ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699...

141

Transcript of ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699...

Page 1: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE
Page 2: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE
Page 3: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

ANEXA 1

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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 0,192299 0,173069

2 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 0,192299 0,173069

3 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 0,192299 0,173069

4 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 0,192299 0,173069

5 A02BA02 RANITIDINUM N - RANITIDIN COMPR. FILM. 150mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 COMPR. FILM. P-6L 20 3,99 0,199500 0,192299 0,173069

6 A02BA02 RANITIDINUM RANITIDINA LAROPHARM 150 mg COMPR. FILM. 150mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 4,55 0,227500 0,192299 0,173069

7 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 0,192299 0,173069

8 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 0,192299 0,173069

9 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 0,384599 0,346139

10 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 0,384599 0,346139

11 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

12 A02BA03 FAMOTIDINUM FAMODIN 20 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 0,192299 0,173069

13 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 0,192299 0,173069

14 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 0,192299 0,173069

15 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 0,231599

16 A02BA03 FAMOTIDINUM FAMODIN 40 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 0,384599 0,346139

17 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 4,435200

18 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 0,192299 0,173069

19 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 10 mg CAPS. GASTROREZ. 10mg AUROBINDO PHARMA (MALTA) LIMITED MACEDONIA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L 14 4,61 0,329285 0,329285 0,296356

20 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 0,662699 0,596429

21 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 0,662699 0,596429

22 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 0,576000

23 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 0,662699 0,596429

24 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 0,662699 0,596429

25 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 0,662699 0,596429

26 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 0,662699 0,596429

27 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 0,662699 0,596429

28 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 15,04 0,752000 0,662699 0,596429

29 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 0,649000 0,584100

30 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 0,662699 0,596429

31 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 0,518785

32 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 0,662699 0,596429

33 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 0,656428 0,590785

34 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 0,662699 0,596429

35 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mg CAPS. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MACEDONIA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ. P6L 28 8,94 0,319285 0,319285 0,287356

36 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 0,662699 0,596429

37 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 0,662699 0,596429

38 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA SLOVACA CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 40 ML X 28 CAPS. GASTROREZ. P6L 28 18,38 0,656428 0,656428 0,590785

39 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

40 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mg CAPS. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MACEDONIA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L 14 12,76 0,911428 0,911428 0,820285

41 A02BC01 OMEPRAZOLUM OMEDAR (R) COMPR. FILM. GASTROREZ. 20mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. DE STICLA BRUNA X 14 COMPR. FILM. GASTROREZ. P-6L 14 14,45 1,032142 0,662699 0,596429

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

DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI

MODIFICARILE ULTERIOARE VALABILA INCEPAND CU

1 OCTOMBRIE 2013

Pagina 1 din 27

Page 4: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

42 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 0,331349 0,298214

43 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 0,464463

44 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 0,662699 0,596429

45 A02BC01 OMEPRAZOLUM LOSEC 40 mg LIOF. PT. SOL. PERF. 40mg ASTRAZENECA AB SUEDIA CUTIE X 5 FLAC. X 45 MG LIOF. PT. SOL. PERF. S/P-RF 5 114,72 22,944000 22,375800 20,138220

46 A02BC01 OMEPRAZOLUM OMEZ PULBERE PENTRU SOLUTIE PERFUZABILA 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 16,220000 14,598000

47 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 19,43 19,430000 19,430000 17,487000

48 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 0,331349 0,298214

49 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 0,662699 0,596429

50 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 0,662699 0,596429

51 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 0,662699 0,596429

52 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 0,752099

53 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 0,752099

54 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 0,376049

55 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 0,333598

56 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 0,333598

57 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 0,333598

58 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 0,667200

59 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 1,000801

60 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 10,845000

61 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 0,174453

62 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 0,348907

63 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 1,16 0,029000 0,029000 0,026100

64 A03FA01 METOCLOPRAMIDUM N - METOCLOPRAMID COMPR. 10mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 40 COMPR. P-6L 40 1,36 0,034000 0,030768 0,027691

65 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 5,39 0,134750 0,030768 0,027691

66 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID ARENA 10 mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 40 COMPR. P-6L 40 1,39 0,034750 0,030768 0,027691

67 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID PIC. ORALE-SOL. 7mg/ml BIOFARM SA ROMANIA CUTIE X 1 FLACON DIN STICLA X 20 ML PIC. ORALE.,SOLUTIE, PREVAZUT CU PICURATOR P-RF 1 2,85 2,850000 2,850000 2,565000

68 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 2,230071 2,007063

69 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 ML P-RF 5 12,02 2,404000 2,404000 2,163600

70 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 0,030768 0,027691

71 A03FA03 DOMPERIDONUM OROPERIDYS 10 mg COMPR. ORODISPERSABILE 10mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA/GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP. P6L 30 25,07 0,835666 0,030768 0,027691

72 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 1,118520

73 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 1,206765

74 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 1,206765

75 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 0,832050

76 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 0,724059

77 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 1,448118

78 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 2,413530

79 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 2,413530

80 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 60,338307

81 A06AD11 LACTULOSUM DUPHALAC (R) LICHID ORAL 66,7% ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P-RF 1 10,37 10,370000 7,090140 6,381126

82 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 10,364149 9,327734

83 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 3,454716 3,109244

84 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 15,507000

85 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 30,006000

86 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 7,09 7,090000 7,015731 6,314157

87 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 D P-RF 1 3,57 3,570000 3,561015 3,204913

88 A07AA02 NYSTATINUM NISTATINA COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 8,47 0,423500 0,423500 0,381150

89 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 0,508320

90 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

91 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 1,660342 1,494307

Pagina 2 din 27

Page 5: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

92 A07EC02 MESALAZINUM** PENTASA 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 0,830171 0,747153

93 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 0,830171 0,747153

94 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 0,415084 0,373575

95 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 0,830171 0,747153

96 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 0,830171 0,747153

97 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 47,43 0,790500 0,664135 0,597721

98 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 90,11 1,501833 1,328274 1,195446

99 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 90 130,49 1,449888 1,328274 1,195446

100 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 5,586427

101 A07EC02 MESALAZINUM** PENTASA SUPOZ. 1g 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 5,586427

102 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 5,586427

103 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 1,396602

104 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 2,793213

105 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 21,807000

106 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 0,163049

107 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 0,304200

108 B01AC05 TICLOPIDINUM1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 35,53 1,776500 0,603000 0,542700

109 B01AC05 TICLOPIDINUM1) 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 0,603000 0,542700

110 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 14,64 2,928000 2,928000 2,635200

111 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 0,257400

112 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 0,208881

113 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 0,580229

114 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 7,902000

115 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 7,928999

116 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 7,928999

117 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 7,928999

118 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 5,285999

119 B03AEN1 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES COMPR. FILM. FARA CONCENTRATIE EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM. P-6L 50 14,85 0,297000 0,297000 0,267300

120 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 0,221999

121 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 0,120240

122 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 0,120240

123 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 1,434600

124 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 0,618500 0,556650

125 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 0,326092

126 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 0,326092

127 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 0,326092

128 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 0,326092

129 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 0,326092

130 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 0,314550

131 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 0,325620

132 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 0,652185

133 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 6,622200

134 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

135 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 0,219899

136 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 0,245099

137 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 3,328199

138 C01BD01 AMIODARONUM AMIOKORDIN SOL INJ. 50mg/ml KRKA ROMANIA CUTIE X 5 FIOLE X 3ML SOLUTIE INJECTABILA PRF 5 18,49 3,698000 3,697999 3,328199

139 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 9,88 0,164666 0,151319 0,136187

140 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 0,103730

141 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 1,662300

Pagina 3 din 27

Page 6: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

142 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 13,770000

143 C01DA08 ISOSORBIDI DINITRAS DINITER SR 40 mg CAPS. ELIB. PREL. 40mg TERAPIA SA ROMANIA CUTIEX 2 BLIST. X 10 CAPS. ELIB. PREL. P-6L 20 9,03 0,451500 0,193998 0,174598

144 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 0,032099

145 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 0,059099

146 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 0,290998 0,261898

147 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 0,290998 0,261898

148 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 0,436497 0,392847

149 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 0,436497 0,392847

150 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 49,977675

151 C01EA01 ALPROSTADILUM*** VASAPROSTAN 20 LIOF. PT. SOL. PERF. 20mcg SCHWARZ PHARMA AG GERMANIA CUTIE X 10 FIOLE X 5 ML LIOF. PT. SOL. PERF. S/P-RF 10 521,11 52,111000 52,111000 46,899900

152 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 0,228299

153 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 0,443978 0,399580

154 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 0,443978 0,399580

155 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 0,443978 0,399580

156 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 0,443978 0,399580

157 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 0,228299

158 C01EB15 TRIMETAZIDINUM DILATAN 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-6L 30 14,61 0,487000 0,253702 0,228331

159 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 0,253702 0,228331

160 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 0,253702 0,228331

161 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 0,443978 0,399580

162 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 0,443978 0,399580

163 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 11,097000

164 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 0,481140

165 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 10,05 0,201000 0,201000 0,180900

166 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 0,217854 0,196068

167 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 0,150480

168 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 0,343424 0,309081

169 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 0,452099

170 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 0,343424 0,309081

171 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 0,446999

172 C03BA11 INDAPAMIDUM INDAPAMIDA MYLAN 1,5 mg COMPR. ELIB. PREL. 1,5 mg MYLAN S.A.S. FRANTA/GERMANIA CUTIE CU BLIST DIN PVC/AL X 30 COMPR. ELIB. PREL. P-6L 30 12,60 0,420000 0,343424 0,309081

173 C03BA11 INDAPAMIDUM TERTENSIF (R) SR COMPR. ELIB. PREL. 1,5mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-6L 30 21,05 0,701666 0,343424 0,309081

174 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 0,343424 0,309081

175 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 0,343424 0,309081

176 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 0,343424 0,309081

177 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 0,343424 0,309081

178 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 0,343424 0,309081

179 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 0,343424 0,309081

180 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 0,452099

181 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 0,343424 0,309081

182 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 0,343424 0,309081

183 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 0,343424 0,309081

184 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 0,343424 0,309081

185 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 0,343424 0,309081

186 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 0,343424 0,309081

187 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 0,329333 0,296399

188 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 0,135900

189 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,28 0,114000 0,114000 0,102600

190 C03CA01 FUROSEMIDUM FUROSEMID EEL COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5,42 0,271000 0,151250 0,136125

191 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 0,136125

Pagina 4 din 27

Page 7: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

192 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 0,136125

193 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 0,136125

194 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 1,092600

195 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 0,884983 0,796484

196 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 0,221245 0,199120

197 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 0,221245 0,199120

198 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 0,442491 0,398241

199 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 0,442491 0,398241

200 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA EEL 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 0,193500

201 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA OZONE 25 mg COMPR. 25mg OZONE LABORATORIES PHARMA S.A. ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10,79 0,215800 0,215800 0,194220

202 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 16,21 0,324200 0,221245 0,199120

203 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 0,193500

204 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 0,442491 0,398241

205 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 0,944399

206 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 1,078374 0,970536

207 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 0,358732 0,322858

208 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 0,358732 0,322858

209 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 0,538099 0,484289

210 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 0,538099 0,484289

211 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 0,538099 0,484289

212 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 0,275850

213 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. FILM. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 40 22,42 0,560500 0,358732 0,322858

214 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 0,358732 0,322858

215 C04AD03 PENTOXIFYLLINUM OXIFLUX 400 mg COMPR. FILM. ELIB. PREL. 400mg LABORMED PHARMA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 20 6,13 0,306500 0,306500 0,275850

216 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 0,275999

217 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 0,538099 0,484289

218 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 0,027363

219 C07AA05 PROPRANOLOLUM N - PROPRANOLOL 10 mg COMPR. 10mg SC MEDUMAN SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 3,22 0,064400 0,030404 0,027363

220 C07AA05 PROPRANOLOLUM PROPRANOLOL 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 3,59 0,071800 0,030404 0,027363

221 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 0,089640

222 C07AA05 PROPRANOLOLUM PROPRANOLOL 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,64 0,092800 0,092800 0,083520

223 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 0,089640

224 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 0,437824

225 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 0,437824

226 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 0,437824

227 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 0,437824

228 C07AA07 SOTALOLUM DAROB (R) 80 mg COMPR. 80mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PP/AL X 10 COMPR. P-6L 20 10,06 0,503000 0,243236 0,218912

229 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 0,218912

230 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 0,218912

231 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 0,218912

232 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 0,273549 0,246194

233 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 0,273549 0,246194

234 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 0,273549 0,246194

235 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 0,213599

236 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 0,273549 0,246194

237 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 9,12 0,304000 0,273549 0,246194

238 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 100 19,75 0,197500 0,197500 0,177750

239 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 13,00 0,260000 0,260000 0,234000

240 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 0,273549 0,246194

241 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 0,273549 0,246194

Pagina 5 din 27

Page 8: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

242 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 0,273549 0,246194

243 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 0,210299

244 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 0,273549 0,246194

245 C07AB02 METOPROLOLUM METOPROLOL TARTRAT INTAS 100 mg COMPR. 100mg INTAS PHARMACEUTICALS LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P6L 30 8,09 0,269666 0,269666 0,242699

246 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 0,068387 0,061548

247 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 0,068387 0,061548

248 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 0,068387 0,061548

249 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 0,068387 0,061548

250 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 0,136774 0,123096

251 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 0,136774 0,123096

252 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 0,136774 0,123096

253 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 0,136774 0,123096

254 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 5,27 0,175666 0,136774 0,123096

255 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/ALX 10 COMPR P-6L 100 8,40 0,084000 0,084000 0,075600

256 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 7,09 0,141800 0,136774 0,123096

257 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 0,136774 0,123096

258 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 0,136774 0,123096

259 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 0,136774 0,123096

260 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 0,136774 0,123096

261 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 0,136774 0,123096

262 C07AB02 METOPROLOLUM METOPROLOL TARTRAT INTAS 50 mg COMPR. 50mg INTAS PHARMACEUTICALS LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P6L 30 5,27 0,175666 0,136774 0,123096

263 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 0,273549 0,246194

264 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 0,273549 0,246194

265 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 0,136774 0,123096

266 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 0,519744 0,467769

267 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 0,129936 0,116942

268 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 0,259872 0,233884

269 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 0,324900

270 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 0,316800

271 C07AB03 ATENOLOLUM ATENOLOL 100 mg COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 6,26 0,313000 0,313000 0,281700

272 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 0,281700

273 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 0,176850

274 C07AB03 ATENOLOLUM ATENOLOL MEDUMAN 50mg COMPR. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 3,70 0,185000 0,185000 0,166500

275 C07AB03 ATENOLOLUM ATENOLOL 50 mg COMPR. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4,50 0,225000 0,225000 0,202500

276 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 0,160499

277 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 0,160200

278 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 0,207450

279 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 0,308892

280 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 0,410325 0,369292

281 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 0,410325 0,369292

282 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 0,410325 0,369292

283 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 0,410325 0,369292

284 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 0,410325 0,369292

285 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 0,410325 0,369292

286 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 0,205162 0,184645

287 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 0,205162 0,184645

288 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 0,410325 0,369292

289 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 0,410325 0,369292

290 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 0,410325 0,369292

291 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 0,410325 0,369292

Pagina 6 din 27

Page 9: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

292 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 0,410325 0,369292

293 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 0,410325 0,369292

294 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 0,102581 0,092322

295 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 0,205162 0,184645

296 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 0,205162 0,184645

297 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 0,205162 0,184645

298 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 0,205162 0,184645

299 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 0,205162 0,184645

300 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 0,205162 0,184645

301 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8,74 0,291333 0,291333 0,262199

302 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 0,354299 0,318869

303 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 0,354299 0,318869

304 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 0,354299 0,318869

305 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 0,354299 0,318869

306 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 0,336000 0,302400

307 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 0,354299 0,318869

308 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 0,354299 0,318869

309 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 0,354299 0,318869

310 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 0,708599 0,637739

311 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 0,708599 0,637739

312 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 0,708599 0,637739

313 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 0,275400

314 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 0,708599 0,637739

315 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 0,708599 0,637739

316 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 0,708599 0,637739

317 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 0,708599 0,637739

318 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 0,177149 0,159434

319 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 0,177149 0,159434

320 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 0,177149 0,159434

321 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 6,25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 6,89 0,229666 0,177149 0,159434

322 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 0,177149 0,159434

323 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 0,177149 0,159434

324 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 0,177149 0,159434

325 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 0,177149 0,159434

326 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 14,81 0,528928 0,354299 0,318869

327 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 21,99 0,785357 0,708599 0,637739

328 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 7,32 0,261428 0,177149 0,159434

329 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 0,345899

330 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 0,577800 0,520020

331 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 0,577800 0,520020

332 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 0,577800 0,520020

333 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 0,577800 0,520020

334 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 0,577800 0,520020

335 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 0,577800 0,520020

336 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC-COC-PVDC/AL X 10 COMPR. P-6L 20 12,85 0,642500 0,577800 0,520020

337 C08CA01 AMLODIPINUM AMLODIPINE VALEANT 10 mg COMPR. 10mg ICN POLFA RZESZOW POLONIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 14,05 0,468333 0,468333 0,421499

338 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 0,577800 0,520020

339 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 0,471535

340 C08CA01 AMLODIPINUM AMLODIPINA BLUEFISH 10 mg COMPR. 10mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 10,96 0,365333 0,365333 0,328799

341 C08CA01 AMLODIPINUM AMLODIPINA BIOGALENICA 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 0,577800 0,520020

Pagina 7 din 27

Page 10: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

342 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 10 mg COMPR. 10mg HELCOR S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 12,87 0,643500 0,577800 0,520020

343 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 0,577800 0,520020

344 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 0,577800 0,520020

345 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 0,221400

346 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 0,421499

347 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 0,254700

348 C08CA01 AMLODIPINUM AMLODIPINA ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 7,04 0,234666 0,234666 0,211199

349 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 0,577800 0,520020

350 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 8,49 0,283000 0,283000 0,254700

351 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 0,172800

352 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 0,288900 0,260010

353 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 0,288900 0,260010

354 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 0,288900 0,260010

355 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 0,288900 0,260010

356 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 0,288900 0,260010

357 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 0,288900 0,260010

358 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC-COC-PVDC/AL X 10 COMPR. P-6L 20 7,44 0,372000 0,288900 0,260010

359 C08CA01 AMLODIPINUM AMLODIPINE VALEANT 5 mg COMPR. 5mg ICN POLFA RZESZOW POLONIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 7,63 0,254333 0,254333 0,228899

