 1,155000 1,155000255 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 29,28 0,976000 0,976000 0,976000256 C09CA06 CANDESARTANUM CILEXETIL** CADEXYL 16 mg COMPR. 16mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 29,85 1,066071 1,066071 1,066071257 C09CA06 CANDESARTANUM CILEXETIL** ATACAND 32 mg COMPR. 32mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. P-6L 28 117,40 4,192857 1,465999 1,465999258 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN CILEXETIL ZENTIVA 32 mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 36,65 1,221666 1,221666 1,221666259 C09CA06 CANDESARTANUM CILEXETIL** HIPOSTYN 32 mg COMPR. 32mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 71,36 2,378666 1,465999 1,465999260 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 81,75 2,725000 1,465999 1,465999261 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN TORRENT 32 mg COMPR. 32mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 81,75 2,725000 1,465999 1,465999262 C09CA06 CANDESARTANUM CILEXETIL** CLASTINOL 32 mg COMPR. 32mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 69,33 2,476071 1,465999 1,465999263 C09CA06 CANDESARTANUM CILEXETIL** CANDEPOL 32 mg COMPR. 32mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. AL/PVC-PVDC X 28 COMPR. P6L 28 76,32 2,725714 1,465999 1,465999264 C09CA06 CANDESARTANUM CILEXETIL** CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 36,65 1,221666 1,221666 1,221666265 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN CILEXETIL TEVA 32 mg COMPR. 32mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/PVC-PVAC-AL-OPA X 30 COMPR. P6L 30 36,65 1,221666 1,221666 1,221666266 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN LABORMED 32 mg COMPR. 32mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L 28 56,66 2,023571 1,465999 1,465999267 C09CA06 CANDESARTANUM CILEXETIL** CADEXYL 32 mg COMPR. 32mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 36,65 1,308928 1,308928 1,308928268 C09CA06 CANDESARTANUM CILEXETIL** ATACAND COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 56,10 2,003571 0,648799 0,648799269 C09CA06 CANDESARTANUM CILEXETIL** TANDESAR 8 mg COMPR. 8mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L 28 36,46 1,302142 0,648799 0,648799270 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN CILEXETIL ZENTIVA 8 mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 16,22 0,540666 0,540666 0,540666271 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L 28 16,81 0,600357 0,600357 0,600357272 C09CA06 CANDESARTANUM CILEXETIL** HIPOSTYN 8 mg COMPR. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 24,13 0,804333 0,648799 0,648799273 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 33,01 1,100333 0,648799 0,648799274 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN TORRENT 8 mg COMPR. 8mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 39,07 1,302333 0,648799 0,648799275 C09CA06 CANDESARTANUM CILEXETIL** CLASTINOL 8 mg COMPR. 8mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 36,46 1,302142 0,648799 0,648799276 C09CA06 CANDESARTANUM CILEXETIL** CANDEPOL 8 mg COMPR. 8mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. AL/PVC-PVDC X 28 COMPR. P6L 28 36,46 1,302142 0,648799 0,648799277 C09CA06 CANDESARTANUM CILEXETIL** CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 16,22 0,540666 0,540666 0,540666278 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN CILEXETIL TEVA 8 mg COMPR. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/PVC-PVAC-AL-OPA X 30 COMPR. P6L 30 23,07 0,769000 0,648799 0,648799279 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 33,65 1,201785 0,648799 0,648799280 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 21,57 0,719000 0,648799 0,648799281 C09CA06 CANDESARTANUM CILEXETIL** CADEXYL 8 mg COMPR. 8mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 16,22 0,579285 0,579285 0,579285

1 B01AA07 ACENOCUMAROLUM* TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,53 0,217666 0,217666 0,2176662 B01AA07 ACENOCUMAROLUM* SINTROM 4 mg COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,76 0,338000 0,338000 0,338000

2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

Pagina 6 din 45

Page 62: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

Tratamentul se initiază de către medicul în specialitatea cardiologie si chirurgie cardiaca si a vaselor mari

1 B01AC04 CLOPIDOGRELUM*** PLAVIX 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA) P-RF 30 359,66 11,988666 11,988666 11,9886662 B01AC04 CLOPIDOGRELUM*** CLOPIDOGREL TEVA 75 mg COMPR. FILM. 75 mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. AL/AL X 28 X 1 COMPR. FILM. P-RF 28 37,53 1,340357 0,665066 0,6650663 B01AC04 CLOPIDOGRELUM*** ZYLLT COMPR. FILM. 75 mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA/AL/PVC-AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 0,665066 0,6650664 B01AC04 CLOPIDOGRELUM*** PLAVIX 75mg COMPR. FILM. 75mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-RF 28 57,74 2,062142 0,665066 0,6650665 B01AC04 CLOPIDOGRELUM*** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 COMPR. FILM. P-RF 30 17,86 0,595333 0,595333 0,5953336 B01AC04 CLOPIDOGRELUM*** EGITROMB 75 mg COMPR. FILM. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 0,665066 0,6650667 B01AC04 CLOPIDOGRELUM*** TROMBEX 75 mg COMPR. FILM. 75mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 90 COMPR. FILM. P-RF 90 52,86 0,587333 0,587333 0,5873338 B01AC04 CLOPIDOGRELUM*** CLOPIDOGREL MYLAN 75mg COMPR. FILM. 75mg MYLAN S.A.S. FRANTA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM. P-RF 28 79,52 2,840000 0,665066 0,6650669 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 79,52 2,840000 0,665066 0,665066

10 B01AC04 CLOPIDOGRELUM*** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 0,665066 0,66506611 B01AC04 CLOPIDOGRELUM*** CLOPIGAMMA 75 mg COMPR. FILM. 75mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 0,665066 0,66506612 B01AC04 CLOPIDOGRELUM*** PLAVOCORIN 75 mg COMPR. FILM. 75mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 0,665066 0,66506613 B01AC04 CLOPIDOGRELUM*** CLOPIDOGREL ACTAVIS 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 0,665066 0,66506614 B01AC04 CLOPIDOGRELUM*** DEFROZYP 75 mg COMPR. FILM. 75mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,53 1,340357 0,665066 0,66506615 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 40,26 1,342000 0,665066 0,66506616 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 40,22 1,340666 0,665066 0,66506617 B01AC04 CLOPIDOGRELUM*** MOYTOR 75 mg COMPR. FILM. 75mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PCTFE-PE-PVC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 0,665066 0,66506618 B01AC04 CLOPIDOGRELUM*** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. P-RF 10 13,82 1,382000 0,665066 0,66506619 B01AC04 CLOPIDOGRELUM*** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 60 COMPR. FILM. P-RF 60 76,22 1,270333 0,665066 0,66506620 B01AC04 CLOPIDOGRELUM*** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-RF 90 114,32 1,270222 0,665066 0,66506621 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 51,97 1,732333 0,665066 0,66506622 B01AC04 CLOPIDOGRELUM*** PLATEL 75 mg COMPR. FILM. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 37,46 1,337857 0,665066 0,66506623 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 40,20 1,340000 0,665066 0,66506624 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 17,18 0,572666 0,572666 0,57266625 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 49,88 0,554222 0,554222 0,55422226 B01AC04 CLOPIDOGRELUM*** CLOPIDOGREL POLIPHARMA 75 mg COMPR. FILM. 75mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P6L 30 40,22 1,340666 0,665066 0,66506627 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 16,02 0,572142 0,572142 0,572142

Tratamentul se iniţiază de către medicul în specialitatea cardiologie.

1 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 609,00 4,350000 4,350000 4,3500002 J05AB04 RIBAVIRINUM**** COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 665,28 3,960000 3,960000 3,9600003 J05AF05 LAMIVUDINUM**** LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 194,11 6,470333 6,470333 6,4703334 J05AF05 LAMIVUDINUM**** ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 278,73 9,954642 7,764399 7,7643995 J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE**** VIREAD 245mg COMPR. FILM. 245mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM P-RF/R 30 1.233,89 41,129666 41,129666 41,1296666 J05AF08 ADEFOVIRUM DIPIVOXILUM**** HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 1.928,98 64,299333 64,299333 64,2993337 J05AF10 ENTECAVIRUM**** 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 1.748,63 58,287666 58,287666 58,2876668 J05AF10 ENTECAVIRUM**** 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 1.938,42 64,614000 64,614000 64,6140009 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 326,02 326,020000 237,468000 237,468000

10 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 514,01 514,010000 382,224000 382,22400011 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 197,89 197,890000 197,890000 197,89000012 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 318,52 318,520000 318,520000 318,520000

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 7 din 45

Page 63: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

13 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 12 MU/0,2ml SOL. INJ./PERF. 120µg/0,2ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,2ML SOL. INJ. SAU PERF. P-RF 5 494,26 98,852000 98,852000 98,85200014 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0,5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. S/P-RF/R 1 261,45 261,450000 237,468000 237,46800015 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 1.129,37 225,874000 225,874000 225,87400016 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0,8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF. S/P-RF/R 1 426,08 426,080000 382,224000 382,22400017 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 1.843,52 368,704000 368,704000 368,70400018 L03AB04 INTERFERONUM ALFA 2A**** ROFERON A SOL. INJ. 3Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR 1 87,43 87,430000 87,430000 87,43000019 L03AB04 INTERFERONUM ALFA 2A**** 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 1 171,94 171,940000 171,940000 171,94000020 L03AB05 INTERFERONUM ALFA 2B**** 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 1 434,34 434,340000 434,340000 434,34000021 L03AB05 INTERFERONUM ALFA 2B**** 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 1 715,89 715,890000 715,890000 715,89000022 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 652,37 652,370000 652,370000 652,37000023 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 652,37 652,370000 652,370000 652,37000024 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 768,67 768,670000 768,670000 768,67000025 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 768,67 768,670000 768,670000 768,67000026 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 943,12 943,120000 943,120000 943,12000027 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 943,12 943,120000 943,120000 943,12000028 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 358,21 358,210000 358,210000 358,21000029 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 358,21 358,210000 358,210000 358,21000030 L03AB11 PEGINTERFERON ALFA-2A**** 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 1 975,16 975,160000 975,160000 975,16000031 N04BB01 AMANTADINUM** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 17,07 0,341400 0,341400 0,341400

1 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 32,62 0,652400 0,652400 0,6524002 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 29,65 1,482500 1,482500 1,4825003 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,81 8,810000 8,810000 8,8100004 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 31,02 31,020000 31,020000 31,0200005 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 20,48 20,480000 20,480000 20,4800006 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 95,62 31,873333 31,873333 31,8733337 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 35,71 11,903333 11,903333 11,9033338 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,702100 0,7021009 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 78,89 0,788900 0,788900 0,788900

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

1 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 124,28 1,242800 1,109400 1,1094002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 71,49 1,429800 1,109400 1,1094003 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 68,77 1,375400 1,109400 1,1094004 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 55,47 0,924500 0,924500 0,9245005 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 150 mg COMPR. 150mg ZAMBON S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-6L 60 54,19 0,903166 0,903166 0,9031666 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 300 mg COMPR. 300mg ZAMBON S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 35,88 1,794000 1,794000 1,7940007 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 50 136,52 2,730400 2,730400 2,7304008 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 100 268,17 2,681700 2,681700 2,6817009 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 97,49 97,490000 97,490000 97,490000

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 / boli infectioase si nefrologie (doar pentru pacientii cu afectare renala consecutiva infectiei cu virusuri hepatitice)

Pagina 8 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

7. CIROZA HEPATICA - G7

1 A06AD11 LACTULOSUM* DUPHALAC (R) LICHID ORAL 66,7% ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 10,37 10,370000 10,370000 10,3700002 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 10,42 10,420000 10,420000 10,4200003 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 3,47 3,470000 3,470000 3,4700004 A06AD11 LACTULOSUM* LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 17,23 17,230000 17,230000 17,2300005 A06AD11 LACTULOSUM* LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 33,34 33,340000 33,340000 33,3400006 A06AD11 LACTULOSUM* LACTULAK 660 mg/ml SOL. ORALA 660 mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L 1 6,73 6,730000 6,730000 6,7300007 A06AD11 LACTULOSUM* LAEVOLAC 670mg/ml SOL. ORALA 670mg/ml FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA + DISPOZITIV DE CURGERE + MASURA CU GRADATII DE LA 5 ML LA 30 ML P-RF 1 3,57 3,570000 3,570000 3,5700008 A07AA11 RIFAXIMINUM* NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM. P-RF 12 33,10 2,758333 2,758333 2,7583339 A07AA11 RIFAXIMINUM* NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF 36 91,26 2,535000 2,535000 2,535000

10 A07AA11 RIFAXIMINUM* NORMIX 100mg/5ml GRAN. PT. SUSP. ORALA 100mg/5ml ALFA WASSERMANN SPA ITALIA CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML P-RF 1 19,11 19,110000 19,110000 19,11000011 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 3,02 0,151000 0,151000 0,15100012 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,151000 0,15100013 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 6,02 0,301000 0,181200 0,18120014 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,04 0,152000 0,152000 0,15200015 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 6,02 0,301000 0,181200 0,18120016 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5,42 0,271000 0,181200 0,18120017 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 6,07 1,214000 1,214000 1,21400018 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 28,51 0,950333 0,950333 0,95033319 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 16,07 0,321400 0,258000 0,25800020 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 19,46 0,324333 0,258000 0,25800021 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 16,72 0,557333 0,557333 0,55733322 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 16,24 0,541333 0,541333 0,54133323 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,30 0,215000 0,215000 0,21500024 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 17,83 0,356600 0,258000 0,25800025 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 4,30 0,215000 0,215000 0,21500026 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 13,74 0,687000 0,649599 0,64959927 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 95,62 31,873333 31,873333 31,87333328 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 35,71 11,903333 11,903333 11,90333329 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 609,00 4,350000 4,350000 4,35000030 J05AB04 RIBAVIRINUM**** COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 665,28 3,960000 3,960000 3,96000031 J05AF05 LAMIVUDINUM**** LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 194,11 6,470333 6,470333 6,47033332 J05AF05 LAMIVUDINUM**** ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R 28 278,73 9,954642 7,764399 7,76439933 J05AF08 ADEFOVIRUM DIPIVOXILUM**** HEPSERA COMPR. 10mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R 30 1.928,98 64,299333 64,299333 64,29933334 J05AF10 ENTECAVIRUM**** 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 1.748,63 58,287666 58,287666 58,28766635 J05AF10 ENTECAVIRUM**** 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 1.938,42 64,614000 64,614000 64,61400036 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 326,02 326,020000 237,468000 237,46800037 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML S/P-RF 1 514,01 514,010000 382,224000 382,22400038 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 197,89 197,890000 197,890000 197,89000039 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5ml SOL. INJ. /PERF. IN SERINGA PREUMPLUTA 96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL P-RF/R 1 318,52 318,520000 318,520000 318,52000040 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 12 MU/0,2ml SOL. INJ./PERF. 120µg/0,2ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,2ML SOL. INJ. SAU PERF. P-RF 5 494,26 98,852000 98,852000 98,85200041 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0,5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. S/P-RF/R 1 261,45 261,450000 237,468000 237,46800042 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 1.129,37 225,874000 225,874000 225,87400043 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0,8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF. S/P-RF/R 1 426,08 426,080000 382,224000 382,22400044 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 1.843,52 368,704000 368,704000 368,704000

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

Pagina 9 din 45

Page 65: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

45 L03AB04 INTERFERONUM ALFA 2A**** ROFERON A SOL. INJ. 3Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR 1 87,43 87,430000 87,430000 87,43000046 L03AB04 INTERFERONUM ALFA 2A**** 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 1 171,94 171,940000 171,940000 171,94000047 L03AB05 INTERFERONUM ALFA 2B**** 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 1 434,34 434,340000 434,340000 434,34000048 L03AB05 INTERFERONUM ALFA 2B**** 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 1 715,89 715,890000 715,890000 715,89000049 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 652,37 652,370000 652,370000 652,37000050 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 652,37 652,370000 652,370000 652,37000051 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 768,67 768,670000 768,670000 768,67000052 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 768,67 768,670000 768,670000 768,67000053 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 943,12 943,120000 943,120000 943,12000054 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 943,12 943,120000 943,120000 943,12000055 L03AB10 PEGINTERFERON ALFA-2B**** 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 1 358,21 358,210000 358,210000 358,21000056 L03AB10 PEGINTERFERON ALFA-2B**** 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. PR 1 358,21 358,210000 358,210000 358,21000057 L03AB11 PEGINTERFERON ALFA-2A**** 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 1 975,16 975,160000 975,160000 975,16000058 N04BB01 AMANTADINUM** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 17,07 0,341400 0,341400 0,341400

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

1 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 19,04 1,904000 1,904000 1,9040002 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 33,31 3,331000 3,331000 3,3310003 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 43,75 8,750000 8,750000 8,7500004 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 23,79 4,758000 4,758000 4,7580005 A04AA01 ONDANSETRONUM** EMESET 8 mg/4 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 4ML SOL. INJ. / PERF. S/P-RF 5 43,73 8,746000 8,746000 8,7460006 A04AA01 ONDANSETRONUM** EMESET 4 mg/2 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 2ML SOL. INJ/ PERF. S/P-RF 5 23,79 4,758000 4,758000 4,7580007 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 10 148,63 14,863000 14,863000 14,8630008 A04AA02 GRANISETRONUM** GRANEGIS 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF 10 148,63 14,863000 14,863000 14,8630009 A04AA02 GRANISETRONUM** GRANORED 1 mg COMPR. FILM. 1mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 178,35 17,835000 17,835000 17,835000

10 A04AA02 GRANISETRONUM** SETROGEN 1 mg COMPR. FILM. 1mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. PRF 10 171,89 17,189000 17,189000 17,18900011 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 10 236,15 23,615000 23,615000 23,61500012 A04AA02 GRANISETRONUM** GRANORED 2 mg COMPR. FILM. 2mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 271,77 27,177000 27,177000 27,17700013 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 71,52 14,304000 14,304000 14,30400014 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 5 199,86 39,972000 39,972000 39,97200015 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 5 199,30 39,860000 39,860000 39,86000016 A04AA05 PALONOSETRONUM** ALOXI 500mcg CAPS. MOI 500mcg HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA CUTIE X BLISTER DIN POLIAMIDA/AL/PVC X 1 CAPSULA MOALE PRF 1 403,43 403,430000 403,430000 403,43000017 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 1 381,18 381,180000 381,180000 381,18000018 B03XA01 EPOETINUM ALFA*** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1.728,54 288,090000 288,090000 288,09000019 B03XA01 EPOETINUM ALFA*** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 218,42 36,403333 36,403333 36,40333320 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. S/P-RF/R 6 425,83 70,971666 70,971666 70,97166621 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 1 788,23 788,230000 788,230000 788,23000022 B03XA01 EPOETINUM ALFA*** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 603,73 100,621666 100,621666 100,62166623 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 1.353,47 1.353,470000 1.193,316000 1.193,31600024 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 1 994,43 994,430000 994,430000 994,43000025 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. S/P-RF/R 6 781,57 130,261666 130,261666 130,26166626 B03XA01 EPOETINUM ALFA*** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 959,37 159,895000 159,895000 159,89500027 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 2.346,60 391,100000 391,100000 391,10000028 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 6 526,27 87,711666 87,711666 87,71166629 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 1.174,53 1.174,530000 1.174,530000 1.174,53000030 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 6 981,05 163,508333 163,508333 163,508333

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

Pagina 10 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

31 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 1.208,30 201,383333 201,383333 201,38333332 B03XA01 EPOETINUM ZETA** RETACRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1.141,34 190,223333 190,223333 190,22333333 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 1 219,83 219,830000 219,830000 219,83000034 B03XA01 EPOETINUM ZETA** RETACRIT 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 62,98 10,496666 10,496666 10,49666635 B03XA01 EPOETINUM ZETA** RETACRIT 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,3ML SOL. INJ. PR 1 10,85 10,850000 10,850000 10,85000036 B03XA01 EPOETINUM ZETA** RETACRIT 20000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20000UI/0,5ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL. INJ. S/P-RF/R 1 442,32 442,320000 442,320000 442,32000037 B03XA01 EPOETINUM ZETA** RETACRIT 20000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20000UI/0,5ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 2.299,68 383,280000 383,280000 383,28000038 B03XA01 EPOETINUM ZETA** RETACRIT 2000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,6ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 274,59 45,765000 45,765000 45,76500039 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 50,82 50,820000 50,820000 50,82000040 B03XA01 EPOETINUM ZETA** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. S/P-RF/R 1 628,06 628,060000 628,060000 628,06000041 B03XA01 EPOETINUM ZETA** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,75ML SOL. INJ. S/P-RF/R 6 3.414,10 569,016666 569,016666 569,01666642 B03XA01 EPOETINUM ZETA** RETACRIT 3000UI/0,9ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,9ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,9ML SOL. INJ. S/P-RF/R 6 405,17 67,528333 67,528333 67,52833343 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 72,39 72,390000 72,390000 72,39000044 B03XA01 EPOETINUM ZETA** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. S/P-RF/R 1 813,79 813,790000 813,790000 813,79000045 B03XA01 EPOETINUM ZETA** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 4.528,51 754,751666 754,751666 754,75166646 B03XA01 EPOETINUM ZETA** RETACRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 516,62 86,103333 86,103333 86,10333347 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 96,52 96,520000 96,520000 96,52000048 B03XA01 EPOETINUM ZETA** RETACRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 628,06 104,676666 104,676666 104,67666649 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 1 120,65 120,650000 120,650000 120,65000050 B03XA01 EPOETINUM ZETA** RETACRIT 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 739,50 123,250000 123,250000 123,25000051 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 1 137,30 137,300000 137,300000 137,30000052 B03XA01 EPOETINUM ZETA** RETACRIT 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 962,38 160,396666 160,396666 160,39666653 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 1 188,92 188,920000 188,920000 188,92000054 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 3.173,01 793,252500 793,252500 793,25250055 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 4 391,56 97,890000 97,890000 97,89000056 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 4.708,35 1.177,087500 1.177,087500 1.177,08750057 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 4 702,64 175,660000 175,660000 175,66000058 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 2.208,61 2.208,610000 2.208,610000 2.208,61000059 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 1.009,47 252,367500 252,367500 252,36750060 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 1.318,95 329,737500 329,737500 329,73750061 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 3.633,81 3.633,810000 3.633,810000 3.633,81000062 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 1.626,76 406,690000 406,690000 406,69000063 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 1.937,17 484,292500 484,292500 484,29250064 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 2.555,95 638,987500 638,987500 638,98750065 G03HA01 CYPROTERONUM** ANDROCUR COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF 50 108,46 2,169200 2,169200 2,16920066 H02AB02 DEXAMETHASONUM DEXAMED COMPR. 0,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLISTERE X 10 COMPRIMATE PRF 100 18,38 0,183800 0,183800 0,18380067 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 8,32 0,832000 0,832000 0,83200068 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 20,42 0,816800 0,816800 0,81680069 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 73,64 0,736400 0,736400 0,73640070 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 13,87 1,387000 1,387000 1,38700071 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 33,18 1,327200 1,327200 1,32720072 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 100 124,62 1,246200 1,246200 1,24620073 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 100 123,66 1,236600 1,236600 1,23660074 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 6,98 1,396000 1,396000 1,39600075 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF/S 100 118,60 1,186000 1,186000 1,18600076 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 14,38 1,438000 1,423200 1,42320077 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 76,92 5,128000 4,203999 4,20399978 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 3,50400079 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 3,50400080 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 52,55 3,503333 3,503333 3,503333

Pagina 11 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

81 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 52,56 3,504000 3,504000 3,50400082 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.917,72 139,918571 139,918571 139,91857183 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 1.032,33 36,868928 36,868928 36,86892884 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 537,45 537,450000 537,450000 537,45000085 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 P-RF 1 2.439,99 2.439,990000 2.439,990000 2.439,99000086 J02AC04 POSACONAZOLUM** NOXAFIL 100mg CAPS. GASTROREZ. 100mg MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 3.667,85 152,827083 152,827083 152,82708387 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 2.750,28 2.750,280000 2.750,280000 2.750,28000088 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 1.348,76 1.348,760000 1.348,760000 1.348,76000089 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 1.738,70 1.738,700000 1.738,700000 1.738,70000090 L01XX35 ANAGRELIDUM*** THROMBOREDUCTIN CAPS. 0,5mg ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH AUSTRIA CUTIE X 1 FLAC. DIN PE X 42 CAPS. P-RF 42 875,92 20,855238 19,865760 19,86576091 L01XX35 ANAGRELIDUM*** THROMBOREDUCTIN CAPS. 0,5mg ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH AUSTRIA CUTIE X 1 FLAC. DIN PE X 100 CAPS. P-RF/S 100 1.655,48 16,554800 16,554800 16,55480092 L04AD01 CICLOSPORINUM* EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,15200093 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 137,32 2,746400 1,804080 1,80408094 L04AD01 CICLOSPORINUM* EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,50340095 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 292,16 5,843200 3,541920 3,54192096 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,95160097 N02AA01 MORPHYNUM MST CONTINUS 100 mg COMPR. ELIB. MODIF. 100mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 205,94 3,432333 2,873599 2,87359998 N02AA01 MORPHYNUM MST CONTINUS 10 mg COMPR. ELIB. MODIF. 10mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 37,61 0,626833 0,626833 0,62683399 N02AA01 MORPHYNUM MST CONTINUS 200 mg COMPR. ELIB. MODIF. 200mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 393,65 6,560833 6,560833 6,560833100 N02AA01 MORPHYNUM MST CONTINUS 30 mg COMPR. ELIB. MODIF. 30mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 65,71 1,095166 0,921600 0,921600101 N02AA01 MORPHYNUM MST CONTINUS 60 mg COMPR. ELIB. MODIF. 60mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD. P-TS 60 132,81 2,213500 1,882399 1,882399102 N02AA01 MORPHYNUM SEVREDOL 10 mg COMPR. FILM. 10mg MUNDIPHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. P-TS 60 50,10 0,835000 0,752199 0,752199103 N02AA01 MORPHYNUM SEVREDOL 20 mg COMPR. FILM. 20mg MUNDIPHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM. P-TS 60 71,78 1,196333 1,196333 1,196333104 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 71,84 2,394666 2,394666 2,394666105 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 23,04 0,768000 0,768000 0,768000106 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 47,06 1,568666 1,568666 1,568666107 N02AA01 MORPHYNUM MORFINA 20 mg/ml SOL. INJ. 20mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML P-TS 5 8,29 1,658000 1,658000 1,658000108 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 8,29 1,658000 1,658000 1,658000109 N02AA05 OXYCODONUM OXYCONTIN 10 mg COMPR. CU ELIB. MODIF. 10 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 64,10 1,068333 0,861799 0,861799110 N02AA05 OXYCODONUM OXYCONTIN 20 mg COMPR. CU ELIB. MODIF. 20 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 121,02 2,017000 1,572000 1,572000111 N02AA05 OXYCODONUM OXYCONTIN 40 mg COMPR. CU ELIB. MODIF. 40 mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 172,88 2,881333 2,367799 2,367799112 N02AA05 OXYCODONUM OXYCONTIN 80 mg COMPR. CU ELIB. MODIF. 80mg MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. PS 60 309,83 5,163833 4,026000 4,026000113 N02AA05 OXYCODONUM RELTEBON 10 mg COMPR. CU ELIB. PREL. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 43,09 0,718166 0,718166 0,718166114 N02AA05 OXYCODONUM RELTEBON 20 mg COMPR. CU ELIB. PREL. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 78,60 1,310000 1,310000 1,310000115 N02AA05 OXYCODONUM RELTEBON 40 mg COMPR. CU ELIB. PREL. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 118,39 1,973166 1,973166 1,973166116 N02AA05 OXYCODONUM RELTEBON 80 mg COMPR. CU ELIB. PREL. 80mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL. PR, PS 60 201,30 3,355000 3,355000 3,355000117 N02AA05 OXYCODONUM OXIDOLOR 10 mg COMPR. ELIB. PREL. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P-TS 60 43,09 0,718166 0,718166 0,718166118 N02AA05 OXYCODONUM ALNAGON 10 mg COMPR. ELIB. PREL. 10mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. ELIB. PREL. P-RF 56 48,27 0,861964 0,861799 0,861799119 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 78,65 1,310833 1,310833 1,310833120 N02AA05 OXYCODONUM ALNAGON 20 mg COMPR. ELIB. PREL. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. ELIB. PREL. P-RF 56 88,08 1,572857 1,572000 1,572000121 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 60 118,50 1,975000 1,975000 1,975000122 N02AA05 OXYCODONUM ALNAGON 40 mg COMPR. ELIB. PREL. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. ELIB. PREL. P-RF 56 132,72 2,370000 2,367799 2,367799123 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 47,40 2,370000 2,367799 2,367799124 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 20 139,36 6,968000 6,968000 6,968000125 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 60 201,38 3,356333 3,356333 3,356333126 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 80,55 4,027500 4,026000 4,026000127 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 56 128,54 2,295357 2,295357 2,295357128 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 29,34 0,523928 0,523928 0,523928129 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 56 101,69 1,815892 1,815892 1,815892130 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 9,35 1,870000 1,870000 1,870000

