AANEXA 1SUBLISTA 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 CU02 IUNIE 2014Nr crt.Cod_Comercialcod ATCDCIDenumire Comercialaforma farm.concentratieDetinator APPtara det. APPAmbalajPrescriptiecant/ambalajPret amanuntul 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. Adultisublista?SE ADAUGA1329W60585002C03EB01COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)DIOCOR 50 mg/20 mgCAPS.50mg/20mgSANIENCE S.R.L.ROMANIACUTIE CU 3 BLIST. PVC/AL X 10 CAPS.P6L3031.481.0493331.0493330.944399ASE MODIFICA214W07005001C03EB01COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)DIUREX 50CAPS.50mg/20mgTERAPIA SAROMANIACUTIE X 2 BLIST. AL/PVC X 10 CAPS.P-6L2023.311.1655001.0493330.944399A1193W52902001N06AB03FLUOXETINUM*ROFLUXIN 20 mgCAPS.20mgANTIBIOTICE S.A.ROMANIACUTIE X 2 BLIST. AL/PVC X 10 CAPS.P-RF2015.120.7560000.5663990.509759A1192W08497001N06AB03FLUOXETINUM*MAGRILAN 20 mgCAPS.20mgMEDOCHEMIE LTD.CIPRUCUTIE X 3 BLIST. AL/PVC X 10 CAPS.P-RF3017.630.5876660.5663990.509759A1190W13241001N06AB03FLUOXETINUM*FLUOXIN 20 mgCAPS.20mgVIM SPECTRUM SRLROMANIACUTIE X 2 BLIST. PVC/AL X 7 CAPS.P-RF1411.280.8057140.5663990.509759A1191W13241002N06AB03FLUOXETINUM*FLUOXIN 20 mgCAPS.20mgVIM SPECTRUM SRLROMANIACUTIE X 4 BLIST. PVC/AL X 7 CAPS.P-RF2822.060.7878570.5663990.509759A1194W10228001N06AB03FLUOXETINUM*PROZAC 20 mgCOMPR. DISP.20mgELI LILLY SASPANIACUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 14 COMPR. DISP.P-RF2836.821.3150000.5663990.509759A1197W43706001N06AB04CITALOPRAMUM**LINISAN 20 mgCOMPR. FILM.20mgGEDEON RICHTER ROMANIA SAROMANIACUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.P-RF3039.541.3180000.5663990.509759A1199W43995001N06AB04CITALOPRAMUM**DALSAN 40 mgCOMPR. FILM.40mgEGIS PHARMACEUTICALS P.L.C.UNGARIACUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. FILM.P-RF2833.591.1996421.1327991.019519A1200W41796001N06AB05PAROXETINUM*ARKETISCOMPR.20mgMEDOCHEMIE LTD.CIPRUCUTIE X 3 BLIST. AL/PVC X 10 COMPR.P-RF3023.050.7683330.5663990.509759A1204W56363007N06AB05PAROXETINUM*PALUXETIL 20 mgCOMPR. FILM.20mgSANDOZ S.R.L.ROMANIACUTIE CU BLIST. DIN AL/PVC X 30 COMPR.FILM.P-RF3020.480.6826660.5663990.509759A1202W04913003N06AB05PAROXETINUM*SEROXAT 20 mgCOMPR. FILM.20mgSMITHKLINE BEECHAMMAREA BRITANIECUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.P-RF3034.301.1433330.5663990.509759A1203W43958002N06AB05PAROXETINUM*PAXETIN 20 mgCOMPR. FILM.20mgACTAVIS GROUP HF.ISLANDACUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM.P-RF3023.050.7683330.5663990.509759A1201W57051001N06AB05PAROXETINUM*PAROXETIN ATB 20 mgCOMPR. FILM.20 mgANTIBIOTICE SAROMANIACUTIE CU 3 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. FILM.PRF3023.040.7680000.5663990.509759A1205W56364007N06AB05PAROXETINUM*PALUXETIL 40 mgCOMPR. FILM.40mgSANDOZ S.R.L.ROMANIACUTIE CU BLIST. DIN AL/PVC X 30 COMPR.FILM.P-RF3036.771.2256661.1327991.019519A1206W44097001N06AB06SERTRALINUM*SERLIFT 100 mgCOMPR. FILM.100mgTERAPIA SAROMANIACUTIE X 2 BLIST. X 14 COMPR. FILM.P-RF2835.281.2600001.1327991.019519A1215W44096001N06AB06SERTRALINUM*SERLIFT 50 mgCOMPR. FILM.50mgTERAPIA SAROMANIACUTIE X 2 BLIST. X 14 COMPR. FILM.P-RF2819.540.6978570.5663990.509759A1216W12873001N06AB06SERTRALINUM*ASENTRA (R)COMPR. FILM.50mgKRKA D.D.SLOVENIACUTIE X 4 BLIST. X 7 COMPR. FILM.P-RF2822.870.8167850.5663990.509759A1207W12874001N06AB06SERTRALINUM*ASENTRA (R)COMPR. FILM.100mgKRKA