360 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 0,288900 0,260010

361 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 0,288900 0,260010

362 C08CA01 AMLODIPINUM AMLODIPINA BLUEFISH 5 mg COMPR. 5mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 9,00 0,300000 0,288900 0,260010

363 C08CA01 AMLODIPINUM AMLODIPINA BIOGALENICA 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 0,236700

364 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 5 mg COMPR. 5mg HELCOR S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 8,63 0,431500 0,288900 0,260010

365 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 0,288900 0,260010

366 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 0,288900 0,260010

367 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 0,157500

368 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 0,228899

369 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 0,122999

370 C08CA01 AMLODIPINUM AMLODIPINA ACCORD 5 mg COMPR. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 6,35 0,211666 0,211666 0,190499

371 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 0,288900 0,260010

372 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 5 mg COMPR. 5mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 4,10 0,136666 0,136666 0,122999

373 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 0,577800 0,520020

374 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 0,577800 0,520020

375 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 0,144450 0,130005

376 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 0,144450 0,130005

377 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 0,288900 0,260010

378 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 0,288900 0,260010

379 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 0,577800 0,520020

380 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 0,144450 0,130005

381 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 0,288900 0,260010

382 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 0,577800 0,520020

383 C08CA02 FELODIPINUM PRESID (R) 10 mg COMPR. FILM. ELIB. PREL. 10mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 33,56 1,118666 0,577800 0,520020

384 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 0,577800 0,520020

385 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 0,144450 0,130005

386 C08CA02 FELODIPINUM PRESID (R) 2,5 mg COMPR. FILM. ELIB. PREL. 2,5mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 8,61 0,287000 0,144450 0,130005

387 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 0,288900 0,260010

388 C08CA02 FELODIPINUM PRESID (R) 5 mg COMPR. FILM. ELIB. PREL. 5mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 17,21 0,573666 0,288900 0,260010

389 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 0,288900 0,260010

390 C08CA05 NIFEDIPINUM ADALAT CR 30 COMPR. ELIB. MODIF. 30mg BAYER HEALTHCARE AG GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L 28 29,88 1,067142 0,288900 0,260010

391 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 0,288900 0,260010

Pagina 8 din 27

Page 11: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

392 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 0,192599 0,173339

393 C08DA01 VERAPAMILUM CORDAMIL 40 COMPR. FILM. 40mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 3,33 0,111000 0,095917 0,086325

394 C08DA01 VERAPAMILUM ISOPTIN (R) 40 mg COMPR. FILM. 40mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 100 17,09 0,170900 0,095917 0,086325

395 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 0,191835 0,172651

396 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 0,191835 0,172651

397 C08DA01 VERAPAMILUM CORDAMIL 80 COMPR. FILM. 80mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 5,96 0,198666 0,191835 0,172651

398 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 0,191835 0,172651

399 C08DA01 VERAPAMILUM VEROGALID (R) ER 240 mg COMPR. FILM. ELIB. PREL. 240mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 3 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 30 22,60 0,753333 0,575506 0,517955

400 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 0,575506 0,517955

401 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 0,095917 0,086325

402 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 0,191835 0,172651

403 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 2,291400

404 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 0,241605

405 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 0,241605

406 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 0,240660

407 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 0,241605

408 C08DB01 DILTIAZEMUM DILTIAZEM BIOEEL 60 mg COMPR. 60mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10 COMPR. P-6L 50 13,37 0,267400 0,267400 0,240660

409 C08DB01 DILTIAZEMUM CORZEM 120 COMPR. FILM. 120mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 10 12,84 1,284000 0,536900 0,483210

410 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 0,362407

411 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 0,046767 0,042090

412 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 0,093535 0,084181

413 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 0,093535 0,084181

414 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 0,093535 0,084181

415 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 0,093535 0,084181

416 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 0,093535 0,084181

417 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 0,093535 0,084181

418 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 0,093535 0,084181

419 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 0,120150

420 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 0,187071 0,168363

421 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 0,187071 0,168363

422 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 0,120150

423 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 0,135000

424 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 0,117900

425 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 0,187071 0,168363

426 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 0,187071 0,168363

427 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 0,187071 0,168363

428 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 0,187071 0,168363

429 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 0,187071 0,168363

430 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 0,187071 0,168363

431 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 0,187071 0,168363

432 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 0,187071 0,168363

433 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 0,187071 0,168363

434 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 0,187071 0,168363

435 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 11,28 0,564000 0,187071 0,168363

436 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 0,187071 0,168363

437 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 0,187071 0,168363

438 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 0,374142 0,336727

439 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 0,374142 0,336727

440 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 0,374142 0,336727

441 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 0,374142 0,336727

Pagina 9 din 27

Page 12: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

442 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 0,374142 0,336727

443 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 0,374142 0,336727

444 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 0,333599

445 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 0,295740

446 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 0,374142 0,336727

447 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 0,374142 0,336727

448 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 0,093535 0,084181

449 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 0,093535 0,084181

450 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 0,093535 0,084181

451 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 0,093535 0,084181

452 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 0,093535 0,084181

453 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 0,093535 0,084181

454 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 0,093535 0,084181

455 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 3,65 0,182500 0,093535 0,084181

456 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 0,093535 0,084181

457 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 0,093535 0,084181

458 C09AA02 ENALAPRILUM ENAP (R) SOL. INJ. 1,25mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 15,45 3,090000 3,090000 2,781000

459 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 0,187071 0,168363

460 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 0,187071 0,168363

461 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 0,187071 0,168363

462 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 0,187071 0,168363

463 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 0,187071 0,168363

464 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 0,187071 0,168363

465 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 0,187071 0,168363

466 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 0,187071 0,168363

467 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 0,046767 0,042090

468 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 0,374142 0,336727

469 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 0,374142 0,336727

470 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 0,374142 0,336727

471 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 0,374142 0,336727

472 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 14,44 0,722000 0,374142 0,336727

473 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 0,374142 0,336727

474 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 0,374142 0,336727

475 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 0,374142 0,336727

476 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 0,748285 0,673456

477 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 0,093535 0,084181

478 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,15 0,238333 0,093535 0,084181

479 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 0,093535 0,084181

480 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 0,093535 0,084181

481 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 0,093535 0,084181

482 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 0,093535 0,084181

483 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 0,296677

484 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 0,748285 0,673456

485 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 0,292199

486 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 0,748285 0,673456

487 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 0,296035

488 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 0,296677

489 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 0,456106

490 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 0,305035

491 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 0,748285 0,673456

Pagina 10 din 27

Page 13: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

492 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 0,149463

493 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 0,187071 0,168363

494 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 0,146099

495 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 0,187071 0,168363

496 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 0,148500

497 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 0,149463

498 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 0,187071 0,168363

499 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 0,187071 0,168363

500 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 0,215356

501 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 0,363214 0,326892

502 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 0,215399

503 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 0,361666 0,325499

504 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 0,215035

505 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 0,215356

506 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 0,368214 0,331392

507 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 0,228213

508 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 0,358333 0,322499

509 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 0,124714 0,112242

510 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 0,249428 0,224485

511 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 0,062357 0,056121

512 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 0,124714 0,112242

513 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 0,124714 0,112242

514 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 0,249428 0,224485

515 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 0,249428 0,224485

516 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 0,441900 0,397710

517 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 0,441900 0,397710

518 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 0,357750

519 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL HL COMPR. FARA CONCENTRATIE VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. PVC/COC/PVDC-AL X 10 COMPR. P-6L 30 8,88 0,296000 0,296000 0,266400

520 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL H COMPR. FARA CONCENTRATIE VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. PVC/COC/PVDC-AL X 10 COMPR. P-6L 30 11,82 0,394000 0,394000 0,354600

521 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

522 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 0,441900 0,397710

523 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 0,278677

524 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 0,441900 0,397710

525 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 0,441900 0,397710

526 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 0,441900 0,397710

527 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 1,066772 0,960094

528 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 1,066772 0,960094

529 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 0,431399

530 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 1,066772 0,960094

531 C09CA01 LOSARTANUM TALOSAN 12,5 mg COMPR. FILM. 12,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 4,25 0,141666 0,133346 0,120011

532 C09CA01 LOSARTANUM TALOSAN 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 7,81 0,260333 0,260333 0,234299

533 C09CA01 LOSARTANUM TALOSAN 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 7,81 0,260333 0,260333 0,234299

534 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 0,533386 0,480047

535 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 0,533386 0,480047

536 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 0,533386 0,480047

537 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 0,232499

538 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 0,533386 0,480047

539 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 0,533386 0,480047

540 C10AA01 SIMVASTATINUM SIMVASTATINA BIOGALENICA 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 0,218707 0,196836

541 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 0,218707 0,196836

Pagina 11 din 27

Page 14: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

542 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 0,218707 0,196836

543 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 0,218707 0,196836

544 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 0,218707 0,196836

545 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 0,218707 0,196836

546 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 0,218707 0,196836

547 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 0,218707 0,196836

548 C10AA01 SIMVASTATINUM SIMVASTATINA ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 8,75 0,312500 0,218707 0,196836

549 C10AA01 SIMVASTATINUM SIMVASTATINA ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 9,35 0,311666 0,218707 0,196836

550 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 9,26 0,308666 0,218707 0,196836

551 C10AA01 SIMVASTATINUM SIMVASTATIN BLUEFISH 10 mg COMPR. FILM. 10mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L 30 5,56 0,185333 0,185333 0,166799

552 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 0,218707 0,196836

553 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 0,218707 0,196836

554 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 0,218707 0,196836

555 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 0,127927

556 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 0,128892

557 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 0,218707 0,196836

558 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 0,128892

559 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 0,128399

560 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 9,21 0,307000 0,218707 0,196836

561 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 8,75 0,312500 0,218707 0,196836

562 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 0,218707 0,196836

563 C10AA01 SIMVASTATINUM SIMVASTATINA BIOGALENICA 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 0,437415 0,393673

564 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 0,437415 0,393673

565 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 0,437415 0,393673

566 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 0,437415 0,393673

567 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 0,437415 0,393673

568 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 0,437415 0,393673

569 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 0,437415 0,393673

570 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 0,437415 0,393673

571 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 0,437415 0,393673

572 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 0,437415 0,393673

573 C10AA01 SIMVASTATINUM SIMVASTATINA ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM P-6L 28 13,11 0,468214 0,437415 0,393673

574 C10AA01 SIMVASTATINUM SIMVASTATINA ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 14,05 0,468333 0,437415 0,393673

575 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 17,73 0,591000 0,437415 0,393673

576 C10AA01 SIMVASTATINUM SIMVASTATIN BLUEFISH 20 mg COMPR. FILM. 20mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 13,61 0,486071 0,437415 0,393673

577 C10AA01 SIMVASTATINUM SIMVASTATIN BLUEFISH 20 mg COMPR. FILM. 20mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L 30 14,58 0,486000 0,437415 0,393673

578 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 0,437415 0,393673

579 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 0,437415 0,393673

580 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 0,437415 0,393673

581 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 0,211500

582 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 0,213106

583 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 0,437415 0,393673

584 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 0,213106

585 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 0,212999

586 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 17,46 0,582000 0,437415 0,393673

587 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 13,11 0,468214 0,437415 0,393673

588 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 0,437415 0,393673

589 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 0,656124 0,590511

590 C10AA01 SIMVASTATINUM SIMVASTATINA BIOGALENICA 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 0,874832 0,787348

591 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 0,874832 0,787348

Pagina 12 din 27

Page 15: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

592 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 0,874832 0,787348

593 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 0,874832 0,787348

594 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 0,874832 0,787348

595 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 0,874832 0,787348

596 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 0,874832 0,787348

597 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 0,874832 0,787348

598 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 0,874832 0,787348

599 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 0,874832 0,787348

600 C10AA01 SIMVASTATINUM SIMVASTATINA ACTAVIS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 21,56 0,770000 0,770000 0,693000

601 C10AA01 SIMVASTATINUM SIMVASTATINA ACTAVIS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 23,11 0,770333 0,770333 0,693299

602 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 40 mg COMPR. FILM. 40mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 31,99 1,066333 0,874832 0,787348

603 C10AA01 SIMVASTATINUM SIMVASTATIN BLUEFISH 40 mg COMPR. FILM. 40mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 14 15,01 1,072142 0,874832 0,787348

604 C10AA01 SIMVASTATINUM SIMVASTATIN BLUEFISH 40 mg COMPR. FILM. 40mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 30,03 1,072500 0,874832 0,787348

605 C10AA01 SIMVASTATINUM SIMVASTATIN BLUEFISH 40 mg COMPR. FILM. 40mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L 30 18,54 0,618000 0,618000 0,556200

606 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 0,874832 0,787348

607 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 0,694199

608 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 0,291213

609 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 0,694199

610 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 0,293142

611 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 0,293142

612 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 0,293099

613 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 31,51 1,050333 0,874832 0,787348

614 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 21,56 0,770000 0,770000 0,693000

615 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 0,693299

616 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 1,749665 1,574698

617 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. X 10 COMPR. P-6L 100 67,59 0,675900 0,291610 0,262449

618 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 14,44 1,444000 0,291610 0,262449

619 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 20,79 0,693000 0,291610 0,262449

620 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 0,291610 0,262449

621 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 0,583221 0,524898

622 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 0,437415 0,393673

623 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 0,874832 0,787348

624 C10AB05 FENOFIBRATUM LIPANTHYL (R) 100 CAPS. 100mg LAB. FOURNIER SA FRANTA CUTIE X 4 BLIST. AL/PVC X 12 CAPS. P-6L 48 20,74 0,432083 0,432083 0,388874

625 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 0,753479 0,678131

626 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 0,753479 0,678131

627 C10AB05 FENOFIBRATUM LIPANTHYL 200 M CAPS. 200mg LAB. FOURNIER SA FRANTA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-6L 10 13,56 1,356000 0,941849 0,847664

628 C10AB05 FENOFIBRATUM LIPOFIB 267 mg CAPS. 267mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 30 33,54 1,118000 1,118000 1,006200

629 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 0,792900

630 C10AB05 FENOFIBRATUM TRIGLIPO 160 mg COMPR. 160mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 26,87 0,895666 0,753479 0,678131

631 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 0,682841 0,614556

632 C10AB05 FENOFIBRATUM FENOFIBRAT TEVA 160 mg COMPR. FILM. 160mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 26,89 0,896333 0,753479 0,678131

633 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 0,753479 0,678131

634 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 0,753479 0,678131

635 D01AC02 MICONAZOLUM MEDACTER CREMA 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 30G P-RF 1 8,57 8,570000 8,570000 7,713000

636 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 6,224250 5,601825

637 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 6,048000 5,443200

638 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 2,016000 1,814400

639 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 2,016000 1,814400

640 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 6,048000 5,443200

641 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 4,230000

Pagina 13 din 27

Page 16: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

642 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 6,048000 5,443200

643 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 6,048000 5,443200

644 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 6,660000

645 D07AC01 BETAMETHASONUM BETADERM CREMA 0,1% 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 3,213000

646 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 6,660000

647 D07AC01 BETAMETHASONUM BETADERM UNGUENT 0,1% 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 3,213000

648 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 0,893999

649 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 1,715999

650 G01AF04 MICONAZOLUM MEDACTER CREMA VAG. 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 78 G P-RF 1 19,37 19,370000 12,203098 10,982788

651 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 1,283400

652 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 0,709949

653 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 5,800274

654 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 5,500199

655 G03BA03 TESTOSTERONUM* NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FIOLA X 4 ML SOL. INJ. S/P-RF 1 484,53 484,530000 484,530000 436,077000

656 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 10,252796 9,227516

657 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 9,842684 8,858415

658 G03CA03 ESTRADIOLUM* CLIMARA PLASTURE TRANSDERM. 50mcg/24ore BAYER SCHERING PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L 4 33,33 8,332500 8,332500 7,499250

659 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 0,170533

660 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 0,170533

661 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 0,341067

662 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 0,341067

663 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 0,682135

664 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 0,682135

665 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 0,682135

666 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 0,682135

667 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 0,682135

668 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 0,682135

669 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 7,454250

670 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 27,918000

671 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 14,908500

672 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 0,078599

673 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 0,078599

674 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 0,078599

675 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 0,078599

676 H02AB09 HYDROCORTISONUM* HYDROCORTISONE ROUSSEL COMPR. 10mg CN UNIFARM ROMANIA CUTIE X 1 FLAC. 25 COMPR. PRF 25 12,20 0,488000 0,488000 0,439200

677 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 2,381999 2,143799

678 H02AB09 HYDROCORTISONUM* HYDROCORTISONE 500 mg LIOF. PT. SOL. INJ. + SOLV. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 4 ML SOLV. P-RF 1 11,91 11,910000 11,910000 10,719000

679 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 20 ML, INCCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, C PR/PRF 1 11,91 11,910000 11,910000 10,719000

680 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA X 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CON PR/PRF 1 7,09 7,090000 2,381999 2,143799

681 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 0,595499 0,535949

682 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 0,308610

683 J01AA02 DOXYCYCLINUM DOXICICLINA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,00 0,350000 0,342900 0,308610

684 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 0,308610

685 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 0,308610

686 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 0,280800 0,252720

687 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,24 0,312000 0,280800 0,252720

688 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 0,280800 0,252720

689 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg CAPSULE CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,15 0,307500 0,280800 0,252720

690 J01CA04 AMOXICILLINUM AMOXICILINA FARMEX 250 mg CAPS. 250mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,25 0,262500 0,262500 0,236250

691 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5,69 0,569000 0,481978 0,433780

Pagina 14 din 27

Page 17: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

692 J01CA04 AMOXICILLINUM E - MOX CAPS. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 8 CAPS. P-RF 8 7,53 0,941250 0,481978 0,433780

693 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 0,481978 0,433780

694 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 0,396450

695 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 0,481978 0,433780

696 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPSULE CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4,92 0,492000 0,481978 0,433780

697 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 0,963957 0,867561

698 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 0,426749

699 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 0,831856

700 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 0,963957 0,867561

701 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 0,280800 0,252720

702 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 0,481978 0,433780

703 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 0,722968 0,650671

704 J01CA04 AMOXICILLINUM JULPHAMOX PULB. PT. SUSP. ORALA 125mg/5ml GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 100 ML SUSP. P-RF 1 7,55 7,550000 2,808000 2,527200

705 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 125 mg/5 ml PULBERE PENTRU SUSPENSIE ORALA 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 1,684800 1,516320