Pagina 12 din 45

Page 68: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

131 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 5 191,24 38,248000 38,248000 38,248000132 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 5 190,93 38,186000 38,186000 38,186000133 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 5 191,24 38,248000 38,248000 38,248000134 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 5 191,24 38,248000 38,248000 38,248000135 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 71,80 14,360000 14,287200 14,287200136 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 69,07 13,814000 13,814000 13,814000137 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 59,53 11,906000 11,906000 11,906000138 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 69,71 13,942000 13,942000 13,942000139 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 5 120,78 24,156000 24,156000 24,156000140 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 5 120,72 24,144000 24,144000 24,144000141 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 5 113,05 22,610000 22,610000 22,610000142 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 5 120,78 24,156000 24,156000 24,156000143 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 5 154,58 30,916000 30,916000 30,916000144 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 5 154,58 30,916000 30,916000 30,916000145 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 5 154,58 30,916000 30,916000 30,916000146 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,61 0,280500 0,280500 0,280500147 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,82 0,291000 0,291000 0,291000148 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,85 0,385000 0,336600 0,336600149 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,67 0,383500 0,336600 0,336600150 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,67 0,383500 0,336600 0,336600151 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 9,00 0,450000 0,336600 0,336600152 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 3,85 0,385000 0,336600 0,336600153 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,61 0,280500 0,280500 0,280500154 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,67 0,383500 0,336600 0,336600155 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,67 0,383500 0,336600 0,336600156 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-RF 10 6,30 0,630000 0,630000 0,630000157 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 18,89 0,629666 0,629666 0,629666158 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 18,91 0,630333 0,630333 0,630333159 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 18,89 0,629666 0,629666 0,629666160 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 27,55 0,918333 0,918333 0,918333161 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 33,41 1,113666 1,101999 1,101999162 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 27,55 0,918333 0,918333 0,918333163 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 34,30 1,143333 1,143333 1,143333164 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF 30 10,65 0,355000 0,336600 0,336600165 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 9,69 0,969000 0,755599 0,755599166 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 22,03 2,203000 1,101999 1,101999167 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 41,57 1,385666 1,101999 1,101999168 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. ELIB. PREL. P-RF 10 28,18 2,818000 1,371999 1,371999169 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 53,20 1,773333 1,371999 1,371999170 N02AX02 TRAMADOLUM TRALGIT 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,336600 0,336600171 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,336600 0,336600172 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,336600 0,336600173 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 9,83 1,966000 1,614720 1,614720174 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 134,56 1,345600 1,345600 1,345600175 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 4,93 0,986000 0,986000 0,986000176 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 13,10 2,620000 1,614720 1,614720177 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 5,58 1,116000 1,116000 1,116000178 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 24,41 0,488200 0,488200 0,488200179 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 15,72 0,314400 0,314400 0,314400180 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,01 0,200333 0,181200 0,181200

Pagina 13 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

181 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 5,13 0,205200 0,181200 0,181200182 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 3,02 0,151000 0,151000 0,151000183 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3,41 0,170500 0,170500 0,170500184 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 3,19 0,159500 0,159500 0,159500185 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 3,65 0,182500 0,181200 0,181200186 V03AC01 DEFEROXAMINUM** 3) DESFERAL LIOF. PT. SOL. INJ./PERF. 500mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF. S/P-RF 10 135,07 13,507000 13,507000 13,507000187 V03AC03 DEFERASIROXUM*** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 787,57 28,127500 28,127500 28,127500188 V03AC03 DEFERASIROXUM*** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 1.631,03 58,251071 58,251071 58,251071189 V03AC03 DEFERASIROXUM*** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 2.937,68 104,917142 104,917142 104,917142

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

1 N03AA02 PHENOBARBITALUM FENOBARBITAL 100 mg COMPR. 100 mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 4,39 0,175600 0,136800 0,1368002 N03AA02 PHENOBARBITALUM FENOBARBITAL ARENA 100mg COMPR. 100mg SC ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 10 COMPR. P-RF 10 1,14 0,114000 0,114000 0,1140003 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 5,41 0,180333 0,136800 0,1368004 N03AA02 PHENOBARBITALUM FENOBARBITAL 200 mg/ 2 ml SOL. INJ. 10% ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 5 10,96 2,192000 2,192000 2,1920005 N03AB02 PHENYTOINUM FENITOINA RICHTER 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 2,77 0,138500 0,138500 0,1385006 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 67,73 13,546000 13,546000 13,5460007 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 6,89 0,137800 0,137800 0,1378008 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 6,56 0,218666 0,218666 0,2186669 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 17,38 0,347600 0,270000 0,270000

10 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,22620011 N03AF01 CARBAMAZEPINUM CARBAVIM COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,22620012 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,22620013 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,96 0,248000 0,248000 0,24800014 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,50 0,225000 0,225000 0,22500015 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,96 0,248000 0,248000 0,24800016 N03AF01 CARBAMAZEPINUM FINLEPSIN COMPR. 200mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,22620017 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 26,26 0,525200 0,525200 0,52520018 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 10,51 0,525500 0,525500 0,52550019 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 15,16 0,303200 0,303200 0,30320020 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 20,62 0,412400 0,412400 0,41240021 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 36,53 0,730600 0,730600 0,73060022 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 20,68 0,413600 0,413600 0,41360023 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 36,59 0,731800 0,731800 0,73180024 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 19,17 0,383400 0,270000 0,27000025 N03AF01 CARBAMAZEPINUM FINLEPSIN 200 RETARD COMPR. FILM. ELIB. PREL. 200mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 12,43 0,248600 0,248600 0,24860026 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 25,35 0,845000 0,606480 0,60648027 N03AF01 CARBAMAZEPINUM FINLEPSIN 400 RETARD COMPR. FILM. ELIB. PREL. 400mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 25,27 0,505400 0,505400 0,50540028 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 22,51 22,510000 22,510000 22,51000029 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 64,73 1,294600 1,294600 1,29460030 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 50 118,30 2,366000 2,366000 2,36600031 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 17,52 0,350400 0,184920 0,18492032 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 300 mg CAPS. ELIB. PREL. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PREL. P-6L 50 26,76 0,535200 0,268680 0,26868033 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 18,29 0,182900 0,182900 0,18290034 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 18,29 0,182900 0,182900 0,18290035 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 23,10 0,231000 0,231000 0,23100036 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 23,10 0,231000 0,231000 0,231000

9. EPILEPSIE - G11

Pagina 14 din 45

Page 70: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

37 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ. P-6L 100 33,65 0,336500 0,336500 0,33650038 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 33,65 0,336500 0,336500 0,33650039 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. FILM. ELIB. PREL. P-RF 30 16,06 0,535333 0,403800 0,40380040 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. FILM. ELIB. PREL. DIVIZ. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. FILM. ELIB. PREL., DIVIZIBILE P-6L 100 34,40 0,344000 0,268680 0,26868041 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 150 COMPR. FILM. GASTROREZ. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. X 100 COMPR.FILM. GASTROREZ. P-6L 100 15,41 0,154100 0,154100 0,15410042 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. FILM. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. FILM. GASTROREZ. P-6L 40 10,72 0,268000 0,268000 0,26800043 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 300 COMPR. FILM. GASTROREZ. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. X 100 COMPR.FILM. GASTROREZ. P-6L 100 22,39 0,223900 0,223900 0,22390044 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 600 COMPR. FILM. GASTROREZ. 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. X 50 COMPR. FILM. GASTRORE P-6L 50 21,57 0,431400 0,431400 0,43140045 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 94,92 1,898400 1,898400 1,89840046 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 500 mg MINICOMPR. ELIB. PREL. 500mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 35,24 0,704800 0,403800 0,40380047 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL SIROP SIROP 300mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML + LINGURITA DOZATOARE PP A 5 ML P-6L 1 19,24 19,240000 19,240000 19,24000048 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 17,77 17,770000 17,770000 17,77000049 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 17,77 17,770000 17,770000 17,77000050 N03AX09 LAMOTRIGINUM** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 28,86 0,962000 0,962000 0,96200051 N03AX09 LAMOTRIGINUM** PLEXXO (R) 100 mg COMPR. 100mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 28,86 0,962000 0,962000 0,96200052 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 100 mg COMPR. 100mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 28,84 0,961333 0,961333 0,96133353 N03AX09 LAMOTRIGINUM** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 40,13 1,433214 1,116642 1,11664254 N03AX09 LAMOTRIGINUM** LAMOTRIGINA SUN 100 mg COMPR. 100mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 14 COMPR. P-6L 56 52,11 0,930535 0,930535 0,93053555 N03AX09 LAMOTRIGINUM** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 60,33 2,011000 2,011000 2,01100056 N03AX09 LAMOTRIGINUM** LAMOTRIGINA SUN 200 mg COMPR. 200mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 14 COMPR. P-6L 56 99,51 1,776964 1,776964 1,77696457 N03AX09 LAMOTRIGINUM** LAMOTRIX 25 mg COMPR. 25mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,26 0,242000 0,242000 0,24200058 N03AX09 LAMOTRIGINUM** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 10,40 0,371428 0,290400 0,29040059 N03AX09 LAMOTRIGINUM** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14,41 0,480333 0,480333 0,48033360 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 50 mg COMPR. 50mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 14,42 0,480666 0,480666 0,48066661 N03AX09 LAMOTRIGINUM** LAMICTAL 50 mg COMPR. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 20,69 0,738928 0,576213 0,57621362 N03AX09 LAMOTRIGINUM** LAMOTRIGINA SUN 50 mg COMPR. 50mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 14 COMPR. P-6L 56 26,89 0,480178 0,480178 0,48017863 N03AX09 LAMOTRIGINUM** LAMOTRIN 100 mg COMPR. DISP. 100mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 28,84 0,961333 0,961333 0,96133364 N03AX09 LAMOTRIGINUM** LAMOTRIN 50 mg COMPR. DISP. 50mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 16,95 0,565000 0,565000 0,56500065 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 0,28 0,009333 0,009333 0,00933366 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 0,76 0,025333 0,025333 0,02533367 N03AX11 TOPIRAMATUM** TOPRAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 165,90 2,765000 1,173999 1,17399968 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 100 mg COMPR. FILM. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 90,25 3,008333 1,173999 1,17399969 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 69,19 1,153166 1,153166 1,15316670 N03AX11 TOPIRAMATUM** LUSITRAX 100mg COMPR. FILM. 100mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF 30 52,46 1,748666 1,173999 1,17399971 N03AX11 TOPIRAMATUM** TORLEPTA 100 mg COMPR. FILM. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 80,21 2,673666 1,173999 1,17399972 N03AX11 TOPIRAMATUM** NEXTOP 100 mg COMPR. FILM. 100mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 87,16 2,905333 1,173999 1,17399973 N03AX11 TOPIRAMATUM** TOPAMAX 100 mg COMPR. FILM. 100mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 40,80 1,457142 1,173999 1,17399974 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 29,35 0,978333 0,978333 0,97833375 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 200 mg COMPR. FILM. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 159,08 5,302666 5,302666 5,30266676 N03AX11 TOPIRAMATUM** NEXTOP 200 mg COMPR. FILM. 200mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 155,05 5,168333 5,168333 5,16833377 N03AX11 TOPIRAMATUM** TOPRAN 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 53,96 0,899333 0,451599 0,45159978 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 25 mg COMPR. FILM. 25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 29,21 0,973666 0,451599 0,45159979 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 25,42 0,423666 0,423666 0,42366680 N03AX11 TOPIRAMATUM** LUSITRAX 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF 30 20,83 0,694333 0,451599 0,45159981 N03AX11 TOPIRAMATUM** TORLEPTA 25 mg COMPR. FILM. 25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 26,67 0,889000 0,451599 0,45159982 N03AX11 TOPIRAMATUM** NEXTOP 25 mg COMPR. FILM. 25mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 27,57 0,919000 0,451599 0,45159983 N03AX11 TOPIRAMATUM** TOPAMAX 25 mg COMPR. FILM. 25mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 16,21 0,578928 0,451599 0,45159984 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 11,29 0,376333 0,376333 0,37633385 N03AX11 TOPIRAMATUM** TOPRAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 97,27 1,621166 0,748399 0,74839986 N03AX11 TOPIRAMATUM** TOPIRAMAT TEVA 50 mg COMPR. FILM. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 53,67 1,789000 0,748399 0,748399

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Page 71: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

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PRET AMANUNTUL MAXIMAL/UT

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87 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 44,73 0,745500 0,745500 0,74550088 N03AX11 TOPIRAMATUM** LUSITRAX 50 mg COMPR. FILM. 50mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF 30 35,46 1,182000 0,748399 0,74839989 N03AX11 TOPIRAMATUM** TORLEPTA 50 mg COMPR. FILM. 50mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 44,81 1,493666 0,748399 0,74839990 N03AX11 TOPIRAMATUM** NEXTOP 50 mg COMPR. FILM. 50mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 50,82 1,694000 0,748399 0,74839991 N03AX11 TOPIRAMATUM** TOPAMAX 50 mg COMPR. FILM. 50mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 27,58 0,985000 0,748399 0,74839992 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 18,71 0,623666 0,623666 0,62366693 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 7,20 0,144000 0,144000 0,14400094 N03AX12 GABAPENTINUM*** GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 60,61 0,606100 0,172800 0,17280095 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 33,34 0,555666 0,172800 0,17280096 N03AX12 GABAPENTINUM*** GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 22,54 0,450800 0,172800 0,17280097 N03AX12 GABAPENTINUM*** GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 43,63 0,436300 0,172800 0,17280098 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 23,56 0,392666 0,172800 0,17280099 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 21,80 0,436000 0,436000 0,436000100 N03AX12 GABAPENTINUM*** GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 133,56 1,335600 0,523200 0,523200101 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 65,96 1,319200 0,523200 0,523200102 N03AX12 GABAPENTINUM*** GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 133,09 1,330900 0,523200 0,523200103 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 63,62 1,060333 0,523200 0,523200104 N03AX12 GABAPENTINUM*** GABAPENTINA PFIZER 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 47,92 0,958400 0,523200 0,523200105 N03AX12 GABAPENTINUM*** GABAPENTINA PFIZER 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 91,03 0,910300 0,523200 0,523200106 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 51,89 0,864833 0,523200 0,523200107 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 28,81 0,576200 0,576200 0,576200108 N03AX12 GABAPENTINUM*** GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 175,18 1,751800 0,691440 0,691440109 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 72,72 1,454400 0,691440 0,691440110 N03AX12 GABAPENTINUM*** GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 169,16 1,691600 0,691440 0,691440111 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 85,96 1,432666 0,691440 0,691440112 N03AX12 GABAPENTINUM*** GABAPENTINA PFIZER 400 mg CAPS. 400mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 64,12 1,282400 0,691440 0,691440113 N03AX12 GABAPENTINUM*** GABAPENTINA PFIZER 400 mg CAPS. 400mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 121,79 1,217900 0,691440 0,691440114 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 64,86 1,081000 0,691440 0,691440115 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 65,21 2,173666 2,173666 2,173666116 N03AX12 GABAPENTINUM*** GRIMODIN 600 mg COMPR. FILM. 600mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 123,68 2,061333 2,061333 2,061333117 N03AX12 GABAPENTINUM*** GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 104,24 3,474666 3,474666 3,474666118 N03AX12 GABAPENTINUM*** GRIMODIN 800 mg COMPR. FILM. 800mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 197,38 3,289666 3,289666 3,289666119 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TORRENT 1000 mg COMPR. FILM. 1000 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 114,07 3,802333 3,802333 3,802333120 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM G.L. PHARMA 1000 mg COMPR. FILM. 1000 mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 104,85 3,495000 3,495000 3,495000121 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 30 114,11 3,803666 3,803666 3,803666122 N03AX14 LEVETIRACETAMUM** KEPPRA 1000 mg COMPR. FILM. 1000mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM.1 (BLIST. AL/PVC) P-RF 30 166,48 5,549333 3,910800 3,910800123 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM ACCORD 1000mg COMPR. FILM. 1000mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. PRF 30 222,85 7,428333 3,910800 3,910800124 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM ACTAVIS 1000mg COMPR. FILM. 1000mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF 30 101,18 3,372666 3,372666 3,372666125 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM PHARMASWISS 1000 mg COMPR. FILM. 1000mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 114,11 3,803666 3,803666 3,803666126 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TEVA 1000mg COMPR. FILM. 1000mg TEVA PHARMA OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF 30 114,11 3,803666 3,803666 3,803666127 N03AX14 LEVETIRACETAMUM** TRUND 1000 mg COMPR. FILM. 1000mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 60 216,42 3,607000 3,607000 3,607000128 N03AX14 LEVETIRACETAMUM** EPILETAM 1000 mg COMPR. FILM. 1000mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 30 108,21 3,607000 3,607000 3,607000129 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM DR. REDDY'S 1000 mg COMPR. FILM. 1000mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 100,56 3,352000 3,352000 3,352000130 N03AX14 LEVETIRACETAMUM** LERETAN 1000 mg COMPR. FILM. 1000mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 120,67 4,022333 3,910800 3,910800131 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 97,77 3,259000 3,259000 3,259000132 N03AX14 LEVETIRACETAMUM** MYAKELL 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 114,11 3,803666 3,803666 3,803666133 N03AX14 LEVETIRACETAMUM** NORMEG 1000 mg COMPR. FILM. 1000mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM. PRF 30 114,11 3,803666 3,803666 3,803666134 N03AX14 LEVETIRACETAMUM** VETIRA 1000 mg COMPR. FILM. 1000mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. AL/PVC-PE-PVDC X 30 COMPR. PRF 30 114,11 3,803666 3,803666 3,803666135 N03AX14 LEVETIRACETAMUM** LEVELANZ 1000 mg COMPR. FILM. 1000mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 106,51 3,803928 3,803928 3,803928136 N03AX14 LEVETIRACETAMUM** LEVELANZ 1000 mg COMPR. FILM. 1000mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 106,51 3,803928 3,803928 3,803928

Pagina 16 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

137 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM POLIPHARMA 1000mg COMPR. FILM. 1000mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL A CATE 10 COMPR.FILM PRF 30 97,77 3,259000 3,259000 3,259000138 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TEVA 250 mg COMPR. FILM. 250 mg TEVA PHARMA OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF 30 31,08 1,036000 0,886800 0,886800139 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TORRENT 250 mg COMPR. FILM. 250 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 26,50 0,883333 0,883333 0,883333140 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM G.L. PHARMA 250 mg COMPR. FILM. 250 mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 29,23 0,974333 0,886800 0,886800141 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TERAPIA 250 mg COMPR. FILM. 250 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF 30 30,82 1,027333 0,886800 0,886800142 N03AX14 LEVETIRACETAMUM** KEPPRA 250 mg COMPR. FILM. 250mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF 30 46,27 1,542333 0,886800 0,886800143 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM ACTAVIS 250mg COMPR. FILM. 250mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF 30 31,08 1,036000 0,886800 0,886800144 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM ACCORD 250mg COMPR. FILM. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. PRF 30 61,87 2,062333 0,886800 0,886800145 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM PHARMASWISS 250 mg COMPR. FILM. 250mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 31,06 1,035333 0,886800 0,886800146 N03AX14 LEVETIRACETAMUM** TRUND 250 mg COMPR. FILM. 250mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 60 53,20 0,886666 0,886666 0,886666147 N03AX14 LEVETIRACETAMUM** EPILETAM 250 mg COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 30 30,09 1,003000 0,886800 0,886800148 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 22,17 0,739000 0,739000 0,739000149 N03AX14 LEVETIRACETAMUM** MYAKELL 250 mg COMPR. FILM. 250mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 31,08 1,036000 0,886800 0,886800150 N03AX14 LEVETIRACETAMUM** NORMEG 250 mg COMPR. FILM. 250mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM. PRF 30 31,08 1,036000 0,886800 0,886800151 N03AX14 LEVETIRACETAMUM** VETIRA 250 mg COMPR. FILM. 250mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. AL/PVC-PE-PVDC X 30 COMPR. PRF 30 31,08 1,036000 0,886800 0,886800152 N03AX14 LEVETIRACETAMUM** LEVELANZ 250 mg COMPR. FILM. 250mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 29,00 1,035714 0,886800 0,886800153 N03AX14 LEVETIRACETAMUM** LEVELANZ 250 mg COMPR. FILM. 250mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 29,00 1,035714 0,886800 0,886800154 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM POLIPHARMA 250mg COMPR. FILM. 250mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL A CATE 10 COMPR.FILM PRF 30 30,09 1,003000 0,886800 0,886800155 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TORRENT 500 mg COMPR. FILM. 500 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 56,89 1,896333 1,896333 1,896333156 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM G.L. PHARMA 500 mg COMPR. FILM. 500 mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 56,63 1,887666 1,887666 1,887666157 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 58,90 1,963333 1,896799 1,896799158 N03AX14 LEVETIRACETAMUM** KEPPRA 500 mg COMPR. FILM. 500mg UCB PHARMA SA BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF 30 87,23 2,907666 1,896799 1,896799159 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM ACCORD 500mg COMPR. FILM. 500mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. PRF 30 117,50 3,916666 1,896799 1,896799160 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM ACTAVIS 500mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF 30 49,73 1,657666 1,657666 1,657666161 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM PHARMASWISS 500 mg COMPR. FILM. 500mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PRF 30 59,70 1,990000 1,896799 1,896799162 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMA OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF 30 59,67 1,989000 1,896799 1,896799163 N03AX14 LEVETIRACETAMUM** TRUND 500 mg COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 60 113,40 1,890000 1,890000 1,890000164 N03AX14 LEVETIRACETAMUM** EPILETAM 500 mg COMPR. FILM. 500mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF 30 56,71 1,890333 1,890333 1,890333165 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 50,06 1,668666 1,668666 1,668666166 N03AX14 LEVETIRACETAMUM** LERETAN 500 mg COMPR. FILM. 500mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 60,08 2,002666 1,896799 1,896799167 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 47,42 1,580666 1,580666 1,580666168 N03AX14 LEVETIRACETAMUM** MYAKELL 500 mg COMPR. FILM. 500mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 60,06 2,002000 1,896799 1,896799169 N03AX14 LEVETIRACETAMUM** NORMEG 500 mg COMPR. FILM. 500mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM. PRF 30 59,67 1,989000 1,896799 1,896799170 N03AX14 LEVETIRACETAMUM** VETIRA 500 mg COMPR. FILM. 500mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. AL/PVC-PE-PVDC X 30 COMPR. PRF 30 59,64 1,988000 1,896799 1,896799171 N03AX14 LEVETIRACETAMUM** LEVELANZ 500 mg COMPR. FILM. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 55,72 1,990000 1,896799 1,896799172 N03AX14 LEVETIRACETAMUM** LEVELANZ 500 mg COMPR. FILM. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 55,72 1,990000 1,896799 1,896799173 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM POLIPHARMA 500mg COMPR. FILM. 500mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL A CATE 10 COMPR.FILM PRF 30 47,42 1,580666 1,580666 1,580666174 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 78,51 2,617000 2,617000 2,617000175 N03AX14 LEVETIRACETAMUM** VETIRA 750 mg COMPR. FILM. 750mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. AL/PVC-PE-PVDC X 30 COMPR. PRF 30 85,68 2,856000 2,856000 2,856000176 N03AX14 LEVETIRACETAMUM** MYAKELL 750 mg COMPR. FILM. 750mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 94,20 3,140000 3,140000 3,140000177 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM POLIPHARMA 750mg COMPR. FILM. 750mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL A CATE 10 COMPR.FILM PRF 30 78,51 2,617000 2,617000 2,617000178 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 30 120,67 4,022333 3,910800 3,910800179 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 34,74 1,158000 0,886800 0,886800180 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 59,67 1,989000 1,896799 1,896799181 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 60 188,00 3,133333 3,133333 3,133333182 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM ACTAVIS GROUP 100mg/ml SOL. ORALA 100 mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU UN FLACON DIN STICLA BRUNA A 300ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII, CU PRF 1 114,11 114,110000 114,110000 114,110000183 N03AX14 LEVETIRACETAMUM** KEPPRA 100 mg/ml SOL. ORALA 100mg/ml UCB PHARMA SA BELGIA CUTIE X 1 FLACON X 300 ML SOL. ORALA + SERINGA PT. ADMIN. ORALA P-RF 1 166,48 166,480000 136,836000 136,836000184 N03AX14 LEVETIRACETAMUM** TRUND 100 mg/ml SOL. ORALA 100mg/ml GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC DIN STICLA BRUNA X 300 ML SOL. ORALA + 1 SERINGA DOZATOARE (PP,PE) DE 10 ML SI UN AD PRF 1 114,03 114,030000 114,030000 114,030000185 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM RATIOPHARM 100mg/ml SOL. ORALA 100mg/ml RATIOPHARM GMBH GERMANIA CUTIE CU UN FLACON DIN STICLA BRUNA A 300 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + O SERINGA PENTRU ADMINISTRARE ORALA GRADATA A 10ML PRF 1 114,11 114,110000 114,110000 114,110000186 N03AX14 LEVETIRACETAMUM** VETIRA 100 mg/ml SOL. ORALA 100mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 300 ML SOL. ORALA, + 1 SERINGA GRADATA (PP, PE) X 10 ML SI UN AD PRF 1 114,11 114,110000 114,110000 114,110000

Pagina 17 din 45

Page 73: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

187 N03AX16 PREGABALINUM*** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 76,16 5,440000 5,440000 5,440000188 N03AX16 PREGABALINUM*** LYRICA 150 mg CAPS. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 288,91 5,159107 5,159107 5,159107189 N03AX16 PREGABALINUM*** LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 422,67 7,547678 7,547678 7,547678190 N03AX16 PREGABALINUM*** LYRICA 300 mg CAPS. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 114,28 8,162857 8,162857 8,162857191 N03AX16 PREGABALINUM*** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF 14 53,71 3,836428 3,836428 3,836428192 N03AX16 PREGABALINUM*** LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF 56 193,52 3,455714 3,455714 3,455714193 N03AX17 STIRIPENTOLUM** DIACOMIT 250mg CAPS. 250mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 776,40 12,940000 12,940000 12,940000194 N03AX17 STIRIPENTOLUM** DIACOMIT 500mg CAPS. 500mg BIOCODEX FRANTA CUTIE X 1 FLAC. DIN PP X 60 CAPS. P-RF/R 60 1.513,60 25,226666 25,226666 25,226666195 N03AX17 STIRIPENTOLUM** DIACOMIT 250mg PULB. PT. SUSP. ORALA 250mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 776,40 12,940000 12,940000 12,940000196 N03AX17 STIRIPENTOLUM** DIACOMIT 500mg PULB. PT. SUSP. ORALA 500mg BIOCODEX FRANTA CUTIE X 60 PLICURI HARTIE/AL/PE P-RF/R 60 1.513,60 25,226666 25,226666 25,226666