D.D.SLOVENIACUTIE X 4 BLIST. X 7 COMPR. FILM.P-RF2840.841.4585711.1327991.019519A1217W42836001N06AB06SERTRALINUM*SERTRALINA 50 mgCOMPR. FILM.50mgARENA GROUP SAROMANIACUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.P-RF3020.920.6973330.5663990.509759A1208W43276001N06AB06SERTRALINUM*SERTRALINA 100 mgCOMPR. FILM.100mgARENA GROUP S.A.ROMANIACUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.P-RF3037.641.2546661.1327991.019519A1218W52510006N06AB06SERTRALINUM*SETALOFT 50 mgCOMPR. FILM.50mgACTAVIS GROUP PTC EHF.ISLANDACUTIE CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM.P-RF2818.740.6692850.5663990.509759A1209W52511006N06AB06SERTRALINUM*SETALOFT 100 mgCOMPR. FILM.100mgACTAVIS GROUP PTC EHF.ISLANDACUTIE CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM.P-RF2834.091.2175001.1327991.019519A1219W56168002N06AB06SERTRALINUM*XIMPROVE 50 mgCOMPR. FILM.50mgDR. REDDY'S LABORATORIESROMANIACUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.P-RF2819.540.6978570.5663990.509759A1210W56169002N06AB06SERTRALINUM*XIMPROVE 100 mgCOMPR. FILM.100mgDR. REDDY'S LABORATORIESROMANIACUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.P-RF2835.281.2600001.1327991.019519A1220W55562001N06AB06SERTRALINUM*ZOLOFT 50 mgCOMPR. FILM.50mgPFIZER EUROPE MA EEIGMAREA BRITANIECUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM.P-RF2836.981.3207140.5663990.509759A1211W55563001N06AB06SERTRALINUM*ZOLOFT 100 mgCOMPR. FILM.100mgPFIZER EUROPE MA EEIGMAREA BRITANIECUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM.P-RF2868.512.4467851.1327991.019519A1221W59050001N06AB06SERTRALINUM*ADJUVIN 50 mgCOMPR. FILM.50mgLANNACHER HEILMITTEL GES.M.B.H.AUSTRIACUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.PRF3020.060.6686660.5663990.509759A1212W59051001N06AB06SERTRALINUM*ADJUVIN 100 mgCOMPR. FILM.100mgLANNACHER HEILMITTEL GES.M.B.H.AUSTRIACUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.PRF3036.521.2173331.1327991.019519A1213W59303002N06AB06SERTRALINUM*STIMULOTON 100 mgCOMPR. FILM.100mgEGIS PHARMACEUTICALS P.L.C.UNGARIACUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.P-RF2835.281.2600001.1327991.019519A1222W59302001N06AB06SERTRALINUM*STIMULOTON 50 mgCOMPR. FILM.50mgEGIS PHARMACEUTICALS P.L.C.UNGARIACUTIE X 3 BLIST. X 10 COMPR. FILM.P-RF3020.940.6980000.5663990.509759A1214W60444001N06AB06SERTRALINUM*SERTRALINA ARENA 100 mgCOMPR. FILM.100mgARENA GROUP S.A.ROMANIACUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.P-RF3037.641.2546661.1327991.019519A1223W60443001N06AB06SERTRALINUM*SERTRALINA ARENA 50 mgCOMPR. FILM.50mgARENA GROUP SAROMANIACUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.P-RF3020.920.6973330.5663990.509759A1224W55564001N06AB06SERTRALINUM*ZOLOFT 20 mg/mlCONC. PT. SOL. ORALA20mg/mlPFIZER EUROPE MA EEIGMAREA BRITANIECUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA + 1 PIPETA GRADATAP-RF165.6165.61000013.59359812.234238A1225W56859001N06AB08FLUVOXAMINUM*FEVARIN (R) 100COMPR. FILM.100mgABBOTT HEALTHCARE PRODUCTS B.V.OLANDACUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.P-RF3048.831.6276660.5663990.509759A1226W56858001N06AB08FLUVOXAMINUM*FEVARIN (R) 50COMPR. FILM.50mgABBOTT HEALTHCARE PRODUCTS B.V.OLANDACUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.P-RF3025.210.8403330.2831990.254879A

Pagina &P din &N