706 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 1,684800 1,516320

707 J01CA04 AMOXICILLINUM JULPHAMOX PULB. PT. SUSP. ORALA 250mg/5ml GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 100 ML SUSP. P-RF 1 8,20 8,200000 5,616000 5,054400

708 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg/ 5 ml PULBERE PENTRU SUSPENSIE ORALA 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 3,369600 3,032640

709 J01CA04 AMOXICILLINUM E - MOX PULB. PT. SUSP. ORALA 250mg/5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 60 ML SUSP. P-RF 1 4,88 4,880000 3,369600 3,032640

710 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 3,369600 3,032640

711 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 0,260249

712 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 6,10 0,508333 0,440718 0,396646

713 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 0,132215

714 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400 SIROP 400000ui/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLACON X 60ML P-RF 1 9,51 9,510000 0,195874 0,176286

715 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 3,904919

716 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 3,904919

717 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 0,266499

718 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 0,266499

719 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 0,266499

720 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 0,532998

721 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 0,532998

722 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 0,502650

723 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 0,532998

724 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 2,302942

725 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 2,302942

726 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 4,032540

727 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 4,605885

728 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 1,601428 1,441285

729 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 1,498615 1,348753

730 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 0,856351 0,770715

731 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 0,696213

732 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 0,856351 0,770715

733 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 0,856351 0,770715

734 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 1,355000 1,219500

735 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 1,498615 1,348753

736 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 1,498615 1,348753

737 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 0,856351 0,770715

738 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 6,123214 5,510892

739 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 6,123214 5,510892

740 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 12,246428 11,021785

741 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 5,814000

Pagina 15 din 27

Page 18: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

742 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 11,637000

743 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 + PRF 1 6,47 6,470000 6,470000 5,823000

744 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 6,857999 6,172199

745 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 6,857999 6,172199

746 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 13,715999 12,344399

747 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 29,391428 26,452285

748 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 250 mg/ 62,5 mg/5 ml PULB. PT.SUSP. ORALA 250 mg/ 62,5 mg/5 ml RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID CU PULB. PT. SUSP. ORALA MARCAT PT. 100ML+ MASURA DOZATOARE P-RF 1 22,71 22,710000 12,246428 11,021785

749 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 12,246428 11,021785

750 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 0,405810

751 J01DB01 CEFALEXINUM CEFALEXINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 11,82 0,591000 0,450900 0,405810

752 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 0,405810

753 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 0,405810

754 J01DB01 CEFALEXINUM CEFALEXINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 10,51 1,051000 0,901800 0,811620

755 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 0,810000

756 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 0,811620

757 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 1,184249

758 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 0,811620

759 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 4,622625

760 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 4,622625

761 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 4,622625

762 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 9,245250

763 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 8,685000

764 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 8,667000

765 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 0,405810

766 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 0,811620

767 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 0,811620

768 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 1,623240

769 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 4,622625

770 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 9,245250

771 J01DC02 CEFUROXIMUM CEROXIM 250 mg COMPR. 250mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 14,38 1,438000 1,289699 1,160729

772 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 1,289699 1,160729

773 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 1,289699 1,160729

774 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 0,972000

775 J01DC02 CEFUROXIMUM CEROXIM 500 mg COMPR. 500mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 30,20 3,020000 2,579399 2,321459

776 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 2,579399 2,321459

777 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 2,579399 2,321459

778 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 1,617300

779 J01DC02 CEFUROXIMUM AXYCEF (R) 125 COMPR. ACOPERITE 125mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ACOPERITE P-RF 10 9,82 0,982000 0,982000 0,883800

780 J01DC02 CEFUROXIMUM AXYCEF (R) 250 COMPR. ACOPERITE 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ACOPERITE P-RF 10 11,82 1,182000 1,182000 1,063800

781 J01DC02 CEFUROXIMUM AXYCEF (R) 500 COMPR. ACOPERITE 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ACOPERITE P-RF 10 20,22 2,022000 2,022000 1,819800

782 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 1,283999 1,155599

783 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 1,289699 1,160729

784 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 2,579399 2,321459

785 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 12,839999 11,555999

786 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 15,894000

787 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 0,644849 0,580364

788 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 0,644849 0,580364

789 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 0,644849 0,580364

790 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 0,644849 0,580364

791 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 1,289699 1,160729

Pagina 16 din 27

Page 19: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

792 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 1,289699 1,160729

793 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 1,289699 1,160729

794 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 1,289699 1,160729

795 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 1,289699 1,160729

796 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 1,934549 1,741094

797 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 0,967274 0,870546

798 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 1,934549 1,741094

799 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 0,967274 0,870546

800 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 1,289699 1,160729

801 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 1,934549 1,741094

802 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 9,629999 8,666999

803 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 9,629999 8,666999

804 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 19,259999 17,333999

805 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 25,679999 23,111999

806 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 19,259999 17,333999

807 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 9,629999 8,666999

808 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 7,703999 6,933599

809 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 19,259999 17,333999

810 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 15,407999 13,867199

811 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 1,752524 1,577271

812 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 3,129300

813 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 0,296055

814 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 0,296055

815 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 0,296055

816 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 0,296055

817 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SIROP 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 8,20 8,200000 3,853124 3,467811

818 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 4,284000

819 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 0,319050

820 J01FA01 ERYTHROMYCINUM ERITROMICINA 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,60 0,480000 0,429171 0,386253

821 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 0,379800

822 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 10,314000

823 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 2,145855 1,931269

824 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 2,145855 1,931269

825 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 1,072927 0,965634

826 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 32,23 2,302142 1,072927 0,965634

827 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 1,072927 0,965634

828 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 0,943071

829 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 1,072927 0,965634

830 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 0,729000

831 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 37,95 2,710714 2,145855 1,931269

832 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 2,145855 1,931269

833 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 2,145855 1,931269

834 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 2,145855 1,931269

835 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 2,145855 1,931269

836 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 1,582713

837 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 2,145855 1,931269

838 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 2,145855 1,931269

839 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 2,145855 1,931269

840 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 28,228499 25,405649

841 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 16,937100 15,243390

Pagina 17 din 27

Page 20: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

842 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 16,937100 15,243390

843 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 16,937100 15,243390

844 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 16,937100 15,243390

845 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 61,52 61,520000 56,456999 50,811299

846 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 45,981000

847 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 44,85 44,850000 33,874200 30,486780

848 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 31,680000 28,512000

849 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 23,018625

850 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 1,022400

851 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 1,070820

852 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 0,214164

853 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 0,214164

854 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 0,535410

855 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 0,535410

856 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 0,535410

857 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 0,535410

858 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 0,535410

859 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 7,87 0,787000 0,594900 0,535410

860 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 0,535410

861 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 0,535410

862 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 0,535410

863 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 0,428400

864 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 1,070820

865 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 1,070820

866 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 1,070820

867 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 1,070820

868 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 15,12 1,512000 1,189800 1,070820

869 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 0,790200

870 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 1,070820

871 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 0,830700

872 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 0,739350

873 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 0,535410

874 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 1,606230

875 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 1,606230

876 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 84,70 12,100000 2,379600 2,141640

877 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 2,141640

878 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 27,63 9,210000 1,189800 1,070820

879 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 1,070820

880 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 1,070820

881 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 0,660875 0,594787

882 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 0,557100

883 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 0,660875 0,594787

884 J01MA06 NORFLOXACINUM EPINOR COMPR. FILM. 400mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 7,70 0,550000 0,550000 0,495000

885 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 0,660875 0,594787

886 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 0,660875 0,594787

887 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

888 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 0,231599

889 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 0,231599

890 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 0,267468

891 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 0,267468

Pagina 18 din 27

Page 21: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

892 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 7,518749

893 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 7,768874

894 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 7,371749

895 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 7,768874

896 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 3,884436

897 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 3,884436

898 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 3,884436

899 J02AB02 KETOCONAZOLUM NIZORAL 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 20,48 2,048000 0,803000 0,722700

900 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 8,03 0,803000 0,803000 0,722700

901 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6,87 0,687000 0,687000 0,618300

902 J02AB02 KETOCONAZOLUM KETOSTIN 200 mg COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 12,62 1,262000 0,803000 0,722700

903 J02AB02 KETOCONAZOLUM KETOCONAZOL ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 9,17 0,917000 0,803000 0,722700

904 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 236,41 8,443214 4,102713 3,692441

905 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 25,61 6,402500 4,102713 3,692441

906 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 4,102713 3,692441

907 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 4,102713 3,692441

908 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 4,102713 3,692441

909 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 22,51 22,510000 6,154069 5,538662

910 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 9,94 9,940000 6,154069 5,538662

911 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 6,154069 5,538662

912 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 6,154069 5,538662

913 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 6,154069 5,538662

914 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 6,154069 5,538662

915 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 6,154069 5,538662

916 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 6,154069 5,538662

917 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 6,154069 5,538662

918 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 6,154069 5,538662

919 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 6,154069 5,538662

920 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 6,154069 5,538662

921 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 12,53 12,530000 6,154069 5,538662

922 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 6,154069 5,538662

923 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 6,154069 5,538662

924 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 13,54 13,540000 6,154069 5,538662

925 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 5,061856

926 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 61,72 8,817142 2,051356 1,846220

927 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 22,56 3,222857 2,051356 1,846220

928 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 2,051356 1,846220

929 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 2,051356 1,846220

930 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 2,051356 1,846220

931 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 19,04 2,380000 2,051356 1,846220

932 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 2,051356 1,846220

933 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 2,051356 1,846220

934 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 2,051356 1,846220

935 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 2,051356 1,846220

936 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 2,051356 1,846220

937 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 2,051356 1,846220

938 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, PREVAZUT CU CAPAC DIN AL CU FILET + 1 LINGURITA DOZATOAR PRF 1 31,71 31,710000 14,359495 12,923545

939 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 31,71 31,710000 14,359495 12,923545

940 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 33,484612 30,136150

941 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 0,748422 0,673579

Pagina 19 din 27

Page 22: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

942 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 0,748422 0,673579

943 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 0,748422 0,673579

944 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 1,496844 1,347159

945 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 0,748422 0,673579

946 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 0,748422 0,673579

947 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 0,621450

948 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 13,00 0,650000 0,650000 0,585000

949 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 19,23 1,923000 1,496844 1,347159

950 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 50,934600

951 L02BG01 AMINOGLUTETHIMIDUM ROGLUTEN (R) 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 40 COMPR. P-RF 40 151,38 3,784500 3,784500 3,406050

952 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 0,071775 0,064597

953 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 0,064199

954 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 0,143550 0,129195

955 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 0,312750 0,281475

956 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 0,312750 0,281475

957 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 0,312750 0,281475

958 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 0,430650 0,387585

959 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 0,215325 0,193792

960 M01AB05 DICLOFENACUM TRATUL 50 CAPS. MOI GASTROREZ. 50mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI GASTROREZ. P-6L 30 6,39 0,213000 0,143550 0,129195

961 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 8,21 0,410500 0,287100 0,258390

962 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 0,215325 0,193792

963 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 0,287100 0,258390

964 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 0,287100 0,258390

965 M01AB05 DICLOFENACUM RHEUMAVEK COMPR. FILM. GASTROREZ. 25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. PVC-AL/PVDC X 10 COMPR. FILM. GASTROREZ. P-6L 30 5,72 0,190666 0,071775 0,064597

966 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 0,143550 0,129195

967 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 0,143550 0,129195

968 M01AB05 DICLOFENACUM CLAFEN 50 mg COMPR. FILM. GASTROREZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. GASTROREZ. P-6L 20 3,04 0,152000 0,143550 0,129195

969 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2,27 0,113500 0,113500 0,102150

970 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 0,143550 0,129195

971 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 0,071775 0,064597

972 M01AB05 DICLOFENACUM N - DICLOFENAC DRAJ. GASTROREZ. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 DRAJ. GASTROREZ. P-6L 20 2,54 0,127000 0,127000 0,114300

973 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 0,119250

974 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 0,119399

975 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 1,097999 0,988199

976 M01AB05 DICLOFENACUM RHEUMAVEK SOL. INJ. 25mg/ml FARAN LABORATORIES S.A. GRECIA CUTIE X 5 FIOLE DE STICLA BRUNA PREVAZUTE CU INEL DE RUPERE X 3 ML P-RF 5 6,10 1,220000 1,097999 0,988199

977 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 14,24 2,848000 1,317600 1,185840

978 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 1,097999 0,988199

979 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 5 6,10 1,220000 1,097999 0,988199

980 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH GERMANIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 10 12,22 1,222000 1,097999 0,988199

981 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 0,729000

982 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 0,625500 0,562950

983 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 0,625500 0,562950

984 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 0,625500 0,562950

985 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 0,625500 0,562950

986 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 0,312750 0,281475

987 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 0,095699 0,086129

988 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 0,095699 0,086129

989 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 1,464000 1,317600

990 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 1,464000 1,317600

991 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 0,143550 0,129195

Pagina 20 din 27

Page 23: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

992 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 0,406215

993 M01AC02 TENOXICAMUM TENOXICAM 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 0,406215

994 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 0,406215

995 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 0,406215

996 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 2,570850 2,313765

997 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

998 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 0,406215

999 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 0,406215

1000 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 0,406215

1001 M01AC06 MELOXICAMUM MELOX 15 mg COMPR. 15mg MEDOCHEMIE LTD CIPRU CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 30,39 1,013000 0,451350 0,406215

1002 M01AC06 MELOXICAMUM MELOX 15 mg COMPR. 15mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 10 10,60 1,060000 0,451350 0,406215

1003 M01AC06 MELOXICAMUM RECOXA 15 COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 8,69 0,434500 0,434500 0,391050

1004 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 0,406215

1005 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 0,406215

1006 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 0,406215

1007 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 0,406215

1008 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 0,406215

1009 M01AC06 MELOXICAMUM MELOX 7,5 mg COMPR. 7,5 mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 10 9,61 0,961000 0,225675 0,203107

1010 M01AC06 MELOXICAMUM MELOX 7,5 mg COMPR. 7,5 mg MEDOCHEMIE LTD CIPRU CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. P-6L 30 25,65 0,855000 0,225675 0,203107

1011 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 0,203107

1012 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 0,203107

1013 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 0,203107

1014 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 0,203107

1015 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 0,203107

1016 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 0,203107

1017 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 0,203107

1018 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 0,203107

1019 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 2,570850 2,313765

1020 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 0,597780

1021 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 0,496874 0,447186

1022 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 0,745312 0,670780

1023 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 0,993749 0,894374

1024 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 0,993749 0,894374

1025 M01AE03 KETOPROFENUM KETARD 200 mg CAPS. ELIB. PREL. 200mg LABORMED PHARMA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 10 7,57 0,757000 0,757000 0,681300

1026 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 0,745312 0,670780

1027 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 0,406350

1028 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 0,396000

1029 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 0,496874 0,447186

1030 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 0,355050

1031 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 0,248437 0,223593

1032 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 0,858856

1033 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 1,049499 0,944549

1034 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 1,926000 1,733400

1035 M01AE03 KETOPROFENUM KETONAL 100 mg SUPOZ. 100mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 FOLII AL/PE X 6 SUPOZ. P-6L 12 8,20 0,683333 0,668166 0,601349

1036 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 0,668166 0,601349

1037 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 0,587700

1038 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 0,133559

1039 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 0,386100

1040 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 0,129600

1041 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 1,231875

Pagina 21 din 27

Page 24: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

1042 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 1,201500

1043 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,82 0,291000 0,283574 0,255216

1044 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 0,283574 0,255216

1045 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 0,283574 0,255216

1046 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 0,283574 0,255216

1047 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 3,85 0,385000 0,283574 0,255216

1048 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 0,283574 0,255216

1049 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 3,82 0,382000 0,283574 0,255216

1050 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 0,283574 0,255216

1051 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 0,283574 0,255216

1052 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 0,283574 0,255216

1053 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 0,567149 0,510434

1054 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 18,91 0,630333 0,567149 0,510434

1055 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 0,567149 0,510434

1056 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 0,850725 0,765652

1057 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 0,850725 0,765652

1058 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 1,134299 1,020869

1059 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 0,283574 0,255216

1060 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 0,567149 0,510434

1061 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 0,850725 0,765652

1062 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 0,850725 0,765652

1063 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 1,134299 1,020869

1064 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 1,134299 1,020869

1065 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 0,283574 0,255216

1066 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 1,572302 1,415071

1067 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 1,211040

1068 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 12,28 2,456000 1,572302 1,415071

1069 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 0,786148 0,707533

1070 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 4,90 0,980000 0,786148 0,707533

1071 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 1,572302 1,415071

1072 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 7,67 1,534000 1,534000 1,380600

1073 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 1,004400

1074 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 8,936249

1075 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 4,468124

1076 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 8,717999

1077 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 8,936249

1078 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 8,717999

1079 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 4,468124

1080 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 4,468124

1081 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 4,468124

1082 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 0,226200 0,203580

1083 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 0,203580

1084 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 0,203580

1085 N03AF01 CARBAMAZEPINUM CARBEPSIL 200 COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,203580

1086 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,42 0,221000 0,221000 0,198900

1087 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 0,202500

1088 N03AF01 CARBAMAZEPINUM FINLEPSIN COMPR. 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,203580

1089 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 0,226200 0,203580

1090 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 0,203580

1091 N03AF01 CARBAMAZEPINUM CARBEPSIL 400 COMPR. 400mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 26,26 0,525200 0,452400 0,407160

Pagina 22 din 27

Page 25: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

1092 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 0,452400 0,407160

1093 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 0,169650 0,152685

1094 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 0,339300 0,305370

1095 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 0,678600 0,610740

1096 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 0,339300 0,305370

1097 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 0,678600 0,610740

1098 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 0,226200 0,203580

1099 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 0,226200 0,203580

1100 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 0,452400 0,407160

1101 N03AF01 CARBAMAZEPINUM FINLEPSIN 400 RETARD COMPR. FILM. ELIB. PREL. 400mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 25,27 0,505400 0,452400 0,407160

1102 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 0,452400 0,407160

1103 N03AF01 CARBAMAZEPINUM FINLEPSIN 200 RETARD COMPR.FILM.ELIB.PREL 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 12,43 0,248600 0,226200 0,203580