10. BOALA PARKINSON - G12

1 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 27,10 0,542000 0,542000 0,5420002 N04AA02 BIPERIDENUM AKINETON 2 mg COMPR. 2mg DESMA GMBH GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 10,57 0,211400 0,211400 0,2114003 N04BA02 COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR HBS CAPS. ELIB. MODIF. 100mg+25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 CAPS. CU ELIB. MODIF. P-6L 100 58,87 0,588700 0,588700 0,5887004 N04BA02 COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR 200mg/50mg COMPR. 200mg+50mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 23,59 0,786333 0,629199 0,6291995 N04BA02 COMBINATII (LEVODOPUM+BENSERAZIDUM)** LEVODOPA/BENSERAZIDE TEVA 200mg/50mg COMPR. 200mg/50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLACON PEID X 30 COMPR. P-6L 30 15,73 0,524333 0,524333 0,5243336 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM)** NAKOM COMPR. 250mg+25mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 62,05 0,620500 0,620500 0,6205007 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 74,57 0,745700 0,744600 0,7446008 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM)** DUODOPA GEL INT. FARA CONCENTRATIE SOLVAY PHARMACEUTICALS GMBH GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC S/P-RF 7 3.070,90 438,700000 438,700000 438,7000009 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM)** DUODOPA GEL INT. FARA CONCENTRATIE ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC S/P-RF 7 3.070,90 438,700000 438,700000 438,700000

10 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 414,46 4,144600 4,144600 4,14460011 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF 100 414,46 4,144600 4,144600 4,14460012 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 414,46 4,144600 4,144600 4,14460013 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 544,89 5,448900 5,448900 5,44890014 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF 100 414,46 4,144600 4,144600 4,14460015 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF 100 414,46 4,144600 4,144600 4,14460016 N04BB01 AMANTADINUM** VIREGYT (R)- K CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 CAPS. P-6L 50 17,07 0,341400 0,341400 0,34140017 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 21,16 0,529000 0,529000 0,52900018 N04BC04 ROPINIROLUM** ROPINIROL TEVA 2 mg COMPR. CU ELIB. PREL. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF 30 42,74 1,424666 1,424666 1,42466619 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 40,72 1,454285 1,454285 1,45428520 N04BC04 ROPINIROLUM** ROPINIROL LPH 2 mg COMPR. CU ELIB. PREL. 2mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 (4X7) COMPR. CU ELIB. PREL. PRF 28 39,89 1,424642 1,424642 1,42464221 N04BC04 ROPINIROLUM** ROPINIROL TEVA 4 mg COMPR. CU ELIB. PREL. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF 30 81,12 2,704000 2,704000 2,70400022 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 77,41 2,764642 2,764642 2,76464223 N04BC04 ROPINIROLUM** ROPINIROL LPH 4 mg COMPR. CU ELIB. PREL. 4mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 (4X7) COMPR. CU ELIB. PREL. PRF 28 75,71 2,703928 2,703928 2,70392824 N04BC04 ROPINIROLUM** ROPINIROL TEVA 8 mg COMPR. CU ELIB. PREL. 8mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF 30 153,89 5,129666 5,129666 5,12966625 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 28 134,78 4,813571 4,813571 4,81357126 N04BC04 ROPINIROLUM** ROPINIROL LPH 8 mg COMPR. CU ELIB. PREL. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 (4X7) COMPR. CU ELIB. PREL. PRF 28 143,63 5,129642 5,129642 5,12964227 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 39,89 1,424642 1,424642 1,42464228 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 75,71 2,703928 2,703928 2,70392829 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 28 143,63 5,129642 5,129642 5,12964230 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 36,96 1,320000 1,320000 1,32000031 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 39,81 1,421785 1,421785 1,42178532 N04BC04 ROPINIROLUM** NERVAMAT 2 mg COMPR. ELIB. PREL. 2mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF 28 39,89 1,424642 1,424642 1,42464233 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 67,67 2,416785 2,416785 2,416785

Tratamentul se initiază de către medicul în specialitatea neurologie

Pagina 18 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

34 N04BC04 ROPINIROLUM** NERVAMAT 4 mg COMPR. ELIB. PREL. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF 28 75,71 2,703928 2,703928 2,70392835 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 75,62 2,700714 2,700714 2,70071436 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 28 121,86 4,352142 4,352142 4,35214237 N04BC04 ROPINIROLUM** NERVAMAT 8 mg COMPR. ELIB. PREL. 8mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF 28 143,62 5,129285 5,129285 5,12928538 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 28 143,55 5,126785 5,126785 5,12678539 N04BC05 PRAMIPEXOLUM** OPRYMEA 0,088mg COMPR. 0,088mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 19,75 0,658333 0,658333 0,65833340 N04BC05 PRAMIPEXOLUM** MIPARKAN 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 17,43 0,581000 0,581000 0,58100041 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 17,43 0,581000 0,581000 0,58100042 N04BC05 PRAMIPEXOLUM** MIRAPEXIN 0,18 mg COMPR. 0,18mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 49,77 1,659000 0,594799 0,59479943 N04BC05 PRAMIPEXOLUM** OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 17,70 0,590000 0,590000 0,59000044 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL TEVA 0,18mg COMPR. 0,18mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 33,41 1,113666 0,594799 0,59479945 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL SANDOZ 0,18 mg COMPR. 0,18mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF/R 30 33,42 1,114000 0,594799 0,59479946 N04BC05 PRAMIPEXOLUM** MEDOPEXOL 0,18 mg COMPR. 0,18mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 27,83 0,927666 0,594799 0,59479947 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 14,88 0,496000 0,496000 0,49600048 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL RANBAXY 0,18 mg COMPR. 0,18mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC X 30 COMPR. P-RF 30 30,86 1,028666 0,594799 0,59479949 N04BC05 PRAMIPEXOLUM** MIGLASEN 0,18 mg COMPR. 0,18mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 14,87 0,495666 0,495666 0,49566650 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL TORRENT 0,18 mg COMPR. 0,18mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 17,72 0,590666 0,590666 0,59066651 N04BC05 PRAMIPEXOLUM** PRAXITAB 0,18mg COMPR. 0,18mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 25,30 0,843333 0,594799 0,59479952 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL AUROBINDO 0,18 mg COMPR. 0,18mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 23,56 0,785333 0,594799 0,59479953 N04BC05 PRAMIPEXOLUM** MIGLASEN 0,18 mg COMPR. 0,18mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 14,87 0,495666 0,495666 0,49566654 N04BC05 PRAMIPEXOLUM** PRAMIPEXOLE ACCORD 0,35mg COMPR. 0,35mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 30 48,92 1,630666 1,630666 1,63066655 N04BC05 PRAMIPEXOLUM** MIPARKAN 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 60,97 2,032333 2,032333 2,03233356 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL AUROBINDO 0,7 mg COMPR. 0,7 mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF 30 83,51 2,783666 2,438799 2,43879957 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 60,97 2,032333 2,032333 2,03233358 N04BC05 PRAMIPEXOLUM** MIRAPEXIN 0,7 mg COMPR. 0,7mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-RF 30 167,86 5,595333 2,438799 2,43879959 N04BC05 PRAMIPEXOLUM** OPRYMEA 0,7mg COMPR. 0,7mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 73,16 2,438666 2,438666 2,43866660 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL TEVA 0,7mg COMPR. 0,7mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF 30 115,05 3,835000 2,438799 2,43879961 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL SANDOZ 0,7 mg COMPR. 0,7mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF/R 30 115,05 3,835000 2,438799 2,43879962 N04BC05 PRAMIPEXOLUM** MEDOPEXOL 0,7 mg COMPR. 0,7mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 99,54 3,318000 2,438799 2,43879963 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 72,02 2,400666 2,400666 2,40066664 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL RANBAXY 0,7 mg COMPR. 0,7mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC X 30 COMPR. P-RF 30 106,21 3,540333 2,438799 2,43879965 N04BC05 PRAMIPEXOLUM** MIGLASEN 0,7 mg COMPR. 0,7mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 72,03 2,401000 2,401000 2,40100066 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL TORRENT 0,7 mg COMPR. 0,7mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF 30 73,14 2,438000 2,438000 2,43800067 N04BC05 PRAMIPEXOLUM** PRAXITAB 0,7 mg COMPR. 0,7mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 90,45 3,015000 2,438799 2,43879968 N04BC05 PRAMIPEXOLUM** MIGLASEN 0,7 mg COMPR. 0,7mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L 30 72,03 2,401000 2,401000 2,40100069 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. P-RF 10 58,12 5,812000 2,050800 2,05080070 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 61,20 2,040000 2,040000 2,04000071 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 17,09 1,709000 1,709000 1,70900072 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. P-RF 30 314,07 10,469000 3,769599 3,76959973 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 30 112,50 3,750000 3,750000 3,75000074 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 94,24 3,141333 3,141333 3,14133375 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. P-RF 30 650,35 21,678333 6,436800 6,43680076 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 30 160,92 5,364000 5,364000 5,36400077 N04BC05 PRAMIPEXOLUM** OPRYMEA 1,57mg COMPR. ELIB. PREL. 1,57mg KRKA D.D. SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF 30 241,13 8,037666 8,037666 8,03766678 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 30 274,79 9,159666 9,159666 9,15966679 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. P-RF 30 1.229,85 40,995000 9,173599 9,17359980 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 30 229,34 7,644666 7,644666 7,64466681 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. P-RF 30 1.809,33 60,311000 60,311000 60,31100082 N04BC09 ROTIGOTINUM*** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 367,49 13,124642 13,124642 13,12464283 N04BC09 ROTIGOTINUM*** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 98,15 14,021428 14,021428 14,021428

Pagina 19 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

84 N04BC09 ROTIGOTINUM*** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 101,65 14,521428 14,521428 14,52142885 N04BC09 ROTIGOTINUM*** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 382,31 13,653928 13,653928 13,65392886 N04BC09 ROTIGOTINUM*** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 477,57 17,056071 17,056071 17,05607187 N04BC09 ROTIGOTINUM*** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 127,57 18,224285 18,224285 18,22428588 N04BC09 ROTIGOTINUM*** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 571,41 20,407500 20,407500 20,40750089 N04BC09 ROTIGOTINUM*** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h SCHWARZ PHARMA LTD IRLANDA CUTIE X 7 PLASTURI TRANSDERMICI P-RF 7 154,18 22,025714 22,025714 22,02571490 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 BLIST. DIN AL/PVC X 10 COMPR. P-6L 50 36,31 0,726200 0,726200 0,72620091 N04BD01 SELEGILINUM SELEGOS COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L 100 70,37 0,703700 0,703700 0,70370092 N04BD02 RASAGILINUM*** AZILECT 1mg COMPR. 1mg TEVA PHARMA GMBH GERMANIA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 523,59 17,453000 17,453000 17,45300093 N04BX02 ENTACAPONUM*** COMTAN 200mg COMPR. FILM. 200mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 100 COMPR. FILM. P-RF 100 391,65 3,916500 3,087999 3,08799994 N04BX02 ENTACAPONUM*** COMTAN 200mg COMPR. FILM. 200mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 30 COMPR. FILM. P-RF 30 125,26 4,175333 3,087999 3,08799995 N04BX02 ENTACAPONUM*** ENTACAPONE TEVA COMPR. FILM. 200mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN PEID X 100 COMPR. FILM PRF 100 257,35 2,573500 2,573500 2,57350096 N04BX02 ENTACAPONUM*** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 81,41 2,713666 2,713666 2,71366697 N04BX02 ENTACAPONUM*** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PRF 60 154,40 2,573333 2,573333 2,57333398 N04BX02 ENTACAPONUM*** ENCAPIA 200 mg COMPR. FILM. 200mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 100 COMPR. FILM. PRF 100 257,35 2,573500 2,573500 2,57350099 N05AH02 CLOZAPINUM** LEPONEX (R) 100 mg COMPR. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 106,79 2,135800 2,135800 2,135800100 N05AH02 CLOZAPINUM** LEPONEX (R) 25 mg COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 33,65 0,673000 0,673000 0,673000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

1 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 2,65 0,132500 0,104799 0,1047992 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,62 0,087333 0,087333 0,0873333 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,71 0,123666 0,104799 0,1047994 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 2,57 0,128500 0,104799 0,1047995 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,8810006 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,7206667 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 400,81 400,810000 400,810000 400,8100008 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 241,07 48,214000 48,214000 48,2140009 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 89,66 89,660000 89,660000 89,660000

10 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 23,82 2,382000 2,382000 2,38200011 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 78,67 78,670000 78,670000 78,67000012 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 59,64 59,640000 59,640000 59,64000013 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 1 122,50 122,500000 122,500000 122,50000014 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 1 110,09 110,090000 110,090000 110,09000015 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 124,21 124,210000 124,210000 124,21000016 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 78,67 78,670000 78,670000 78,67000017 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,15ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,80 74,800000 71,568000 71,56800018 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 109,54 109,540000 109,540000 109,54000019 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,702100 0,70210020 L04AX01 AZATHIOPRINUM IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 78,89 0,788900 0,788900 0,78890021 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 13,73 0,686500 0,686500 0,68650022 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg MEDA AB SUEDIA CUTIE X 1 FLAC. X 20 DRAJ. S/P-RF 20 12,33 0,616500 0,616500 0,616500

Tratamentul se initiaza de catre medicul in specialitatea neurologie

12. SCLEROZA MULTIPLA - G14

11. MIASTENIA GRAVIS - G13

Pagina 20 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

1 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 32,62 0,652400 0,652400 0,6524002 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 29,65 1,482500 1,482500 1,4825003 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,81 8,810000 8,810000 8,8100004 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 31,02 31,020000 31,020000 31,0200005 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 20,48 20,480000 20,480000 20,4800006 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 2,65 0,132500 0,104799 0,1047997 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,62 0,087333 0,087333 0,0873338 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,71 0,123666 0,104799 0,1047999 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 2,57 0,128500 0,104799 0,104799

10 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,88100011 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,72066612 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 400,81 400,810000 400,810000 400,81000013 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 241,07 48,214000 48,214000 48,21400014 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 89,66 89,660000 89,660000 89,66000015 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 23,82 2,382000 2,382000 2,38200016 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 78,67 78,670000 78,670000 78,67000017 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 59,64 59,640000 59,640000 59,64000018 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 1 122,50 122,500000 122,500000 122,50000019 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 1 110,09 110,090000 110,090000 110,09000020 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 124,21 124,210000 124,210000 124,21000021 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 78,67 78,670000 78,670000 78,67000022 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,15ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,80 74,800000 71,568000 71,56800023 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 109,54 109,540000 109,540000 109,54000024 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 1 643,62 643,620000 643,620000 643,62000025 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,702100 0,70210026 L04AX01 AZATHIOPRINUM IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 78,89 0,788900 0,788900 0,788900

Tratamentul se initiaza de catre medicul in specialitatea neurologie

1 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 17,52 0,350400 0,184920 0,1849202 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 300 mg CAPS. ELIB. PREL. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PREL. P-6L 50 26,76 0,535200 0,268680 0,2686803 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 150 mg CAPS. MOI GASTROREZ. 150mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 18,29 0,182900 0,182900 0,1829004 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 18,29 0,182900 0,182900 0,1829005 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 300 mg CAPS. MOI GASTROREZ. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L 100 23,10 0,231000 0,231000 0,2310006 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 23,10 0,231000 0,231000 0,2310007 N03AG01 ACIDUM VALPROICUM + SARURI CONVULEX (R) 500 mg CAPS. MOI GASTROREZ. 500mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ. P-6L 100 33,65 0,336500 0,336500 0,3365008 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 33,65 0,336500 0,336500 0,3365009 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. FILM. ELIB. PREL. P-RF 30 16,06 0,535333 0,403800 0,403800

10 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE CHRONO 300 mg COMPR. FILM. ELIB. PREL. DIVIZ. 300mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 FLAC. DIN PP X 50 COMPR. FILM. ELIB. PREL., DIVIZIBILE P-6L 100 34,40 0,344000 0,268680 0,26868011 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 150 COMPR. FILM. GASTROREZ. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. X 100 COMPR.FILM. GASTROREZ. P-6L 100 15,41 0,154100 0,154100 0,15410012 N03AG01 ACIDUM VALPROICUM + SARURI DEPAKINE 200 mg COMPR. FILM. GASTROREZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLAC. DIN PP X 40 COMPR. FILM. GASTROREZ. P-6L 40 10,72 0,268000 0,268000 0,26800013 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 300 COMPR. FILM. GASTROREZ. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. X 100 COMPR.FILM. GASTROREZ. P-6L 100 22,39 0,223900 0,223900 0,22390014 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 600 COMPR. FILM. GASTROREZ. 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. X 50 COMPR. FILM. GASTRORE P-6L 50 21,57 0,431400 0,431400 0,43140015 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 94,92 1,898400 1,898400 1,898400

Medicamentele specifice se prescriu numai pentru pacientii inclusi in Programul National de boli neurologice (Subprogramul de tratament al screlozei multiple)

13. BOLI PSIHICE (SCHIZOFRENIE, TULBURARI SCHIZOTIPALE SI DELIRANTE, TULBURARI AFECTIVE MAJORE, TULBURARI PSIHOTICE ACUTE SI BOLI PSIHICE COPII, AUTISM) - G15

Pagina 21 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

16 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 500 mg MINICOMPR. ELIB. PREL. 500mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG. P-6L 50 35,24 0,704800 0,403800 0,40380017 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL SIROP SIROP 300mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML + LINGURITA DOZATOARE PP A 5 ML P-6L 1 19,24 19,240000 19,240000 19,24000018 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 17,77 17,770000 17,770000 17,77000019 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 17,77 17,770000 17,770000 17,77000020 N03AX09 LAMOTRIGINUM** LAMOTRIX 100 mg COMPR. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 28,86 0,962000 0,962000 0,96200021 N03AX09 LAMOTRIGINUM** PLEXXO (R) 100 mg COMPR. 100mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 28,86 0,962000 0,962000 0,96200022 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 100 mg COMPR. 100mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 28,84 0,961333 0,961333 0,96133323 N03AX09 LAMOTRIGINUM** LAMICTAL 100 mg COMPR. 100mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 40,13 1,433214 1,116642 1,11664224 N03AX09 LAMOTRIGINUM** LAMOTRIGINA SUN 100 mg COMPR. 100mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 14 COMPR. P-6L 56 52,11 0,930535 0,930535 0,93053525 N03AX09 LAMOTRIGINUM** LAMOTRIX 200 mg COMPR. 200mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 60,33 2,011000 2,011000 2,01100026 N03AX09 LAMOTRIGINUM** LAMOTRIGINA SUN 200 mg COMPR. 200mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 14 COMPR. P-6L 56 99,51 1,776964 1,776964 1,77696427 N03AX09 LAMOTRIGINUM** LAMOTRIX 25 mg COMPR. 25mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,26 0,242000 0,242000 0,24200028 N03AX09 LAMOTRIGINUM** LAMICTAL 25 mg COMPR. 25mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 10,40 0,371428 0,290400 0,29040029 N03AX09 LAMOTRIGINUM** LAMOTRIX 50 mg COMPR. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14,41 0,480333 0,480333 0,48033330 N03AX09 LAMOTRIGINUM** LAMOTRIGINE FARMAL 50 mg COMPR. 50mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 14,42 0,480666 0,480666 0,48066631 N03AX09 LAMOTRIGINUM** LAMICTAL 50 mg COMPR. 50mg THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 20,69 0,738928 0,576213 0,57621332 N03AX09 LAMOTRIGINUM** LAMOTRIGINA SUN 50 mg COMPR. 50mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 14 COMPR. P-6L 56 26,89 0,480178 0,480178 0,48017833 N03AX09 LAMOTRIGINUM** LAMOTRIN 100 mg COMPR. DISP. 100mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 28,84 0,961333 0,961333 0,96133334 N03AX09 LAMOTRIGINUM** LAMOTRIN 50 mg COMPR. DISP. 50mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 16,95 0,565000 0,565000 0,56500035 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 0,28 0,009333 0,009333 0,00933336 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 0,76 0,025333 0,025333 0,02533337 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 27,10 0,542000 0,542000 0,54200038 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 3,24 0,162000 0,162000 0,16200039 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 7,72 0,257333 0,257333 0,25733340 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF 30 10,80 0,360000 0,360000 0,36000041 N05AD01 HALOPERIDOLUM HALDOL COMPR. 5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 17,94 0,717600 0,717600 0,71760042 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 5,39 5,390000 5,390000 5,39000043 N05AD01 HALOPERIDOLUM HALOPERIDOL 2 mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF 1 6,66 6,660000 6,468000 6,46800044 N05AD01 HALOPERIDOLUM HALOPERIDOL DECANOAT SOL. INJ. 50mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 44,52 8,904000 8,904000 8,90400045 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 12,48 2,496000 2,496000 2,49600046 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 28 484,77 17,313214 17,313214 17,31321447 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 30 127,86 4,262000 4,262000 4,26200048 N05AE04 ZIPRASIDONUM** ZELDOX (R) 40 mg CAPS. 40mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 14 CAPS. P-RF 56 416,90 7,444642 5,823799 5,82379949 N05AE04 ZIPRASIDONUM** ZIXADOX 40 mg CAPS. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF 56 277,12 4,948571 4,948571 4,94857150 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 60 291,19 4,853166 4,853166 4,85316651 N05AE04 ZIPRASIDONUM** ZELDOX (R) 60 mg CAPS. 60mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 14 CAPS. P-RF 56 542,18 9,681785 7,167799 7,16779952 N05AE04 ZIPRASIDONUM** ZIXADOX 60 mg CAPS. 60mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF 56 354,75 6,334821 6,334821 6,33482153 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 60 358,39 5,973166 5,973166 5,97316654 N05AE04 ZIPRASIDONUM** ZELDOX (R) 80 mg CAPS. 80mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 14 CAPS. P-RF 56 583,10 10,412500 7,729399 7,72939955 N05AE04 ZIPRASIDONUM** ZIXADOX 80 mg CAPS. 80mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF 56 403,81 7,210892 7,210892 7,21089256 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 60 386,47 6,441166 6,441166 6,44116657 N05AE04 ZIPRASIDONUM** ZELDOX (R) 20 mg/ml LIOF. PT. SOL. INJ. + SOLV. 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 1,2 ML SOLV. S/P-RF 1 64,19 64,190000 64,190000 64,19000058 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 71,81 7,181000 7,181000 7,18100059 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 18,98 0,379600 0,379600 0,37960060 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL 25 mg COMPR. FILM. 25mg 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 28,40 0,568000 0,568000 0,56800061 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 32,70 32,700000 32,700000 32,70000062 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL (R) DEPOT SOL. INJ. 200mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 10 FIOLE X 1 ML P-RF 10 157,82 15,782000 15,782000 15,78200063 N05AF05 ZUCLOPENTHIXOLUM** CLOPIXOL ACUPHASE (R) SOL. INJ. 50mg/ml H. LUNDBECK A/S DANEMARCA CUTIE X 5 FIOLE X 1 ML P-RF 5 46,49 9,298000 9,298000 9,29800064 N05AH02 CLOZAPINUM** LEPONEX (R) 100 mg COMPR. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 106,79 2,135800 2,135800 2,13580065 N05AH02 CLOZAPINUM** LEPONEX (R) 25 mg COMPR. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. X 10 COMPR. P-RF 50 33,65 0,673000 0,673000 0,673000

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Page 78: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

66 N05AH03 OLANZAPINUM** ZALASTA 10mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR. (BLISTER OPA/AL/PVC/AL) P-RF 28 27,89 0,996071 0,996000 0,99600067 N05AH03 OLANZAPINUM** OLAZAX 10 mg COMPR. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. P-RF 28 27,80 0,992857 0,992857 0,99285768 N05AH03 OLANZAPINUM** OLANZAPINA AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL/PVC/AL X 28 COMPR. PRF 28 27,89 0,996071 0,996000 0,99600069 N05AH03 OLANZAPINUM** OLANZAPINA AUROBINDO 15 mg COMPR. 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL/PVC/AL X 28 COMPR. PRF 28 191,36 6,834285 4,855285 4,85528570 N05AH03 OLANZAPINUM** OLANZAPINA AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL/PVC/AL X 28 COMPR. PRF 28 241,96 8,641428 5,978570 5,97857071 N05AH03 OLANZAPINUM** ZALASTA 5mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR. (BLISTER OPA/AL/PVC/AL) P-RF 28 14,96 0,534285 0,534285 0,53428572 N05AH03 OLANZAPINUM** OLAZAX 5 mg COMPR. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. P-RF 28 14,96 0,534285 0,534285 0,53428573 N05AH03 OLANZAPINUM** OLANZAPINA AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL/PVC/AL X 28 COMPR. PRF 28 14,96 0,534285 0,534285 0,53428574 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 28 208,23 7,436785 0,996000 0,99600075 N05AH03 OLANZAPINUM** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 135,35 4,833928 0,996000 0,99600076 N05AH03 OLANZAPINUM** LAPOZAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 145,02 4,834000 0,996000 0,99600077 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 29,74 0,991333 0,991333 0,99133378 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 23,24 0,830000 0,830000 0,83000079 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/AL X 35 COMPR. FILM. P-RF 35 169,19 4,834000 0,996000 0,99600080 N05AH03 OLANZAPINUM** EGOLANZA 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 135,34 4,833571 0,996000 0,99600081 N05AH03 OLANZAPINUM** OLANZAPINA LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 133,72 4,775714 0,996000 0,99600082 N05AH03 OLANZAPINUM** OLANZAPINE GSK 10 mg COMPR. FILM. 10mg GLAXOSMITHKLINE S.R.L. ROMANIA CUTIE CU BLIST. DIN PA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 135,35 4,833928 0,996000 0,99600083 N05AH03 OLANZAPINUM** OLANZAPINA POLIPHARMA 10 mg COMPR. FILM. 10mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 23,24 0,830000 0,830000 0,83000084 N05AH03 OLANZAPINUM** LAPOZAN 15 mg COMPR. FILM. 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 197,35 7,048214 4,855285 4,85528585 N05AH03 OLANZAPINUM** EGOLANZA 15 mg COMPR. FILM. 15mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 205,18 7,327857 4,855285 4,85528586 N05AH03 OLANZAPINUM** OLANZAPINA LPH 15 mg COMPR. FILM. 15mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 196,62 7,022142 4,855285 4,85528587 N05AH03 OLANZAPINUM** OLANZAPINA POLIPHARMA 15 mg COMPR. FILM. 15mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 171,61 6,128928 4,855285 4,85528588 N05AH03 OLANZAPINUM** OLANZAPINA ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 270,68 9,667142 5,978570 5,97857089 N05AH03 OLANZAPINUM** EGOLANZA 20 mg COMPR. FILM. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 274,48 9,802857 5,978570 5,97857090 N05AH03 OLANZAPINUM** OLANZAPINA LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 262,17 9,363214 5,978570 5,97857091 N05AH03 OLANZAPINUM** OLANZAPINA POLIPHARMA 20 mg COMPR. FILM. 20mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 228,83 8,172500 5,978570 5,97857092 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 28 109,79 3,921071 0,534428 0,53442893 N05AH03 OLANZAPINUM** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 71,36 2,548571 0,534428 0,53442894 N05AH03 OLANZAPINUM** LAPOZAN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 76,46 2,548666 0,534428 0,53442895 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 16,02 0,534000 0,534000 0,53400096 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 12,47 0,445357 0,445357 0,44535797 N05AH03 OLANZAPINUM** EGOLANZA 5 mg COMPR. FILM. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 71,36 2,548571 0,534428 0,53442898 N05AH03 OLANZAPINUM** OLANZAPINA LPH 5 mg COMPR. FILM. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 68,89 2,460357 0,534428 0,53442899 N05AH03 OLANZAPINUM** OLANZAPINE GSK 5 mg COMPR. FILM. 5mg GLAXOSMITHKLINE S.R.L. ROMANIA CUTIE CU BLIST. DIN PA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 71,36 2,548571 0,534428 0,534428100 N05AH03 OLANZAPINUM** OLANZAPINA POLIPHARMA 5 mg COMPR. FILM. 5mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. PRF 28 12,47 0,445357 0,445357 0,445357101 N05AH03 OLANZAPINUM** OLANZAPINA POLPHARMA 10 mg COMPR. ORODISPERSABILE 10 mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 28 COMPR. ORODISP. PRF 28 131,30 4,689285 0,996000 0,996000102 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 10 mg COMPR. ORODISPERSABILE 10mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 466,24 16,651428 0,996000 0,996000103 N05AH03 OLANZAPINUM** ZALASTA 10mg COMPR. ORODISPERSABILE 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 27,89 0,996071 0,996000 0,996000104 N05AH03 OLANZAPINUM** OLANZAPINE TEVA 10mg COMPR. ORODISPERSABILE 10mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP. P-RF 30 29,88 0,996000 0,996000 0,996000105 N05AH03 OLANZAPINUM** OLANZAPINA TERAPIA 10 mg COMPR. ORODISPERSABILE 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 134,53 4,804642 0,996000 0,996000106 N05AH03 OLANZAPINUM** OLAZAX DISPERZI 10 mg COMPR. ORODISPERSABILE 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 27,80 0,992857 0,992857 0,992857107 N05AH03 OLANZAPINUM** LAPOZAN 10 mg COMPR. ORODISPERSABILE 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 148,62 4,954000 0,996000 0,996000108 N05AH03 OLANZAPINUM** LAPOZAN 10 mg COMPR. ORODISPERSABILE 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 50 COMPR. ORODISPERSABILE P-RF 50 247,69 4,953800 0,996000 0,996000109 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 27,87 0,995357 0,995357 0,995357110 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 10 mg COMPR. ORODISPERSABILE 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF 35 171,82 4,909142 0,996000 0,996000111 N05AH03 OLANZAPINUM** OLANZAPINA ACTAVIS 10 mg COMPR. ORODISPERSABILE 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 27,73 0,990357 0,990357 0,990357112 N05AH03 OLANZAPINUM** AEDON 10 mg COMPR. ORODISPERSABILE 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. ORODISPERSABILE P-RF 30 60,67 2,022333 0,996000 0,996000113 N05AH03 OLANZAPINUM** IRROPIA 10 mg COMPR. ORODISPERSABILE 10mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 27,87 0,995357 0,995357 0,995357114 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 28 171,22 6,115000 0,996000 0,996000115 N05AH03 OLANZAPINUM** ZOLASWIFT 10 mg COMPR. ORODISPERSABILE 10mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 121,63 4,343928 0,996000 0,996000