BANEXA 2SUBLISTA 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 02 IUNIE 2014Nr. crtCod_Comercialcod ATCDCIDenumire Comercialaforma farm.concentratieDetinator APPtara det. APPAmbalajPrescriptiecant/ambalajPret amanuntul 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. Adultisublista?SE ADAUGA1172W60206003C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TEZEO HCT 80 mg/12,5 mgCOMPR.80mg/12,5mgZENTIVA, K.S.REPUBLICA CEHACUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.P6L3029.540.9846660.9846660.492333B1173W54966005N06AB10ESCITALOPRAMUM**ESCITALOPRAM-TEVA 10 mgCOMPR. FILM.10mgTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.P-RF3022.510.7503330.7503330.375166B1174W54964005N06AB10ESCITALOPRAMUM**ESCITALOPRAM-TEVA 20 mgCOMPR. FILM.20mgTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.P-RF3043.571.4523331.4523330.726166B1175W60622002R06AX27DESLORATADINUMLORDESTIN 0,5 mg/mlSOL. ORALA0,5mg/mlGEDEON RICHTER ROMANIA SAROMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA, CU O LINGURITA DOZATOARE GRADATA LA 2,5 ML SI 5 ML X 120 ML SOL.P6L110.8810.88000010.8800005.440000BSE MODIFICA401W51880002C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HYDROCHLOROTHIAZIDE WINTHROP 300mg/12,5mgCOMPR. FILM300mg/12,5mgSANOFI PHARMA - BRISTOL MYERS SQUIBBFRANTACUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM.P-6L2833.701.2035711.1290170.564508B402W59585002C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mgCOMPR. FILM300mg/12,5mgSANOFI-AVENTIS GROUPEFRANTACUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM.P-6L2833.701.2035711.1290170.564508B406W58451006C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mgCOMPR. FILM.150mg/12,5mgRANBAXY (U.K.) LIMITEDMAREA BRITANIECUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.P6L2835.501.2678571.1290170.564508B416W58453006C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mgCOMPR. FILM.300mg/25mgRANBAXY (U.K.) LIMITEDMAREA BRITANIECUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.P6L2868.912.4610711.1290170.564508B413W58452021C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mgCOMPR. FILM.300mg/12,5mgRANBAXY (U.K.) LIMITEDMAREA BRITANIECUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.P6L2868.912.4610711.1290170.564508B409W55470017C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 300 mg/12,5 mgCOMPR. FILM.300 mg/12,5mgTEVA PHARMA B.V.OLANDACUTIE X BLIST. AL/AL X 28 COMPR. FILM.P-6L2851.491.8389281.1290170.564508B408W56734003C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRPREZIDE 300 mg/12,5 mgCOMPR. FILM.300 mg/12,5 mgACTAVIS GROUP PTC EHF.ISLANDACUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.P6L3046.281.5426661.1290170.564508B410W56735003C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRPREZIDE 300 mg/25 mgCOMPR. FILM.300 mg/25 mgACTAVIS GROUP PTC EHF.IRLANDACUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.P6L3055.161.8386661.1290170.564508B405W57419003C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IFIRMACOMBI 150mg/12,5mgCOMPR. FILM.150mg/12,5mgKRKA D.D. NOVO MESTOSLOVENIACUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM.P6L3039.591.3196661.1290170.564508B411W57420003C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IFIRMACOMBI 300mg/12,5mgCOMPR. FILM.300mg/12,5mgKRKA D.D. NOVO MESTOSLOVENIACUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM.P6L3073.912.4636661.1290170.564508B415W57421003C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IFIRMACOMBI 