1104 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 20,259000

1105 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 0,129600

1106 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 0,309197 0,278277

1107 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 0,309197 0,278277

1108 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 0,309197 0,278277

1109 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 0,309197 0,278277

1110 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 0,392400

1111 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 0,927597 0,834837

1112 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 0,927597 0,834837

1113 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 0,927597 0,834837

1114 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 0,927597 0,834837

1115 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 0,927597 0,834837

1116 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 0,910300 0,819270

1117 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 0,518580

1118 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 1,236799 1,113119

1119 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 1,236799 1,113119

1120 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 1,236799 1,113119

1121 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 1,236799 1,113119

1122 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 1,236799 1,113119

1123 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 1,217900 1,096110

1124 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 1,855199 1,669679

1125 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 1,855199 1,669679

1126 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 2,473599 2,226239

1127 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 2,473599 2,226239

1128 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 0,081000 0,072900

1129 N05AD01 HALOPERIDOLUM HALOPERIDOL 1 mg COMPR. 1mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,72 0,257333 0,162000 0,145800

1130 N05AD01 HALOPERIDOLUM HALOPERIDOL 2 mg COMPR. 2mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 10,80 0,360000 0,324000 0,291600

1131 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 0,645840

1132 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. OFT., 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 4,31 4,310000 4,310000 3,879000

1133 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 3,240000 2,916000

1134 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 8,013600

1135 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 1,046357

1136 N05BA01 DIAZEPAMUM DIAZEPAM 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 0,089550

1137 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 0,120299

1138 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 0,093600

1139 N05BA01 DIAZEPAMUM DIAZEPAM 10 mg SOL. INJ. 10mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 10,48 2,096000 2,096000 1,886400

1140 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 5,871600

1141 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

Pagina 23 din 27

Page 26: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

1142 N05BA03 MEDAZEPAMUM* ANSILAN 10 mg CAPS. 10mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 CAPS. P-RF 25 3,82 0,152800 0,123599 0,111239

1143 N05BA03 MEDAZEPAMUM* MEDAZEPAM COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2,45 0,122500 0,122500 0,110250

1144 N05BA03 MEDAZEPAMUM* MEDAZEPAM COMPR. 10 mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF 50 5,61 0,112200 0,112200 0,100980

1145 N05BA03 MEDAZEPAMUM* MEDAZEPAM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 20 COMPR. P-RF 20 3,05 0,152500 0,123599 0,111239

1146 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 0,111150

1147 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 0,098879 0,088991

1148 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 0,037079 0,033371

1149 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 0,074159 0,066743

1150 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 0,074159 0,066743

1151 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 0,074159 0,066743

1152 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 0,074159 0,066743

1153 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 0,061799 0,055619

1154 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 0,061799 0,055619

1155 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 0,061799 0,055619

1156 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 0,061799 0,055619

1157 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 0,061799 0,055619

1158 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 0,061799 0,055619

1159 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 0,061799 0,055619

1160 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 0,123599 0,111239

1161 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 0,123599 0,111239

1162 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 0,123599 0,111239

1163 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 0,123599 0,111239

1164 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 0,123599 0,111239

1165 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 0,123599 0,111239

1166 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 0,123599 0,111239

1167 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 0,247199 0,222479

1168 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 0,247199 0,222479

1169 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 0,247199 0,222479

1170 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 0,247199 0,222479

1171 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 0,247199 0,222479

1172 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 0,247199 0,222479

1173 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 0,247199 0,222479

1174 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 0,055912 0,050320

1175 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 0,070650

1176 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 0,111825 0,100642

1177 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 0,775000 0,697500

1178 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 0,407250 0,366525

1179 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 0,407250 0,366525

1180 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 0,407250 0,366525

1181 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 0,407250 0,366525

1182 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 0,351000

1183 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 0,351000

1184 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 0,203625 0,183262

1185 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 12,217500 10,995750

1186 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 0,149053 0,134147

1187 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 0,372633 0,335369

1188 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

1189 N06AA12 DOXEPINUM* DOXEPIN 25 mg DRAJ. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. P-RF 30 19,95 0,665000 0,372633 0,335369

1190 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 0,567000 0,510300

1191 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 0,567000 0,510300

Pagina 24 din 27

Page 27: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

1192 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 0,567000 0,510300

1193 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 0,567000 0,510300

1194 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 0,567000 0,510300

1195 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 0,213599

1196 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 0,237856

1197 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 0,567000 0,510300

1198 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 0,344571

1199 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 1,134000 1,020600

1200 N06AB05 PAROXETINUM* ARKETIS COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 23,05 0,768333 0,567000 0,510300

1201 N06AB05 PAROXETINUM* PAROXETIN 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 0,567000 0,510300

1202 N06AB05 PAROXETINUM* SEROXAT 20 mg COMPR. FILM. 20mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 34,30 1,143333 0,567000 0,510300

1203 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 0,567000 0,510300

1204 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 0,567000 0,510300

1205 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 1,134000 1,020600

1206 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 1,134000 1,020600

1207 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 1,134000 1,020600

1208 N06AB06 SERTRALINUM* SERTRALIN SANDOZ 100 mg COMPR. FILM. 100mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 37,80 1,260000 1,134000 1,020600

1209 N06AB06 SERTRALINUM* SERTRALINA 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 1,134000 1,020600

1210 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 1,134000 1,020600

1211 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 1,134000 1,020600

1212 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 1,134000 1,020600

1213 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 49,28 1,642666 1,134000 1,020600

1214 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 1,134000 1,020600

1215 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 0,567000 0,510300

1216 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 0,567000 0,510300

1217 N06AB06 SERTRALINUM* SERTRALIN SANDOZ 50 mg COMPR. FILM. 50mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 20,82 0,694000 0,567000 0,510300

1218 N06AB06 SERTRALINUM* SERTRALINA 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 0,567000 0,510300

1219 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 0,567000 0,510300

1220 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 0,567000 0,510300

1221 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 0,567000 0,510300

1222 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 26,58 0,886000 0,567000 0,510300

1223 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 0,567000 0,510300

1224 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 13,608000 12,247200

1225 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 0,567000 0,510300

1226 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 0,283500 0,255150

1227 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 0,358423

1228 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 1,075275

1229 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 1,263499 1,137149

1230 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 1,263499 1,137149

1231 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 1,080299

1232 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 0,417299

1233 N06AX11 MIRTAZAPINUM* MIRTAZAPIN AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 24,62 0,820666 0,631749 0,568574

1234 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 1,263499 1,137149

1235 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. ORODISPERSABILE P-RF 30 37,92 1,264000 1,263499 1,137149

1236 N06AX11 MIRTAZAPINUM* MIRTAZAPIN AUROBINDO 30 mg COMPR. ORODISPERSABILE 30mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 38,11 1,270333 1,263499 1,137149

1237 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

1238 N06AX11 MIRTAZAPINUM* MIRTAZAPIN AUROBINDO 45 mg COMPR. ORODISPERSABILE 45mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE P-RF 30 63,52 2,117333 1,895249 1,705724

1239 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 0,746356

1240 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 1,362285 1,226056

1241 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 1,362285 1,226056

Pagina 25 din 27

Page 28: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

1242 N06AX16 VENLAFAXINUM** EFECTIN ER 150 mg CAPS. ELIB. PREL. 150mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 58,69 2,096071 1,362285 1,226056

1243 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 1,362142 1,225927

1244 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 1,362285 1,226056

1245 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 1,362285 1,226056

1246 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 1,362285 1,226056

1247 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 0,742821

1248 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 1,357000 1,221300

1249 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 1,362285 1,226056

1250 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 1,362285 1,226056

1251 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 24,38 0,812666 0,340571 0,306513

1252 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 0,340571 0,306513

1253 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 0,575035

1254 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 0,681142 0,613027

1255 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 0,681142 0,613027

1256 N06AX16 VENLAFAXINUM** EFECTIN ER 75 mg CAPS. ELIB. PREL. 75mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 35,58 1,270714 0,681142 0,613027

1257 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 0,681142 0,613027

1258 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 0,681142 0,613027

1259 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 25,59 0,853000 0,681142 0,613027

1260 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 0,681142 0,613027

1261 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 0,569571

1262 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 0,681142 0,613027

1263 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 0,681142 0,613027

1264 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 0,681142 0,613027

1265 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 0,340571 0,306513

1266 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 0,454095 0,408685

1267 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 0,681142 0,613027

1268 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 0,622199

1269 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 0,479399

1270 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 37,5 mg COMPR. FILM. 37,5 mg ACTAVIS S.R.L. ROMANIA CUTIE X 4 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 56 38,11 0,680535 0,340571 0,306513

1271 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 0,617850

1272 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 0,534936

1273 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P-RF 4 3,68 0,920000 0,594374 0,534936

1274 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 0,534936

1275 P01AB02 TINIDAZOLUM TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. X 4 COMPR.FILM. P-RF 4 3,68 0,920000 0,594374 0,534936

1276 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 2,771249

1277 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 5,375999

1278 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 2,771249

1279 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 2,771249

1280 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 3,432375

1281 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 3,366000

1282 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 3,078000

1283 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 3,078000

1284 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 1,025989

1285 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 1,025989

1286 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

1287 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 1,402920

1288 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 7,014600

1289 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 6,129000

1290 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 91,764000

1291 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 39,480000 35,532000

Pagina 26 din 27

Page 29: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

tara det.

APP Ambalaj Prescriptie

cant/a

mbal

aj

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

1292 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 75,000000 67,500000

1293 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 40,790000 36,711000

1294 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 81,580000 73,422000

1295 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 163,160000 146,844000

1296 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 43,509332 39,158398

1297 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 43,509332 39,158398

1298 R03BB01 IPRATROPII BROMIDUM* IPRAXA 500mcg/2ml SOL. DE INHALAT PRIN NEBULIZ. 500mcg/2ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 20 FIOLE DIN PEJD X 2 ML SOL. DE INHALAT PRIN NEBULIZATOR P-6L 20 31,83 1,591500 1,579124 1,421211

1299 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 11,340000

1300 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 2,745000

1301 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 0,640800

1302 R03DA04 THEOPHYLLINUM THEO SR 100 CAPS. ELIB. PREL. 100mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 2 BLIST. PVC/PVDC-AL X 10 CAPS. ELIB. PREL. P-RF 20 5,72 0,286000 0,178800 0,160920

1303 R03DA04 THEOPHYLLINUM TEOTARD (R) 200 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 0,211050

1304 R03DA04 THEOPHYLLINUM THEO SR 200 CAPS. ELIB. PREL. 200mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 10 CAPS. ELIB. PREL. P-RF 10 4,27 0,427000 0,357600 0,321840

1305 R03DA04 THEOPHYLLINUM THEO SR 300 CAPS. ELIB. PREL. 300mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 1 BLIST. PVC/PVDC - AL X 10 CAPS. ELIB. PREL. P-RF 10 5,96 0,596000 0,536400 0,482760

1306 R03DA04 THEOPHYLLINUM TEOTARD (R) 350 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 0,314550

1307 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 0,153124 0,137811

1308 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 0,153124 0,137811

1309 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 3,02 0,151000 0,151000 0,135900

1310 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3,02 0,151000 0,151000 0,135900

1311 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 0,153124 0,137811

1312 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 0,153124 0,137811

1313 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 0,103949

1314 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 0,642937 0,578643

1315 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 0,642937 0,578643

1316 R06AE07 CETIRIZINUM ZYRTEC 10 mg/ml PICATURI ORALE-SOL. 10mg/ml U.C.B. GMBH GERMANIA CUTIE X 1 FLAC. STICLA BRUNA X 20 ML PIC. ORAL. SOL + APLICATOR PT. PICURARE P-6L 1 22,99 22,990000 12,858750 11,572875

1317 R06AX17 KETOTIFENUM KETOF 1 mg CAPS. 1mg HEXAL AG GERMANIA CUTIE X 5 BLIST. AL/PP X 10 CAPS. P-6L 50 13,81 0,276200 0,172500 0,155250

1318 R06AX17 KETOTIFENUM KETOF 1 mg CAPS. 1mg HEXAL AG GERMANIA CUTIE X 2 BLIST. AL/PP X 10 CAPS. P-6L 20 5,25 0,262500 0,172500 0,155250

1319 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 0,155250

1320 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 0,155250

1321 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 0,155250

1322 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 0,148950

1323 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 10,287000

1324 S01AX13 CIPROFLOXACINUM CIPLOX (vezi S01AX13) UNG. OFT. 0,3% CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 TUB DIN AL + VARF APLICATOR SI CAPAC DIN PEID X 5G UNG. OFT. P-RF 1 4,27 4,270000 4,270000 3,843000

1325 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 8,479125

1326 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 10,107000

1327 S01BC03 DICLOFENACUM VOLTAREN OPHTHA CD PICATURI OFT.-SOL. 0,1% LABORATOIRES THEA FRANTA/GERMANIA 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 8,479125

1328 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL PICATURI OFT.SUSP. 0,2g+0,5g/100ml THEA FARMASPA 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 12,105000

1329 S01CA05 COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM) BETABIOPTAL UNG. OFT. 0,2g+0,5g/100g THEA FARMACEUTICI S ITALIA CUTIE X 1 TUB AL X 5 G P-RF 1 15,45 15,450000 13,950000 12,555000

NOTĂ: - 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 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.

Pagina 27 din 27

Page 30: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 0,662699 0,3313492 A02BC02 PANTOPRAZOLUM SELTRAZ 20 mg COMPR. FILM. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. FILM. GASTROREZISTENTE P-6L 28 22,06 0,787857 0,662699 0,3313493 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 1,325399 0,6626994 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 0,5646425 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 0,1139286 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 0,662699 0,3313497 A02BC02 PANTOPRAZOLUM PANTOSAL 20 mg COMPR. GASTROREZ. 20mg NYCOMED GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. GASTROREZ. P-6L 28 21,91 0,782500 0,662699 0,3313498 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 0,662699 0,3313499 A02BC02 PANTOPRAZOLUM AZATOL 20 mg COMPR. GASTROREZ. 20mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ. P-6L 28 22,57 0,806071 0,662699 0,331349

10 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 0,662699 0,33134911 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 0,20767812 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 0,56464213 A02BC02 PANTOPRAZOLUM PANTOSAL 40 mg COMPR. GASTROREZ. 40mg NYCOMED GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. GASTROREZ. P-6L 28 31,39 1,121071 1,121071 0,56053514 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 AZATOL 40 mg COMPR. GASTROREZ. 40mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ. P-6L 28 33,80 1,207142 1,207142 0,60357116 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 0,60283317 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 0,29650018 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 0,32616619 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 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 0,662699 0,33134921 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 0,56833322 A02BC02 PANTOPRAZOLUM CONTROLOC 40mg LIOFILIZAT PENTRU SOLUTIE INJECTABILA LIOF. 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 6,69500023 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 19,310000 9,65500024 A02BC02 PANTOPRAZOLUM PANTOPRAZOL ACTAVIS 40 mg PULB. PT. SOL. INJ. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA CU CAPACITATEA DE 15 ML CONTINAND 40 MG PANTOPRAZOL PR/PRF 1 21,85 21,850000 21,850000 10,92500025 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 6,69500026 A02BC02 PANTOPRAZOLUM PANTOPRAZOL TEVA 40 mg PULB. PT. SOL. INJ. SAU PERF. 40 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. SAU PERF.PR/PRF 10 190,42 19,042000 19,042000 9,52100027 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 0,883598 0,44179928 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 51,23 1,829642 0,883598 0,44179929 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 0,883598 0,44179931 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 1,767198 0,88359932 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 73,54 2,626428 1,767198 0,88359933 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 1,767198 0,88359935 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 0,883598 0,44179936 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 0,883598 0,44179937 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 0,883598 0,44179938 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 0,883598 0,44179939 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 0,883598 0,44179940 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 1,767198 0,88359941 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 1,767198 0,88359942 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 1,767198 0,88359943 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 1,767198 0,88359944 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 OCTOMBRIE 2013

Pagina 1 din 23

Page 31: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 0,883598 0,44179946 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 1,767198 0,88359947 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 29,747000 14,87350049 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 2,048287 1,02414365 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 2,048287 1,02414366 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 1,89498567 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 1,79625068 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 0,26166669 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 0,26166670 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 0,52333371 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 0,52333372 A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**# THIOGAMMA (R) 600 oral (vezi A16AX01) COMPR. FILM. 600mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 6 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L 60 104,94 1,749000 1,749000 0,87450073 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 80,78 2,692666 2,350875 1,17543774 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 5 125,48 25,096000 25,096000 12,54800075 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 25,194000 12,59700076 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 32,676388 16,33819477 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 39,211666 19,60583378 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 47,054000 23,52700079 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 6,535277 3,26763880 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 13,070555 6,53527781 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 19,605833 9,80291682 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 6,409000 3,20450083 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 5,94200084 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 7,22250085 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 10,03500086 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 75,42 7,542000 6,535277 3,26763887 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 10 103,46 10,346000 8,713701 4,35685088 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 10 132,46 13,246000 13,070555 6,53527789 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 10 189,75 18,975000 17,427403 8,71370190 B01AB08 REVIPARINUM**# CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25MLS/P-RF 10 84,46 8,446000 6,544414 3,27220791 B01AB08 REVIPARINUM**# CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 MLS/P-RF 5 101,41 20,282000 15,702952 7,85147692 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 10000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 2 ML SOL. INJ. (10000 U-AXA/ML) S/P-RF 10 536,03 53,603000 37,344439 18,67221993 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 10000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 10 SERINGI PREUMPLUTE X 0.35 ML SOL. INJ. (3500 U-AXA)S/P-RF 10 129,10 12,910000 6,535277 3,26763894 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 10000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 10 SERINGI PREUMPLUTE X 0.45 ML SOL. INJ. (4500 U-AXA)S/P-RF 10 155,09 15,509000 8,402498 4,20124995 B01AB10 TINZAPARINUM**# INNOHEP SOL. INJ. 20000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,50 ML SOL. IN. (10000 U-AXA) S/P-RF 2 73,65 36,825000 18,672216 9,336108