Pagina 23 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

116 N05AH03 OLANZAPINUM** WRANELON 10 mg COMPR. ORODISPERSABILE 10mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 27,89 0,996071 0,996000 0,996000117 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 27,89 0,996071 0,996000 0,996000118 N05AH03 OLANZAPINUM** OLANZAPINA POLPHARMA 15 mg COMPR. ORODISPERSABILE 15 mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 28 COMPR. ORODISP. PRF 28 195,54 6,983571 4,855285 4,855285119 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 15 mg COMPR. ORODISPERSABILE 15mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 616,92 22,032857 4,855285 4,855285120 N05AH03 OLANZAPINUM** ZALASTA 15mg COMPR. ORODISPERSABILE 15mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 135,81 4,850357 4,850357 4,850357121 N05AH03 OLANZAPINUM** OLANZAPINE TEVA 15mg COMPR. ORODISPERSABILE 15mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP. P-RF 30 196,25 6,541666 4,855285 4,855285122 N05AH03 OLANZAPINUM** OLANZAPINA TERAPIA 15 mg COMPR. ORODISPERSABILE 15mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 203,82 7,279285 4,855285 4,855285123 N05AH03 OLANZAPINUM** OLAZAX DISPERZI 15 mg COMPR. ORODISPERSABILE 15mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 183,16 6,541428 4,855285 4,855285124 N05AH03 OLANZAPINUM** LAPOZAN 15 mg COMPR. ORODISPERSABILE 15mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 200,22 6,674000 4,855285 4,855285125 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 28 135,94 4,855000 4,855000 4,855000126 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 15 mg COMPR. ORODISPERSABILE 15mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF 35 257,36 7,353142 4,855285 4,855285127 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 28 131,26 4,687857 4,687857 4,687857128 N05AH03 OLANZAPINUM** AEDON 15 mg COMPR. ORODISPERSABILE 15mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. ORODISPERSABILE P-RF 30 163,54 5,451333 4,855285 4,855285129 N05AH03 OLANZAPINUM** IRROPIA 15 mg COMPR. ORODISPERSABILE 15mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 201,43 7,193928 4,855285 4,855285130 N05AH03 OLANZAPINUM** OLANZAPINA TORRENT 15 mg COMPR. ORODISPERSABILE 15mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 183,17 6,541785 4,855285 4,855285131 N05AH03 OLANZAPINUM** ZOLASWIFT 15 mg COMPR. ORODISPERSABILE 15mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 205,94 7,355000 4,855285 4,855285132 N05AH03 OLANZAPINUM** WRANELON 15 mg COMPR. ORODISPERSABILE 15mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 152,63 5,451071 4,855285 4,855285133 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 28 113,29 4,046071 4,046071 4,046071134 N05AH03 OLANZAPINUM** OLANZAPINA POLPHARMA 20 mg COMPR. ORODISPERSABILE 20 mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 28 COMPR. ORODISP. PRF 28 262,48 9,374285 5,978570 5,978570135 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 20 mg COMPR. ORODISPERSABILE 20mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 1.013,57 36,198928 5,978570 5,978570136 N05AH03 OLANZAPINUM** ZALASTA 20mg COMPR. ORODISPERSABILE 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 167,93 5,997500 5,978570 5,978570137 N05AH03 OLANZAPINUM** OLANZAPINE TEVA 20mg COMPR. ORODISPERSABILE 20mg TEVA PHARMA BV OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP. P-RF 30 179,92 5,997333 5,978570 5,978570138 N05AH03 OLANZAPINUM** OLANZAPINA TERAPIA 20 mg COMPR. ORODISPERSABILE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 271,77 9,706071 5,978570 5,978570139 N05AH03 OLANZAPINUM** OLAZAX DISPERZI 20 mg COMPR. ORODISPERSABILE 20mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 167,91 5,996785 5,978570 5,978570140 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 28 139,94 4,997857 4,997857 4,997857141 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 20 mg COMPR. ORODISPERSABILE 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF 35 342,90 9,797142 5,978570 5,978570142 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 28 161,15 5,755357 5,755357 5,755357143 N05AH03 OLANZAPINUM** AEDON 20 mg COMPR. ORODISPERSABILE 20mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. ORODISPERSABILE P-RF 30 179,91 5,997000 5,978570 5,978570144 N05AH03 OLANZAPINUM** IRROPIA 20 mg COMPR. ORODISPERSABILE 20mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 167,93 5,997500 5,978570 5,978570145 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 28 168,26 6,009285 5,978570 5,978570146 N05AH03 OLANZAPINUM** ZOLASWIFT 20 mg COMPR. ORODISPERSABILE 20mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 274,59 9,806785 5,978570 5,978570147 N05AH03 OLANZAPINUM** WRANELON 20 mg COMPR. ORODISPERSABILE 20mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF 28 139,50 4,982142 4,982142 4,982142148 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 28 139,94 4,997857 4,997857 4,997857149 N05AH03 OLANZAPINUM** OLANZAPINA POLPHARMA 5 mg COMPR. ORODISPERSABILE 5 mg PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 28 COMPR. ORODISP. PRF 28 67,78 2,420714 0,534428 0,534428150 N05AH03 OLANZAPINUM** ZYPREXA VELOTAB 5 mg COMPR. ORODISPERSABILE 5mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28COMPR. ORODISPERSABILE (BLIST. AL/AL ) P-RF 28 243,53 8,697500 0,534428 0,534428151 N05AH03 OLANZAPINUM** ZALASTA 5mg COMPR. ORODISPERSABILE 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL) P-RF 28 14,96 0,534285 0,534285 0,534285152 N05AH03 OLANZAPINUM** OLANZAPINE TEVA 5mg COMPR. ORODISPERSABILE 5mg TEVA PHARMA BV OLANDA CUTIE X 30 COMPR. FILM. (BLIST. OPA-AL-PVC/AL) P-RF 30 16,02 0,534000 0,534000 0,534000153 N05AH03 OLANZAPINUM** OLANZAPINA TERAPIA 5 mg COMPR. ORODISPERSABILE 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 73,57 2,627500 0,534428 0,534428154 N05AH03 OLANZAPINUM** OLAZAX DISPERZI 5 mg COMPR. ORODISPERSABILE 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE P-RF 28 14,96 0,534285 0,534285 0,534285155 N05AH03 OLANZAPINUM** LAPOZAN 5 mg COMPR. ORODISPERSABILE 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 78,30 2,610000 0,534428 0,534428156 N05AH03 OLANZAPINUM** LAPOZAN 5 mg COMPR. ORODISPERSABILE 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. AL/AL X 50 COMPR. ORODISPERSABILE P-RF 50 126,00 2,520000 0,534428 0,534428157 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 5 mg COMPR. ORODISPERSABILE 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF 35 90,49 2,585428 0,534428 0,534428158 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 14,95 0,533928 0,533928 0,533928159 N05AH03 OLANZAPINUM** AEDON 5 mg COMPR. ORODISPERSABILE 5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. ORODISPERSABILE P-RF 30 19,18 0,639333 0,534428 0,534428160 N05AH03 OLANZAPINUM** IRROPIA 5 mg COMPR. ORODISPERSABILE 5mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF 28 14,96 0,534285 0,534285 0,534285161 N05AH03 OLANZAPINUM** OLANZAPINA TORRENT 5 mg COMPR. ORODISPERSABILE 5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 120,37 4,298928 0,534428 0,534428162 N05AH03 OLANZAPINUM** ZOLASWIFT 5 mg COMPR. ORODISPERSABILE 5mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (2X14) COMPR. ORODISPERSABILE PRF 28 61,24 2,187142 0,534428 0,534428163 N05AH03 OLANZAPINUM** WRANELON 5 mg COMPR. ORODISPERSABILE 5mg GALENICA S.A. GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (2X14) COMPR. ORODISPERSABILE PRF 28 14,96 0,534285 0,534285 0,534285164 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 14,96 0,534285 0,534285 0,534285165 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 92,78 3,313571 3,313571 3,313571

Pagina 24 din 45

Page 80: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

166 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 1 893,61 893,610000 893,610000 893,610000167 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 1.379,83 1.379,830000 1.379,830000 1.379,830000168 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 1.716,38 1.716,380000 1.716,380000 1.716,380000169 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 19,95 19,950000 19,950000 19,950000170 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 60 444,50 7,408333 7,408333 7,408333171 N05AH04 QUETIAPINUM** KETILEPT 100 mg COMPR. FILM. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF 60 73,82 1,230333 0,867799 0,867799172 N05AH04 QUETIAPINUM** QUETIAPINE TEVA 100 mg COMPR. FILM. 100mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 60 COMPR. FILM. P-RF/S 60 63,13 1,052166 0,867799 0,867799173 N05AH04 QUETIAPINUM** SETININ 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 43,39 0,723166 0,723166 0,723166174 N05AH04 QUETIAPINUM** HEDONIN 100 mg COMPR. FILM. 100mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 60 COMPR. FILM. P-RF 60 79,63 1,327166 0,867799 0,867799175 N05AH04 QUETIAPINUM** KVENTIAX 100 mg COMPR. FILM. 100mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 50,70 0,845000 0,845000 0,845000176 N05AH04 QUETIAPINUM** QUETROP 100 mg COMPR. FILM. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 60 84,46 1,407666 0,867799 0,867799177 N05AH04 QUETIAPINUM** QUETIAPINE ACCORD 100 mg COMPR. FILM. 100mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. PRF 60 83,49 1,391500 0,867799 0,867799178 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 50,70 0,845000 0,845000 0,845000179 N05AH04 QUETIAPINUM** QUERSUS 100 mg COMPR. FILM. 100mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 65,00 1,083333 0,867799 0,867799180 N05AH04 QUETIAPINUM** KATHIRA 100 mg COMPR. FILM. 100mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 52,05 0,867500 0,867500 0,867500181 N05AH04 QUETIAPINUM** KATHIRA 100 mg COMPR. FILM. 100mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 52,05 0,867500 0,867500 0,867500182 N05AH04 QUETIAPINUM** SETININ 150 mg COMPR. FILM. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 71,93 1,198833 1,198833 1,198833183 N05AH04 QUETIAPINUM** QUETIAPINE ACCORD 150 mg COMPR. FILM. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. PRF 60 105,47 1,757833 1,438599 1,438599184 N05AH04 QUETIAPINUM** KATHIRA 150 mg COMPR. FILM. 150mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 86,31 1,438500 1,438500 1,438500185 N05AH04 QUETIAPINUM** KATHIRA 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 86,31 1,438500 1,438500 1,438500186 N05AH04 QUETIAPINUM** KETILEPT 200 mg COMPR. FILM. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF 60 114,86 1,914333 0,903600 0,903600187 N05AH04 QUETIAPINUM** QUETIAPINE TEVA 200 mg COMPR. FILM. 200mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 60 COMPR. FILM. P-RF/S 60 45,18 0,753000 0,753000 0,753000188 N05AH04 QUETIAPINUM** SETININ 200 mg COMPR. FILM. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 71,93 1,198833 0,903600 0,903600189 N05AH04 QUETIAPINUM** HEDONIN 200 mg COMPR. FILM. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 60 COMPR. FILM. P-RF 60 118,36 1,972666 0,903600 0,903600190 N05AH04 QUETIAPINUM** KVENTIAX 200 mg COMPR. FILM. 200mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 53,68 0,894666 0,894666 0,894666191 N05AH04 QUETIAPINUM** QUETROP 200 mg COMPR. FILM. 200mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 60 108,59 1,809833 0,903600 0,903600192 N05AH04 QUETIAPINUM** QUETIAPINE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. PRF 60 128,64 2,144000 0,903600 0,903600193 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 84,97 1,416166 0,903600 0,903600194 N05AH04 QUETIAPINUM** QUERSUS 200 mg COMPR. FILM. 200mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 94,12 1,568666 0,903600 0,903600195 N05AH04 QUETIAPINUM** KATHIRA 200 mg COMPR. FILM. 200mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 86,31 1,438500 0,903600 0,903600196 N05AH04 QUETIAPINUM** KATHIRA 200 mg COMPR. FILM. 200mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 86,31 1,438500 0,903600 0,903600197 N05AH04 QUETIAPINUM** HEDONIN 25 mg COMPR. FILM. 25mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-RF 30 17,00 0,566666 0,566666 0,566666198 N05AH04 QUETIAPINUM** QUETIAPINE ACCORD 25 mg COMPR. FILM. 25mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. PRF 60 43,97 0,732833 0,679999 0,679999199 N05AH04 QUETIAPINUM** KATHIRA 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 34,00 0,566666 0,566666 0,566666200 N05AH04 QUETIAPINUM** KATHIRA 25 mg COMPR. FILM. 25mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 34,00 0,566666 0,566666 0,566666201 N05AH04 QUETIAPINUM** KETILEPT 300 mg COMPR. FILM. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF 60 183,06 3,051000 1,485199 1,485199202 N05AH04 QUETIAPINUM** QUETIAPINE TEVA 300 mg COMPR. FILM. 300mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 60 COMPR. FILM. P-RF/S 60 74,26 1,237666 1,237666 1,237666203 N05AH04 QUETIAPINUM** SETININ 300 mg COMPR. FILM. 300mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 94,31 1,571833 1,485199 1,485199204 N05AH04 QUETIAPINUM** KVENTIAX 300 mg COMPR. FILM. 300mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 123,81 2,063500 1,485199 1,485199205 N05AH04 QUETIAPINUM** QUETROP 300 mg COMPR. FILM. 300mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 60 156,27 2,604500 1,485199 1,485199206 N05AH04 QUETIAPINUM** QUETIAPINE ACCORD 300 mg COMPR. FILM. 300mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. PRF 60 159,59 2,659833 1,485199 1,485199207 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 60 104,79 1,746500 1,485199 1,485199208 N05AH04 QUETIAPINUM** QUERSUS 300 mg COMPR. FILM. 300mg CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 163,04 2,717333 1,485199 1,485199209 N05AH04 QUETIAPINUM** KATHIRA 300 mg COMPR. FILM. 300mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 113,16 1,886000 1,485199 1,485199210 N05AH04 QUETIAPINUM** KATHIRA 300 mg COMPR. FILM. 300mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF 60 113,16 1,886000 1,485199 1,485199211 N05AH04 QUETIAPINUM** SEROQUEL XR 200 mg COMPR. FILM. ELIB. PREL. 200mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 444,50 7,408333 7,408333 7,408333212 N05AH04 QUETIAPINUM** SEROQUEL XR 300 mg COMPR. FILM. ELIB. PREL. 300mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL. P-RF 60 576,10 9,601666 9,601666 9,601666213 N05AH04 QUETIAPINUM** SEROQUEL XR 400 mg COMPR. FILM. ELIB. PREL. 400mg ASTRAZENECA UK LIMITED MAREA BRITANIE CUTIE X 6 BLIST. PVC-PCTFE/AL X 10 COMPR. CU ELIB. PREL. P-RF 60 743,17 12,386166 12,386166 12,386166214 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 60 232,04 3,867333 3,867333 3,867333215 N05AL01 SULPIRIDUM EGLONYL (R) 50 mg CAPS. 50mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 2 BLIST. X 15 CAPS. P-RF 30 7,94 0,264666 0,264666 0,264666

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Page 81: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

216 N05AL01 SULPIRIDUM EGLONYL (R) 200 mg COMPR. 200mg SANOFI-SYNTHELABO FRANCE FRANTA CUTIE X 1 BLIST. X 12 COMPR. P-RF 12 8,07 0,672500 0,672500 0,672500217 N05AL05 AMISULPRIDUM** AMISAN 200 mg COMPR. 200mg PRO. MED. CS PRAHA AS REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-RF 30 49,82 1,660666 1,660666 1,660666218 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 49,82 1,660666 1,660666 1,660666219 N05AL05 AMISULPRIDUM** MIDORA 200 mg COMPR. 200mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 59,64 1,988000 1,988000 1,988000220 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 72,80 2,426666 1,992799 1,992799221 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 30 107,23 3,574333 3,574333 3,574333222 N05AX08 RISPERIDONUM** RILEPTID 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 51,35 0,855833 0,444000 0,444000223 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 24,62 0,410333 0,410333 0,410333224 N05AX08 RISPERIDONUM** SPRING 1 mg COMPR. FILM. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 15,45 0,515000 0,444000 0,444000225 N05AX08 RISPERIDONUM** RONYDAL 1 mg COMPR. FILM. 1mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 24,02 0,400333 0,400333 0,400333226 N05AX08 RISPERIDONUM** RISPEN 1 COMPR. FILM. 1mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 23,64 0,472800 0,444000 0,444000227 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 7,40 0,370000 0,370000 0,370000228 N05AX08 RISPERIDONUM** RONYDAL 1 mg COMPR. FILM. 1mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 24,02 0,400333 0,400333 0,400333229 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 45,73 0,914600 0,914600 0,914600230 N05AX08 RISPERIDONUM** RILEPTID 2 mg COMPR. FILM. 2mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 101,34 1,689000 0,933999 0,933999231 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 46,70 0,778333 0,778333 0,778333232 N05AX08 RISPERIDONUM** RISON 2 mg COMPR. FILM. 2mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 17,15 0,857500 0,857500 0,857500233 N05AX08 RISPERIDONUM** SPRING 2 mg COMPR. FILM. 2mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 26,19 0,873000 0,873000 0,873000234 N05AX08 RISPERIDONUM** RONYDAL 2 mg COMPR. FILM. 2mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 53,40 0,890000 0,890000 0,890000235 N05AX08 RISPERIDONUM** RISPERIDONA MEDOCHEMIE 2 mg COMPR. FILM. 2mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. PRF 20 17,60 0,880000 0,880000 0,880000236 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 16,18 0,809000 0,809000 0,809000237 N05AX08 RISPERIDONUM** RONYDAL 2 mg COMPR. FILM. 2mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 53,40 0,890000 0,890000 0,890000238 N05AX08 RISPERIDONUM** RILEPTID 3 mg COMPR. FILM. 3mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 145,26 2,421000 1,384800 1,384800239 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 34,62 1,154000 1,154000 1,154000240 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 75,48 1,258000 1,258000 1,258000241 N05AX08 RISPERIDONUM** RISON 3 mg COMPR. FILM. 3mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 27,44 1,372000 1,372000 1,372000242 N05AX08 RISPERIDONUM** SPRING 3 mg COMPR. FILM. 3mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 41,45 1,381666 1,381666 1,381666243 N05AX08 RISPERIDONUM** RONYDAL 3 mg COMPR. FILM. 3mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 82,53 1,375500 1,375500 1,375500244 N05AX08 RISPERIDONUM** XENOMA 3 mg COMPR. FILM. 3mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 74,79 1,246500 1,246500 1,246500245 N05AX08 RISPERIDONUM** RISPEN 3 COMPR. FILM. 3mg ZENTIVA KS CEHIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 50 66,32 1,326400 1,326400 1,326400246 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 26,19 1,309500 1,309500 1,309500247 N05AX08 RISPERIDONUM** RONYDAL 3 mg COMPR. FILM. 3mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 82,53 1,375500 1,375500 1,375500248 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 86,87 1,737400 1,737400 1,737400249 N05AX08 RISPERIDONUM** RILEPTID 4 mg COMPR. FILM. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 194,33 3,238833 1,904400 1,904400250 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 47,61 1,587000 1,587000 1,587000251 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 60 100,81 1,680166 1,680166 1,680166252 N05AX08 RISPERIDONUM** RISON 4 mg COMPR. FILM. 4mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 37,41 1,870500 1,870500 1,870500253 N05AX08 RISPERIDONUM** SPRING 4 mg COMPR. FILM. 4mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 56,66 1,888666 1,888666 1,888666254 N05AX08 RISPERIDONUM** RONYDAL 4 mg COMPR. FILM. 4mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 110,91 1,848500 1,848500 1,848500255 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 34,94 1,747000 1,747000 1,747000256 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 33,25 1,662500 1,662500 1,662500257 N05AX08 RISPERIDONUM** RONYDAL 4 mg COMPR. FILM. 4mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 60 110,91 1,848500 1,848500 1,848500258 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 12,34 0,411333 0,411333 0,411333259 N05AX08 RISPERIDONUM** ESSENS OD 1 mg COMPR. ORODISPERSABILE 1mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 12,56 0,418666 0,418666 0,418666260 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 26,86 0,895333 0,895333 0,895333261 N05AX08 RISPERIDONUM** ESSENS OD 2 mg COMPR. ORODISPERSABILE 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 26,86 0,895333 0,895333 0,895333262 N05AX08 RISPERIDONUM** ESSENS OD 3 mg COMPR. ORODISPERSABILE 3mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF 30 41,56 1,385333 1,384800 1,384800263 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA 25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 25mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU UN FLAC.DIN STICLA INCOLORA CU PULB. PENTRU SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA DIN STICLA INCOLORA CU 2 ML SOLVENT, UN DISPOZITIV ALARIS™ SMARTSITE +2 ACE PENTRU INJECTARE I.M. ÎN MUSCHIUL DELTOID SI IN MUSCHIUL GLUTEAL S/P-RF 1 424,25 424,250000 424,250000 424,250000264 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA 37,5 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 37,5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU UN FLAC.DIN STICLA INCOLORA CU PULB. PENTRU SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA DIN STICLA INCOLORA CU 2 ML SOLVENT, UN DISPOZITIV ALARIS™ SMARTSITE +2 ACE PENTRU INJECTARE I.M. ÎN MUSCHIUL DELTOID SI IN MUSCHIUL GLUTEAL S/P-RF 1 597,43 597,430000 597,430000 597,430000265 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA 50 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE CU UN FLAC.DIN STICLA INCOLORA CU PULB. PENTRU SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA DIN STICLA INCOLORA CU 2 ML SOLVENT, UN DISPOZITIV ALARIS™ SMARTSITE +2 ACE PENTRU INJECTARE I.M. ÎN MUSCHIUL DELTOID SI IN MUSCHIUL GLUTEAL S/P-RF 1 719,03 719,030000 719,030000 719,030000

Pagina 26 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

266 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 52,14 52,140000 52,140000 52,140000267 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 28 421,87 15,066785 15,066785 15,066785268 N05AX12 ARIPIPRAZOLUM** ABILIFY 15mg COMPR. 15mg OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR. P-RF 28 416,40 14,871428 14,871428 14,871428269 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 1.554,70 1.554,700000 1.554,700000 1.554,700000270 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 19,95 19,950000 19,950000 19,950000271 N05AX13 PALIPERIDONUM** INVEGA 3mg COMPR. ELIB. PREL. 3mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1FLAC. DIN PEID X 30 COMPR.ELIB.PREL. P-RF 30 497,50 16,583333 16,583333 16,583333272 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 30 497,50 16,583333 16,583333 16,583333273 N05AX13 PALIPERIDONUM** INVEGA 6mg COMPR. ELIB. PREL. 6mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1FLAC. DIN PEID X 30 COMPR.ELIB.PREL. P-RF 30 516,62 17,220666 17,220666 17,220666274 N05AX13 PALIPERIDONUM** INVEGA 6mg COMPR. ELIB. PREL. 6mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIEX 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL) P-RF 30 516,62 17,220666 17,220666 17,220666275 N05AX13 PALIPERIDONUM** INVEGA 9mg COMPR. ELIB. PREL. 9mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1FLAC. DIN PEID X 30 COMPR.ELIB.PREL. P-RF 30 519,41 17,313666 17,313666 17,313666276 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 30 519,41 17,313666 17,313666 17,313666277 N05AX13 PALIPERIDONUM** XEPLION SUSP. INJ. CU ELIB. PREL. 100mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1.801,16 1.801,160000 1.801,160000 1.801,160000278 N05AX13 PALIPERIDONUM** XEPLION SUSP. INJ. CU ELIB. PREL. 150mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 2.320,29 2.320,290000 2.320,290000 2.320,290000279 N05AX13 PALIPERIDONUM** XEPLION SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1.048,75 1.048,750000 1.048,750000 1.048,750000280 N05AX13 PALIPERIDONUM** XEPLION SUSP. INJ. CU ELIB. PREL. 75mg JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE PR 1 1.488,77 1.488,770000 1.488,770000 1.488,770000281 N06AB04 CITALOPRAMUM** LINISAN 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 7,12 0,237333 0,237333 0,237333282 N06AB04 CITALOPRAMUM** DALSAN 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. FILM. P-RF 28 7,40 0,264285 0,264285 0,264285283 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 39,54 1,318000 0,459428 0,459428284 N06AB04 CITALOPRAMUM** DALSAN 20 mg COMPR. FILM. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. FILM. P-RF 28 10,72 0,382857 0,382857 0,382857285 N06AB04 CITALOPRAMUM** DALSAN 40 mg COMPR. FILM. 40mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. FILM. P-RF 28 33,59 1,199642 1,199642 1,199642286 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 22,51 0,750333 0,750333 0,750333287 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 90,38 3,227857 0,900000 0,900000288 N06AB10 ESCITALOPRAMUM** ESCITIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 25,01 0,893214 0,893214 0,893214289 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM-TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 22,51 0,750333 0,750333 0,750333290 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 27,57 0,984642 0,900000 0,900000291 N06AB10 ESCITALOPRAMUM** ESLOREX 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 22,57 0,752333 0,752333 0,752333292 N06AB10 ESCITALOPRAMUM** SERODEPS 10mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 21,06 0,752142 0,752142 0,752142293 N06AB10 ESCITALOPRAMUM** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. PRF 14 12,68 0,905714 0,900000 0,900000294 N06AB10 ESCITALOPRAMUM** ESTAN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PRF 28 25,27 0,902500 0,900000 0,900000295 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 21,00 0,750000 0,750000 0,750000296 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 22,57 0,752333 0,752333 0,752333297 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 21,00 0,750000 0,750000 0,750000298 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 32,82 1,172142 1,172142 1,172142299 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM-TEVA 15 mg COMPR. FILM. 15mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 33,77 1,125666 1,125666 1,125666300 N06AB10 ESCITALOPRAMUM** ELICEA 15 mg COMPR. FILM. 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 39,57 1,319000 1,319000 1,319000301 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM-TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 43,57 1,452333 1,452333 1,452333302 N06AB10 ESCITALOPRAMUM** SERODEPS 20mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 36,70 1,310714 1,310714 1,310714303 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 63,52 2,268571 1,572856 1,572856304 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 42,56 1,520000 1,520000 1,520000305 N06AB10 ESCITALOPRAMUM** ELICEA 20 mg COMPR. FILM. 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF 30 45,60 1,520000 1,520000 1,520000306 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 10 mg COMPR. ORODISPERSABILE 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 21,06 0,752142 0,752142 0,752142307 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 10 mg COMPR. ORODISPERSABILE 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 21,06 0,752142 0,752142 0,752142308 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE PRF 30 27,00 0,900000 0,900000 0,900000309 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 15 mg COMPR. ORODISPERSABILE 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 36,95 1,319642 1,319642 1,319642310 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 15 mg COMPR. ORODISPERSABILE 15mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 36,95 1,319642 1,319642 1,319642311 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 20 mg COMPR. ORODISPERSABILE 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE PRF 28 42,56 1,520000 1,520000 1,520000312 N06AB10 ESCITALOPRAMUM** ELICEA Q-TAB 20 mg COMPR. ORODISPERSABILE 20mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF 28 42,56 1,520000 1,520000 1,520000313 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM TEVA 20 mg COMPR. ORODISPERSABILE 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE PRF 30 47,18 1,572666 1,572666 1,572666314 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 24,95 1,247500 1,247500 1,247500315 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 63,31 1,055166 1,055166 1,055166