300mg/25mgCOMPR. FILM.300mg/25mgKRKA D.D. NOVO MESTOSLOVENIACUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM.P6L3073.912.4636661.1290170.564508B407W58451021C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mgCOMPR. FILM.150mg/12,5mgRANBAXY (U.K.) LIMITEDMAREA BRITANIECUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.P6L2835.501.2678571.1290170.564508B412W58452006C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mgCOMPR. FILM.300mg/12,5mgRANBAXY (U.K.) LIMITEDMAREA BRITANIECUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.P6L2868.912.4610711.1290170.564508B417W58453021C09DA04COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mgCOMPR. FILM.300mg/25mgRANBAXY (U.K.) LIMITEDMAREA BRITANIECUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.P6L2868.912.4610711.1290170.564508B431W54276007C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)PRITOR PLUS 80mg/25mgCOMPR.80mg/25mgBAYER SCHERING PHARMA AGGERMANIACUTIE X 28COMPR.( BLIST. PA/AL/PVC SAU PA/PA/AL/PVC/AL PERFORATE UNIDOZA)P-6L28104.853.7446421.1290170.564508B424W54271007C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)PRITOR PLUS 80mg/12,5mgCOMPR.80mg/12,5mgBAYER SCHERING PHARMA AGGERMANIACUTIE X 28COMPR.( BLIST. PA/AL/PVC PERFORATE)P-6L2879.572.8417851.1290170.564508B423W53178002C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)MICARDISPLUS 80/25mgCOMPR.80/25mgBOEHRINGER INGELHEIM INTERNATIONAL GMBHGERMANIACUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL)P-6L28104.853.7446421.1290170.564508B422W12033002C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)MICARDISPLUS 80/12,5mgCOMPR.80/12,5mgBOEHRINGER INGELHEIM INTERNATIONAL GMBHGERMANIACUTIE X 28COMPR. ( BLIST. PA/AL/PVC)P-6L2877.422.7650001.1290170.564508B436W60430005C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mgCOMPR.80mg/25mgTERAPIA S.A.ROMANIACUTIE CU BLIST. AL/AL X 28X1 COMPR.P6L2869.382.4778571.1290170.564508B435W60430004C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mgCOMPR.80mg/25mgTERAPIA S.A.ROMANIACUTIE CU BLIST. AL/AL X 28 COMPR.P6L2869.382.4778571.1290170.564508B430W60429005C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mgCOMPR.80mg/12,5mgTERAPIA S.A.ROMANIACUTIE CU BLIST. AL/AL X 28X1 COMPR.P6L2852.991.8925001.1290170.564508B429W60429004C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mgCOMPR.80mg/12,5mgTERAPIA S.A.ROMANIACUTIE CU BLIST. AL/AL X 28 COMPR.P6L2852.991.8925001.1290170.564508B434W60249003C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMARK PLUS 80mg/25mgCOMPR.80mg/25mgGLENMARK PHARMACEUTICALS S.R.O.REPUBLICA CEHACUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATEP-6L3073.022.4340001.1290170.564508B428W60248003C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMARK PLUS 80mg/12,5mgCOMPR.80mg/12,5mgGLENMARK PHARMACEUTICALS S.R.O.REPUBLICA CEHACUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATEP-6L3056.771.8923331.1290170.564508B433W60207003C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TEZEO HCT 80 mg/25 mgCOMPR.80mg/25mgZENTIVA, K.S.REPUBLICA CEHACUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.P6L3041.711.3903331.1290170.564508B420W59820005C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TOLUCOMBI 80 mg/25mgCOMPR.80 mg/25mgKRKA D.D.SLOVENIACUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATEPRF3073.022.4340001.1290170.564508B418W59718002C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)ACTELSAR