Pagina 2 din 23

Page 32: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 2,056600 1,02830097 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 7,843000 3,92150098 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 9,648000 4,82400099 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 0,670178100 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 0,670178101 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 1,031071102 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 0,297666103 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 0,670000104 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 0,293666105 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 2,412000 1,206000106 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 2,412000 1,206000107 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 0,670178108 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 0,670178109 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 0,670178110 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 0,670178111 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 0,670178112 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 0,671000113 B01AC04 CLOPIDOGRELUM** CLORODEN 75 mg COMPR. FILM. 75mg IWA CONSULTING APS DANEMARCA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 68,48 2,445714 2,412000 1,206000114 B01AC04 CLOPIDOGRELUM** CLORODEN 75 mg COMPR. FILM. 75mg IWA CONSULTING APS DANEMARCA CUTIE CU BLIST. PA-AL-PVC/AL (AL-AL) X 28 COMPR. FILM. P-RF 28 68,48 2,445714 2,412000 1,206000115 B01AC04 CLOPIDOGRELUM** VATOUD 75 mg COMPR. FILM. 75mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 1,340000 0,670000116 B01AC04 CLOPIDOGRELUM** LOFRADYK 75 mg COMPR. FILM. 75mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 1,340000 0,670000117 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 0,670333118 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 0,670000119 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 0,691000120 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 0,635166121 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 0,635111122 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 0,866166123 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 0,668928124 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 0,670000125 B01AC04 CLOPIDOGRELUM** CLOPIDOGREL ACCORD 75 mg COMPR. FILM. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL/AL X 10 COMPR. FILM. PRF 30 85,21 2,840333 2,412000 1,206000126 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 0,286333127 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 0,277111128 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 0,670333129 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 0,581200130 B01AC18 TRIFLUSALUM AFLEN (R) CAPS. 300mg GALENICA S.A. GRECIA CUTIE X 5 BLIST. X 10 CAPS. P-RF 50 84,93 1,698600 1,206000 0,603000131 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 63,61 1,060166 1,060166 0,530083132 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 10 233,80 23,380000 22,176499 11,088249133 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 10 653,26 65,326000 65,326000 32,663000134 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 14,977000135 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 1,636258136 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 1,636258137 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 2,324642138 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 2,454388139 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 0,363333140 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. P-6L 28 13,24 0,472857 0,472857 0,236428141 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 0,871417 0,435708142 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 0,431166143 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 0,552333144 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. P-6L 28 26,58 0,949285 0,949285 0,474642145 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 0,781964146 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 1,307128 0,653564

Pagina 3 din 23

Page 33: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,465666148 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 1,933229149 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 3,093166150 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 0,486749 0,243374151 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 0,973499 0,486749152 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 0,324499 0,162249153 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 0,324499 0,162249154 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 0,973499 0,486749155 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 0,973499 0,486749156 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 0,973499 0,486749157 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 0,162249 0,081124158 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 0,324499 0,162249159 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 0,973499 0,486749160 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 0,973499 0,486749161 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 0,463000162 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 0,157750163 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 0,543166164 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 0,388999 0,194499165 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 0,388999 0,194499166 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 0,377416167 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 0,562333168 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 0,388999 0,194499169 C04AXN1 GINKGO BILOBA** GINKOFAR 40 mg (vezi N06DX02) COMPR. FILM. 40mg BMF PHARM S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 60 26,61 0,443500 0,388999 0,194499170 C04AXN1 GINKGO BILOBA** GINKOFAR 40 mg (vezi N06DX02) COMPR. FILM. 40mg BMF PHARM S.R.L. ROMANIA CUTIE X 9 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 90 36,73 0,408111 0,388999 0,194499171 C04AXN1 GINKGO BILOBA** GINKO 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 0,388999 0,194499172 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 0,388999 0,194499173 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 0,388999 0,194499174 C04AXN1 GINKGO BILOBA** TANAKAN (EGB 761) (N06DX02) COMPR. FILM. 40mg IPSEN PHARMA FRANTA/GERMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 23,17 0,772333 0,388999 0,194499175 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 0,777999 0,388999176 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 0,772333 0,386166177 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 0,373666178 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 12,440000179 C04AXN1 GINKGO BILOBA** TANAKAN (EGB 761) (C04AXN1) PICATURI ORALE-SOL. 40mg/ml IPSEN PHARMA FRANTA/GERMANIA CUTIE X 1 FLACON DE STICLA BRUNA X 30 ML + 1 PIPETA DIN POLIETILENA P-6L 1 24,88 24,880000 24,880000 12,440000180 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 0,439833181 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 0,820650 0,410325182 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 0,386666183 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 0,820650 0,410325184 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 0,820650 0,410325185 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 0,407142186 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 0,407333187 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 0,820650 0,410325188 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 0,247142189 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 0,404464190 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 0,409833191 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 0,409464192 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 0,451374193 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 0,451374194 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 0,438166195 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 0,438166196 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 0,451374197 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 0,451374

Pagina 4 din 23

Page 34: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,577800 0,288900199 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 0,224333200 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 0,577800 0,288900201 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVC X 28 COMPR. FILM. P-6L 28 16,58 0,592142 0,577800 0,288900202 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 17,77 0,592333 0,577800 0,288900203 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 0,577800 0,288900204 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 0,577800 0,288900205 C08CA13 LERCANIDIPINUM KAPIDIN10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L 30 17,77 0,592333 0,577800 0,288900206 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 0,577800 0,288900207 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 0,362833208 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 0,548500209 C08CA13 LERCANIDIPINUM LERCANIDIPIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVC X 28 COMPR. FILM. P-6L 28 26,44 0,944285 0,944285 0,472142210 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 28,34 0,944666 0,944666 0,472333211 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 0,539583212 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 1,155600 0,577800213 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 1,155600 0,577800214 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 0,187071 0,093535215 C09AA04 PERINDOPRILUM PRICORON 4 mg COMPR. 4 mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 23,14 0,771333 0,374142 0,187071216 C09AA04 PERINDOPRILUM COVEREX (R) 4 mg COMPR. 4mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 29,01 0,967000 0,374142 0,187071217 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 0,374142 0,187071218 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 0,374142 0,187071219 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 0,374142 0,187071220 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 0,374142 0,187071221 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 0,374142 0,187071222 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 0,374142 0,187071223 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 0,374142 0,187071224 C09AA04 PERINDOPRILUM PRESTPRIL 4 mg COMPR. 4mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. P6L 30 25,87 0,862333 0,374142 0,187071225 C09AA04 PERINDOPRILUM PRICORON 8 mg COMPR. 8 mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 44,36 1,478666 0,748285 0,374142226 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 0,748285 0,374142227 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 0,748285 0,374142228 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 0,748285 0,374142229 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 0,748285 0,374142230 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 0,748285 0,374142231 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 0,748285 0,374142232 C09AA04 PERINDOPRILUM PRESTPRIL 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. P6L 30 49,12 1,637333 0,748285 0,374142233 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 0,748285 0,374142234 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 0,935356 0,467678235 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 0,935356 0,467678236 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 2,5 mg COMPR. FILM. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 13,81 0,460333 0,233839 0,116919237 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 0,467678 0,233839238 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 0,467678 0,233839239 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 0,498856 0,249428240 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 0,997713 0,498856241 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 0,249428 0,124714242 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 0,093535 0,046767243 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 0,374142 0,187071244 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 0,748285 0,374142245 C09AA15 ZOFENOPRILUM ZOMEN (R) 30 mg COMPR. FILM. 30mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 44,47 1,588214 0,374142 0,187071246 C09AA15 ZOFENOPRILUM ZOMEN (R) 7,5 mg COMPR. FILM. 7,5mg MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A. LUXEMBURG CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 19,69 0,703214 0,093535 0,046767247 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 0,262000248 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 0,269666

Pagina 5 din 23

Page 35: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,269666250 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) INDAPRIL 2 mg/0,625 mg COMPR. 2mg/0,625mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. P6L 30 18,71 0,623666 0,623666 0,311833251 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRICORON COMBI 2 mg/0,625 mg COMPR. 2mg/0,625mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 16,18 0,539333 0,539333 0,269666252 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 0,269666253 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 0,403500254 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 0,883800 0,441900255 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) INDAPRIL 4 mg/1,25 mg COMPR. 4mg+1.25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. AL/AL X 10 COMPR. P6L 30 31,19 1,039666 0,883800 0,441900256 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRICORON COMBI 4 mg/1,25 mg COMPR. 4mg+1.25mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L 30 29,41 0,980333 0,883800 0,441900257 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PANINDORIL 4 mg/1,25 mg COMPR. 4mg/1, 25mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL IN SAC DE AL X 30 COMPR. P-6L 30 21,09 0,703000 0,703000 0,351500258 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 0,883800 0,441900259 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 0,883800 0,441900260 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 0,883800 0,441900261 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 0,883800 0,441900262 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 0,883800 0,441900263 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 0,883800 0,441900264 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 0,883800 0,441900265 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 0,883800 0,441900266 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 0,883800 0,441900267 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 0,361333268 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 0,883800 0,441900269 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 1,608666270 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 0,943750271 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 0,943750272 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 0,943750273 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 0,581964274 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 0,361785275 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 2,133545 1,066772276 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 2,133545 1,066772277 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 0,565166278 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 2,133545 1,066772279 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 2,133545 1,066772280 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 0,586607281 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 2,133545 1,066772282 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 0,406964283 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 0,586071284 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 0,586071285 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 0,533386 0,266693286 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 0,533386 0,266693287 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 0,199285288 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 0,199285289 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 1,066772 0,533386290 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 1,066772 0,533386291 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 0,387500292 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 1,066772 0,533386293 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 1,066772 0,533386294 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 1,030000 0,515000295 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 1,066772 0,533386296 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 0,266964297 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 0,324642298 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 0,324642299 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 6,400637 3,200318

Pagina 6 din 23

Page 36: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 27,21 0,971785 0,971785 0,485892301 C09CA04 IRBESARTANUM IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 35,53 1,268928 1,268928 0,634464302 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 0,323214303 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 33,14 1,183571 1,066772 0,533386304 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 0,323571305 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 1,065357 0,532678306 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 1,066772 0,533386307 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 0,384666308 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 1,066772 0,533386309 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 0,384642310 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 0,384642311 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 44,88 1,602857 1,066772 0,533386312 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA/GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 18,12 0,647142 0,647142 0,323571313 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 0,518035314 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 0,525535315 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 0,771428316 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 0,523571317 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 0,694107318 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 2,133545 1,066772319 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 2,133545 1,066772320 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 0,518035321 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 60,29 2,153214 2,133545 1,066772322 C09CA04 IRBESARTANUM IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA/GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 29,32 1,047142 1,047142 0,523571323 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 0,533386 0,266693324 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 40,39 1,442500 0,533386 0,266693325 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 2,133545 1,066772326 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 0,801250327 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 0,497500328 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 0,708333329 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL CU DESICANT X 28 COMPR. P-6L 28 39,65 1,416071 1,416071 0,708035330 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 0,720666331 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 0,800500332 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 0,800892333 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 0,801428334 C09CA06 CANDESARTANUM CILEXETIL CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,497500335 C09CA06 CANDESARTANUM CILEXETIL CANDEGAMMA 16 mg COMPR. 16mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 30 (3X10) COMPR. P6L 30 39,63 1,321000 1,321000 0,660500336 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 0,497500337 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 0,739642338 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 4,192857 2,096428339 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 0,610833340 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 1,189333341 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 1,362500342 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 1,362500343 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 1,238035344 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 1,362857345 C09CA06 CANDESARTANUM CILEXETIL CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 36,65 1,221666 1,221666 0,610833346 C09CA06 CANDESARTANUM CILEXETIL CANDEGAMMA 32 mg COMPR. 32mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 30 (3X10) COMPR. P6L 30 72,06 2,402000 2,402000 1,201000347 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 0,610833348 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 1,011785349 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 1,066772 0,533386350 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 1,066772 0,533386

Pagina 7 din 23

Page 37: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,270333352 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 0,402166353 C09CA06 CANDESARTANUM CILEXETIL CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL CU DESICANT X 28 COMPR. P-6L 28 33,45 1,194642 1,066772 0,533386354 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 1,066772 0,533386355 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 1,066772 0,533386356 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 1,066772 0,533386357 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 1,066772 0,533386358 C09CA06 CANDESARTANUM CILEXETIL CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 16,22 0,540666 0,540666 0,270333359 C09CA06 CANDESARTANUM CILEXETIL CANDEGAMMA 8 mg COMPR. 8mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 30 (3X10) COMPR. P6L 30 33,77 1,125666 1,066772 0,533386360 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 0,384500361 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 1,066772 0,533386362 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 1,066772 0,533386363 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 1,066772 0,533386364 C09CA07 TELMISARTANUM PRITOR 40 mg COMPR. 40mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 28COMPR.( BLIST. PERFORATE UNIDOZA PA/AL/PVC ) P-6L 28 64,10 2,289285 1,066772 0,533386365 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 1,066772 0,533386366 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 0,286666367 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 1,066772 0,533386368 C09CA07 TELMISARTANUM TELMISARTAN LABORMED 40 mg COMPR. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 36,43 1,301071 1,066772 0,533386369 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 1,066772 0,533386370 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 0,307142371 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 0,946250372 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 2,133545 1,066772373 C09CA07 TELMISARTANUM PRITOR 80 mg COMPR. 80mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 28COMPR.( BLIST. PERFORATE UNIDOZA PA/AL/PVC ) P-6L 28 77,42 2,765000 2,133545 1,066772374 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 0,946250375 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 0,468166376 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 0,946166377 C09CA07 TELMISARTANUM TELMISARTAN LABORMED 80 mg COMPR. 80mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L 28 48,91 1,746785 1,746785 0,873392378 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 0,946250379 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 0,405000380 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 1,066772 0,533386381 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 1,066772 0,533386382 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 1,066772 0,533386383 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 1,066772 0,533386384 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 0,946250385 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 0,946333386 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 0,946071387 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 0,946166388 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 1,141071 0,570535389 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 1,073571 0,536785390 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 1,046785 0,523392391 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 0,322500392 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 28 122,45 4,373214 1,141071 0,570535393 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 1,141071 0,570535394 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 1,141071 0,570535395 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 1,141071 0,570535396 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 28 105,59 3,771071 1,141071 0,570535397 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 39,44 1,408571 1,141071 0,570535398 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 75,22 2,686428 1,141071 0,570535399 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 0,364107400 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM 150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA/GERMANIA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 20,39 0,728214 0,728214 0,364107401 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 1,141071 0,570535

Pagina 8 din 23

Page 38: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM 300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA/GERMANIA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L 28 33,70 1,203571 1,141071 0,570535403 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRPREZIDE 150 mg/12,5 mg COMPR. FILM. 150 mg/12,5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 28,38 0,946000 0,946000 0,473000404 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 0,473035405 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 1,141071 0,570535406 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 1,141071 0,570535407 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 1,141071 0,570535408 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRPREZIDE 300 mg/12,5 mg COMPR. FILM. 300 mg/12,5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 46,28 1,542666 1,141071 0,570535409 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 1,141071 0,570535410 C09DA04 COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRPREZIDE 300 mg/25 mg COMPR. FILM. 300 mg/25 mg ACTAVIS GROUP PTC EHF. IRLANDA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 55,16 1,838666 1,141071 0,570535411 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 1,141071 0,570535412 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 1,141071 0,570535413 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 1,141071 0,570535414 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 75,22 2,686428 1,141071 0,570535415 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 1,141071 0,570535416 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 1,141071 0,570535417 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 1,141071 0,570535418 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 52,93 1,890357 1,141071 0,570535419 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 1,141071 0,570535420 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 1,141071 0,570535421 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 69,19 2,471071 1,141071 0,570535422 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 1,141071 0,570535423 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 1,141071 0,570535424 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) PRITOR PLUS 80mg/12,5mg COMPR. 80mg/12,5mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 28COMPR.( BLIST. PA/AL/PVC PERFORATE) P-6L 28 79,57 2,841785 1,141071 0,570535425 C09DA07 COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) PRITOR PLUS 80mg/25mg COMPR. 80mg/25mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 28COMPR.( BLIST. PA/AL/PVC SAU PA/PA/AL/PVC/AL PERFORATE UNIDOZA) P-6L 28 104,85 3,744642 1,141071 0,570535426 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 2,081026427 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 2,081026428 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 2,081026429 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 2,081026430 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 1,917946431 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 2,022500432 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 0,437415 0,218707433 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 0,874831 0,437415434 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 1,651428 0,825714435 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 0,612666 0,306333436 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 0,279166437 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 0,656124 0,328062438 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 0,176166439 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 0,647666 0,323833440 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 0,656124 0,328062441 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 0,656124 0,328062442 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 0,279166443 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 0,656124 0,328062444 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 0,616111 0,308055445 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 0,656124 0,328062446 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 0,625666 0,312833447 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 0,656124 0,328062448 C10AA05 ATORVASTATINUM MODLIP 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL CU CAPSULA DIN POLISTIREN ROSU CE CONTINE GRANULE ABSORBANTE X 30 COMP P6L 30 27,86 0,928666 0,656124 0,328062449 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 0,647666 0,323833450 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 0,176166451 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 0,176166452 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 0,113571

Pagina 9 din 23

Page 39: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,448333454 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 0,409333455 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 1,312249 0,656124456 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 0,263666457 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 0,490833458 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 0,525166459 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 0,578500460 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 0,402333461 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 0,510833462 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 0,441666463 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 0,560178464 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 0,477333465 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 0,578500466 C10AA05 ATORVASTATINUM MODLIP 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL CU CAPSULA DIN POLISTIREN ROSU CE CONTINE GRANULE ABSORBANTE X 30 COMP P6L 30 34,71 1,157000 1,157000 0,578500467 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 0,490833468 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 0,263666469 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 0,263666470 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 0,133928471 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 1,020714472 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 0,987666473 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 0,842500474 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 2,624498 1,312249475 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 0,544666476 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 0,923571477 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 0,893500478 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 1,051000479 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 0,944833480 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 0,881000481 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 1,028833482 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 0,846222483 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 1,050714484 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 0,878000485 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 1,050666486 C10AA05 ATORVASTATINUM MODLIP 40 mg COMPR. FILM. 40mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL CU CAPSULA DIN POLISTIREN ROSU CE CONTINE GRANULE ABSORBANTE X 30 COMP P6L 30 63,04 2,101333 2,101333 1,050666487 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 0,893500488 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 0,535000489 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 0,544666490 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 0,478214491 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 5,190000 2,595000492 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 1,686833493 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 1,686785494 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 1,686833495 C10AA05 ATORVASTATINUM MODLIP 80 mg COMPR. FILM. 80mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL CU CAPSULA DIN POLISTIREN ROSU CE CONTINE GRANULE ABSORBANTE X 30 COMP P6L 30 101,21 3,373666 3,373666 1,686833496 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 0,733833497 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 0,834000498 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 0,733833499 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 0,683035500 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 73,14 2,438000 1,312249 0,656124501 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 1,312249 0,656124502 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 0,401333503 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.P-6L 30 53,55 1,785000 1,312249 0,656124