Pagina 27 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

316 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 63,31 1,055166 1,055166 1,055166317 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 24,95 1,247500 1,247500 1,247500318 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 18,71 0,623666 0,623666 0,623666319 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 18,71 0,623666 0,623666 0,623666320 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 22,65 0,755000 0,755000 0,755000321 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 63,54 0,706000 0,706000 0,706000322 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 22,65 0,755000 0,755000 0,755000323 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 22,65 0,755000 0,755000 0,755000324 N06AX14 TIANEPTINUM** COAXIL (R) DRAJ. 12,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF 30 33,74 1,124666 0,847200 0,847200325 N06AX16 VENLAFAXINUM** IVRYX 150mg CAPS. ELIB. PREL. 150 mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 23,22 0,829285 0,829285 0,829285326 N06AX16 VENLAFAXINUM** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN ACLAR-PE-PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 58,69 2,096071 0,829599 0,829599327 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 40,87 1,362333 0,829599 0,829599328 N06AX16 VENLAFAXINUM** IVRYX 150mg CAPS. ELIB. PREL. 150 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 23,22 0,829285 0,829285 0,829285329 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 38,14 1,362142 0,829599 0,829599330 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 40,87 1,362333 0,829599 0,829599331 N06AX16 VENLAFAXINUM** FOBILESS 150 mg CAPS. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 40,87 1,362333 0,829599 0,829599332 N06AX16 VENLAFAXINUM** ADOXA EP 150 mg CAPS. ELIB. PREL. 150mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 40,87 1,362333 0,829599 0,829599333 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 23,11 0,825357 0,825357 0,825357334 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 40,71 1,357000 0,829599 0,829599335 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 40,87 1,362333 0,829599 0,829599336 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 40,87 1,362333 0,829599 0,829599337 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 17,24 0,574666 0,574666 0,574666338 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 24,04 0,801333 0,689599 0,689599339 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 17,89 0,638928 0,638928 0,638928340 N06AX16 VENLAFAXINUM** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN ACLAR-PE-PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 35,58 1,270714 0,639199 0,639199341 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 25,61 0,853666 0,639199 0,639199342 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 17,89 0,638928 0,638928 0,638928343 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 17,89 0,638928 0,638928 0,638928344 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 23,88 0,852857 0,639199 0,639199345 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 25,59 0,853000 0,639199 0,639199346 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 19,15 0,638333 0,638333 0,638333347 N06AX16 VENLAFAXINUM** ADOXA EP 75 mg CAPS. ELIB. PREL. 75mg RANBAXY (UK) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 25,61 0,853666 0,639199 0,639199348 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 17,72 0,632857 0,632857 0,632857349 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 25,42 0,847333 0,639199 0,639199350 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 25,61 0,853666 0,639199 0,639199351 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 25,61 0,853666 0,639199 0,639199352 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 24,04 0,801333 0,689599 0,689599353 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 24,50 0,816666 0,816666 0,816666354 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 25,42 0,847333 0,639199 0,639199355 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 20,74 0,691333 0,691333 0,691333356 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 15,98 0,532666 0,532666 0,532666357 N06AX21 DULOXETINUM** CYMBALTA 30mg CAPS. GASTROREZ. 30mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 105,39 3,763928 3,763928 3,763928358 N06AX21 DULOXETINUM** CYMBALTA 60mg CAPS. GASTROREZ. 60mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF 28 178,89 6,388928 6,388928 6,388928

Tratamentul se initiaza de catre medicul in specialitatea psihiatrie

1 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 52,19 1,863928 1,863928 1,863928

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

Pagina 28 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

2 N06DA02 DONEPEZILUM*** ZILDON 10mg COMPR. FILM. 10mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 171,82 6,136428 2,075570 2,0755703 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 62,25 2,075000 2,075000 2,0750004 N06DA02 DONEPEZILUM*** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 62,25 2,075000 2,075000 2,0750005 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 65,30 2,176666 2,075570 2,0755706 N06DA02 DONEPEZILUM*** PRIDIA 10 mg COMPR. FILM. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 62,61 2,236071 2,075570 2,0755707 N06DA02 DONEPEZILUM*** ALZEPIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 108,76 3,884285 2,075570 2,0755708 N06DA02 DONEPEZILUM*** ALZEPIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P-RF 56 206,27 3,683392 2,075570 2,0755709 N06DA02 DONEPEZILUM*** ALZEPIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 108,76 3,884285 2,075570 2,075570

10 N06DA02 DONEPEZILUM*** ALZEPIL 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P-RF 56 206,27 3,683392 2,075570 2,07557011 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 57,41 2,050357 2,050357 2,05035712 N06DA02 DONEPEZILUM*** COGITON 10 mg COMPR. FILM. 10mg BMF PHARM S.R.L. ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 COMPR. FILM. P-RF 28 134,46 4,802142 2,075570 2,07557013 N06DA02 DONEPEZILUM*** COGNEZIL 10 mg COMPR. FILM. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 4 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 28 48,43 1,729642 1,729642 1,72964214 N06DA02 DONEPEZILUM*** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 57,17 2,041785 2,041785 2,04178515 N06DA02 DONEPEZILUM*** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 96,95 1,939000 1,939000 1,93900016 N06DA02 DONEPEZILUM*** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 108,57 1,938750 1,938750 1,93875017 N06DA02 DONEPEZILUM*** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 116,33 1,938833 1,938833 1,93883318 N06DA02 DONEPEZILUM*** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 180,19 1,838673 1,838673 1,83867319 N06DA02 DONEPEZILUM*** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 183,87 1,838700 1,838700 1,83870020 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 54,62 1,820666 1,820666 1,82066621 N06DA02 DONEPEZILUM*** XALINAT 10 mg COMPR. FILM. 10mg GALENICA S.A. GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 64,86 2,316428 2,075570 2,07557022 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 37,28 1,331428 1,331428 1,33142823 N06DA02 DONEPEZILUM*** ZILDON 5 mg COMPR. FILM. 5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 145,89 5,210357 1,487570 1,48757024 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 44,61 1,487000 1,487000 1,48700025 N06DA02 DONEPEZILUM*** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 44,61 1,487000 1,487000 1,48700026 N06DA02 DONEPEZILUM*** TUADIN 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 45,18 1,506000 1,487570 1,48757027 N06DA02 DONEPEZILUM*** ALZEPIL 5 mg COMPR. FILM. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-RF 28 106,21 3,793214 1,487570 1,48757028 N06DA02 DONEPEZILUM*** ALZEPIL 5 mg COMPR. FILM. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 106,21 3,793214 1,487570 1,48757029 N06DA02 DONEPEZILUM*** ALZEPIL 5 mg COMPR. FILM. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P-RF 56 201,43 3,596964 1,487570 1,48757030 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 41,01 1,464642 1,464642 1,46464231 N06DA02 DONEPEZILUM*** COGITON 5 mg COMPR. FILM. 5mg BMF PHARM S.R.L. ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 COMPR. FILM. P-RF 28 118,91 4,246785 1,487570 1,48757032 N06DA02 DONEPEZILUM*** COGNEZIL 5 mg COMPR. FILM. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 4 BLIST. AL/PVC X 7 COMPR. FILM. P-RF 28 34,71 1,239642 1,239642 1,23964233 N06DA02 DONEPEZILUM*** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 41,29 1,474642 1,474642 1,47464234 N06DA02 DONEPEZILUM*** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 71,26 1,425200 1,425200 1,42520035 N06DA02 DONEPEZILUM*** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 78,43 1,400535 1,400535 1,40053536 N06DA02 DONEPEZILUM*** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 84,02 1,400333 1,400333 1,40033337 N06DA02 DONEPEZILUM*** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 132,50 1,352040 1,352040 1,35204038 N06DA02 DONEPEZILUM*** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 135,21 1,352100 1,352100 1,35210039 N06DA02 DONEPEZILUM*** DONEPEZIL TORRENT 5 mg COMPR. FILM. 5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 37,78 1,259333 1,259333 1,25933340 N06DA02 DONEPEZILUM*** XALINAT 5 mg COMPR. FILM. 5mg GALENICA S.A. GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 47,94 1,712142 1,487570 1,48757041 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 52,19 1,863928 1,863928 1,86392842 N06DA02 DONEPEZILUM*** ARICEPT EVESS COMPR. ORODISPERSABILE 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE P-RF 28 379,17 13,541785 2,075570 2,07557043 N06DA02 DONEPEZILUM*** DONEPEZIL TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP. P-RF 28 58,11 2,075357 2,075357 2,07535744 N06DA02 DONEPEZILUM*** DARIZOL 10 mg COMPR. ORODISPERSABILE 10mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE PRF 28 62,61 2,236071 2,075570 2,07557045 N06DA02 DONEPEZILUM*** DONEPEZIL STADA HEMOFARM 10 mg COMPR. ORODISPERSABILE 10mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE PRF 28 238,90 8,532142 2,075570 2,07557046 N06DA02 DONEPEZILUM*** DONEPEZIL STADA HEMOFARM 10 mg COMPR. ORODISPERSABILE 10mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 238,90 8,532142 2,075570 2,07557047 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 62,61 2,236071 2,075570 2,07557048 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 37,28 1,331428 1,331428 1,33142849 N06DA02 DONEPEZILUM*** ARICEPT EVESS COMPR. ORODISPERSABILE 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE P-RF 28 305,48 10,910000 1,487570 1,48757050 N06DA02 DONEPEZILUM*** DONEPEZIL TEVA 5 mg COMPR. ORODISPERSABILE 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP. P-RF 28 41,65 1,487500 1,487500 1,48750051 N06DA02 DONEPEZILUM*** DARIZOL 5 mg COMPR. ORODISPERSABILE 5mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE PRF 28 44,72 1,597142 1,487570 1,487570

Pagina 29 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

52 N06DA02 DONEPEZILUM*** DONEPEZIL STADA HEMOFARM 5 mg COMPR. ORODISPERSABILE 5mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE PRF 28 125,98 4,499285 1,487570 1,48757053 N06DA02 DONEPEZILUM*** DONEPEZIL STADA HEMOFARM 5 mg COMPR. ORODISPERSABILE 5mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 125,98 4,499285 1,487570 1,48757054 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 44,72 1,597142 1,487570 1,48757055 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA RATIOPHARM 1,5 mg CAPS. 1,5mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. P-RF/R 56 79,35 1,416964 1,369500 1,36950056 N06DA03 RIVASTIGMINUM*** RIVASTIGMINE SANDOZ1,5mg CAPS. 1,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST.PVC/AL X 56 CAPS. P-RF/R 56 70,74 1,263214 1,263214 1,26321457 N06DA03 RIVASTIGMINUM*** RIDAXIN 1,5 mg CAPS. 1,5mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 63,91 1,141250 1,141250 1,14125058 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TORRENT 1,5 mg CAPS. 1,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. P-RF/R 56 72,39 1,292678 1,292678 1,29267859 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 63,91 1,141250 1,141250 1,14125060 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 37,89 1,353214 1,353214 1,35321461 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 78,01 2,786071 2,786071 2,78607162 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA RATIOPHARM 3 mg CAPS. 3mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. P-RF/R 56 150,48 2,687142 2,687142 2,68714263 N06DA03 RIVASTIGMINUM*** RIVASTIGMINE SANDOZ 3mg CAPS. 3mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST.PVC/AL X 56 CAPS. P-RF/R 56 133,98 2,392500 2,392500 2,39250064 N06DA03 RIVASTIGMINUM*** RIDAXIN 3 mg CAPS. 3mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 130,32 2,327142 2,327142 2,32714265 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/R 56 143,02 2,553928 2,553928 2,55392866 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 56 130,32 2,327142 2,327142 2,32714267 N06DA03 RIVASTIGMINUM*** RIDAXIN 4,5 mg CAPS. 4,5mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 120,75 2,156250 2,156250 2,15625068 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 56 120,75 2,156250 2,156250 2,15625069 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 56 153,96 2,749285 2,749285 2,74928570 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 37,89 1,353214 1,353214 1,35321471 N06DA03 RIVASTIGMINUM*** NIMVASTID 3mg COMPR. ORODISPERSABILE 3mg 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 78,01 2,786071 2,786071 2,78607172 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 89,80 3,207142 2,587500 2,58750073 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 28 101,04 3,608571 3,299142 3,29914274 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 30 589,06 19,635333 19,635333 19,63533375 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 30 390,58 13,019333 10,262799 10,26279976 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 TRANSDERMICPRF 30 256,57 8,552333 8,552333 8,55233377 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TEVA 4,6 mg/24 ore PLASTURE TRANSDERMIC 4,6mg/24ore TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 30 PLICURI MULTILAMINATE, REZISTENTE LA ACTIUNEA COPIILOR, DIN HARTIE/PET/AL/PAN X 1 PASTUR PRF 30 256,57 8,552333 8,552333 8,55233378 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 30 390,58 13,019333 10,262799 10,26279979 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 TRANSDERMICPRF 30 256,57 8,552333 8,552333 8,55233380 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TEVA 9,5 mg/24 ore PLASTURE TRANSDERMIC 9,5mg/24ore TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 30 PLICURI MULTILAMINATE, REZISTENTE LA ACTIUNEA COPIILOR, DIN HARTIE/PET/AL/PAN X 1 PASTUR PRF 30 256,57 8,552333 8,552333 8,55233381 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA DR. REDDY'S 4,6 mg/24 ore PLASTURI TRANSDERMICI 4,6mg/24ore DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HÂRTIE/POLIETILENTEREFTALAT/AL/POLIACRILONITRIL CU CU SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, A CÂTE 1 PLASTURE TRANSDERMIC PROTEJ. DE O FOLIE DIN FILM DIN TEREFTALAT DE POLIETILENA SILICONATA PRF 30 256,57 8,552333 8,552333 8,55233382 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA DR. REDDY'S 9,5 mg/24 ore PLASTURI TRANSDERMICI 9,5mg/24ore DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HÂRTIE/POLIETILENTEREFTALAT/AL/POLIACRILONITRIL CU CU SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, A CÂTE 1 PLASTURE TRANSDERMIC PROTEJ. DE O FOLIE DIN FILM DIN TEREFTALAT DE POLIETILENA SILICONATA PRF 30 256,57 8,552333 8,552333 8,55233383 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TEVA 2 mg/ml SOL. ORALA 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 125 ML SOL. ORALA + 1 SERINGA DOZATOARE P-RF/R 1 420,26 420,260000 420,260000 420,26000084 N06DA04 GALANTAMINUM*** REMINYL 16 mg CAPS. ELIB. PREL. 16mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 4 BLIST. PVC-PE-PVDC X 7 CAPS. CU ELIB. PREL. P-RF 28 374,39 13,371071 1,750285 1,75028585 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 52,50 1,750000 1,750000 1,75000086 N06DA04 GALANTAMINUM*** GALANTAMINA ZENTIVA 16 mg CAPS. ELIB. PREL. 16mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 40,84 1,458571 1,458571 1,45857187 N06DA04 GALANTAMINUM*** REMINYL 24 mg CAPS. ELIB. PREL. 24mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 4 BLIST. PVC-PE-PVDC X 7 CAPS. CU ELIB. PREL. P-RF 28 417,57 14,913214 1,750285 1,75028588 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 52,50 1,750000 1,750000 1,75000089 N06DA04 GALANTAMINUM*** GALANTAMINA ZENTIVA 24 mg CAPS. ELIB. PREL. 24mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 40,84 1,458571 1,458571 1,45857190 N06DA04 GALANTAMINUM*** REMINYL 8 mg CAPS. ELIB. PREL. 8mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 4 BLIST. PVC-PE-PVDC X 7 CAPS. CU ELIB. PREL. P-RF 28 201,08 7,181428 1,750285 1,75028591 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 52,50 1,750000 1,750000 1,75000092 N06DA04 GALANTAMINUM*** GALANTAMINA ZENTIVA 8 mg CAPS. ELIB. PREL. 8mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 40,84 1,458571 1,458571 1,45857193 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 1 254,22 254,220000 254,220000 254,22000094 N06DX01 MEMANTINUM*** MEMANTINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBH GERMANIA CUTIE CU BLISTERE DIN FOLIE PVC/PVDC-AL X 56 COMPRIMATE FILMATE PR 56 47,09 0,840892 0,660428 0,66042895 N06DX01 MEMANTINUM*** MEMANTINA POLIPHARMA 10 mg COMPR. FILM. 10 mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC/AL X 28 COMPR. FILM. PR 28 99,13 3,540357 0,660428 0,66042896 N06DX01 MEMANTINUM*** MEMANTINA POLIPHARMA 10 mg COMPR. FILM. 10 mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC/AL X 56 COMPR. FILM. PR 56 188,00 3,357142 0,660428 0,66042897 N06DX01 MEMANTINUM*** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R 56 132,46 2,365357 0,660428 0,66042898 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 36,98 0,660357 0,660357 0,66035799 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 18,18 0,649285 0,649285 0,649285100 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 30,82 0,550357 0,550357 0,550357101 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 56,51 1,009107 0,660428 0,660428

Pagina 30 din 45

Page 86: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

102 N06DX01 MEMANTINUM*** MEMIGMIN 10 mg COMPR. FILM. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 202,77 3,620892 0,660428 0,660428103 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 46,22 0,825357 0,660428 0,660428104 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 36,98 0,660357 0,660357 0,660357105 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 36,98 0,660357 0,660357 0,660357106 N06DX01 MEMANTINUM*** MEMANTINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 36,74 0,656071 0,656071 0,656071107 N06DX01 MEMANTINUM*** MARIXINO 10mg COMPR. FILM. 10mg CONSILIENT HEALTH LTD. IRLANDA CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE PR 56 36,96 0,660000 0,660000 0,660000108 N06DX01 MEMANTINUM*** COGNOMEM 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 36,98 0,660357 0,660357 0,660357109 N06DX01 MEMANTINUM*** TORMORO 10 mg COMPR. FILM. 10mg ABBOTT PRODUCTS SAS FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PR 60 60,48 1,008000 0,660428 0,660428110 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 70 156,14 2,230571 0,660428 0,660428111 N06DX01 MEMANTINUM*** MEMANTINA POLIPHARMA 20 mg COMPR. FILM. 20 mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC/AL X 28 COMPR. FILM. PR 28 265,89 9,496071 1,584856 1,584856112 N06DX01 MEMANTINUM*** MEMANTINA POLIPHARMA 20 mg COMPR. FILM. 20 mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC/AL X 56 COMPR. FILM. PR 56 519,49 9,276607 1,584856 1,584856113 N06DX01 MEMANTINUM*** MEMANTINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBH GERMANIA CUTIE X BLISTERE DIN FOLIE PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 47,09 1,681785 1,584856 1,584856114 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 56 113,02 2,018214 1,584856 1,584856115 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 43,24 1,544285 1,544285 1,544285116 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 56,51 2,018214 1,584856 1,584856117 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 56,51 2,018214 1,584856 1,584856118 N06DX01 MEMANTINUM*** MEMANTINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PR 30 110,25 3,675000 1,584856 1,584856119 N06DX01 MEMANTINUM*** COGNOMEM 20 mg COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 404,46 7,222500 1,584856 1,584856120 N06DX01 MEMANTINUM*** MEMANTINA TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. ORODISPERSABILE PR 56 36,98 0,660357 0,660357 0,660357121 N06DX01 MEMANTINUM*** ZENMEM 10 mg COMPR. ORODISPERSABILE 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODISPERSABILE PR 28 67,46 2,409285 0,660428 0,660428122 N06DX01 MEMANTINUM*** MEMANTINA TEVA 20 mg COMPR. ORODISPERSABILE 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 28X1 COMPR. ORODISPERSABILE PR 28 36,98 1,320714 1,320714 1,320714123 N06DX01 MEMANTINUM*** ZENMEM 20 mg COMPR. ORODISPERSABILE 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODISPERSABILE PR 28 151,58 5,413571 1,584856 1,584856124 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 1 352,22 352,220000 274,740000 274,740000125 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 1 228,95 228,950000 228,950000 228,950000126 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 1 441,45 441,450000 441,450000 441,450000127 N06DX01 MEMANTINUM*** COGNOMEM 5 mg/doza eliberata SOL. ORALA 5mg/doza eliberata ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA BRUNA PREVAZUT CU POMPA DOZATOARE X 50 ML SOL. ORALA PR 1 228,95 228,950000 228,950000 228,950000

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

1 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 32,62 0,652400 0,652400 0,6524002 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 29,65 1,482500 1,482500 1,4825003 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 26,13 0,522600 0,522600 0,5226004 L01AA01 CYCLOPHOSPHAMIDUM* ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 15,89 15,890000 15,890000 15,8900005 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,702100 0,7021006 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 78,89 0,788900 0,788900 0,7889007 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL® COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 31,39 0,523166 0,523166 0,523166

Tratamentul se initiaza si se monitorizeaza de catre medicul in specialitatea reumatologie, nefrologie si boli infectioase.

1 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 28,24 0,564800 0,564800 0,5648002 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 28,20 0,564000 0,564000 0,5640003 H02AB01 BETAMETHASONUM DIPROPHOS® SUSP. INJ. I.M. 7mg/ml MERCK SHARP & DOHME BELGIA CUTIE X 5 FIOLE X 1 ML P-RF 5 34,53 6,906000 6,906000 6,9060004 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 32,62 0,652400 0,652400 0,6524005 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 29,65 1,482500 1,482500 1,482500

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

16. POLIARTRITA REUMATOIDA , ARTROPATIA PSORIAZICA SI ARTRITA JUVENILA - G 18

Pagina 31 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

6 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,8810007 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,7206668 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 400,81 400,810000 400,810000 400,8100009 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 241,07 48,214000 48,214000 48,214000

10 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 89,66 89,660000 89,660000 89,66000011 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 23,82 2,382000 2,382000 2,38200012 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 78,67 78,670000 78,670000 78,67000013 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 59,64 59,640000 59,640000 59,64000014 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 1 122,50 122,500000 122,500000 122,50000015 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 1 110,09 110,090000 110,090000 110,09000016 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 124,21 124,210000 124,210000 124,21000017 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 78,67 78,670000 78,670000 78,67000018 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,15ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,80 74,800000 71,568000 71,56800019 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 109,54 109,540000 109,540000 109,54000020 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDA SANDOZ 10 mg COMPR. FILM. 10 mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP CU DESICANT X 30 COMPR. FILM. PR 30 54,93 1,831000 1,831000 1,83100021 L04AA13 LEFLUNOMIDUM** ARAVA 10mg COMPR. FILM. 10mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 80,27 2,675666 2,197200 2,19720022 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDA RATIOPHARM 10 MG COMPR. FILM. 10mg RATIOPHARM GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. P-RF/R 30 54,93 1,831000 1,831000 1,83100023 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDE WINTHROP 10mg COMPR. FILM. 10mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 54,93 1,831000 1,831000 1,83100024 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDA MEDAC 10 mg COMPR. FILM. 10mg MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE CU 1 FLACON DIN PEID X 30 COMPR. FILM. PR 30 133,74 4,458000 2,197200 2,19720025 L04AA13 LEFLUNOMIDUM** LEFLON 10 mg COMPR. FILM. 10mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR 30 54,93 1,831000 1,831000 1,83100026 L04AA13 LEFLUNOMIDUM** LEFLON 10 mg COMPR. FILM. 10mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR 30 54,93 1,831000 1,831000 1,83100027 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 30 104,33 3,477666 3,477666 3,47766628 L04AA13 LEFLUNOMIDUM** ARAVA 20mg COMPR. FILM. 20mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 152,20 5,073333 4,173199 4,17319929 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDA RATIOPHARM 20 MG COMPR. FILM. 20mg RATIOPHARM GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. P-RF 30 104,33 3,477666 3,477666 3,47766630 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDE WINTHROP 20mg COMPR. FILM. 20mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR 30 104,33 3,477666 3,477666 3,47766631 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDA MEDAC 20 mg COMPR. FILM. 20mg MEDAC GESELLSCHAFT FUR KLINISCHE SPEZIALPRAPARATE GERMANIA CUTIE CU 1 FLACON DIN PEID X 30 COMPR.FILM PR 30 190,22 6,340666 4,173199 4,17319932 L04AA13 LEFLUNOMIDUM** LEFLON 20 mg COMPR. FILM. 20mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR 30 104,33 3,477666 3,477666 3,47766633 L04AA13 LEFLUNOMIDUM** LEFLON 20 mg COMPR. FILM. 20mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR 30 104,33 3,477666 3,477666 3,47766634 L04AD01 CICLOSPORINUM* EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,15200035 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 137,32 2,746400 1,804080 1,80408036 L04AD01 CICLOSPORINUM* EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,50340037 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 292,16 5,843200 3,541920 3,54192038 L04AD01 CICLOSPORINUM* EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,95160039 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,702100 0,70210040 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 78,89 0,788900 0,788900 0,78890041 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 47,70 2,385000 2,385000 2,38500042 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 20,49 0,683000 0,471600 0,47160043 M01AB05 DICLOFENACUM TRATUL 50 mg CAPS. MOI GASTROREZ. 50mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI GASTROREZ. P-6L 30 6,39 0,213000 0,136200 0,13620044 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 8,54 0,427000 0,427000 0,42700045 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 3,93 0,393000 0,393000 0,39300046 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 6,56 0,656000 0,512400 0,51240047 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 8,55 0,427500 0,427500 0,42750048 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 6,56 0,328000 0,136200 0,13620049 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 4,25 0,212500 0,136200 0,13620050 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 2,27 0,113500 0,113500 0,11350051 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 2,34 0,234000 0,136200 0,13620052 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 5,72 0,190666 0,190666 0,19066653 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 2,65 0,132500 0,132500 0,13250054 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 3,98 0,132666 0,132666 0,13266655 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF 5 9,40 1,880000 0,972000 0,972000

Pagina 32 din 45

Page 88: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

56 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 14,24 2,848000 0,972000 0,97200057 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 6,10 1,220000 0,972000 0,97200058 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 4,05 0,810000 0,810000 0,81000059 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 3,94 0,656666 0,656666 0,65666660 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 5,47 1,094000 0,765600 0,76560061 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 6,95 0,695000 0,695000 0,69500062 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 6,38 0,638000 0,638000 0,63800063 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 3,64 0,606666 0,606666 0,60666664 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 6,01 0,601000 0,601000 0,60100065 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 9,45 0,945000 0,945000 0,94500066 P01BA02 HYDROXYCHLOROQUINUM PLAQUENIL® COMPR. FILM. 200mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L 60 31,39 0,523166 0,523166 0,523166

1 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 28,24 0,564800 0,564800 0,5648002 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 28,20 0,564000 0,564000 0,5640003 H02AB01 BETAMETHASONUM DIPROPHOS® SUSP. INJ. I.M. 7mg/ml MERCK SHARP & DOHME BELGIA CUTIE X 5 FIOLE X 1 ML P-RF 5 34,53 6,906000 6,906000 6,9060004 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 47,70 2,385000 2,385000 2,3850005 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 20,49 0,683000 0,471600 0,4716006 M01AB05 DICLOFENACUM TRATUL 50 mg CAPS. MOI GASTROREZ. 50mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI GASTROREZ. P-6L 30 6,39 0,213000 0,136200 0,1362007 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 8,54 0,427000 0,427000 0,4270008 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 3,93 0,393000 0,393000 0,3930009 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 6,56 0,656000 0,512400 0,512400