HCT 80 mg/12,5 mgCOMPR.80 mg/12,5 mgACTAVIS GROUP PTC EHF.ISLANDACUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATEPRF2843.241.5442851.1290170.564508B419W59819005C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TOLUCOMBI 80 mg/12,5mgCOMPR.80 mg/12,5mgKRKA D.D.SLOVENIACUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATEPRF3056.771.8923331.1290170.564508B421W59719001C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)ACTELSAR HCT 80 mg/25mgCOMPR.80 mg/25mgACTAVIS GROUP PTC EHF.ISLANDACUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATEPRF2853.681.9171421.1290170.564508B426W59921002C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mgCOMPR.80mg/12,5mgEGIS PHARMACEUTICALS P.L.C.UNGARIACUTIE CU BLIST. AL/AL X 28 COMPR.P6L2835.001.2500001.1290170.564508B427W59979001C09DA07COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)TELMISARTAN/HIDROCLOROTIAZIDA DR. REDDY'S 80 mg/12,5 mgCOMPR.80mg/12,5mgDR. REDDY'S LABORATORIESROMANIACUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR.P6L2852.991.8925001.1290170.564508B964W13298008N06AB10ESCITALOPRAMUM**CIPRALEX 10 mgCOMPR. FILM.10mgH. LUNDBECK A/SDANEMARCACUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM.P-RF2890.383.2278571.1327990.566399B1145W58525005R06AX27DESLORATADINUMDESLORATADINA ALVOGEN 0,5 mg/mlSOL. ORALA0,5mg/mlALVOGEN IPCO S.A.R.LLUXEMBURGCUTIE CU 1 FLAC. DIN STICLA BRUNA A 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOARP6L113.3113.31000012.0000006.000000B1148W60474006R06AX27DESLORATADINUMAERIUS 0,5mg/mlSOL. ORALA0,5mg/mlMERCK SHARP&DOHME LTD.MAREA BRITANIECUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 MLP-RF116.7316.73000012.0000006.000000B1149W58827006R06AX27DESLORATADINUMDYNID 0,5 mg/mlSOL. ORALA0,5mg/mlGLENMARK PHARMACEUTICALS S.R.O.REPUBLICA CEHACUTIE CU 1 FLAC. DIN STICLA BRUNA X 150 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOARP6L116.8616.86000015.0000007.500000B1143W58720004R06AX27DESLORATADINUMDESLORATADINA SANDOZ 0.5 mg/mlSOL. ORALA0,5 mg/mlSANDOZ S.R.L.ROMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 125 ML X 120 ML, SOL. ORALA + LINGURITA DOZATOARP6L113.3113.31000012.0000006.000000B1147W59747004R06AX27DESLORATADINUMDESLORATADINA TEVA 0,5 mg/mlSOL. ORALA0,5mg/mlTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU 1 FLAC. DIN STICLA + 1 LINGURA DOZATOARE DIN PEID GRADATA LA DOZE DE 2,5 ML SI 5 ML X 120 MP6L113.3113.31000012.0000006.000000B1144W52756006R06AX27DESLORATADINUMAERIUS 0,5mg/mlSOL. ORALA0,5mg/mlSP EUROPEBELGIACUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 MLP-RF116.7316.73000012.0000006.000000B1146W58827005R06AX27DESLORATADINUMDYNID 0,5 mg/mlSOL. ORALA0,5mg/mlGLENMARK PHARMACEUTICALS S.R.O.REPUBLICA CEHACUTIE CU 1 FLAC. DIN STICLA BRUNA X 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOARP6L113.3113.31000012.0000006.000000B