Pagina 10 din 23

Page 40: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 1,312249 0,656124505 C10AA07 ROSUVASTATINUM ROSTAT 10 mg COMPR. FILM. 10mg GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 73,16 2,438666 1,312249 0,656124506 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 1,312249 0,656124507 C10AA07 ROSUVASTATINUM STARCREST 10 mg COMPR. FILM. 10mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPR. FILM. P6L 30 59,03 1,967666 1,312249 0,656124508 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 1,312249 0,656124509 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 39,13 1,397500 1,312249 0,656124510 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 1,197142 0,598571511 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 1,197142 0,598571512 C10AA07 ROSUVASTATINUM ROSUVASTATINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 109,71 3,657000 2,624498 1,312249513 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 2,624498 1,312249514 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 0,445333515 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.P-6L 30 92,42 3,080666 2,624498 1,312249516 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 2,624498 1,312249517 C10AA07 ROSUVASTATINUM ROSTAT 20 mg COMPR. FILM. 20mg GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 109,71 3,657000 2,624498 1,312249518 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 2,624498 1,312249519 C10AA07 ROSUVASTATINUM STARCREST 20 mg COMPR. FILM. 20mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPR. FILM. P6L 30 95,09 3,169666 2,624498 1,312249520 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 0,945535521 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 69,09 2,467500 2,467500 1,233750522 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 0,860000523 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 0,860000524 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 0,842666525 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 40 mg COMPR. FILM. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.P-6L 30 109,71 3,657000 3,657000 1,828500526 C10AA07 ROSUVASTATINUM ROSTAT 40 mg COMPR. FILM. 40mg GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 109,71 3,657000 3,657000 1,828500527 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 1,828500528 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 1,225714529 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 90,19 3,221071 3,221071 1,610535530 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 1,341785531 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 1,341785532 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 0,656124 0,328062533 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 5 mg COMPR. FILM. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.P-6L 30 50,53 1,684333 0,656124 0,328062534 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 0,656124 0,328062535 C10AA07 ROSUVASTATINUM ROSTAT 5 mg COMPR. FILM. 5mg GEDEON RICHTER PLC. UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 64,78 2,159333 0,656124 0,328062536 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 0,656124 0,328062537 C10AA07 ROSUVASTATINUM STARCREST 5 mg COMPR. FILM. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPR. FILM. P6L 30 50,53 1,684333 0,656124 0,328062538 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 0,656124 0,328062539 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 38,78 1,385000 0,656124 0,328062540 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 0,656124 0,328062541 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 0,656124 0,328062542 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 0,285500543 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 1,182000544 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 1,199796545 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 6,552410 3,276205546 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 6,463928 3,231964547 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 1,839000 0,919500548 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 1,839000 0,919500549 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 1,839000 0,919500550 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 48,46 1,615333 1,615333 0,807666551 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 1,927916 0,963958552 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 0,813666553 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM) TORVALIPIN PLUS 5 mg/10 mg COMPR. FILM. 10mg/5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 55,17 1,839000 1,839000 0,919500554 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 1,927916 0,963958

Pagina 11 din 23

Page 41: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 1,839000 0,919500556 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 0,589062557 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 0,589062558 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 0,589062559 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 0,531071560 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 0,589062561 D01BA02 TERBINAFINUM TERBINAFINA BIOGALENICA 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 0,571250562 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 0,589062563 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 0,589062564 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 28,117499565 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 28,117499566 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 28,117499567 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 26,715000568 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 1,245666569 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 15,19 15,190000 15,190000 7,595000570 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 15,19 15,190000 15,190000 7,595000571 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA BORCAN X 500 G CREMA PRF 1 105,59 105,590000 105,590000 52,795000572 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 22,901607573 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 37,980000574 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 11,059583575 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 6,203750576 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 6,203750577 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 6,203750578 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 5,615000579 D07AC13 MOMETASONUM ELOCOM CREMA 1mg/g SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 15,69 15,690000 10,180000 5,090000580 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 10,180000 5,090000581 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 13,573333 6,786666582 D07AC13 MOMETASONUM ELOCOM UNGUENT 1mg/g SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 TUB DIN AL X 15 G P-RF 1 15,69 15,690000 10,180000 5,090000583 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 10,180000 5,090000584 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN CREMA 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 12,70 12,700000 12,013125 6,006562585 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 12,013125 6,006562586 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 24,026250 12,013125587 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 7,875000588 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 17,015000589 D07AC14 METHYLPREDNISOLONUM ACEPONAT ADVANTAN UNGUENT 1mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 12,99 12,990000 12,013125 6,006562590 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 12,013125 6,006562591 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 24,026250 12,013125592 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 5,155000593 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 5,155000594 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 3,177000595 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 2,605000596 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 3,177000597 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 21,74 21,740000 21,740000 10,870000598 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 23,82 23,820000 23,820000 11,910000599 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 23,500000600 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 7,957500601 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 18,110000602 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 28,492000 14,246000603 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 23,345000604 D10AX03 ACIDUM AZELAICUM SKINOREN 150mg/g GEL 150mg/g INTENDIS GMBH GERMANIA CUTIE X 1 TUB AL X 30 G GEL P-RF 1 28,97 28,970000 28,492000 14,246000605 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 0,543583

Pagina 12 din 23

Page 42: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,543583607 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 1,071333608 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 1,202166609 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 1,202166610 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 1,202166611 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 17,735000612 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 15,644998 7,822499613 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 9,386999 4,693499614 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 24,406197 12,203098615 G01AF15 BUTOCONAZOLUM GYNOFORT 2% CREMA VAG. FARA CONCENTRATIE 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 1,564499 0,782249616 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 0,850500 0,425250617 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 4,815000618 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 6,435000619 G01AF20 COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON OVULE FARA CONCENTRATIE ALFA WASSERMAN SPA ITALIA CUTIE X 2 FOLII PVC-PE X 5 OVULE P-RF 10 11,17 1,117000 0,850500 0,425250620 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 0,850500 0,425250621 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 4,131375622 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 4,131375623 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 256,765000624 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 0,687333625 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 0,331769626 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 4,976549627 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 1,300357628 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 0,649666 0,324833629 G03DA04 PROGESTERONUM* AREFAM 100 mg CAPS. MOI 100mg LADEE PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L 30 19,49 0,649666 0,649666 0,324833630 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 0,649666 0,324833631 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 1,299332 0,649666632 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 0,629000633 G03DA04 PROGESTERONUM* PROGESTOGEL 10 mg/g GEL 10mg/g LABORATOIRES BESINS INTERNATIONAL FRANTA/GERMANIA CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE PRF 1 21,14 21,140000 21,140000 10,570000634 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 0,539250635 G03DC03 LYNESTRENOLUM* ORGAMETRIL COMPR. 5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 30 COMPR. P-6L 30 9,12 0,304000 0,304000 0,152000636 G03FA14 COMBINATII** FEMOSTON CONTI 1 mg/ 5mg COMPR. FILM. 1mg/5mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. TIP CALENDAR AL/PVC X 28 COMPR. FILM. P-6L 28 28,91 1,032500 1,032500 0,516250637 G03FA17 COMBINATII** ANGELIQ COMPR. FILM. FARA CONCENTRATIE BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P-RF 28 68,38 2,442142 1,384910 0,692455638 G03FB01 COMBINATII** CYCLO PROGINOVA (R) DRAJ. FARA CONCENTRATIE BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 BLIST. TIP CALENDAR X 21 DRAJEURI P-RF 21 8,07 0,384285 0,384285 0,192142639 G03FB08 COMBINATII** FEMOSTON 2/10 COMPR. FILM. FARA CONCENTRATIE SOLVAY PHARMACEUTICALS BV 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 0,670981 0,335490640 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 0,670981 0,335490641 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 1 137,81 137,810000 123,093333 61,546666642 G03GA05 FOLLITROPINUM ALFA****# GONAL-f 300 UI/0,5 ml ( 22 mcg/0,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 5 ACE PT. ADM. P-RF/R 1 527,76 527,760000 492,373333 246,186666643 G03GA05 FOLLITROPINUM ALFA****# GONAL-f 450 UI/0,75 ml (33 mcg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 7 ACE PT. ADM. SUBCUTANATA P-RF/R 1 756,26 756,260000 738,560000 369,280000644 G03GA05 FOLLITROPINUM ALFA****# GONAL-f 900 UI/1,5ml (66 mcg/1,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 900UI/0,75ml SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 14 ACE PT. ADM. SUBCUTANATA P-RF/R 1 1.441,72 1.441,720000 1.441,720000 720,860000645 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 164,124403 82,062201646 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 492,176384 246,088192647 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 705,415000648 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 73,360000649 G03GB02 CLOMIFENUM CLOSTILBEGYT COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. P-RF 10 14,31 1,431000 1,431000 0,715500650 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 2,231607651 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 0,221916652 G04BD07 TOLTERODINUM**# DETRUSITOL SR 4 mg CAPS. ELIB. PREL. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. X 7 CAPS. ELIB. PREL. P-6L 28 174,60 6,235714 2,287799 1,143899653 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 0,571949 0,285974654 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 0,476071655 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 4,575599 2,287799656 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 4,575599 2,287799

Pagina 13 din 23

Page 43: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 2,287799 1,143899658 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 2,287799 1,143899659 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 0,857924 0,428962660 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 1,715849 0,857924661 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 0,600666662 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 0,676500663 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 0,280714664 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 0,605666665 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 0,350000666 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 0,448833667 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 0,353333668 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 0,382666669 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 0,448833670 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 0,334666671 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 0,531666672 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 0,757928673 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 0,587678674 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 0,587678675 G04CB01 FINASTERIDUM* FINASTERIDE TEVA 5mg COMPR. FILM. 5mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 35,18 1,172666 1,172666 0,586333676 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 0,587678677 G04CB01 FINASTERIDUM* FINASTERIDA BIOGALENICA 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 0,587678678 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 1,593666679 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 2,875000680 H01AC01 SOMATROPINUM***# ZOMACTON LIOF. + 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 198,242000681 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 264,322666682 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 743,407500683 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 495,605000684 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 242,060000685 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 382,865000686 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 495,605000687 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 495,605000688 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 247,802500689 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 60,647303690 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 P-RF 7 845,15 120,735714 120,735714 60,367857691 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 0,477800692 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 3,453000693 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 15,936666694 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 3,490574695 H03BB01 CARBIMAZOLUM CARBIMAZOLE 5 COMPR. FILM. 5mg REMEDICA LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 100 16,87 0,168700 0,113639 0,056819696 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 0,340920 0,170460697 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 0,255200698 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 0,170460 0,085230699 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 3,236000700 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 1,867500701 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS (R) 1,5 g PULB. PT. SOL. INJ. 1g+500mg ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. PULB. PT. SOL. INJ. X 1,5 G P-RF/S 50 728,96 14,579200 14,579200 7,289600702 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 7,289600703 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 1,382500704 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 11,346250705 J01DD14 CEFTIBUTENUM CEDAX CAPS. 400mg SCHERING PLOUGH EUROPE BELGIA CUTIE X 5 BLIST. X 1 CAPS. P-RF 5 70,49 14,098000 14,020199 7,010099706 J01DD14 CEFTIBUTENUM CEDAX PULB. PT. SUSP. ORALA 36mg/ml SCHERING PLOUGH EUROPE BELGIA CUTIE X 1 FLAC. PULB. PT. 30 ML SUSP. ORALA + 1 LINGURITA GRADATA PT. 45 MG, 90 MG, 135 MG + 1 CAPAC P-RF 1 43,69 43,690000 43,690000 21,845000707 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 0,307812

Pagina 14 din 23

Page 44: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 1,430568 0,715284709 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 3,576424 1,788212710 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 3,576424 1,788212711 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 1,788210 0,894105712 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 3,576424 1,788212713 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 3,576424 1,788212714 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 3,576424 1,788212715 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 7,152849 3,576424716 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 7,152849 3,576424717 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 7,152849 3,576424718 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 7,152849 3,576424719 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 7,152849 3,576424720 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 7,152849 3,576424721 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 7,152849 3,576424722 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 3,543333723 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 8,583422 4,291711724 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 8,583422 4,291711725 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 8,180000726 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 15,055196 7,527598727 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 30,110392 15,055196728 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 22,582800 11,291400729 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 45,165600 22,582800730 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 56,456999 28,228499731 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 0,368242732 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 0,729062733 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 0,728437734 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 0,736484735 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 1,472968736 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 1,472968737 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 28,06 4,008571 2,379600 1,189800738 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 1,189800739 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 1,189800740 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 1,189800741 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACCORD 250 mg COMPR. FILM. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. PRF 7 17,40 2,485714 2,379600 1,189800742 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 2,379600743 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 2,379600744 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 2,379600745 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 2,379600746 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA BLUEFISH 500 mg COMPR. FILM. 500mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. PRF 7 31,96 4,565714 4,565714 2,282857747 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA BLUEFISH 500 mg COMPR. FILM. 500mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/PVC X 7 COMPR. FILM. PRF 7 31,96 4,565714 4,565714 2,282857748 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACCORD 500 mg COMPR. FILM. 500mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. PRF 7 33,40 4,771428 4,759200 2,379600749 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg COMPR. FILM. 400mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 80,90 16,180000 4,759200 2,379600750 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 80,90 16,180000 4,759200 2,379600751 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 2,564000752 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 1,752000753 J02AC02 ITRACONAZOLUM* ITRACONAZOL 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 1,752000754 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 1,752000755 J02AC02 ITRACONAZOLUM* SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 1,752000756 J02AC02 ITRACONAZOLUM* ITRACONAZOL LPH 100 mg CAPS. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 1,752000757 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 1,751666758 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 4,989460 2,494730

Pagina 15 din 23

Page 45: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 23,755714760 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 0,261300761 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 1 994,94 994,940000 994,940000 497,470000762 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 1 429,71 429,710000 378,914998 189,457499763 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 201,136246764 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 10,104391 5,052195765 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 B S/P-RF 1 1.184,81 1.184,810000 1.136,745010 568,372505766 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 B S/P-RF 1 440,58 440,580000 440,580000 220,290000767 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 1,353989 0,676994768 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 0,284987769 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 0,065750770 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 0,451350771 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 0,451350772 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 0,078250773 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 0,061750774 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 0,111000775 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 0,451350776 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 0,451350777 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 0,451350778 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 0,451350779 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 1,177000780 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 0,370000781 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 0,370000782 M01AC01 PIROXICAMUM PIROXICAM 20 mg SUPOZ. 20mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L 10 7,32 0,732000 0,732000 0,366000783 M01AC05 LORNOXICAMUM XEFO RAPID 8 mg COMPR. FILM. 8mg NYCOMED AUSTRIA AUSTRIA CUTIE CU BLIST. AL/AL X 10 COMPR. FILM. P-6L 10 16,61 1,661000 0,601799 0,300899784 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 1,713898 0,856949785 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 0,496874 0,248437786 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 4,197999 2,098999787 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 1,165874 0,582937788 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 2,331749 1,165874789 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 2,331749 1,165874790 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 4,663499 2,331749791 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 4,596071 2,298035792 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 4,663499 2,331749793 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 4,663499 2,331749794 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 1,165874 0,582937795 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 2,331749 1,165874796 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 2,331749 1,165874797 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 2,331749 1,165874798 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 3,497624 1,748812799 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 3,497624 1,748812800 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 3,497624 1,748812801 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 3,497624 1,748812802 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 1,394999 0,697499803 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 1,388333 0,694166804 M01AX05 GLUCOSAMINUM DONA (R) PULB. PT. SOL. ORALA 1500mg ROTTAPHARM SPA ITALIA CUTIE X 20 PLICURI UNIDOZA CU PULB. P-6L 20 43,20 2,160000 1,394999 0,697499805 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 0,243000806 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 0,243500807 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 0,362000808 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 0,205000809 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 0,225500

Pagina 16 din 23

Page 46: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,239000811 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 0,360000812 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 0,293039 0,146519813 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 0,335000814 M05BA04 ACIDUM ALENDRONICUM* ACID ALENDRONIC ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 48,27 1,723928 1,455107 0,727553815 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 10,185750 5,092875816 M05BA04 ACIDUM ALENDRONICUM* ACID ALENDRONIC ACCORD 70 mg COMPR. 70mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA -AL-PVC/AL X 4 COMPR. P-6L 4 48,27 12,067500 10,185750 5,092875817 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 10,185750 5,092875818 M05BA04 ACIDUM ALENDRONICUM* FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. AL/AL X 2 COMPR. P-6L 2 37,13 18,565000 10,185750 5,092875819 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 3,205000820 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 10,185750 5,092875821 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 10,185750 5,092875822 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 10,185750 5,092875823 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 83,20 83,200000 43,653214 21,826607824 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 43,653214 21,826607825 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 72,31 72,310000 43,653214 21,826607826 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 43,653214 21,826607827 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 19,400000828 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 43,653214 21,826607829 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 119,885000830 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 267,305062 133,652531831 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 267,305062 133,652531832 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 267,305062 133,652531833 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 91,415000834 M05BA07 ACIDUM RISEDRONICUM* RISEDRONAT BLUEFISH 35 mg COMPR. FILM. 35 mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. DIN PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L 4 35,79 8,947500 8,947500 4,473750835 M05BA07 ACIDUM RISEDRONICUM* RISENDROS 35 mg COMPR. FILM. 35mg ZENTIVA A.S. CEHIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 14,31 3,577500 3,577500 1,788750836 M05BA07 ACIDUM RISEDRONICUM* RISEDRONAT TEVA 35 mg COMPR. FILM. 35mg TEVA PHARMACEUTICAL S.R.L. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 45,27 11,317500 10,185750 5,092875837 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 4,562500838 M05BA07 ACIDUM RISEDRONICUM* OSTEORON 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L 4 28,35 7,087500 7,087500 3,543750839 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 10,185750 5,092875840 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 67,31 16,827500 10,185750 5,092875841 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 3,547500842 M05BA07 ACIDUM RISEDRONICUM* RISEDRONAT SODIC ZENTIVA 35mg COMPR. FILM. 35mg ZENTIVA KS REPUBLICA SLOVACA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE P-6L 4 14,31 3,577500 3,577500 1,788750843 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 21,826607 10,913303844 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 10,185750 5,092875845 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 10,185750 5,092875846 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 10,185750 5,092875847 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 10,185750 5,092875848 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 3,273571849 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 3,117857850 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 0,545169 0,272584851 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 1,090338 0,545169852 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 2,180681 1,090340853 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 4,361362 2,180681854 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 0,545169 0,272584855 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 0,545169 0,272584856 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 1,090338 0,545169857 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 1,090338 0,545169858 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 0,987500859 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 2,180681 1,090340860 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 2,180681 1,090340