10 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 8,55 0,427500 0,427500 0,42750011 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 6,56 0,328000 0,136200 0,13620012 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 4,25 0,212500 0,136200 0,13620013 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 2,27 0,113500 0,113500 0,11350014 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 2,34 0,234000 0,136200 0,13620015 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 5,72 0,190666 0,190666 0,19066616 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 2,65 0,132500 0,132500 0,13250017 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 3,98 0,132666 0,132666 0,13266618 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF 5 9,40 1,880000 0,972000 0,97200019 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 14,24 2,848000 0,972000 0,97200020 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF 5 6,10 1,220000 0,972000 0,97200021 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 4,05 0,810000 0,810000 0,81000022 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 3,94 0,656666 0,656666 0,65666623 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 5,47 1,094000 0,765600 0,76560024 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 6,95 0,695000 0,695000 0,69500025 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 6,38 0,638000 0,638000 0,63800026 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 3,64 0,606666 0,606666 0,60666627 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 6,01 0,601000 0,601000 0,60100028 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 9,45 0,945000 0,945000 0,945000

Tratamentul se initiaza si se monitorizeaza de catre medicul in specialitatea reumatologie, nefrologie, medicina interna sau recuperare medicina fizica balneofizioterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii pt specialitatea recuperare, medicina fizica balneofizioterapie )

17. SPONDILITA ANKILOZANTA - G 19

Tratamentul se initiaza si se monitorizeaza de catre medicul in specialitatea reumatologie sau recuperare medicina fizica balneofizioterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii pt specialitatea

Pagina 33 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

1 G02CB03 CABERGOLINUM** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR. P-RF 2 43,59 21,795000 18,561000 18,5610002 G02CB03 CABERGOLINUM** DOSTINEX COMPR. 0,5mg PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR. P-RF 8 123,74 15,467500 15,467500 15,4675003 H01AX01 PEGVISOMANTUM**** SOMAVERT 10 mg LIOF. + SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE X 30 FLAC. CU PULB., INSOTITE DE 30 FLAC. X 8 ML SOLV. PT. RECONSTITUIRE P-RF/R 30 8.603,01 286,767000 286,767000 286,7670004 H01AX01 PEGVISOMANTUM**** SOMAVERT 20 mg LIOF. + SOLV. PT. SOL. INJ. 20mg PFIZER LIMITED MAREA BRITANIE CUTIE X 30 FLAC. CU LIOF., INSOTITE DE 30 FLAC. A 8 ML SOLV. PT. RECONSTITUIRE P-RF/R 30 17.135,17 571,172333 571,172333 571,1723335 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 30 128,50 4,283333 4,283333 4,2833336 H01BA02 DESMOPRESSINUM MINIRIN 0,2 mg COMPR. 0,2mg FERRING GMBH GERMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF 30 120,65 4,021666 4,021666 4,0216667 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 30 183,02 6,100666 6,100666 6,1006668 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 34,06 3,406000 3,406000 3,4060009 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 97,02 3,234000 3,234000 3,234000

10 H01CB02 OCTREOTIDUM**** SANDOSTATIN LAR 20 mg PULB. + SOLV. PT. SUSP. INJ. (I.M.) CU ELIB. PRELU 20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF 1 3.829,62 3.829,620000 3.829,620000 3.829,62000011 H01CB02 OCTREOTIDUM**** SANDOSTATIN LAR 10 mg PULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG. 10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF 1 2.400,54 2.400,540000 2.400,540000 2.400,54000012 H01CB02 OCTREOTIDUM**** SANDOSTATIN LAR 30 mg PULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG. 30mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULB. + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE S/P-RF 1 5.288,92 5.288,920000 5.288,920000 5.288,92000013 H01CB02 OCTREOTIDUM**** OCTREOTID KABI 0,1 mg/ml SOL INJ. 0,1mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 5 FLAC. DIN SICLA INCOLORA, CU CAPACITATEA DE 2 ML X 1 ML SOL. INJ. PRF 5 95,45 19,090000 19,090000 19,09000014 H01CB03 LANREOTIDUM**** 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 1.572,80 1.572,800000 1.572,800000 1.572,80000015 H01CB03 LANREOTIDUM**** SOMATULINE AUTOGEL 120 mg SOL. INJ. CU ELIB. PREL. 120mg IPSEN PHARMA FRANTA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. CU ELIB. PREL., IN PUNGA AL/NYLON/PE + AC S/P-RF 1 5.089,12 5.089,120000 5.089,120000 5.089,12000016 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 7.863,11 262,103666 262,103666 262,10366617 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 8.674,14 289,138000 289,138000 289,13800018 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 9.264,78 308,826000 308,826000 308,82600019 H02AA02 FLUDROCORTISONUM ASTONIN H COMPR. 0,1mg MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF 50 47,78 0,955600 0,955600 0,95560020 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 250 LIOF. + SOLV. PT. SOL. INJ. 250mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. DIN STICLA INCOLORA X 250 MG FIOF. PT. SOL. INJ. + 3 FIOLE X 5 ML SOLV. P-RF 3 95,62 31,873333 31,873333 31,87333321 H02AB06 PREDNISOLONUM SOLU - DECORTIN H 50 LIOF. + SOLV. PT. SOL. INJ. 50mg MERCK KGAA GERMANIA CUTIE X 3 FLAC. X 50 MG LIOF. PT. SOL. INJ. + 3 FIOLE X 1 ML SOLVENT P-RF 3 35,71 11,903333 11,903333 11,90333322 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 2,65 0,132500 0,104799 0,10479923 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,62 0,087333 0,087333 0,08733324 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,71 0,123666 0,104799 0,10479925 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 2,57 0,128500 0,104799 0,10479926 H02AB09 HYDROCORTISONUM HYDROCORTISONE ROUSSEL COMPR. 10mg CN UNIFARM ROMANIA CUTIE X 1 FLAC. 25 COMPR. PRF 25 12,20 0,488000 0,488000 0,48800027 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 3,91 3,910000 3,910000 3,91000028 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 11,91 11,910000 11,910000 11,91000029 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 7,09 7,090000 4,692000 4,69200030 H02AB09 HYDROCORTISONUM HIDROCORTIZON HEMISUCCINAT SOL. INJ. I.V. 25mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B S/P-RF 5 21,33 4,266000 4,266000 4,26600031 H03AA01 LEVOTHYROXINUM EUTHYROX 100mcg COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 11,69 0,116900 0,091200 0,09120032 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 100 micrograme COMPR. 100micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 7,60 0,076000 0,076000 0,07600033 H03AA01 LEVOTHYROXINUM EUTHYROX 100µg COMPR. 100µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 11,69 0,116900 0,091200 0,09120034 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 125 micrograme COMPR. 125micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 9,49 0,094900 0,094900 0,09490035 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 150 micrograme COMPR. 150micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 11,40 0,114000 0,114000 0,11400036 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 175 micrograme COMPR. 175micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 13,30 0,133000 0,133000 0,13300037 H03AA01 LEVOTHYROXINUM EUTHYROX 200mcg COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 24,14 0,241400 0,188400 0,18840038 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 200 micrograme COMPR. 200micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 15,70 0,157000 0,157000 0,15700039 H03AA01 LEVOTHYROXINUM EUTHYROX 200µg COMPR. 200µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-6L 100 24,14 0,241400 0,188400 0,18840040 H03AA01 LEVOTHYROXINUM EUTHYROX 25mcg COMPR. 25mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 9,51 0,095100 0,074160 0,07416041 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 25 micrograme COMPR. 25micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 6,18 0,061800 0,061800 0,06180042 H03AA01 LEVOTHYROXINUM EUTHYROX 25µg COMPR. 25µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 9,51 0,095100 0,074160 0,07416043 H03AA01 LEVOTHYROXINUM EUTHYROX 50mcg COMPR. 50mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 8,27 0,082700 0,064560 0,06456044 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 50 micrograme COMPR. 50micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 5,38 0,053800 0,053800 0,05380045 H03AA01 LEVOTHYROXINUM EUTHYROX 50µg COMPR. 50µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 8,27 0,082700 0,064560 0,064560

recuperare, medicina fizica balneofizioterapie )

18. BOLI ENDOCRINE (GUSA ENDEMICA, INSUFICIENTA SUPRARENALA CRONICA, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARA SI TUMORI NEUROENDOCRINE) - G 22

Pagina 34 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

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UT (RON) PT. ADULTI

46 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 75 micrograme COMPR. 75micrograme TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 8,07 0,080700 0,080700 0,08070047 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF 100 12,33 0,123300 0,123300 0,12330048 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 12,33 0,123300 0,123300 0,12330049 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-RF 100 19,23 0,192300 0,192300 0,19230050 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-RF 100 19,23 0,192300 0,192300 0,19230051 N04BC01 BROMOCRIPTINUM BROCRIPTIN (N04BC01) DRAJ. 2,5mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF 40 21,16 0,529000 0,529000 0,529000

Tratamentul se initiaza de catre medicul in specialitatea endocrinologie sau oncologie

Pagina 35 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

1 M01CC01 PENICILLAMINUM **4) CUPRIPEN 250mg CAPS. 250mg CN UNIFARM S.A. ROMANIA FLACON X 30 CAPSULE PRF 30 39,38 1,312666 1,312666 1,312666

Tratamentul se initiaza de catre medicul in specialitatea endocrinologie sau neurologie

1 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 5 149,77 29,954000 29,954000 29,9540002 B03XA01 EPOETINUM ALFA** BINOCRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1.728,54 288,090000 288,090000 288,0900003 B03XA01 EPOETINUM ALFA** BINOCRIT 1000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 218,42 36,403333 36,403333 36,4033334 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. S/P-RF/R 6 425,83 70,971666 70,971666 70,9716665 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 1 788,23 788,230000 788,230000 788,2300006 B03XA01 EPOETINUM ALFA** BINOCRIT 3000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 603,73 100,621666 100,621666 100,6216667 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 1.353,47 1.353,470000 1.193,316000 1.193,3160008 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 1 994,43 994,430000 994,430000 994,4300009 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. S/P-RF/R 6 781,57 130,261666 130,261666 130,261666

10 B03XA01 EPOETINUM ALFA** BINOCRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 959,37 159,895000 159,895000 159,89500011 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 2.346,60 391,100000 391,100000 391,10000012 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 6 526,27 87,711666 87,711666 87,71166613 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 1.174,53 1.174,530000 1.174,530000 1.174,53000014 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 6 981,05 163,508333 163,508333 163,50833315 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 1.208,30 201,383333 201,383333 201,38333316 B03XA01 EPOETINUM ZETA** RETACRIT 10000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 10000UI/1,0ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 1.141,34 190,223333 190,223333 190,22333317 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 1 219,83 219,830000 219,830000 219,83000018 B03XA01 EPOETINUM ZETA** RETACRIT 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. S/P-RF/R 6 62,98 10,496666 10,496666 10,49666619 B03XA01 EPOETINUM ZETA** RETACRIT 1000UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 1000UI/0,3ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,3ML SOL. INJ. PR 1 10,85 10,850000 10,850000 10,85000020 B03XA01 EPOETINUM ZETA** RETACRIT 20000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20000UI/0,5ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL. INJ. S/P-RF/R 1 442,32 442,320000 442,320000 442,32000021 B03XA01 EPOETINUM ZETA** RETACRIT 20000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 20000UI/0,5ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 2.299,68 383,280000 383,280000 383,28000022 B03XA01 EPOETINUM ZETA** RETACRIT 2000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/0,6ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 274,59 45,765000 45,765000 45,76500023 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 50,82 50,820000 50,820000 50,82000024 B03XA01 EPOETINUM ZETA** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. S/P-RF/R 1 628,06 628,060000 628,060000 628,06000025 B03XA01 EPOETINUM ZETA** RETACRIT 30000UI/0,75ml SOL. INJ. IN SERINGA PREUMPLUTA 30000UI/0,75ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,75ML SOL. INJ. S/P-RF/R 6 3.414,10 569,016666 569,016666 569,01666626 B03XA01 EPOETINUM ZETA** RETACRIT 3000UI/0,9ml SOL. INJ. IN SERINGA PREUMPLUTA 3000UI/0,9ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,9ML SOL. INJ. S/P-RF/R 6 405,17 67,528333 67,528333 67,52833327 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 72,39 72,390000 72,390000 72,39000028 B03XA01 EPOETINUM ZETA** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. S/P-RF/R 1 813,79 813,790000 813,790000 813,79000029 B03XA01 EPOETINUM ZETA** RETACRIT 40000UI/1,0ml SOL. INJ. IN SERINGA PREUMPLUTA 40000UI/1,0ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ. S/P-RF/R 6 4.528,51 754,751666 754,751666 754,75166630 B03XA01 EPOETINUM ZETA** RETACRIT 4000UI/0,4ml SOL. INJ. IN SERINGA PREUMPLUTA 4000UI/0,4ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R 6 516,62 86,103333 86,103333 86,10333331 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 96,52 96,520000 96,520000 96,52000032 B03XA01 EPOETINUM ZETA** RETACRIT 5000UI/0,5ml SOL. INJ. IN SERINGA PREUMPLUTA 5000UI/0,5ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R 6 628,06 104,676666 104,676666 104,67666633 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 1 120,65 120,650000 120,650000 120,65000034 B03XA01 EPOETINUM ZETA** RETACRIT 6000UI/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 6000UI/0,6ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML SOL. INJ. S/P-RF/R 6 739,50 123,250000 123,250000 123,25000035 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 1 137,30 137,300000 137,300000 137,30000036 B03XA01 EPOETINUM ZETA** RETACRIT 8000UI/0,8ml SOL. INJ. IN SERINGA PREUMPLUTA 8000UI/0,8ml HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML SOL. INJ. S/P-RF/R 6 962,38 160,396666 160,396666 160,39666637 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 1 188,92 188,920000 188,920000 188,92000038 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 3.173,01 793,252500 793,252500 793,25250039 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 4 391,56 97,890000 97,890000 97,89000040 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 4.708,35 1.177,087500 1.177,087500 1.177,08750041 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 4 702,64 175,660000 175,660000 175,660000

19. BOALA WILSON - G23

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

Pagina 36 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

42 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 2.208,61 2.208,610000 2.208,610000 2.208,61000043 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 1.009,47 252,367500 252,367500 252,36750044 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 1.318,95 329,737500 329,737500 329,73750045 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 3.633,81 3.633,810000 3.633,810000 3.633,81000046 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 1.626,76 406,690000 406,690000 406,69000047 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 1.937,17 484,292500 484,292500 484,29250048 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 2.555,95 638,987500 638,987500 638,98750049 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 1.118,62 1.118,620000 1.118,620000 1.118,62000050 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 120mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 120mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. S/P-RF/R 1 1.286,54 1.286,540000 1.286,540000 1.286,54000051 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 1.642,54 1.642,540000 1.642,540000 1.642,54000052 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 200mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 200mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. S/P-RF/R 1 2.166,43 2.166,430000 2.166,430000 2.166,43000053 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 250mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 250mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. S/P-RF/R 1 2.653,06 2.653,060000 2.653,060000 2.653,06000054 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 30mcg/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 30mcg/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,3 ML SOL. INJ. S/P-RF/R 1 383,95 383,950000 383,950000 383,95000055 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 360mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 360mcg/0,6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. S/P-RF/R 1 3.385,41 3.385,410000 3.385,410000 3.385,41000056 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 1 594,77 594,770000 594,770000 594,77000057 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 1 856,70 856,700000 856,700000 856,70000058 C09CA04 IRBESARTANUM** IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 16,18 0,577857 0,577857 0,57785759 C09CA04 IRBESARTANUM** IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 26,19 0,935357 0,935357 0,93535760 C09CA04 IRBESARTANUM** IRBESARTAN GALENICA 150 mg COMPR. FILM. 150 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 18,10 0,646428 0,646428 0,64642861 C09CA04 IRBESARTANUM** APROVEL 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 32,76 1,170000 0,693428 0,69342862 C09CA04 IRBESARTANUM** IRBESARTAN WINTHROP 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 18,12 0,647142 0,647142 0,64714263 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 29,83 1,065357 0,693428 0,69342864 C09CA04 IRBESARTANUM** IRBESARTAN SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 33,50 1,196428 0,693428 0,69342865 C09CA04 IRBESARTANUM** IRPRESTAN 150 mg COMPR. FILM. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 23,08 0,769333 0,693428 0,69342866 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 37,35 1,333928 0,693428 0,69342867 C09CA04 IRBESARTANUM** IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 21,54 0,769285 0,693428 0,69342868 C09CA04 IRBESARTANUM** IRBESARTAN TORRENT 150 mg COMPR. FILM. 150mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 21,54 0,769285 0,693428 0,69342869 C09CA04 IRBESARTANUM** ATOKKEN 150 mg COMPR. FILM. 150mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 24,01 0,857500 0,693428 0,69342870 C09CA04 IRBESARTANUM** IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 18,12 0,647142 0,647142 0,64714271 C09CA04 IRBESARTANUM** IRBESARTAN HF 150 mg COMPR. FILM. 150mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 23,08 0,769333 0,693428 0,69342872 C09CA04 IRBESARTANUM** APROVEL 150mg COMPR. FILM. 150mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 32,76 1,170000 0,693428 0,69342873 C09CA04 IRBESARTANUM** ATOKKEN 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 24,01 0,857500 0,693428 0,69342874 C09CA04 IRBESARTANUM** IRBESARTAN TEVA 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 29,01 1,036071 1,036071 1,03607175 C09CA04 IRBESARTANUM** IRBESARTAN GALENICA 300 mg COMPR. FILM. 300 mg GALENICA S.A. GRECIA CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM. P6L 28 29,43 1,051071 1,051071 1,05107176 C09CA04 IRBESARTANUM** APROVEL 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 43,20 1,542857 1,122428 1,12242877 C09CA04 IRBESARTANUM** IRBESARTAN WINTHROP 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 29,32 1,047142 1,047142 1,04714278 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 38,87 1,388214 1,122428 1,12242879 C09CA04 IRBESARTANUM** IRBESARTAN SANDOZ 300 mg COMPR. FILM. 300mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 64,85 2,316071 1,122428 1,12242880 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 60,27 2,152500 1,122428 1,12242881 C09CA04 IRBESARTANUM** IRBESARTAN TORRENT 300 mg COMPR. FILM. 300mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 29,01 1,036071 1,036071 1,03607182 C09CA04 IRBESARTANUM** ATOKKEN 300 mg COMPR. FILM. 300mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 31,00 1,107142 1,107142 1,10714283 C09CA04 IRBESARTANUM** IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 29,32 1,047142 1,047142 1,04714284 C09CA04 IRBESARTANUM** IRBESARTAN HF 300 mg COMPR. FILM. 300mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 31,09 1,036333 1,036333 1,03633385 C09CA04 IRBESARTANUM** APROVEL 300mg COMPR. FILM. 300mg SANOFI CLIR SNC FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 43,20 1,542857 1,122428 1,12242886 C09CA04 IRBESARTANUM** ATOKKEN 300 mg COMPR. FILM. 300mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 31,00 1,107142 1,107142 1,10714287 C09CA04 IRBESARTANUM** IRBESARTAN TORRENT 75 mg COMPR. FILM. 75mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 16,18 0,577857 0,577857 0,57785788 C09CA04 IRBESARTANUM** ATOKKEN 75 mg COMPR. FILM. 75mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 23,11 0,825357 0,693428 0,69342889 C09CA04 IRBESARTANUM** ATOKKEN 75 mg COMPR. FILM. 75mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L 28 23,11 0,825357 0,693428 0,69342890 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 2,65 0,132500 0,104799 0,10479991 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,62 0,087333 0,087333 0,087333

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92 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,71 0,123666 0,104799 0,10479993 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 2,57 0,128500 0,104799 0,10479994 H05BX02 PARICALCITOLUM** ZEMPLAR 1mcg CAPS. MOI 1mcg ABBOTT LABORATORIES S.A. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI P-RF 28 251,66 8,987857 8,987857 8,98785795 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 28 251,66 8,987857 8,987857 8,98785796 H05BX02 PARICALCITOLUM** ZEMPLAR 2mcg CAPS. MOI 2mcg ABBOTT LABORATORIES S.A. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. P-RF 28 469,44 16,765714 16,765714 16,76571497 H05BX02 PARICALCITOLUM** ZEMPLAR 2µg CAPS. MOI 2µg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. P-RF 28 469,44 16,765714 16,765714 16,76571498 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES S.A. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 229,79 45,958000 45,958000 45,95800099 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 µg/ml ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 229,79 45,958000 45,958000 45,958000100 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 26,13 0,522600 0,522600 0,522600101 L04AD01 CICLOSPORINUM* EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,152000102 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 137,32 2,746400 1,804080 1,804080103 L04AD01 CICLOSPORINUM* EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,503400104 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 292,16 5,843200 3,541920 3,541920105 L04AD01 CICLOSPORINUM* EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,951600106 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,702100 0,702100107 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 78,89 0,788900 0,788900 0,788900108 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 100 233,98 2,339800 2,339800 2,339800

Tratamentul se initiaza de catre medicul in specialitatea nefrologie.

1 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 27,37 27,370000 27,370000 27,3700002 S01EC03 DORZOLAMIDUM TRUSOPT SOL. OFT. 20mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON TIP OCULOMETER PLUS X 5 ML SOL. OFT. P-6L 1 40,75 40,750000 32,844000 32,8440003 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 50,95 50,950000 50,950000 50,9500004 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 3,11 3,110000 3,110000 3,1100005 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 4,98 4,980000 4,980000 4,9800006 S01ED01 TIMOLOLUM TIMOPTIC PIC. OFT.-SOL. 5mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON TIP OCUMETER PLUS X 5 ML PIC. OFTALMICE SOL. P-6L 1 10,12 10,120000 5,976000 5,9760007 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 3,13 3,130000 3,130000 3,1300008 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 5,41 5,410000 5,410000 5,4100009 S01ED02 BETAXOLOLUM BETAX PIC. OFT.-SOL. 5mg/ml ROMPHARM SRL ROMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L 1 5,32 5,320000 5,320000 5,320000

10 S01ED02 BETAXOLOLUM BETOPTIC PIC.OFTALMICE,SOL. 5mg/ml ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD PREV. CU PICURATOR X 5 ML PIC.OFTALMICE, SOL. P-6L 1 15,32 15,320000 6,384000 6,38400011 S01ED02 BETAXOLOLUM BETOPTIC - S PICATURI OFT.-SUSP. 0,25% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L 1 15,32 15,320000 15,320000 15,32000012 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 13,59 13,590000 13,590000 13,59000013 S01ED05 CARTEOLOLUM CARTEOL 2% PICATURI OFT.-SOL. 20mg/ml S.I.F.I. SPA ITALIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL. P-6L 1 15,95 15,950000 15,950000 15,95000014 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 55,93 55,930000 55,930000 55,93000015 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 81,85 81,850000 81,850000 81,85000016 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 44,73 44,730000 44,730000 44,73000017 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT PIC. OFT.-SOL. 20mg/ml+5mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DE TIP OCUMETER PLUS X 5ML PIC. OFT., SOL. P-6L 1 69,75 69,750000 53,676000 53,67600018 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 52,19 52,190000 43,896000 43,89600019 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) LATANOPROST/TIMOLOL STADA HEMOFARM 50 micrograme/ml si 5 mg/ml PIC. OFT., SOL 50micrograme/ml+5mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. TRANSPARENT PEJD + PICURATOR TRANSPARENT PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 36,58 36,580000 36,580000 36,58000020 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) XALOPTIC COMBI 50 micrograme/ml + 5 mg/ml PIC. OFTALMICE SOL. 50micrograme/ml+5mg/ml PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 56,71 56,710000 43,896000 43,89600021 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 82,84 82,840000 43,896000 43,89600022 S01ED51 COMBINATII (TAVOPROSTUM+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 88,49 88,490000 88,490000 88,49000023 S01EE01 LATANOPROSTUM SIFITAN 50 micrograme/ml PIC. OFT., SOL 50micrograme/ml NTC S.R.L. ITALIA CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL. P6L 1 27,04 27,040000 27,040000 27,04000024 S01EE01 LATANOPROSTUM LATANOPROST STADA HF 50 micrograme/ml PIC. OFT., SOL. 50 micrograme/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEJD CU CAPAC DIN PEID X 2,5 ML PIC. OFT. PT. APROX. 80 PIC. SOL. P6L 1 27,77 27,770000 27,770000 27,77000025 S01EE01 LATANOPROSTUM UNILAT 50 micrograme/ml PIC. OFT., SOL. 50micrograme/ml UNIMED PHARMA SPOL. S.R.O. REPUBLICA SLOVACA CUTIE CU 1 FLAC. PICURATOR PE X 2,5 ML PIC. OFT., SOL. P-6L 1 51,50 51,500000 30,876000 30,87600026 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 63,52 2,117333 2,117333 2,11733327 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 25,73 25,730000 25,730000 25,730000

21. GLAUCOM - G 26

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

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PRET AMANUNTUL MAXIMAL/UT

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VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

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VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

28 S01EE01 LATANOPROSTUM XALOPTIC PICATURI OFT.-SOL. 0,005% PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE X 1 FLACON PICURATOR PEJD X 2,5 ML PIC. OFT. SOL. P-6L 1 46,18 46,180000 30,876000 30,87600029 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 75,25 75,250000 30,876000 30,87600030 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 42,80 42,800000 42,800000 42,80000031 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 76,07 76,070000 76,070000 76,07000032 S01EE03 BIMATOPROSTUM LUMIGAN 0,3mg/ml PIC. OFT.,SOL. 0,3mg/ml ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFT. SOL. P-RF 1 68,27 68,270000 51,360000 51,36000033 S01EE04 TRAVOPROSTUM IZBA PIC. OFT., SOL 30mcg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 4ML PICATURI OFTALMICE, SOLUTIE PRF 1 84,46 84,460000 84,460000 84,46000034 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 32,23 32,230000 32,230000 32,23000035 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 39,05 39,050000 38,676000 38,67600036 S01EE04 TRAVOPROSTUM TRAVATAN 40mcg/ml PICATURI OFT.SOL. 40mcg/ml ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML P-6L 1 60,09 60,090000 38,676000 38,676000

Tratamentul se iniţiază de către medicul în specialitatea oftalmologie.

1 H02AB02 DEXAMETHASONUM DEXAMED COMPR. 0,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLISTERE X 10 COMPRIMATE PRF 100 18,38 0,183800 0,183800 0,1838002 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 8,32 0,832000 0,832000 0,8320003 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 20,42 0,816800 0,816800 0,8168004 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 73,64 0,736400 0,736400 0,7364005 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 13,87 1,387000 1,387000 1,3870006 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 33,18 1,327200 1,327200 1,3272007 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 100 124,62 1,246200 1,246200 1,2462008 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 100 123,66 1,236600 1,236600 1,2366009 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 6,98 1,396000 1,396000 1,396000

10 H02AB02 DEXAMETHASONUM DEXAMED SOL. INJ. 8mg/2ml MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF/S 100 118,60 1,186000 1,186000 1,18600011 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 14,38 1,438000 1,423200 1,42320012 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 32,62 0,652400 0,652400 0,65240013 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 29,65 1,482500 1,482500 1,48250014 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,81 8,810000 8,810000 8,81000015 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 31,02 31,020000 31,020000 31,02000016 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 20,48 20,480000 20,480000 20,48000017 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 2,65 0,132500 0,104799 0,10479918 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,62 0,087333 0,087333 0,08733319 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,71 0,123666 0,104799 0,10479920 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 2,57 0,128500 0,104799 0,10479921 J04BA02 DAPSONUM 4) DISULONE COMPR. 100mg CN UNIFARM ROMANIA CUTIE X 100 COMPR. P-RF 100 47,19 0,471900 0,471900 0,47190022 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 26,13 0,522600 0,522600 0,52260023 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 15,89 15,890000 15,890000 15,89000024 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,88100025 L01BA01 METHOTREXATUM 4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,72066626 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 400,81 400,810000 400,810000 400,81000027 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 241,07 48,214000 48,214000 48,21400028 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 89,66 89,660000 89,660000 89,66000029 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 23,82 2,382000 2,382000 2,38200030 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 78,67 78,670000 78,670000 78,67000031 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 59,64 59,640000 59,640000 59,64000032 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 1 122,50 122,500000 122,500000 122,50000033 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 1 110,09 110,090000 110,090000 110,09000034 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 124,21 124,210000 124,210000 124,21000035 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 78,67 78,670000 78,670000 78,670000

22. PEMFIGUS - G 27

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

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36 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,15ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,80 74,800000 71,568000 71,56800037 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 109,54 109,540000 109,540000 109,54000038 L04AD01 CICLOSPORINUM* EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,15200039 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 137,32 2,746400 1,804080 1,80408040 L04AD01 CICLOSPORINUM* EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,50340041 L04AD01 CICLOSPORINUM* SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 292,16 5,843200 3,541920 3,54192042 L04AD01 CICLOSPORINUM* EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,95160043 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 70,21 0,702100 0,702100 0,70210044 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR 100 78,89 0,788900 0,788900 0,788900

Tratamentul se iniţiază de către medicul în specialitatea dermatologie.