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C1ANEXA 3SECIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREUL DE REFERIN CONFORMDCI-urilor UTILIZATE N TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI PENTRU CARE DECONTAREA SE FACE PE BAZA PROTOCOALELOR TERAPEUTICE CU MONITORIZAREA PRESCRIERII I CONSUMULUI PRIN COMISIILE PARITARE; MEDICAMENTELE DIN ACEAST SUBLIST SE ELIBEREAZ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZ DE PRESCRIPIE MEDICAL CU REINERE N FARMACIE ( P-RF)DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOAREVALABIL NCEPND CU 02 IUNIE 2014NR.CRTCod CIMCOD ATCDCIDenumire Comercialaforma farm.concentratieDETINATOR APPTARA DET. APPAMBALAJPrescriptiecant/ambalajPRET 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. ADULTISectiuneacod?9. EPILEPSIE - G11SE ADAUGA202W58592002N03AX17STIRIPENTOLUM**DIACOMIT 500mgCAPS.500mgBIOCODEXFRANTACUTIE X 1 FLAC. DIN PP X 60 CAPS.P-RF/R601,513.6025.22666625.22666625.226666C1G11203W51468002N03AX17STIRIPENTOLUM**DIACOMIT 250mgCAPS.250mgBIOCODEXFRANTACUTIE X 1 FLAC. DIN PP X 60 CAPS.P-RF/R60776.4012.94000012.94000012.940000C1G11204W51470002N03AX17STIRIPENTOLUM**DIACOMIT 250mgPULB. PT. SUSP. ORALA250mgBIOCODEXFRANTACUTIE X 60 PLICURI HARTIE/AL/PEP-RF/R60776.4012.94000012.94000012.940000C1G11205W51471002N03AX17STIRIPENTOLUM**DIACOMIT 500mgPULB. PT. SUSP. ORALA500mgBIOCODEXFRANTACUTIE X 60 PLICURI HARTIE/AL/PEP-RF/R601,513.6025.22666625.22666625.226666C1G11SE MODIFICA100W58596003N03AX11TOPIRAMATUM**TOPAMAX 50 mgCOMPR. FILM.50mgJOHNSON & JOHNSON D.O.O.SLOVENIACUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.P6L2827.580.9850000.7683990.768399C1G1176W58595003N03AX11TOPIRAMATUM**TOPAMAX 100 mgCOMPR. FILM.100mgJOHNSON & JOHNSON D.O.O.SLOVENIACUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.P6L2840.801.4571421.1739991.173999C1G1177W59849002N03AX11TOPIRAMATUM**TOPILEX 100 mgCOMPR. FILM.100mgLANNACHER HEILMITTEL GES.M.B.H.AUSTRIACUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.P6L3029.350.9783330.9783330.978333C1G1190W59847002N03AX11TOPIRAMATUM**TOPILEX 25 mgCOMPR. FILM.25mgLANNACHER HEILMITTEL GES.M.B.H.AUSTRIACUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.P6L3011.290.3763330.3763330.376333C1G11101W59848002N03AX11TOPIRAMATUM**TOPILEX 50 mgCOMPR. FILM.50mgLANNACHER HEILMITTEL GES.M.B.H.AUSTRIACUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.P6L3019.210.6403330.6403330.640333C1G1181W52139001N03AX11TOPIRAMATUM**TOPRAN 25 mgCOMPR. FILM.25mgTERAPIA SAROMANIACUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM.P-6L6053.960.8993330.4515990.451599C1G1191W52140001N03AX11TOPIRAMATUM**TOPRAN 50 mgCOMPR. FILM.50mgTERAPIA SAROMANIACUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM.P-6L6097.271.6211660.7683990.768399C1G1167W52141001N03AX11TOPIRAMATUM**TOPRAN 100 mgCOMPR. FILM.100mgTERAPIA SAROMANIACUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM.P-6L60165.902.7650001.1739991.173999C1G1192W53072004N03AX11TOPIRAMATUM**TOPIRAMAT TEVA 50 mgCOMPR. FILM.50mgTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.P-RF3053.671.7890000.7683990.768399C1G1182W53073004N03AX11TOPIRAMATUM**TOPIRAMAT TEVA 25 mgCOMPR. FILM.25mgTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.P-RF3029.210.9736660.4515990.451599C1G1168W53074004N03AX11TOPIRAMATUM**TOPIRAMAT TEVA 100 mgCOMPR. FILM.100mgTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.P-RF3090.253.0083331.1739991.173999C1G1183W53158001N03AX11TOPIRAMATUM**TOPIRAMAT ACTAVIS 25 mgCOMPR. FILM.25mgACTAVIS S.R.L.ROMANIACUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM.P-RF6040.260.6710000.4515990.451599C1G1193W53159001N03AX11TOPIRAMATUM**TOPIRAMAT ACTAVIS 50 mgCOMPR. FILM.50mgACTAVIS S.R.L.ROMANIACUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM.P-RF6069.191.1531660.7683990.768399C1G1169W53160001N03AX11TOPIRAMATUM**TOPIRAMAT