Pagina 17 din 23

Page 47: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 3,271023 1,635511862 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 1,678166863 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 4,027500 2,013750864 N02AA05 OXYCODONUM*# OXYCONTIN (R) 10 mg COMPR. FILM. ELIB. MODIF. 10 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 116,83 2,086250 0,545169 0,272584865 N02AA05 OXYCODONUM*# OXYCONTIN (R) 20 mg COMPR. FILM. ELIB. MODIF. 20 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 214,65 3,833035 1,090338 0,545169866 N02AA05 OXYCODONUM*# OXYCONTIN (R) 40 mg COMPR. FILM. ELIB. MODIF. 40 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 395,50 7,062500 2,180681 1,090340867 N02AA05 OXYCODONUM*# OXYCONTIN (R) 80 mg COMPR. FILM. ELIB. MODIF. 80mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 652,80 11,657142 4,361362 2,180681868 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 0,752222869 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 0,261964870 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 0,564167871 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 0,710100 0,355050872 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 0,710100 0,355050873 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 0,710100 0,355050874 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 0,710100 0,355050875 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 0,710100 0,355050876 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 0,710100 0,355050877 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 0,710100 0,355050878 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 0,710100 0,355050879 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 0,710100 0,355050880 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 0,710100 0,355050881 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 0,710100 0,355050882 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 0,710100 0,355050883 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 0,710100 0,355050884 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 0,710100 0,355050885 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 0,710100 0,355050886 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 0,710100 0,355050887 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 0,710100 0,355050888 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 0,033952889 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 0,109333890 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 2,720000891 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 2,579553892 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 3,773839893 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 4,081428894 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 2,782802 1,391401895 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 2,782802 1,391401896 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 0,105700897 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 0,135262 0,067631898 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 0,276672 0,138336899 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL ZENTIVA 0,18 mg COMPR. 0,18 mg ZENTIVA, K.S. REPUBLICA SLOVACA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 17,43 0,581000 0,276672 0,138336900 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 0,276672 0,138336901 N04BC05 PRAMIPEXOLUM* OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 20,91 0,697000 0,276672 0,138336902 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 0,276672 0,138336903 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 0,276672 0,138336904 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 0,276672 0,138336905 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 0,276672 0,138336906 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 0,276672 0,138336907 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 0,276672 0,138336908 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 30,20 1,006666 0,276672 0,138336909 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 0,276672 0,138336910 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 0,276672 0,138336911 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 0,537975 0,268987

Pagina 18 din 23

Page 48: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 1,075950 0,537975913 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 1,075950 0,537975914 N04BC05 PRAMIPEXOLUM* PRAMIPEXOL ZENTIVA 0,7 mg COMPR. 0,7 mg ZENTIVA, K.S. REPUBLICA SLOVACA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 60,97 2,032333 1,075950 0,537975915 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 1,075950 0,537975916 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 1,075950 0,537975917 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 1,075950 0,537975918 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 1,075950 0,537975919 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 1,075950 0,537975920 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 1,075950 0,537975921 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 1,075950 0,537975922 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 1,075950 0,537975923 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 30 107,98 3,599333 1,075950 0,537975924 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 1,075950 0,537975925 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 0,399638 0,199819926 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 0,799277 0,399638927 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 1,613925 0,806962928 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 3,227851 1,613925929 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 4,841777 2,420888930 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 0,478166931 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 0,230750932 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 0,147916933 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 0,078010934 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 1,134000 0,567000935 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 1,199290 0,599645936 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 0,527583937 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 0,599645 0,299822938 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 0,599645 0,299822939 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 1,059000940 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 0,730500 0,365250941 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 0,353000942 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 0,730500 0,365250943 N06AX17 MILNACIPRANUM** IXEL CAPS. 25mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 71,52 1,277142 1,104508 0,552254944 N06AX17 MILNACIPRANUM** IXEL CAPS. 50mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 117,26 2,093928 2,093928 1,046964945 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 1,668415946 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 3,194464947 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 1,798500948 N06BX18 VINPOCETINUM VIMPOCETIN 5 mg CAPS. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. X 10 CAPS. P-6L 50 10,29 0,205800 0,205800 0,102900949 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 0,205800950 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 0,102900951 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 0,102900952 N06DX02 GINKGO BILOBA** GINKOFAR 40 mg (vezi C04AXN1) COMPR. FILM. 40mg BMF PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 9,18 0,459000 0,388999 0,194499953 N06DX02 GINKGO BILOBA** GINKOFAR 40 mg (vezi C04AXN1) COMPR. FILM. 40mg BMF PHARM S.R.L. ROMANIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 60 26,61 0,443500 0,388999 0,194499954 N06DX02 GINKGO BILOBA** GINKOFAR 40 mg (vezi C04AXN1) COMPR. FILM. 40mg BMF PHARM S.R.L. ROMANIA CUTIE X 9 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 90 36,73 0,408111 0,388999 0,194499955 N06DX02 GINKGO BILOBA** GINKO 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 0,388999 0,194499956 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT ACCORD 16 mg COMPR. 16mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC/PVDC-AL X 10 COMPR. P6L 30 19,18 0,639333 0,355549 0,177774957 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 0,355549 0,177774958 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 0,355549 0,177774959 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 0,533324 0,266662960 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 0,533324 0,266662961 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 0,533324 0,266662962 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 0,533324 0,266662

Pagina 19 din 23

Page 49: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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 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 0,533324 0,266662964 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 0,533324 0,266662965 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 0,533324 0,266662966 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 0,225500967 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 0,533324 0,266662968 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 0,177774 0,088887969 N07CA01 BETAHISTINUM MICROSER COMPR. 8mg PRODOTTI FORMENTI ITALIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 26,66 0,533200 0,177774 0,088887970 N07CA01 BETAHISTINUM VESTIBO 8 mg COMPR. 8mg ACTAVIS GROUP HF. ISLANDA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 100 19,26 0,192600 0,177774 0,088887971 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 0,177774 0,088887972 N07CA01 BETAHISTINUM BETASERC 8 mg COMPR. 8mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 14,76 0,492000 0,177774 0,088887973 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 0,177774 0,088887974 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 0,177774 0,088887975 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT ACCORD 8 mg COMPR. 8mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC/PVDC-AL X 10 COMPR. P6L 30 9,58 0,319333 0,177774 0,088887976 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 0,177774 0,088887977 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 0,177774 0,088887978 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 13,333123 6,666561979 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 26,666246 13,333123980 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 26,13 0,544375 0,544375 0,272187981 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 80,78 2,692666 2,350875 1,175437982 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 100 255,15 2,551500 2,350875 1,175437983 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 12,446000984 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 7,431999985 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 1,486400986 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 0,261583987 R01AD05 BUDESONIDUM* RHINOCORT (R) AQUA SPRAY NAZAL SUSP. 32mcg/doza ASTRAZENECA AB SUEDIA CUTIE X 1 FLACON X 120 DOZE PREVAZUT CU POMPA DOZATOAREP-RF 1 25,27 25,270000 25,270000 12,635000988 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 12,635000989 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 15,325000990 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. NA PRF 1 25,39 25,390000 25,390000 12,695000991 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 30,870000 15,435000992 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 8,330000993 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 20,145000994 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 1 117,43 117,430000 45,702450 22,851225995 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 1 157,36 157,360000 114,256125 57,128062996 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 1 223,87 223,870000 223,870000 111,935000997 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 114,256125 57,128062998 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 228,512250 114,256125999 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 45,702450 22,8512251000 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 58,5062501001 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 113,9050001002 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 29,2531251003 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 15,6294001004 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 39,0735001005 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 68,6200001006 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 19,5367501007 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 15,6294001008 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE NEBULES 0,5 mg/2 ml SUSP. INHAL. PRIN NEBULIZATOR 0,5mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 5 BLIST. PA-AL-PVC/HARTIE-PTF-AL X 2 FIOLE PEJD X 2,5ML CONTINAND 2ML SUSP. INHAL. PRIN NEB P-RF 10 31,39 3,139000 1,041958 0,5209791009 R03BA05 FLUTICASONUM PROPIONAT* FLIXOTIDE NEBULES 2 mg/2 ml SUSP. INHAL. PRIN NEBULIZATOR 2mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE X 5 BLIST. PA-AL-PVC/HARTIE-PTF-AL X 2 FIOLE PEJD X 2,5ML CONTINAND 2ML SUSP. INHAL. PRIN NEB P-RF 10 90,66 9,066000 4,167838 2,0839191010 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 22,4924991011 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 40,8700001012 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 62,3950001013 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 37,440625

Pagina 20 din 23

Page 50: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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.

Adulti1014 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 2,7390001015 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 83,0800001016 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 0,181000 0,0905001017 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 0,0678001018 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 0,173750 0,0868751019 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 0,386000 0,1930001020 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 1,1820001021 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 1,1820001022 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 0,9383921023 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 0,9383921024 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L 28 145,70 5,203571 1,876785 0,9383921025 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 0,9383921026 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 0,9383921027 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 0,7519641028 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 0,8723331029 R03DC03 MONTELUKASTUM* MONTEXAL 10 mg COMPR. FILM. 10mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 52,55 1,876785 1,876785 0,9383921030 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 0,9383921031 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 0,9383921032 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 0,9383921033 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 0,9383921034 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 0,9383921035 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 0,9383921036 R03DC03 MONTELUKASTUM* MONTELUKAST ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 52,55 1,876785 1,876785 0,9383921037 R03DC03 MONTELUKASTUM* MONTELUKAST ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 56,29 1,876333 1,876333 0,9381661038 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 0,9383921039 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 64,39 2,299642 1,876785 0,9383921040 R03DC03 MONTELUKASTUM* VIZENDO 10mg COMPR. FILM. 10mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L 28 49,04 1,751428 1,751428 0,8757141041 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 0,9383921042 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 1,523714 0,7618571043 R03DC03 MONTELUKASTUM* SINGULAIR COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P-RF 28 157,51 5,625357 1,523714 0,7618571044 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 1,523714 0,7618571045 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 1,523714 0,7618571046 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 1,523714 0,7618571047 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 0,5351781048 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 0,6958331049 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 1,523714 0,7618571050 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 1,523714 0,7618571051 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 1,523714 0,7618571052 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 0,7557141053 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 0,7557141054 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 1,523714 0,7618571055 R03DC03 MONTELUKASTUM* VIZENDO 4mg COMPR. MAST. 4mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 30,06 1,073571 1,073571 0,5367851056 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 42,84 1,530000 1,523714 0,7618571057 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 1,523714 0,7618571058 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 1,904642 0,9523211059 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 1,904642 0,9523211060 R03DC03 MONTELUKASTUM* SINGULAIR (R) COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 28 145,31 5,189642 1,904642 0,9523211061 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 1,904642 0,9523211062 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 1,904642 0,9523211063 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 0,6483921064 R03DC03 MONTELUKASTUM* MONTEXAL 5 mg COMPR. MAST. 5mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 53,41 1,907500 1,904642 0,952321

Pagina 21 din 23

Page 51: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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.

Adulti1065 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 0,7953331066 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 1,904642 0,9523211067 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 1,904642 0,9523211068 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 1,904642 0,9523211069 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 1,901785 0,9508921070 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 1,904642 0,9523211071 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 53,46 1,909285 1,904642 0,9523211072 R03DC03 MONTELUKASTUM* VIZENDO 5mg COMPR. MAST. 5mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L 28 36,43 1,301071 1,301071 0,6505351073 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 1,904642 0,9523211074 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 1,904642 0,9523211075 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 1,523714 0,7618571076 R03DC03 MONTELUKASTUM* SINGULAIR 4 mg GRANULE 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 158,93 5,676071 1,523714 0,7618571077 R03DX03 FENSPIRIDUM EURESPAL 80 mg COMPR. CU ELIBERARE PRELUNGITA 80mg LES LAB. SERVIER IND. FRANTA/GERMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.CU ELIBERARE PRELUGITA P-6L 30 28,09 0,936333 0,936333 0,4681661078 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 10,0099991079 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 0,7905001080 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 0,6517811081 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 12,4750001082 R05DA09 DEXTROMETHORPHANUM TUSSIN FORTE COMPR. 20mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,78 0,339000 0,339000 0,1695001083 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 0,1695001084 R05DA09 DEXTROMETHORPHANUM HUMISEC 5mg/5ml SIROP 0,1% LAB. URGO SA FRANTA/GERMANIA CUTIE X 1 FLACON X 125 ML SIROP + O MASURA DOZATOARE PENTRU MASURAREA VOLUMELOR 2,5ML; 5ML; 7,5ML; 1 P-RF 1 8,46 8,460000 2,195832 1,0979161085 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; 1 P-RF 1 8,46 8,460000 8,460000 4,2300001086 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 4,672732 2,3363661087 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 2,6350001088 R05DA09 DEXTROMETHORPHANUM HUMISEC pentru adulti 20mg/15 ml SIROP 20mg/15 ml LAB. URGO SA FRANTA/GERMANIA CUTIE X 1 FLACON X 200 ML + O MASURA DOZATOARE DIN POLIPROPILENA P-RF 1 10,82 10,820000 4,672732 2,3363661089 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 2,626216 1,3131081090 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 1,317499 0,6587491091 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 2,634999 1,3174991092 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 1,285875 0,6429371093 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 1,285875 0,6429371094 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 0,4723331095 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 0,5495001096 R06AE09 LEVOCETIRIZINUM ZENARO 5 mg COMPR. FILM. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR/AL X 20 COMPR. FILM. P-6L 20 12,80 0,640000 0,640000 0,3200001097 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 0,3635001098 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 0,3205001099 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 25,717500 12,8587501100 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 11,9550001101 R06AX26 FEXOFENADINUM EWOFEX 120 mg COMPR. FILM. 120mg EWOPHARMA INTERNATIONAL S.R.O. SLOVACIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 7,03 0,703000 0,703000 0,3515001102 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 0,848333 0,4241661103 R06AX26 FEXOFENADINUM EWOFEX 180 mg COMPR. FILM. 180mg EWOPHARMA INTERNATIONAL S.R.O. SLOVACIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 10 10,03 1,003000 1,003000 0,5015001104 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 0,847333 0,4236661105 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 0,848333 0,4241661106 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 0,848333 0,4241661107 R06AX27 DESLORATADINUM DESLORATADINA SANDOZ 5 mg COMPR. FILM. 5 mg SANDOZ S.R.L. ROMANIA CUTIE CU BLISTER NON UNIDOZA PVC-ACLAR/AL X 30 COMPR.FILM. P6L 30 33,14 1,104666 0,848333 0,4241661108 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg SP EUROPE BELGIA CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 30 54,55 1,818333 0,848333 0,4241661109 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg SP EUROPE BELGIA CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 10 21,77 2,177000 0,848333 0,4241661110 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. FILM. 5mg SP EUROPE BELGIA CUTIE X 7 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF 7 17,46 2,494285 0,848333 0,4241661111 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 0,848333 0,4241661112 R06AX27 DESLORATADINUM DESLORATADINAE RATIOPHARM COMPR. FILM. 5mg RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN PVC/PVDC/AL X 30 COMPRIMATE FILMATEPRF 30 35,44 1,181333 0,848333 0,4241661113 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 0,848333 0,4241661114 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 0,848333 0,4241661115 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 35,46 1,182000 0,848333 0,424166

Pagina 22 din 23

Page 52: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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.

Adulti1116 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 0,848333 0,4241661117 R06AX27 DESLORATADINUM AERIUS 2,5mg COMPR. ORODISPERSABILE 2,5mg SP EUROPE BELGIA CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF 30 49,67 1,655666 0,424166 0,2120831118 R06AX27 DESLORATADINUM AERIUS 5mg COMPR. ORODISPERSABILE 5mg SP EUROPE BELGIA CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF 30 42,82 1,427333 0,848333 0,4241661119 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 0,3323331120 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 DOZATOAR P6L 1 13,31 13,310000 12,655000 6,3275001121 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SOL. ORALA 0,5mg/ml SP EUROPE BELGIA CUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML P-RF 1 20,49 20,490000 12,655000 6,3275001122 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 12,655000 6,3275001123 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 DOZATOAR P6L 1 13,31 13,310000 12,655000 6,3275001124 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 12,655000 6,3275001125 R06AX27 DESLORATADINUM AERIUS 0,5mg/ml SOL. ORALA 0,5mg/ml SP EUROPE BELGIA CUTIE X 1 FLACON X 150 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5ML P-RF 1 25,93 25,930000 15,818750 7,9093751126 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 150 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOAR P6L 1 16,86 16,860000 15,818750 7,9093751127 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 2,3550001128 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 2,0400001129 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 2,0400001130 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 2,0400001131 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 1,5300001132 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 7,0900001133 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 0,6255291134 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 10,4254981135 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 5,6512501136 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 7,6900001137 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 4,5539991138 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 2,2769991139 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 2,2769991140 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 2,2500001141 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.,SOL. FARA CONCENTRATIE 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 5,9602501142 S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX PIC. OFT.SOL. UNIDOZA FARA CONCENTRATIE 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 0,3576151143 S01CA01 COMBINATII (CLORAMPHENICOLUM+DEXAMETHASONUM) SPERSADEX COMP PICATURI OFT.-SOL. 5mg/ml+1mg/ml LABORATOIRES THEA FRANTA/GERMANIA CUTIE X 1 FLACON X 5 ML SOL. OFT. + PICURATOR P-RF 1 12,53 12,530000 11,920500 5,9602501144 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 5,0000001145 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM)TOBRADEX ( R ) PICATURI OFT.-SUSP. 1mg+3mg ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR PEJD X 5 ML P-RF 1 15,39 15,390000 11,920500 5,9602501146 S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM)TOBRADEX (R) UNG. OFT. 1mg+3mg 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 4,1721751147 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 15,2450001148 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 23 din 23

Page 53: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT 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 0,217666

2 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

3 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 0,133600

4 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 0,133600

5 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 1,594000

6 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 0,167200

7 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 0,136800 0,136800

8 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,28 0,114000 0,114000 0,114000

9 C03CA01 FUROSEMIDUM FUROSEMID EEL COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5,42 0,271000 0,136800 0,136800

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 0,136800 0,136800

11 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 0,136800 0,136800

12 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 0,136800 0,136800

13 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 1,214000

14 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 0,950333

15 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 0,258000

16 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 0,258000

17 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 0,557333

18 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 0,541333

19 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA EEL 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 0,215000