1 A16AB02 IMIGLUCERASUM**** CEREZYME 200U PULB. PT.CONC. PT.SOL. PERF. 200U GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. PR 1 3.492,21 3.492,210000 3.492,210000 3.492,2100002 A16AB02 IMIGLUCERASUM**** 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 6.907,43 6.907,430000 6.907,430000 6.907,430000

1 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 4,01 0,401000 0,401000 0,4010002 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,00 0,350000 0,350000 0,3500003 J01AA02 DOXYCYCLINUM DOXICICLINA SANDOZ 100 mg CAPS. 100mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,61 0,361000 0,361000 0,3610004 J01AA02 DOXYCYCLINUM UNIDOX SOLUTAB COMPR. DISP. 100mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 BLIST. DIN AL/PVC X 10 COMPR.DISP. P-RF 10 6,83 0,683000 0,420000 0,4200005 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 2,99 0,149500 0,149500 0,1495006 J01AA07 TETRACYCLINUM TETRACICLINA ATB 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 6,47 0,323500 0,179400 0,1794007 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 1 000 000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF/S 100 401,74 4,017400 4,017400 4,0174008 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 1 000 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 4,68 4,680000 4,680000 4,6800009 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 4,67 4,670000 4,670000 4,670000

10 J01CE01 BENZYLPENICILLINUM PENICILINA G POTASICA PULB. PT. SOL. INJ. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF/S 100 401,74 4,017400 4,017400 4,01740011 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 400 000ui ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF/S 100 274,48 2,744800 2,744800 2,74480012 J01CE01 BENZYLPENICILLINUM PENICILINA G SODICA PULB. PT. SOL. INJ. 400 000ui ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF 1 3,14 3,140000 3,140000 3,14000013 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 3,47 0,289166 0,289166 0,28916614 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN® 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. P-RF 12 6,10 0,508333 0,508333 0,50833315 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 2,62 0,218333 0,218333 0,21833316 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 8,63 8,630000 8,630000 8,63000017 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 5,39 5,390000 5,390000 5,39000018 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. S/P-RF 100 451,96 4,519600 4,519600 4,51960019 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 21,56 2,156000 2,156000 2,15600020 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 34,77 3,477000 3,477000 3,47700021 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 55,99 11,198000 11,198000 11,19800022 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 10 101,25 10,125000 10,125000 10,12500023 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 7,09 0,354500 0,354500 0,35450024 J01FA01 ERYTHROMYCINUM ERITROMICINA 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,60 0,480000 0,425400 0,42540025 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 8,44 0,422000 0,422000 0,42200026 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 9,60 0,480000 0,425400 0,425400

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

23. BOALA GAUCHER - G 29

După precizarea diagnosticului de catre laboratoarele de specialitate, va putea fi prescris de către medicul in specialitatea gastroenterologie, hematologie, neurologie si pediatrie.

Pagina 40 din 45

Page 96: ANEXA 1 - cnas.ro medicamentelor valabile ref A B... · sublista a - lista medicamentelor cu nivel de compensare 90% din pretul de referinta conform denumirilor comune internationale

NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

27 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200mg/5ml PULB. PT. SUSP. ORALA 200mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 30G + PULB. PT. 60 ML SUSP. ORALA + O LIGURITA DOZATOARE P-RF 1 11,46 11,460000 11,460000 11,46000028 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 25,50 4,250000 4,250000 4,25000029 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 37,99 6,331666 5,100000 5,10000030 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 25,36 4,226666 4,226666 4,22666631 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 48,80 8,133333 5,100000 5,10000032 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM. P-RF 6 25,52 4,253333 4,253333 4,25333333 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR. FILM. P-RF 6 25,52 4,253333 4,253333 4,25333334 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 38,17 12,723333 8,503999 8,50399935 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 48,80 16,266666 8,503999 8,50399936 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 25,65 8,550000 8,503999 8,50399937 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 25,64 8,546666 8,503999 8,50399938 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 25,64 8,546666 8,503999 8,50399939 J01FA10 AZITHROMYCINUM ZITROCIN 500 mg COMPR. FILM. 500mg LABORMED PHARMA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 3 COMPR. FILM. P-RF 3 25,65 8,550000 8,503999 8,50399940 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 22,13 7,376666 7,376666 7,37666641 J01FA10 AZITHROMYCINUM AZATRIL 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF 3 21,26 7,086666 7,086666 7,08666642 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 25,64 8,546666 8,503999 8,50399943 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 44,61 14,870000 14,870000 14,87000044 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF 3 44,61 14,870000 14,870000 14,87000045 J01FA10 AZITHROMYCINUM SUMAMED (R) LIOF. PT. SOL. PERF. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FLAC. LIOF. PT. SOL. PERF. S/P-RF 5 161,75 32,350000 32,350000 32,35000046 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PE CU PULB. PT. 15 ML SUSP. ORALA RECONSTITUITA + FLAC. CU SOLV. X 7,5 ML SOLV. P-RF 1 16,36 16,360000 16,360000 16,36000047 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 22,45 22,450000 22,450000 22,45000048 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA CCUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP P-RF 1 34,36 34,360000 34,360000 34,36000049 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 25,18 25,180000 17,844000 17,84400050 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 48,58 48,580000 48,580000 48,58000051 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA 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 60,36 60,360000 60,360000 60,36000052 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 37,31 3,731000 3,731000 3,73100053 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 65,61 3,280500 3,280500 3,28050054 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 6,83 0,683000 0,571200 0,57120055 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 6,83 0,683000 0,571200 0,57120056 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 6,83 0,683000 0,571200 0,57120057 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 6,83 0,683000 0,571200 0,57120058 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 12,30 0,615000 0,571200 0,57120059 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 6,93 0,693000 0,571200 0,57120060 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 6,56 0,656000 0,571200 0,57120061 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 12,30 0,615000 0,571200 0,57120062 J01MA02 CIPROFLOXACINUM ALVEBAR 250 mg COMPR. FILM. 250mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 4,76 0,476000 0,476000 0,47600063 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 13,22 1,322000 0,778800 0,77880064 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 13,22 1,322000 0,778800 0,77880065 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 13,22 1,322000 0,778800 0,77880066 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 13,22 1,322000 0,778800 0,77880067 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 8,78 0,878000 0,778800 0,77880068 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 13,22 1,322000 0,778800 0,77880069 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 9,23 0,923000 0,778800 0,77880070 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 16,43 0,821500 0,778800 0,77880071 J01MA02 CIPROFLOXACINUM ALVEBAR 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 6,49 0,649000 0,649000 0,64900072 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 38,50 3,850000 3,850000 3,85000073 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 37,31 3,731000 3,731000 3,73100074 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 84,70 12,100000 12,100000 12,10000075 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 27,63 9,210000 0,778800 0,77880076 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 136,56 2,731200 2,731200 2,731200

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

77 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 16,79 3,358000 3,277440 3,27744078 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA 100 mg/10 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 S/P-RF 5 16,79 3,358000 3,277440 3,27744079 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 S/P-RF 5 16,79 3,358000 3,277440 3,27744080 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 100mg/50ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 50 ML SOL. PERF. S/P-RF 1 4,79 4,790000 3,277440 3,27744081 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 200mg/100ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 1 9,58 9,580000 9,580000 9,58000082 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 100ML S 10 87,49 8,749000 8,749000 8,74900083 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 157,33 15,733000 15,733000 15,73300084 J01MA02 CIPROFLOXACINUM CIPRINOL (R) SOL. PERF. 400mg/200ml KRKA D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 200 ML S/P-RF 1 19,31 19,310000 18,879600 18,879600

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

1 L04AB02 INFLIXIMABUM**** 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 6.262,99 2.087,663333 2.087,663333 2.087,6633332 L04AB02 INFLIXIMABUM**** 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 5.343,18 1.781,060000 1.781,060000 1.781,0600003 L04AB02 INFLIXIMABUM**** 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 1.828,68 1.828,680000 1.828,680000 1.828,6800004 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAIDENHEAD MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 3.943,62 1.971,810000 1.971,810000 1.971,810000

IMUNOSUPRESOARE SELECTIVE - G3125. BOALA CRONICA INFLAMATORIE INTESTINALA - G31a

Tratamentul se prescrie și se monitorizează de către medicul în specialitatea gastro-enterologie și medicină internă (unități sanitare nominalizate de către Ministerul Sănătății Publice)

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

1 L01XC02 RITUXIMABUM**** MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 2.459,64 1.229,820000 1.229,820000 1.229,8200002 L01XC02 RITUXIMABUM**** 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 6.043,00 6.043,000000 6.043,000000 6.043,0000003 L04AA24 ABATACEPTUM**** 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 1.414,74 1.414,740000 1.414,740000 1.414,7400004 L04AA24 ABATACEPTUM**** 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 4.448,84 1.112,210000 1.112,210000 1.112,2100005 L04AB01 ETANERCEPTUM**** ENBREL 10mg de uz pediatric PULB+SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL PR 4 826,13 206,532500 206,532500 206,5325006 L04AB01 ETANERCEPTUM**** 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 1.944,32 486,080000 486,080000 486,0800007 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 1.915,82 478,955000 478,955000 478,9550008 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900009 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,790000

10 L04AB02 INFLIXIMABUM**** 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 6.262,99 2.087,663333 2.087,663333 2.087,66333311 L04AB02 INFLIXIMABUM**** 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 5.343,18 1.781,060000 1.781,060000 1.781,06000012 L04AB02 INFLIXIMABUM**** 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 1.828,68 1.828,680000 1.828,680000 1.828,68000013 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAIDENHEAD MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 3.943,62 1.971,810000 1.971,810000 1.971,81000014 L04AB05 CERTOLIZUMAB PEGOL**** 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 4.296,34 2.148,170000 2.148,170000 2.148,17000015 L04AB06 GOLIMUMAB**** 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 4.440,38 4.440,380000 4.440,380000 4.440,38000016 L04AB06 GOLIMUMAB**** 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 4.440,38 4.440,380000 4.440,380000 4.440,38000017 L04AC07 TOCILIZUMABUM**** 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 3.438,23 3.438,230000 3.438,230000 3.438,23000018 L04AC07 TOCILIZUMABUM**** ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 FLAC X 20 ML CONC. PT. SOL. PERF. S 4 13.540,42 3.385,105000 3.385,105000 3.385,10500019 L04AC07 TOCILIZUMABUM**** 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 1 744,33 744,330000 744,330000 744,33000020 L04AC07 TOCILIZUMABUM**** ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 FLAC X 4 ML CONC. PT. SOL. PERF. S 4 2.764,76 691,190000 691,190000 691,19000021 L04AC07 TOCILIZUMABUM**** 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 1.754,55 1.754,550000 1.754,550000 1.754,55000022 L04AC07 TOCILIZUMABUM**** ROACTEMRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 FLAC X 10 ML CONC. PT. SOL. PERF. S 4 6.805,62 1.701,405000 1.701,405000 1.701,405000

1 L04AB01 ETANERCEPTUM**** ENBREL 10mg de uz pediatric PULB+SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL PR 4 826,13 206,532500 206,532500 206,5325002 L04AB01 ETANERCEPTUM**** 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 1.944,32 486,080000 486,080000 486,0800003 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 1.915,82 478,955000 478,955000 478,9550004 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900006 L04AB02 INFLIXIMABUM**** 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 6.262,99 2.087,663333 2.087,663333 2.087,6633337 L04AB02 INFLIXIMABUM**** 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 5.343,18 1.781,060000 1.781,060000 1.781,0600008 L04AB02 INFLIXIMABUM**** 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 1.828,68 1.828,680000 1.828,680000 1.828,6800009 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAIDENHEAD MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 3.943,62 1.971,810000 1.971,810000 1.971,810000

10 L04AB06 GOLIMUMAB**** 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 4.440,38 4.440,380000 4.440,380000 4.440,38000011 L04AB06 GOLIMUMAB**** 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 4.440,38 4.440,380000 4.440,380000 4.440,380000

26. POLIARTITRITA REUMATOIDA - G31b

Tratamentul se prescrie si se monitorizeaza de catre medicul in specialitatea reumatologie, medicina interna, nefrologie (pentru pacienţii cu afectare renală), medicina interna sau recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii)

27. ARTROPATIA PSORIAZICA - G31c

Tratamentul se prescrie si se monitorizeaza de catre medicul in specialitatea reumatologie si recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii)

28. SPONDILITA ANKILOZANTA - G 31d

Pagina 43 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

1 L04AB01 ETANERCEPTUM**** ENBREL 10mg de uz pediatric PULB+SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL PR 4 826,13 206,532500 206,532500 206,5325002 L04AB01 ETANERCEPTUM**** 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 1.944,32 486,080000 486,080000 486,0800003 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 1.915,82 478,955000 478,955000 478,9550004 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900006 L04AB02 INFLIXIMABUM**** 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 6.262,99 2.087,663333 2.087,663333 2.087,6633337 L04AB02 INFLIXIMABUM**** 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 5.343,18 1.781,060000 1.781,060000 1.781,0600008 L04AB02 INFLIXIMABUM**** 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 1.828,68 1.828,680000 1.828,680000 1.828,6800009 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAIDENHEAD MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 3.943,62 1.971,810000 1.971,810000 1.971,810000

10 L04AB06 GOLIMUMAB**** 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 4.440,38 4.440,380000 4.440,380000 4.440,38000011 L04AB06 GOLIMUMAB**** 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 4.440,38 4.440,380000 4.440,380000 4.440,380000

Tratamentul se prescrie si se monitorizeaza de catre medicul in specialitatea reumatologie, medicina interna sau recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii)

Pagina 44 din 45

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NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APPTARA

DET. APP AMBALAJ Prescriptie

cant/ambal

aj

PRET AMANUNTUL

MAXIMAL

(RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/

UT(RON)-LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/

UT (RON) PT. ADULTI

1 L04AA24 ABATACEPTUM**** 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 1.414,74 1.414,740000 1.414,740000 1.414,7400002 L04AB01 ETANERCEPTUM**** ENBREL 10mg de uz pediatric PULB+SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL PR 4 826,13 206,532500 206,532500 206,5325003 L04AB01 ETANERCEPTUM**** 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 1.944,32 486,080000 486,080000 486,0800004 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 1.915,82 478,955000 478,955000 478,9550005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900006 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,790000

1 L04AB01 ETANERCEPTUM**** ENBREL 10mg de uz pediatric PULB+SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA BRITANIE CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL PR 4 826,13 206,532500 206,532500 206,5325002 L04AB01 ETANERCEPTUM**** 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 1.944,32 486,080000 486,080000 486,0800003 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. (INSERINGA PREUMPLUTA) 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 1.915,82 478,955000 478,955000 478,9550004 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900005 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 3.779,16 944,790000 944,790000 944,7900006 L04AB02 INFLIXIMABUM**** 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 6.262,99 2.087,663333 2.087,663333 2.087,6633337 L04AB02 INFLIXIMABUM**** 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 5.343,18 1.781,060000 1.781,060000 1.781,0600008 L04AB02 INFLIXIMABUM**** 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 1.828,68 1.828,680000 1.828,680000 1.828,6800009 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBVIE LTD MAIDENHEAD MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 3.943,62 1.971,810000 1.971,810000 1.971,810000

NOTA:

30. PSORIAZIS CRONIC SEVER - G 31f

Tratamentul se prescrie si monitorizeaza de catre medicul in specialitatea dermatologie (unitati sanitare nominalizate de catre Ministerul Sanatatii)

29. ARTRITA JUVENILA - G 31e

Tratamentul se prescrie si se monitorizeaza de catre medicul in specialitatea reumatologie si recuperare medicina fizica şi balneofizioieterapie (unitati sanitare nominalizate de catre Ministerul Sanatatii)

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (5) se utilizeaza numai pentru cazurile fara raspuns terapeutic la prednisonum.

NOTĂ: Medicamentele din această sublistă se eliberează prin farmacii cu circuit deschis pe bază de prescripție medicală cu reținere în farmacie.

- Pentru medicamentele corespunzatoare acestei sectiuni initierea tratamentului se face de catre medicul de specialitate altul decat medicul de familie, exceptie facand medicamentele din G1-INSUFICIENTA CARDIACA CRONICA (CLASA III SAU IV NYHA) pozitiile 2, 3, 4, 5, 6, 7, 9 pentru care initierea tratamentului poate fi efectuata si de medicul de familie; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Caselor Judetene de Asigurari de Sanatate; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Casei Nationale de Asigurari de Sanatate;Medicamentul corespunzator DCI-ului notat cu (3) se livreaza impreuna cu solvent; - Medicamentele corespunzatoare DCI-urilor notate cu (4) se importa cu avizul MS;

Pagina 45 din 45

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ANEXA 4

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara det. APP Ambalaj Prescriptie

cant/ambala

j

PRET AMANUN

TUL MAXIMA

L (RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/ UT(RON)-

LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/ UT

(RON) PT. ADULTI

1 A03AD02 DROTAVERINUM NO - SPA 40 mg/2 ml SOL. INJ. 40mg/2ml CHINOIN PRIVATE CO. LTD. UNGARIA CUTIE X 25 FIOLE X 2ML SOL. INJ. P-RF 25 24,50 0,980000 0,980000 0,9800002 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 7,73 1,546000 1,546000 1,5460003 A03BB01 BUTYLSCOPOLAMMONII BROMIDUM SCOBUTIL 10 mg/ml SOL. INJ. 10mg/ml NYCOMED GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 1 ML SOL. INJ. P-RF 5 3,36 0,672000 0,672000 0,6720004 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 7,23 0,361500 0,361500 0,3615005 A03DA02 COMBINATII ALGIFEN COMPRIMATE COMPR. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,23 0,361500 0,361500 0,3615006 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 12,23 2,446000 2,446000 2,4460007 A05BAN3 COMBINATII ASPATOFORT (R) SOL. INJ. FARA CONCENTRATIE TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 10 ML P-RF 10 31,36 3,136000 3,136000 3,1360008 A06AD65 COMBINATII ENDOFALK PULB. PT. SOL. ORALA FARA CONCENTRATIE DR. FALK PHARMA GMBH GERMANIA CUTIE X 6 PLICURI DE HARTIE/AL/PEJD X 55,318 G PULB. PT. SOL. ORALA P-RF 6 45,93 7,655000 7,655000 7,6550009 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 38,77 9,692500 9,186000 9,186000

10 A07AX03 NIFUROXAZIDUM ERCEFURYL (R) 200 mg CAPS. 200mg SANOFI-SYNTHELABO OTC FRANTA CUTIE X 2 BLIST. X 14 CAPS. P-RF 28 11,40 0,407142 0,407142 0,40714211 A11CA01 RETINOLUM VITAMINA A FORTE CAPS. MOI 50000ui BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 CAPS. MOI P-6L 30 5,52 0,184000 0,084000 0,08400012 A11CA01 RETINOLUM VITAMIN A 50000 ui CAPS. MOI 50000ui PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 12 CAPS. MOI P-6L 24 1,68 0,070000 0,070000 0,07000013 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 2,96 2,960000 2,960000 2,96000014 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 20 CAPS. MOI. P-RF 100 68,12 0,681200 0,681200 0,68120015 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 1000 COMPR. 1000UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 8,27 0,275666 0,275666 0,27566616 A11CC05 COLECALCIFEROLUM VIGANTOLETTEN 500 COMPR. 500UI MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 6,70 0,223333 0,223333 0,22333317 A11CC05 COLECALCIFEROLUM VITAMINA D3 BIOFARM 18000UI/ml PIC. ORALE, SOL. 0,45mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLACON X 10 ML PIC. ORALE, SOL. P-6L 1 5,05 5,050000 5,050000 5,05000018 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 6,36 6,360000 6,360000 6,36000019 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 8,01 0,267000 0,267000 0,26700020 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 6,44 0,214666 0,214666 0,21466621 A11DA01 THIAMINUM VITAMINA B1 ZENTIVA 100 mg/2 ml SOL. 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 6,98 1,396000 1,396000 1,39600022 A11DA03 BENFOTIAMINUM BENFOTIAMINA BIOMEDIAL 300 mg COMPR. FILM. 300mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 130,23 4,341000 4,341000 4,34100023 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-6L 50 28,72 0,574400 0,574400 0,57440024 A11DBN1 COMBINATII MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 50 46,88 0,937600 0,937600 0,93760025 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 89,95 1,499166 1,499166 1,49916626 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 46,88 0,937600 0,937600 0,93760027 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 46,88 0,937600 0,937600 0,93760028 A11DBN1 COMBINATII MILGAMMA (R) N SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 5 18,52 3,704000 3,704000 3,70400029 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 18,52 3,704000 3,704000 3,70400030 A11DBN2 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 11,17 0,558500 0,533640 0,53364031 A11DBN2 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 44,47 0,444700 0,444700 0,44470032 A11GA01 ACIDUM ASCORBICUM VITAMINA C SALF 1000 mg/5 ml SOL INJ. 1000mg/5ml IMECO SA ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA A 5 ML SOL. INJ. X 1000MG/5ML PRF 5 12,65 2,530000 2,530000 2,53000033 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 9,86 1,972000 1,972000 1,97200034 A11GA01 ACIDUM ASCORBICUM VITAMINA C SALF 500mg/5ml SOL. INJ. 500mg/ml IMECO SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 5 ML PRF 5 9,86 1,972000 1,972000 1,97200035 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 25,30 5,060000 2,366400 2,36640036 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 9,11 0,455500 0,455500 0,45550037 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 9,11 0,455500 0,455500 0,45550038 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg/5 ml SOL. INJ. 250mg/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF 5 10,34 2,068000 2,068000 2,06800039 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 6,98 1,396000 1,396000 1,396000

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% - CONFORM DCI-URILOR DIN CANAMED, ALTELE DECÂT CELE DIN SUBLISTELE A, B, C1, C2, INDICATE PENTRU COPII PÂNĂ LA 18 ANI, TINERI DE LA 18 LA 26 DE ANI DACA SUNT ELEVI, STUDENŢI SAU UCENICI DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LĂUZE

DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOAREVALABILĂ ÎNCEPÂND CU 01 IANUARIE 2015

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213 alin.(1) lit. a) si f)

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(RON) PT. ADULTI

40 A11HA03 TOCOFEROLUM VITAMINA E 400 mg CAPS. MOI 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 12 CAPS. MOI P-6L 24 9,35 0,389583 0,389583 0,38958341 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU 94mg/ml SOL. INJ. 94mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FIOLE DIN PEJD X 10 ML SOL. INJ. P-RF 20 16,87 0,843500 0,843500 0,84350042 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 15,92 3,184000 1,012200 1,01220043 A12AA03 CALCII GLUCONAS GLUCONAT DE CALCIU SOL. INJ. FARA CONCENTRATIE ZENTIVA SA ROMANIA CUTIE X 5 FIOLE X 10 ML SOL. INJ. P-RF 5 15,92 3,184000 1,012200 1,01220044 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 29,89 2,989000 2,989000 2,98900045 A16AXN1 DIVERSE ACTOVEGIN (R) DRAJ. 200mg NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P-6L 50 145,08 2,901600 2,901600 2,90160046 A16AXN1 DIVERSE ACTOVEGIN (R) SOL. INJ. 200mg/5ml NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 5 FIOLE PUNCT DE RUPERE X 5 ML P-RF 5 108,72 21,744000 21,744000 21,74400047 B02BX01 ETAMSYLATUM ETAMSILAT 250mg/2ml SOL. INJ. 250mg/2ml ZENTIVA S.A ROMANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. P-RF 5 6,73 1,346000 1,346000 1,34600048 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 6,73 1,346000 1,346000 1,34600049 B02BX02 CARBAZOCHROMI SALICYLAS ADRENOSTAZIN SOL. INJ. 0,3mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 5 ML P-RF 5 12,71 2,542000 2,542000 2,54200050 B03AA03 FERROSI GLUCONAS ASCOFER COMPR. FARA CONCENTRATIE ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 20 COMPR. P-6L 20 7,72 0,386000 0,386000 0,38600051 B03AA03 FERROSI GLUCONAS ALOFER 80,5 mg COMPR. EFF. 80,5mg RECORDATI ROMANIA S.R.L. ROMANIA CUTIE X 1 TUB DIN PP X 20 COMPR. EFF. P-6L 20 21,00 1,050000 1,050000 1,05000052 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 27,57 0,275700 0,275700 0,27570053 B03AD02 COMBINATII FERRETAB (R) CAPS. ELIB. PREL. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 30 10,69 0,356333 0,330840 0,33084054 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 15,02 0,500666 0,500666 0,50066655 B03AD04 COMBINATII MALTOFER FOL COMPR. MAST. FARA CONCENTRATIE VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MAST. P-6L 30 17,87 0,595666 0,595666 0,59566656 B03AE01 COMBINATII FERRO - FOLGAMMA (R) CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. MOI P-RF 50 24,30 0,486000 0,486000 0,48600057 B03AE10 COMBINATII TOT'HEMA SOL. ORALA FARA CONCENTRATIE LAB. INNOTHERA FRANTA CUTIE X 20 FIOLE X 10 ML P-6L 20 17,73 0,886500 0,886500 0,88650058 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 6,98 1,396000 1,396000 1,39600059 C01EA01 ALPROSTADILUM** ALPROSTADIL "PINT" 500 mcg CONC. PT. SOL. PERF. 500mcg TARUS MEDIA S.R.L. ROMANIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF. S 5 1.603,19 320,638000 320,638000 320,63800060 C01EA01 ALPROSTADILUM** ALPROSTADIL "REMEDIA" 500 µg CONC. PT. SOL. PERF. 500µg FARMACEUTICA REMEDIA S.A. ROMANIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF. S 5 1.603,19 320,638000 320,638000 320,63800061 C05AA01 COMBINATII HEMORZON SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOFORMATE PVC X 3 SUPOZ. P-6L 6 7,00 1,166666 1,166666 1,16666662 C05AA01 COMBINATII HEMORZON UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-6L 1 12,50 12,500000 12,500000 12,50000063 C05AA08 COMBINATII ULTRAPROCT SUPOZITOARE SUPOZ. FARA CONCENTRATIE INTENDIS GMBH GERMANIA CUTIE X 2 FOLII X 5 SUPOZ. P-RF 10 12,93 1,293000 1,293000 1,29300064 C05AA08 COMBINATII ULTRAPROCT UNGUENT RECTAL UNGUENT RECTAL FARA CONCENTRATIE INTENDIS GMBH GERMANIA CUTIE X 1 TUB AL X 30 G + 1 CANULA PEJD P-RF 1 30,91 30,910000 30,910000 30,91000065 C05AA08 COMBINATII ULTRAPROCT UNGUENT RECTAL UNGUENT RECTAL FARA CONCENTRATIE INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 15 G + 1 CANULA RECTALA P-RF 1 14,58 14,580000 14,580000 14,58000066 C05AD01 COMBINATII DOXIPROCT UNGUENT RECTAL FARA CONCENTRATIE OM PHARMA S.A. PORTUGALIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT RECTAL + CANULA APLICATOARE P-6L 1 22,31 22,310000 22,310000 22,31000067 C05BX01 CALCII DOBESILAS DOXILEK CAPS. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC. X 10 CAPS. P-6L 30 21,46 0,715333 0,715333 0,71533368 C05CA54 TROXERUTINUM (COMBINATII) GINKOR FORT CAPS. FARA CONCENTRATIE IPSEN PHARMA FRANTA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 25,73 0,857666 0,857666 0,85766669 C07NAN1 COMBINATII DISTONOCALM (R) COMPR. FILM. FARA CONCENTRATIE ZENTIVA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 7,10 0,236666 0,236666 0,23666670 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 70,00 0,700000 0,700000 0,70000071 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 5 153,79 30,758000 30,758000 30,75800072 D01AC05 ISOCONAZOLUM TRAVOGEN CREMA 10mg/1g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA P-RF 1 11,62 11,620000 11,620000 11,62000073 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA 2% TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB PEJD X 15 G P-RF 1 5,38 5,380000 5,380000 5,38000074 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA CREMA 20mg/g SC HYPERION SA ROMANIA CUTIE X 1 TUB DIN AL X 20 G CREMA P-RF 1 7,94 7,940000 7,940000 7,94000075 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 8,29 8,290000 6,456000 6,45600076 D05AXN1 COMBINATII ASORIAN SOL. CUT. FARA CONCENTRATIE BIOFARM SA ROMANIA CUTIE X 1 FLACON X 100 ML P-RF 1 10,17 10,170000 10,170000 10,17000077 D07AC04 FLUOCINOLONI ACETONIDUM FLUOCINOLON ACETONID 0,025% UNGUENT 0,025% LAROPHARM SRL ROMANIA CUTIE X 1 TUB AL X 20 G P-RF 1 7,40 7,400000 7,400000 7,40000078 D07AC05 FLUOCORTOLONUM ULTRALAN CREMA CREMA 0,25% INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 15 G P-RF 1 12,30 12,300000 12,300000 12,30000079 D07AC05 FLUOCORTOLONUM ULTRALAN UNGUENT UNGUENT 0,25% INTENDIS GMBH GERMANIA CUTIE X 1 TUB X 15 G UNGUENT P-RF 1 12,79 12,790000 12,790000 12,79000080 D07CB01 COMBINATII NIDOFLOR CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 10,00 10,000000 10,000000 10,00000081 D07CC02 COMBINATII FLUOCINOLON N UNGUENT 0,25mg/5mg/g ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-RF 1 8,20 8,200000 8,200000 8,20000082 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 8,20 8,200000 8,200000 8,20000083 D07XB02 COMBINATII TRIAMCINOLON S CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 9,00 9,000000 9,000000 9,00000084 D07XC01 COMBINATII DIPROSALIC SOL. CUT. FARA CONCENTRATIE MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR P-RF 1 10,79 10,790000 10,790000 10,79000085 D07XC01 COMBINATII DIPROSALIC UNGUENT FARA CONCENTRATIE MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 6,93 6,930000 6,930000 6,93000086 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 7,00 7,000000 7,000000 7,00000087 D07XC04 COMBINATII TRAVOCORT CREMA 10mg/1mg/1g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 25,21 25,210000 25,210000 25,21000088 D07XC04 COMBINATII TRAVOCORT CREMA 10mg/1mg/1g BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 25,21 25,210000 25,210000 25,210000