ACTAVIS 100 mgCOMPR. FILM.100mgACTAVIS S.R.L.ROMANIACUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM.P-RF60103.381.7230001.1739991.173999C1G1184W54792003N03AX11TOPIRAMATUM**LUSITRAX 25 mgCOMPR. FILM.25mgROMASTRU TRADING S.R.L.ROMANIACUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM.P-RF3020.830.6943330.4515990.451599C1G1194W54793003N03AX11TOPIRAMATUM**LUSITRAX 50 mgCOMPR. FILM.50mgROMASTRU TRADING S.R.L.ROMANIACUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM.P-RF3035.461.1820000.7683990.768399C1G1170W54794003N03AX11TOPIRAMATUM**LUSITRAX 100mgCOMPR. FILM.100mgROMASTRU TRADING S.R.L.ROMANIACUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM.P-RF3052.461.7486661.1739991.173999C1G1171W55389015N03AX11TOPIRAMATUM**TORLEPTA 100 mgCOMPR. FILM.100mgGLENMARK PHARMACEUTICALS S.R.O.REPUBLICA CEHACUTIE CU BLIST. AL/AL X 30 COMPR. FILM.P-RF3080.212.6736661.1739991.173999C1G1185W55387015N03AX11TOPIRAMATUM**TORLEPTA 25 mgCOMPR. FILM.25mgGLENMARK PHARMACEUTICALS S.R.O.REPUBLICA CEHACUTIE CU BLIST. AL/AL X 30 COMPR. FILM.P-RF3026.670.8890000.4515990.451599C1G1195W55388015N03AX11TOPIRAMATUM**TORLEPTA 50 mgCOMPR. FILM.50mgGLENMARK PHARMACEUTICALS S.R.O.REPUBLICA CEHACUTIE CU BLIST. AL/AL X 30 COMPR. FILM.P-RF3044.811.4936660.7683990.768399C1G1186W55542002N03AX11TOPIRAMATUM**TOPIRAMAT BLUEFISH 25 mgCOMPR. FILM.25mgBLUEFISH PHARMACEUTICALS ABSUEDIACUTIE CU BLIST. AL/AL X 60 COMPR. FILM.P-RF6051.290.8548330.4515990.451599C1G1196W55543002N03AX11TOPIRAMATUM**TOPIRAMAT BLUEFISH 50 mgCOMPR. FILM.50mgBLUEFISH PHARMACEUTICALS ABSUEDIACUTIE CU BLIST. AL/AL X 60 COMPR. FILM.P-RF6084.541.4090000.7683990.768399C1G1197W55543005N03AX11TOPIRAMATUM**TOPIRAMAT BLUEFISH 50 mgCOMPR. FILM.50mgBLUEFISH PHARMACEUTICALS ABSUEDIACUTIE CU 1 FLAC. PEID X 60 COMPR. FILM.P-RF6084.541.4090000.7683990.768399C1G1172W55544002N03AX11TOPIRAMATUM**TOPIRAMAT BLUEFISH 100 mgCOMPR. FILM.100mgBLUEFISH PHARMACEUTICALS ABSUEDIACUTIE CU BLIST. AL/AL X 60 COMPR. FILM.P-RF60142.682.3780001.1739991.173999C1G1173W55544005N03AX11TOPIRAMATUM**TOPIRAMAT BLUEFISH 100 mgCOMPR. FILM.100mgBLUEFISH PHARMACEUTICALS ABSUEDIACUTIE CU 1 FLAC. PEID X 60 COMPR. FILM.P-RF60142.682.3780001.1739991.173999C1G1187W57887008N03AX11TOPIRAMATUM**TOPIRAMAT EGIS 25 mgCOMPR. FILM.25mgEGIS PHARMACEUTICALS P.L.C.UNGARIACUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM.PRF6048.190.8031660.4515990.451599C1G1198W57888008N03AX11TOPIRAMATUM**TOPIRAMAT EGIS 50 mgCOMPR. FILM.50mgEGIS PHARMACEUTICALS P.L.C.UNGARIACUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM.PRF6074.801.2466660.7683990.768399C1G1174W57889006N03AX11TOPIRAMATUM**TOPIRAMAT EGIS 100 mgCOMPR. FILM.100mgEGIS PHARMACEUTICALS P.L.C.UNGARIACUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM.PRF60133.792.2298331.1739991.173999C1G1188W56847005N03AX11TOPIRAMATUM**NEXTOP 25 mgCOMPR. FILM.25mgTORRENT PHARMA S.R.L.ROMANIACUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.P-6L3027.570.9190000.4515990.451599C1G1199W56848005N03AX11TOPIRAMATUM**NEXTOP 50 mgCOMPR. FILM.50mgTORRENT PHARMA S.R.L.ROMANIACUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.P-6L3050.821.6940000.7683990.768399C1G1175W56849005N03AX11TOPIRAMATUM**NEXTOP 100 mgCOMPR. FILM.100mgTORRENT PHARMA S.R.L.ROMANIACUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.P-6L3087.162.9053331.1739991.173999C1G1189W58597003N03AX11TOPIRAMATUM**TOPAMAX 25 mgCOMPR. FILM.25mgJOHNSON & JOHNSON D.O.O.SLOVENIACUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.P6L2816.210.5789280.4515990.451599C1G1113. BOLI PSIHICE (SCHIZOFRENIE, TULBURARI SCHIZOTIPALE SI DELIRANTE, TULBURARI AFECTIVE MAJORE, TULBURARI PSIHOTICE ACUTE SI BOLI PSIHICE COPII, AUTISM) - G15SE ADAUGA345W54964005N06AB10ESCITALOPRAMUM**ESCITALOPRAM-TEVA 20 mgCOMPR. FILM.20mgTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.P-RF3043.571.4523331.4523331.452333C1G15346W54966005N06AB10ESCITALOPRAMUM**ESCITALOPRAM-TEVA 10 mgCOMPR. FILM.10mgTEVA PHARMACEUTICALS S.R.L.ROMANIACUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.P-RF3022.510.7503330.7503330.750333C1G15SE MODIFICA301W13298008N06AB10ESCITALOPRAMUM**CIPRALEX 10 mgCOMPR. FILM.10mgH. LUNDBECK A/SDANEMARCACUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM.P-RF2890.383.2278570.9003990.900399C1G1514. DEMENTE(DEGENERATIVE, VASCULARE, MIXTE) - G 16SE ADAUGA118W60434001N06DX01MEMANTINUM***ZENMEM 20 mgCOMPR. ORODISPERSABILE20mgZENTIVA K.S.REPUBLICA CEHACUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODISPERSABILEPR28212.707.5964287.5964287.596428C1G16SE MODIFICA105W60436007N06DX01MEMANTINUM***COGNOMEM 10 mgCOMPR. FILM.10mgZENTIVA K.S.REPUBLICA CEHACUTIE CU BLIST. PVC/AL X 56 COMPR. FILM.PR56160.862.8725002.8725002.872500C1G16113W60437007N06DX01MEMANTINUM***COGNOMEM 20 mgCOMPR. FILM.20mgZENTIVA K.S.REPUBLICA CEHACUTIE CU BLIST. PVC/AL X 56 COMPR. FILM.PR56425.427.5967857.5967857.596785C1G16115W60433001N06DX01MEMANTINUM***ZENMEN 10 mgCOMPR. ORODISPERSABILE10mgZENTIVA K.S.REPUBLICA CEHACUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODISPERSABILEPR2880.422.8721422.8721422.872142C1G1618. BOLI ENDOCRINE (GUSA ENDEMICA, INSUFICIENTA SUPRARENALA CRONICA, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARA SI TUMORI NEUROENDOCRINE) - G 22SE ADAUGA52W58527003H01CB05PASIREOTIDUM**SIGNIFOR 0,9 mgSOL INJ.0,9mgNOVARTIS EUROPHARM LTD.MAREA BRITANIECUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,9 MGPR309,264.78308.826000308.826000308.826000C1G2253W58524003H01CB05PASIREOTIDUM**SIGNIFOR 0,3 mgSOL INJ.0,3mgNOVARTIS EUROPHARM LTD.MAREA BRITANIECUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,3 MGPR307,863.11262.103666262.103666262.103666C1G2254W58526003H01CB05PASIREOTIDUM**SIGNIFOR 0,6 mgSOL INJ.0,6mgNOVARTIS EUROPHARM LTD.MAREA BRITANIECUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,6 MGPR308,674.14289.138000289.138000289.138000C1G2221. GLAUCOM - G 26SE MODIFICA24W54876001S01EE01LATANOPROSTUMUNILAT 50 micrograme/mlPIC. OFT., SOL.50micrograme/mlUNIMED PHARMA SPOL. S.R.O.REPUBLICA SLOVACACUTIE CU 1 FLAC. PICURATOR PE X 2,5 ML PIC. OFT., SOL.P-6L151.5051.50000030.87600030.876000C1G2626W57240001S01EE01LATANOPROSTUMGLAUTAN 0,05 mg/mlPIC. OFT.,SOL.0,05mg/mlROMPHARM COMPANY SRLROMANIACUTIE 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.P6L125.7325.73000025.73000025.730000C1G2627W03937002S01EE01LATANOPROSTUMXALATAN (R)PICATURI OFT.-SOL.0,005%PFIZER EUROPE MA EEIGMAREA BRITANIECUTIE X 1 FLACON PICURATOR PE X 2,5 MLP-6L175.2575.25000030.87600030.876000C1G2628W54612002S01EE01LATANOPROSTUMXALOPTICPICATURI OFT.-SOL.0,005%PHARMACEUTICAL WORKS POLPHARMA SAPOLONIACUTIE X 1 FLACON PICURATOR PEJD X 2,5 ML PIC. OFT. SOL.P-6L146.1846.18000030.87600030.876000C1G26

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