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VAL.SUPORTATAT CNAS/ UT

(RON) PT. ADULTI

89 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 100 ML SOL. CUT. P-RF 1 21,02 21,020000 21,020000 21,02000090 D10AF02 ERYTHROMYCINUM ERYFLUID SOL. CUT. 4g/30ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON X 30 ML SOL. CUT. P-RF 1 8,09 8,090000 8,090000 8,09000091 D10AF52 COMBINATII ZINERYT PULB. + SOLV. SOL. CUT. 40mg/12mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 FLAC. DIN PEID PULB. PT. SOL. CUTANATA + APLICATOR DIN PP CU SOLV. PT 30 ML SOL. CUTANATA P-RF 1 32,50 32,500000 32,500000 32,50000092 D11AH02 PIMECROLIMUS ELIDEL 1% (10mg/g) CREMA 10mg/g MEDA PHARMA GMBH & CO KG GERMANIA CUTIE X 1 TUB AL X 15 G CREMA P-RF 1 68,96 68,960000 68,960000 68,96000093 G01AF01 METRONIDAZOLUM FLAGYL OVULE 500mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST. X 5 OVULE P-RF 10 8,57 0,857000 0,857000 0,85700094 G01AX12 CICLOPIROXUM DAFNEGIN OVULE 100mg POLICHEM SA LUXEMBURG CUTIE X 1 FOLIE. TERMOSUDATA DIN PVC/PE X 6 OVULE + 6 APLICATOARE DIN PEP-6L 6 38,11 6,351666 6,351666 6,35166695 G01AXN1 COMBINATII COLPOSEPTINE (R) COMPR. VAG. 10mg/200mg LAB. THERAMEX MONACO CUTIE X 3 BLIST. X 6 COMPR. VAG. P-RF 18 17,64 0,980000 0,980000 0,98000096 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 25,19 2,519000 2,519000 2,51900097 G03DB04 NOMEGESTROLUM LUTENYL (R) COMPR. 5mg LAB. THERAMEX MONACO CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P6L 10 31,51 3,151000 3,151000 3,15100098 G03GA01 GONADOTROPHINUM CHORIONICUM PREGNYL 5000 LIOF. + SOLV. PT. SOL. INJ. 5000ui/ml NV ORGANON OLANDA CUTIE X 1 FIOLA CU LIOF. PREVAZUTA CU INEL DE RUPERE + 1 FIOLA X 1 ML SOLV. PREVAZUTE CU INEL DE RUPERE S/P-RF 1 15,04 15,040000 15,040000 15,04000099 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 10 825,12 82,512000 82,512000 82,512000100 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 56,93 56,930000 56,930000 56,930000101 H03AA03 COMBINATII NOVOTHYRAL (R) 100 COMPR. 100mcg+20mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 28,94 0,289400 0,289400 0,289400102 J01DB04 CEFAZOLINUM LYZOLIN 1g PULB. PT. SOL. INJ. 1g SC ANSAMED SRL ROMANIA CUTIE X 1 FLACON PR 1 7,15 7,150000 7,150000 7,150000103 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 25,24 25,240000 22,273440 22,273440104 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 10 219,94 21,994000 21,994000 21,994000105 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 50 963,48 19,269600 19,269600 19,269600106 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 1.856,12 18,561200 18,561200 18,561200107 J01DE02 CEFPIROMUM CEFROM (R) 1 g PULB. PT. SOL. INJ./PERF. 1g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-RF 1 75,78 75,780000 75,780000 75,780000108 J01DE02 CEFPIROMUM CEFROM (R) 2 g PULB. PT. SOL. INJ./PERF. 2g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-RF 1 127,27 127,270000 127,270000 127,270000109 J01EB05 SULFAFURAZOLUM SULFAFURAZOL ARENA 500 mg COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,63 0,631500 0,631500 0,631500110 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 40mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF 10 7,13 0,713000 0,713000 0,713000111 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 50 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF/S 50 41,48 0,829600 0,811200 0,811200112 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF 10 9,58 0,958000 0,811200 0,811200113 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 6,76 0,676000 0,676000 0,676000114 J01XB01 COLISTINUM COLISTINA ANTIBIOTICE 1000000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 10 211,79 21,179000 21,179000 21,179000115 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.917,72 139,918571 139,918571 139,918571116 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 1.032,33 36,868928 36,868928 36,868928117 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 P-RF 1 2.439,99 2.439,990000 2.439,990000 2.439,990000118 M01AA01 PHENYLBUTAZONUM FENILBUTAZONA 250 mg SUPOZ. 250mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 10,89 1,089000 1,089000 1,089000119 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 15,79 0,526333 0,526333 0,526333120 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 24,95 0,499000 0,499000 0,499000121 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 10 219,12 21,912000 21,912000 21,912000122 M01AB55 COMBINATII ACECLOFEN SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL/PE X 3 SUPOZ. P-6L 6 5,99 0,998333 0,998333 0,998333123 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 28,57 1,428500 1,428500 1,428500124 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 14,01 1,401000 1,401000 1,401000125 M01AE01 IBUPROFENUM BRUFEN RETARD 800 mg COMPR. CU ELIB. PREL. 800mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. CU ELIB. PREL. P6L 30 18,17 0,605666 0,605666 0,605666126 M01AE01 IBUPROFENUM IBUPROFEN 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4,56 0,228000 0,228000 0,228000127 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. AL/PVC X 20 COMPR. FILM. P-6L 20 10,25 0,512500 0,273600 0,273600128 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 9,18 0,306000 0,273600 0,273600129 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. AL/PVC X 60 COMPR. FILM. P-6L 60 18,38 0,306333 0,273600 0,273600130 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-6L 20 10,25 0,512500 0,273600 0,273600131 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 9,18 0,306000 0,273600 0,273600132 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 18,38 0,306333 0,273600 0,273600133 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P-6L/S 100 30,62 0,306200 0,273600 0,273600134 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 4,56 0,228000 0,228000 0,228000135 M01AE01 IBUPROFENUM IBUPROFEN 600 COMPR. FILM. 600mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 7,32 0,366000 0,366000 0,366000136 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 600 COMPR. FILM. 600mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 7,32 0,366000 0,366000 0,366000137 M01AE01 IBUPROFENUM FASPIC 600 GRAN. PT. SOL. ORALA 600mg ZAMBON S.P.A. ITALIA CUTIE X 30 PLICURI UNIDOZA X 3 G GRAN. PT. SOL. ORALA P-6L 30 25,61 0,853666 0,439200 0,439200

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara det. APP Ambalaj Prescriptie

cant/ambala

j

PRET AMANUN

TUL MAXIMA

L (RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/ UT(RON)-

LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/ UT

(RON) PT. ADULTI

138 M01AE01 IBUPROFENUM BRUFEN 600 mg GRANULE EFF. 600mg ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU 20 PLICURI DIN FOLII LAMINATE DIN HARTIE/PE/AL/PE, TERMOSUDATE, CE CONTIN GRANULE EFF. P6L 20 10,51 0,525500 0,439200 0,439200139 M01AE01 IBUPROFENUM IBALGIN BABY SUSP. ORALA 100mg/5ml ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 100 ML SUSP. ORALA + PIPETA DOZATOARE GRADATA P-RF 1 9,49 9,490000 9,490000 9,490000140 M01AE01 IBUPROFENUM IBALGIN BABY SUSP. ORALA 100mg/5ml ZENTIVA K.S. CEHIA CUTIE CU 1 FLAC. DIN STICLA BRUNA INCHIS CU CAPAC DIN PE X 100 ML SUSP. ORALA + PIPETA DOZATOARE GRA P-RF 1 9,49 9,490000 9,490000 9,490000141 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 9,49 9,490000 9,490000 9,490000142 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 9,49 9,490000 9,490000 9,490000143 M01AE01 IBUPROFENUM BRUFEN 20 mg/ml SUSP. ORALA 20mg/ml ABBOTT SCANDINAVIA AB SUEDIA CUTIE CU 1 FLAC. DE 100 ML SUSP. ORALA, DIN PET DE CULOARE BRUNA CU CAPAC DIN AL SI SIGILIU DIN PEJD + SERINGA DOZATOARE DIN PP DE 5 ML P6L 1 14,61 14,610000 11,388000 11,388000144 M01AE02 NAPROXENUM REUXEN 250 mg COMPR. 250mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 15,02 0,751000 0,751000 0,751000145 M01AE02 NAPROXENUM REUXEN 500 mg COMPR. 500mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 23,93 1,196500 1,196500 1,196500146 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 10,31 1,031000 1,031000 1,031000147 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 17,40 0,870000 0,870000 0,870000148 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 15,50 1,550000 1,550000 1,550000149 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 26,26 1,313000 1,313000 1,313000150 M01AG01 ACIDUM MEFENAMICUM VIDAN COMPR. FILM. 500mg VIANEX SA GRECIA CUTIE X 3 BLIST. AL/PVC X 8 COMPR. FILM. P-6L 24 10,00 0,416666 0,416666 0,416666151 M01AH04 PARECOXIBUM DYNASTAT 40mg PULB. + SOLV. PT. SOL. INJ. 40mg PFIZER LIMITED MAREA BRITANIE CUTIE X 5 FLAC. PULB. X 40 MG + 5 FIOLE X 2 ML SOLV. S/P-RF 5 147,23 29,446000 29,446000 29,446000152 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 10 290,33 29,033000 29,033000 29,033000153 M03BB03 CHLORZOXAZONUM CLORZOXAZON 250 mg COMPR. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,42 0,221000 0,221000 0,221000154 M03BB03 CHLORZOXAZONUM CLORZOXAZONA 250 mg COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6,18 0,206000 0,206000 0,206000155 M03BB03 CHLORZOXAZONUM CLORZOXAZONA ARENA 250 mg COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6,18 0,206000 0,206000 0,206000156 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 14,58 0,486000 0,486000 0,486000157 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 20 9,82 0,491000 0,491000 0,491000158 M03BX04 TOLPERISONUM MYDOCALM COMPR. FILM. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 7,30 0,243333 0,243333 0,243333159 M09AX01 ACIDUM HIALURONICUM HYALGAN (R) SOL. INJ. 20mg/2ml CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 2 ML P-RF 1 143,42 143,420000 143,420000 143,420000160 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 33,01 1,100333 0,764400 0,764400161 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 12,74 0,637000 0,637000 0,637000162 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 19,83 0,991500 0,991500 0,991500163 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 8,26 0,413000 0,361200 0,361200164 N02BB02 METAMIZOLUM NATRIUM ALINDOR COMPR. 500mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 8,26 0,413000 0,361200 0,361200165 N02BB02 METAMIZOLUM NATRIUM SINTOCALMIN COMPR. 500mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,84 0,342000 0,342000 0,342000166 N02BB02 METAMIZOLUM NATRIUM ALGOREMIN COMPR. 500mg REMEDIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,02 0,301000 0,301000 0,301000167 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN COMPR. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 8,17 0,408500 0,361200 0,361200168 N02BB02 METAMIZOLUM NATRIUM METAMIZOL FARMACOM 500 mg COMPR. 500mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 6,52 0,326000 0,326000 0,326000169 N02BB02 METAMIZOLUM NATRIUM ALGIOTOP COMPR. 500mg SANTA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,89 0,344500 0,344500 0,344500170 N02BB02 METAMIZOLUM NATRIUM CENTRALGIN 500 mg COMPR. 500mg SC CENTROFARM S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,87 0,343500 0,343500 0,343500171 N02BB02 METAMIZOLUM NATRIUM ALGOBLOCK COMPR. 500mg BIOFARM S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 6,18 0,309000 0,309000 0,309000172 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 6,80 0,340000 0,340000 0,340000173 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 28,75 28,750000 28,750000 28,750000174 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 5,92 1,184000 1,184000 1,184000175 N02BB02 METAMIZOLUM NATRIUM SINTOCALMIN 300 mg SUPOZ. 300mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. PVC/PE X 3 SUPOZ. P-RF 6 7,57 1,261666 1,261666 1,261666176 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 14,50 1,208333 1,208333 1,208333177 N05CD08 MIDAZOLAMUM DORMICUM (R) COMPR. FILM. 7,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. FILM. P-RF 10 5,58 0,558000 0,558000 0,558000178 N05CD08 MIDAZOLAMUM DORMICUM (R) SOL. INJ. 1mg/ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 10 FIOLE X 5 ML S/P-RF 10 29,14 2,914000 2,272800 2,272800179 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 1 mg/ml SOL. INJ. 1mg/ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 10 FIOLE X 5 ML SOL. INJ. S/P-RF 10 18,94 1,894000 1,894000 1,894000180 N05CD13 CINOLAZEPAMUM GERODORM (R) COMPR. 40mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF 30 23,05 0,768333 0,768333 0,768333181 N06BA04 METHYLFENIDATUM*** MEDIKINET EM 10 mg CAPS. ELIB. MODIF. 10mg MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE CU BLIST. PVC/PVDC/AL X 30 CAPS. ELIB. MODIF. PR 30 47,84 1,594666 1,594666 1,594666182 N06BA04 METHYLFENIDATUM*** MEDIKINET EM 20 mg CAPS. ELIB. MODIF. 20mg MEDICE ARZNEIMITTEL PUTTER GMBH & CO KG GERMANIA CUTIE CU BLIST. PVC/PVDC/AL X 30 CAPS. ELIB. MODIF. PR 30 95,80 3,193333 3,193333 3,193333183 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 30 192,42 6,414000 6,414000 6,414000184 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 30 229,23 7,641000 7,641000 7,641000185 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 30 296,84 9,894666 9,894666 9,894666186 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 7 103,33 14,761428 14,761428 14,761428

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara det. APP Ambalaj Prescriptie

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j

PRET AMANUN

TUL MAXIMA

L (RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/ UT(RON)-

LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/ UT

(RON) PT. ADULTI

187 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 7 103,33 14,761428 14,761428 14,761428188 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 28 388,16 13,862857 13,862857 13,862857189 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 28 388,16 13,862857 13,862857 13,862857190 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 28 388,16 13,862857 13,862857 13,862857191 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/R 28 555,80 19,850000 19,850000 19,850000192 N06BX02 PYRITINOLUM PIRITINOL ARENA 100 mg DRAJ. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. X 10 DRAJ. P-6L 30 18,01 0,600333 0,600333 0,600333193 N06BX02 PYRITINOLUM ENCEPHABOL 100 mg DRAJ. 100mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 33,34 0,666800 0,666800 0,666800194 N06BX02 PYRITINOLUM ENCEPHABOL 200 mg DRAJ. 200mg MERCK KGAA GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ. P6L 50 60,67 1,213400 1,213400 1,213400195 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 P6L 1 40,59 40,590000 40,590000 40,590000196 N06BX03 PIRACETAMUM PIRACETAM ARENA 400 mg CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 10,57 0,352333 0,117199 0,117199197 N06BX03 PIRACETAMUM PIRACETAM SLAVIA 400 mg COMPR. 400mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. DIN PVC/AL X 10 COMPR. P-6L 40 4,64 0,116000 0,116000 0,116000198 N06BX03 PIRACETAMUM PIRACETAM COMPR. 400mg FABIOL SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2,93 0,097666 0,097666 0,097666199 N06BX03 PIRACETAMUM PIRACETAM FARMEX 400 mg COMPR. 400mg FARMEX COMPANY SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 4,44 0,111000 0,111000 0,111000200 N06BX03 PIRACETAMUM PIRACETAM MCC 400mg COMPR. 400mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 3,10 0,155000 0,117199 0,117199201 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mg COMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 3,45 0,172500 0,117199 0,117199202 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mg COMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 4 BLIST. PVC/AL X 10 COMPR. P-6L 40 6,46 0,161500 0,117199 0,117199203 N06BX03 PIRACETAMUM LUCETAM (R) 1200 mg COMPR. FILM. 1200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 20 COMPR. FILM. P-6L 20 6,72 0,336000 0,336000 0,336000204 N06BX03 PIRACETAMUM NOOTROPIL 1200 mg COMPR. FILM. 1200mg U.C.B. PHARMA S.A. BELGIA CUTIE CU 10 BLIST. PVC/AL X 10 COMPR. FILM. P6L 100 50,00 0,500000 0,403200 0,403200205 N06BX03 PIRACETAMUM PIRACETAM 400 mg COMPR. FILM. 400mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 3,50 0,175000 0,117199 0,117199206 N06BX03 PIRACETAMUM PIRACETAM LPH (R) 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 6,33 0,105500 0,105500 0,105500207 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 60 COMPR.FILM. P-6L 60 7,04 0,117333 0,117199 0,117199208 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 2,36 0,118000 0,117199 0,117199209 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 3,50 0,175000 0,117199 0,117199210 N06BX03 PIRACETAMUM PIRACETAM 800 mg COMPR. FILM. 800mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 4,81 0,240500 0,240500 0,240500211 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 800mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.FILM. P-6L 30 6,63 0,221000 0,221000 0,221000212 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 33,27 0,369666 0,264600 0,264600213 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 4,41 0,220500 0,220500 0,220500214 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 4,81 0,240500 0,240500 0,240500215 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 8,97 1,794000 1,794000 1,794000216 N07CA02 CINNARIZINUM CINARIZINA ARENA 25 mg CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. P-6L 40 3,30 0,082500 0,082500 0,082500217 N07CA02 CINNARIZINUM STUGERON 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. P-6L 40 7,04 0,176000 0,090199 0,090199218 N07CA02 CINNARIZINUM CINARIZIN 25 mg COMPR. 25mg LAROPHARM SRL ROMANIA CUTIE X 3 BLIST. X 20 COMPR. P-6L 60 4,51 0,075166 0,075166 0,075166219 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 11,56 1,445000 1,445000 1,445000220 P02CC01 PYRANTELUM HELMINTOX (R) 125 mg COMPR. FILM. 125mg LAB. INNOTECH INT. FRANTA CUTIE X 2 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 6 3,47 0,578333 0,578333 0,578333221 P02CC01 PYRANTELUM HELMINTOX (R) 250 mg COMPR. FILM. 250mg LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. X 3 COMPR. FILM. P-RF 3 3,47 1,156666 1,156666 1,156666222 P02CC01 PYRANTELUM HELMINTOX (R) SUSP. ORALA 125mg/2,5ml LAB. INNOTECH INT. FRANTA CUTIE X 1 FLACON X 15 ML + LINGURITA DOZATOARE X 2,5 ML P-RF 1 6,56 6,560000 6,560000 6,560000223 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 10,48 10,480000 10,480000 10,480000224 R01ADN1 COMBINATII 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 25,87 25,870000 25,870000 25,870000225 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 21,00 2,100000 2,100000 2,100000226 R01BA52 COMBINATII (LORATADINUM+PSEUDOEFEDRINUM) CLARINASE 5 mg/120 mg COMPR. ELIB. MODIF. 5mg/120mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 COMPR. ELIB. MODIF. P-6L 7 9,26 1,322857 1,322857 1,322857227 R02AB03 FUSAFUNGINUM BIOPAROX SPRAY BUCOFARINGIAN SI NAZAL-SOL. 50mg/10ml LES LABORATOIRES SERVIER FRANTA CUTIE X 1 FLACON PRESURIZAT DIN AL X 10 ML SOL. + 3 APLIC. DIN PE: 1 APLIC. BUCAL (ALB) + 2 APLIC. P-RF 1 20,02 20,020000 20,020000 20,020000228 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA ARENA COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 9,38 0,312666 0,312666 0,312666229 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA 50 mg/ ml SOL. INJ. 50mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S 5 7,41 1,482000 1,482000 1,482000230 R03CA02 EPHEDRINI HYDROCHLORIDUM EFEDRINA 50 mg/ ml SOL. INJ. 50mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S 5 7,41 1,482000 1,482000 1,482000231 R03DX05 OMALIZUMABUM** XOLAIR 150 mg SOL INJ. 150mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOLUTIE INJECTABILA PR 1 1.576,28 1.576,280000 1.576,280000 1.576,280000232 R03DX05 OMALIZUMABUM** XOLAIR 75 mg SOL INJ. 75mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA X 0.5ML SOLUTIE INJECTABILA PR 1 915,38 915,380000 915,380000 915,380000233 R05CB01 ACETYLCYSTEINUM ACC INJECT 300mg/3ml SOL. INJ. 300mg/3ml HEXAL AG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. S/P-RF 5 7,55 1,510000 1,510000 1,510000234 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 13,13 13,130000 13,130000 13,130000235 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 S/P-RF 5 8,24 1,648000 1,648000 1,648000

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cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

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PRET AMANUN

TUL MAXIMA

L (RON)

PRET AMANUNTUL MAXIMAL/UT

(RON)

VAL.SUPORTATAT CNAS/ UT(RON)-

LEGEA NR. 95/2006 ART

213 alin.(1) lit. a) si f)

VAL.SUPORTATAT CNAS/ UT

(RON) PT. ADULTI

236 R05CB03 CARBOCISTEINUM HUMEX EXPECTORANT PENTRU COPII SIROP 100mg/5ml LAB. URGO FRANTA CUTIE X 1 FLACON X 125ML SIROP + MASURA DOZATOARE A 5 ML P-RF 1 5,96 5,960000 5,960000 5,960000237 R05CB03 CARBOCISTEINUM RHINATHIOL 2% pentru copii si sugari SIROP 2% SANOFI-AVENTIS OTC FRANTA CUTIE X 1 FLACON DIN STICLA INCOLORA X 125 ML SIROP + LINGURITA DOZATOARE P-RF 1 9,18 9,180000 7,152000 7,152000238 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 4,16 4,160000 4,160000 4,160000239 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 2,80 2,800000 2,800000 2,800000240 R06AE05 MECLOZINUM EMETOSTOP COMPR. 30mg SPECIFAR SA GRECIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 3,59 0,359000 0,359000 0,359000241 R06AX02 CYPROHEPTADINUM PERITOL COMPR. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,25 0,162500 0,162500 0,162500242 R06AX02 CYPROHEPTADINUM CIPROHEPTADINA ARENA 4 mg COMPR. 4mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,90 0,163333 0,163333 0,163333243 R06AX13 LORATADINUM CLARITINE SIROP 1mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON X 120 ML + LINGURITA DOZATOARE P-6L 1 17,98 17,980000 14,400000 14,400000244 R06AX13 LORATADINUM LORATADINA BIOFARM 5mg/5ml SIROP 5mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE DIN PE CU GRADATII DE LA 2,5 LA 2 P-RF 1 7,09 7,090000 7,090000 7,090000245 R06AX13 LORATADINUM FLONIDAN SUSP. ORALA 5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA BRUNA X 120 ML SUSP. ORALA + LINGURITA DOZATOARE P-6L 1 12,00 12,000000 12,000000 12,000000246 R06AX13 LORATADINUM LORATADINA LEK 5mg/5ml SUSP. ORALA 5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA BRUNA X 120 ML SUSP. ORALA + LINGURITA DOZATOARE P-6L 1 12,00 12,000000 12,000000 12,000000247 S01AA01 CHLORAMPHENICOLUM SIFICETINA PULB. + SOLV. PT. SOL. OFT. 0,4% 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 30,39 30,390000 30,390000 30,390000248 S01AA13 ACIDUM FUSIDICUM FUCITHALMIC 10mg/g GEL OFT. 10mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB AL CU CANULA APLICATOARE X 5 G GEL OFTALMIC P-6L 1 14,64 14,640000 14,640000 14,640000249 S01AA24 KANAMYCINUM KANAMICINA SULFAT 1% UNG. OFT. 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL X 6 G P-RF 1 6,39 6,390000 6,390000 6,390000250 S01AA30 COMBINATII COLBIOCIN PULB. + SOLV. PT. SOL. OFT. FARA CONCENTRATIE S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5 ML SOLV. + PLIC REZERVOR PULBERE + DISP. PICURARE P-RF 1 33,28 33,280000 33,280000 33,280000251 S01BA07 FLUOROMETHOLONUM FLUMETOL S PICATURI OFT.SUSP. 2mg/ml THEA FARMA SPA ITALIA CUTIE X 1 FLACON PEJD X 10ML PIC. OFT. SUSP. P-RF 1 32,02 32,020000 32,020000 32,020000252 S01BA07 FLUOROMETHOLONUM FLUMETOL S UNGUENT OFTALMIC UNG. OFT. 1mg/g THEA FARMA SPA ITALIA CUTIE X 1 TUB X 5G P-RF 1 10,12 10,120000 10,120000 10,120000253 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 14,50 14,500000 14,500000 14,500000254 S02CA05 COMBINATII OTIS-T PICATURI AURICULARE-SOL. FARA CONCENTRATIE TIS FARMACEUTIC SA ROMANIA CUTIE X 1 FLACON DIN PE X 10 ML PIC. AURICULARE, SOL. P-RF 1 5,16 5,160000 4,068000 4,068000255 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 3,39 3,390000 3,390000 3,390000

Nota:

Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se face pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Caselor Judetene de Asigurari de Sanatate; Medicamentele din această sublistă corespund DCI-urilor din CANAMED altele decât cele din sublistele A, B si C1. Pentru categoriile de asigurati mentionate in aceasta sublista, medicamentele corespunzatoare denumirilor comune internationale din sublista A, sublista B, sectiunea C1 a sublistei C, se vor acorda in regim de compensare de 100% la pret de referinta, indiferent de indicatia pentru care sunt prevazute in acsubliste .

Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS;

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