20 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA OZONE 25 mg COMPR. 25mg OZONE LABORATORIES PHARMA S.A. ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10,79 0,215800 0,215800 0,215800

21 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 16,21 0,324200 0,258000 0,258000

22 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 0,215000

23 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 0,649599

24 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 0,237000 0,237000

25 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 0,237000 0,237000

26 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 0,237000 0,237000

27 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 0,237000 0,237000

28 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 0,237000 0,237000

29 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 9,12 0,304000 0,237000 0,237000

30 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 100 19,75 0,197500 0,197500 0,197500

31 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 13,00 0,260000 0,237000 0,237000

32 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 0,237000 0,237000

33 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 0,237000 0,237000

34 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 0,237000 0,237000

35 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 0,233666

36 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 0,237000 0,237000

37 C07AB02 METOPROLOLUM METOPROLOL TARTRAT INTAS 100 mg COMPR. 100mg INTAS PHARMACEUTICALS LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P6L 30 8,09 0,269666 0,237000 0,237000

38 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 0,095000

39 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 0,095000

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 ( P-RF)

DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOARE

VALABILĂ ÎNCEPÂND CU 01 OCTOMBRIE 2013

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

Pagina 1 din 41

Page 54: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

40 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 0,095000

41 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

42 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 0,100800 0,100800

43 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 0,100800 0,100800

44 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 0,100800 0,100800

45 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 0,100800 0,100800

46 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 5,27 0,175666 0,100800 0,100800

47 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 10 BLIST. DIN PVC-PVDC/ALX 10 COMPR P-6L 100 8,40 0,084000 0,084000 0,084000

48 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 50 7,09 0,141800 0,100800 0,100800

49 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 0,100800 0,100800

50 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 0,100800 0,100800

51 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 0,100800 0,100800

52 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 0,100800 0,100800

53 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 0,100800 0,100800

54 C07AB02 METOPROLOLUM METOPROLOL TARTRAT INTAS 50 mg COMPR. 50mg INTAS PHARMACEUTICALS LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 30 COMPR. P6L 30 5,27 0,175666 0,100800 0,100800

55 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 0,237000 0,237000

56 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 0,237000 0,237000

57 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 0,100800 0,100800

58 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 0,757000

59 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 0,271333

60 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 0,453000

61 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 4,432000

62 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 0,546799 0,546799

63 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 0,492000 0,492000

64 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 0,292800 0,292800

65 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 0,593142

66 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 0,593142

67 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 0,593142

68 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 0,593142

69 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 0,593142

70 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 0,593142

71 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 0,593142

72 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 0,494285

73 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 0,593142

74 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 0,593142

75 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 0,593142

76 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8,74 0,291333 0,291333 0,291333

77 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 0,349599 0,349599

78 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 0,349599 0,349599

79 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 0,349599 0,349599

80 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 0,349599 0,349599

81 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 0,336000 0,336000

82 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 0,349599 0,349599

83 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 0,349599 0,349599

84 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 0,349599 0,349599

85 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 0,367200 0,367200

86 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 0,367200 0,367200

87 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 0,367200 0,367200

88 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 0,306000

89 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 0,367200 0,367200

90 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 0,367200 0,367200

Pagina 2 din 41

Page 55: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

91 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 0,367200 0,367200

92 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 0,367200 0,367200

93 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 0,267999 0,267999

94 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 0,230000 0,230000

95 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 0,229666 0,229666

96 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ COMPR. 6,25mg HEXAL AG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 6,89 0,229666 0,229666 0,229666

97 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 0,229666 0,229666

98 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 0,228000 0,228000

99 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 0,223333 0,223333

100 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 0,229666 0,229666

101 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 14,81 0,528928 0,349599 0,349599

102 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 21,99 0,785357 0,367200 0,367200

103 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 7,32 0,261428 0,261428 0,261428

104 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 0,113666

105 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 0,136666

106 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 0,136800

107 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 0,114000

108 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 0,114000

109 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 0,114000

110 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 0,136800

111 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 0,114000

112 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 0,133500

113 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 0,157200

114 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 0,157200

115 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 0,133500

116 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 0,150000

117 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 0,131000

118 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 0,219500

119 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 0,198000

120 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 0,219500

121 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 0,219500

122 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 0,219500

123 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 0,237600

124 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 0,237600

125 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 0,229000

126 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 0,225000

127 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 0,220200

128 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 11,28 0,564000 0,237600 0,237600

129 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 0,205000

130 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 0,219500

131 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 0,394320

132 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

133 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 0,394320

134 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 0,394320

135 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 0,394320

136 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 0,394320

137 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 0,370666

138 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 0,328600

139 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 0,394320

140 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 0,394320

141 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 0,183500

Pagina 3 din 41

Page 56: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

142 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 0,183500

143 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 0,183500

144 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 0,219000 0,219000

145 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 0,192000

146 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 0,196500

147 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 0,186000

148 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 3,65 0,182500 0,182500 0,182500

149 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 0,183500

150 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 0,183500

151 C09AA02 ENALAPRILUM ENAP (R) SOL. INJ. 1,25mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 15,45 3,090000 3,090000 3,090000

152 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 0,344400

153 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 0,344400

154 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 0,343666

155 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 0,287000

156 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 0,344400

157 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 0,344400

158 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 0,344400

159 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 0,344400

160 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 0,312500

161 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 0,517200

162 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 0,517200

163 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 0,501666

164 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 0,431000

165 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 14,44 0,722000 0,517200 0,517200

166 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 0,517200

167 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 0,517200

168 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 0,517200

169 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 1,310333

170 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 0,254666

171 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,15 0,238333 0,238333 0,238333

172 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 0,216666

173 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 0,259999

174 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 0,245666

175 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 0,259999

176 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 0,329642

177 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 0,389599

178 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 0,324666

179 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 0,389599

180 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 0,328928

181 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 0,329642

182 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 0,389599

183 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 0,338928

184 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

185 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 0,166071

186 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 0,194799

187 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 0,162333

188 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 0,194799

189 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 0,165000

190 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 0,166071

191 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 0,194799

192 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 0,194799

Pagina 4 din 41

Page 57: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

193 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 0,239285

194 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 0,286713

195 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 0,239333

196 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 0,286713

197 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 0,238928

198 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 0,239285

199 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 0,286713

200 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 0,253571

201 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 0,286713

202 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 0,976713

203 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 0,640713

204 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 0,976713

205 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 0,976713

206 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 0,976713

207 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 0,976713

208 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 0,976713

209 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 0,976713

210 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 0,976713

211 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 0,813928

212 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 0,976713

213 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 0,976713

214 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 0,478285

215 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 0,478285

216 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 0,398571

217 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 0,398571

218 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 0,640713

219 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 0,640713

220 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 0,640713

221 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 0,640713

222 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 0,640713

223 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 0,640713

224 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 0,640713

225 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

226 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 0,640713

227 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 0,640713

228 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 41,420000

229 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 1,194000 1,194000

230 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 1,194000 1,194000

231 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 0,995000

232 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 1,194000 1,194000

233 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN SANDOZ 16 mg COMPR. 16mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL CU DESICANT X 28 COMPR. P-6L 28 39,65 1,416071 1,194000 1,194000

234 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 1,194000 1,194000

235 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 1,194000 1,194000

236 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 1,194000 1,194000

237 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 1,194000 1,194000

238 C09CA06 CANDESARTANUM CILEXETIL** CANZENO 16mg COMPR. 16mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 29,85 0,995000 0,995000 0,995000

239 C09CA06 CANDESARTANUM CILEXETIL** CANDEGAMMA 16 mg COMPR. 16mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 30 (3X10) COMPR. P6L 30 39,63 1,321000 1,194000 1,194000

240 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 0,995000

241 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 1,194000 1,194000

242 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 1,465999

243 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 1,221666

Pagina 5 din 41

Page 58: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

244 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 1,465999

245 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 1,465999

246 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 1,465999

247 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 1,465999

248 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 1,465999

249 C09CA06 CANDESARTANUM CILEXETIL** CANZENO 32mg COMPR. 32mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 36,65 1,221666 1,221666 1,221666

250 C09CA06 CANDESARTANUM CILEXETIL** CANDEGAMMA 32 mg COMPR. 32mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 30 (3X10) COMPR. P6L 30 72,06 2,402000 1,465999 1,465999

251 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 1,221666

252 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 1,465999

253 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 0,648799

254 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 0,648799

255 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 0,540666

256 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 0,648799

257 C09CA06 CANDESARTANUM CILEXETIL** CANDESARTAN SANDOZ 8 mg COMPR. 8mg SANDOZ SRL ROMANIA CUTIE CU BLIST. AL/AL CU DESICANT X 28 COMPR. P-6L 28 33,45 1,194642 0,648799 0,648799

258 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 0,648799

259 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 0,648799

260 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 0,648799

261 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 0,648799

262 C09CA06 CANDESARTANUM CILEXETIL** CANZENO 8mg COMPR. 8mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 16,22 0,540666 0,540666 0,540666

263 C09CA06 CANDESARTANUM CILEXETIL** CANDEGAMMA 8 mg COMPR. 8mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 30 (3X10) COMPR. P6L 30 33,77 1,125666 0,648799 0,648799

264 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 0,648799

265 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 0,648799

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 0,217666

2 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

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 11,988666

2 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 0,665066

3 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 0,665066

4 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 0,665066

5 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 0,595333

6 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 0,665066

7 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 0,587333

8 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 0,665066

9 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 0,665066

11 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 0,665066

12 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 0,665066

13 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 0,665066

14 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 0,665066

15 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 0,665066

16 B01AC04 CLOPIDOGRELUM*** CLORODEN 75 mg COMPR. FILM. 75mg IWA CONSULTING APS DANEMARCA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 68,48 2,445714 0,665066 0,665066

17 B01AC04 CLOPIDOGRELUM*** CLORODEN 75 mg COMPR. FILM. 75mg IWA CONSULTING APS DANEMARCA CUTIE CU BLIST. PA-AL-PVC/AL (AL-AL) X 28 COMPR. FILM. P-RF 28 68,48 2,445714 0,665066 0,665066

2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

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

Pagina 6 din 41

Page 59: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

18 B01AC04 CLOPIDOGRELUM*** VATOUD 75 mg COMPR. FILM. 75mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 0,665066 0,665066

19 B01AC04 CLOPIDOGRELUM*** LOFRADYK 75 mg COMPR. FILM. 75mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 37,52 1,340000 0,665066 0,665066

20 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 0,665066

21 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 0,665066

22 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 0,665066

23 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 0,665066

24 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 0,665066

25 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 0,665066

26 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 0,665066

27 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 0,665066

28 B01AC04 CLOPIDOGRELUM*** CLOPIDOGREL ACCORD 75 mg COMPR. FILM. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. AL/AL X 10 COMPR. FILM. PRF 30 85,21 2,840333 0,665066 0,665066

29 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 0,572666

30 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 0,554222

31 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 0,665066

Tratamentul se iniţiază de către medicul în specialitatea cardiologie.

1 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg SP EUROPE BELGIA CUTIE X 140CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 609,00 4,350000 4,350000 4,350000

2 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 4,350000

3 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 3,960000

4 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 6,470333

5 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 7,764399

6 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 64,299333

7 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 58,287666

8 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 64,614000

9 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 382,224000

11 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 197,890000

12 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

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 98,852000

14 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 237,468000

15 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 225,874000

16 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 382,224000

17 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

18 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 S/P-RF 1 87,43 87,430000 87,430000 87,430000

19 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 S/P-RF 1 183,22 183,220000 183,220000 183,220000

20 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 434,340000

21 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 715,890000

22 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 100 mcg PULB. + SOLV. PT. SOL. INJ. 100mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 820,00 820,000000 820,000000 820,000000

23 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 120 mcg PULB. + SOLV. PT. SOL. INJ. 120mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 969,85 969,850000 969,850000 969,850000

24 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 150 mcg PULB. + SOLV. PT. SOL. INJ. 150mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 1.193,66 1.193,660000 1.193,660000 1.193,660000

25 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 50 mcg PULB. + SOLV. PT. SOL. INJ. 50mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 445,72 445,720000 445,720000 445,720000

26 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 975,160000

27 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

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

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 7 din 41

Page 60: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT 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 0,652400

2 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 1,482500

3 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 8,810000

4 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 31,020000

5 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 20,480000

6 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 31,873333

7 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 11,903333

8 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 0,702100

9 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 1,109400

2 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 1,109400

3 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 1,109400

4 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 0,924500

5 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 0,903166

6 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 1,794000

7 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 2,730400

8 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 2,681700

9 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

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 P-RF 1 10,37 10,370000 10,370000 10,370000

2 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 10,420000

3 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 3,470000

4 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 17,230000

5 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 33,340000

6 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 7,09 7,090000 7,090000 7,090000

7 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 D P-RF 1 3,57 3,570000 3,570000 3,570000

8 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 2,758333

9 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 19,110000

11 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 0,136800 0,136800

12 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,28 0,114000 0,114000 0,114000

13 C03CA01 FUROSEMIDUM FUROSEMID EEL COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5,42 0,271000 0,136800 0,136800

14 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 0,136800 0,136800

15 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 0,136800 0,136800

16 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 0,136800 0,136800

17 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 1,214000

5. HEPATITA AUTOIMUNA - G5

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

Tratamentul se initiază de către medicul în specialitatea gastroenterologie

Pagina 8 din 41

Page 61: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

18 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 0,950333

19 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 0,258000

20 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 0,258000

21 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 0,557333

22 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 0,541333

23 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA EEL 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 0,215000

24 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA OZONE 25 mg COMPR. 25mg OZONE LABORATORIES PHARMA S.A. ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 10,79 0,215800 0,215800 0,215800

25 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 16,21 0,324200 0,258000 0,258000

26 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 0,215000

27 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 0,649599

28 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 31,873333

29 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 11,903333

30 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg SP EUROPE BELGIA CUTIE X 140CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 609,00 4,350000 4,350000 4,350000

31 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 4,350000

32 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 3,960000

33 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 6,470333

34 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 7,764399

35 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 64,299333

36 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 58,287666

37 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 64,614000

38 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

39 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 382,224000

40 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 197,890000

41 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

42 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 98,852000

43 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 237,468000

44 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 225,874000

45 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 382,224000

46 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

47 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 S/P-RF 1 87,43 87,430000 87,430000 87,430000

48 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 S/P-RF 1 183,22 183,220000 183,220000 183,220000

49 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 434,340000

50 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 715,890000

51 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 100 mcg PULB. + SOLV. PT. SOL. INJ. 100mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 820,00 820,000000 820,000000 820,000000

52 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 120 mcg PULB. + SOLV. PT. SOL. INJ. 120mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 969,85 969,850000 969,850000 969,850000

53 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 150 mcg PULB. + SOLV. PT. SOL. INJ. 150mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 1.193,66 1.193,660000 1.193,660000 1.193,660000

54 L03AB10 PEGINTERFERON ALFA-2B**** PEGINTRON 50 mcg PULB. + SOLV. PT. SOL. INJ. 50mcg SP EUROPE BELGIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. P-RF/R 1 445,72 445,720000 445,720000 445,720000

55 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 975,160000

56 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 inițiază 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 1,904000

2 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 3,331000

3 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 8,750000

4 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 4,758000

5 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 8,746000

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

Pagina 9 din 41

Page 62: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

6 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 4,758000

7 A04AA02 GRANISETRONUM** KYTRIL (R) 1 mg COMPR. FILM. 1mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 287,59 28,759000 17,835600 17,835600

8 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 14,863000

9 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 14,863000

10 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

11 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 17,189000

12 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 23,615000

13 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 27,177000

14 A04AA02 GRANISETRONUM** GRANISETRON KABI 1 mg/ml CONC. PT. SOL. INJ./PERF. 1mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FIOLE STICLA INCOLORA X 1 ML CONC. PT. SOL. INJ./PERF. PR 10 135,28 13,528000 13,528000 13,528000

15 A04AA02 GRANISETRONUM** GRANISETRON KABI 1 mg/ml CONC. PT. SOL. INJ./PERF. 1mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 5 FIOLE STICLA INCOLORA X 3 ML CONC. PT. SOL. INJ./PERF. PR 5 199,30 39,860000 39,860000 39,860000

16 A04AA02 GRANISETRONUM** GRANISETRON KABI 1 mg/ml CONC. PT. SOL. INJ./PERF. 1mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FIOLE STICLA INCOLORA X 3 ML CONC. PT. SOL. INJ./PERF. PR 10 394,03 39,403000 39,403000 39,403000

17 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 14,304000

18 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 39,972000

19 A04AA02 GRANISETRONUM** KYTRIL SOL. INJ. 3mg/3ml ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FIOLA X 3 ML SOL. INJ. PR 1 66,02 66,020000 47,283600 47,283600

20 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 403,430000

21 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 381,180000

22 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 288,090000

23 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 36,403333

24 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 70,971666

25 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 788,230000

26 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 100,621666

27 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 1.193,316000

28 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 994,430000

29 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

30 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 159,895000

31 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 391,100000

32 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 87,711666

33 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 1.174,530000

34 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

35 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 201,383333

36 B03XA01 EPOETINUM BETA*** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 143,93 23,988333 23,988333 23,988333

37 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 793,252500

38 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 97,890000

39 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 1.177,087500

40 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

41 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 2.208,610000

42 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 252,367500

43 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 329,737500

44 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 3.633,810000

45 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 406,690000

46 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 484,292500

47 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 638,987500

48 G03HA01 CYPROTERONUM** ANDROCUR COMPR. 50mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FLAC. X 50 COMPR. P-RF 50 162,33 3,246600 3,246600 3,246600

49 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 0,183800

50 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 0,832000

51 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 0,816800

52 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 0,736400

53 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 1,387000

54 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 1,327200

55 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 1,246200

56 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 1,236600

Pagina 10 din 41

Page 63: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

57 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

58 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 1,186000

59 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 1,423200

60 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 4,203999

61 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 3,504000

62 J02AC02 ITRACONAZOLUM ITRACONAZOL 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 3,504000

63 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 3,504000

64 J02AC02 ITRACONAZOLUM SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 3,504000

65 J02AC02 ITRACONAZOLUM ITRACONAZOL LPH 100 mg CAPS. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 52,56 3,504000 3,504000 3,504000

66 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

67 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 139,918571

68 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 36,868928

69 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 537,450000

70 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 2.439,990000

71 J02AC04 POSACONAZOLUM** NOXAFIL SP 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 2.750,280000

72 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 1.348,760000

73 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 1.738,700000

74 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 19,865760

75 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 16,554800

76 L04AD01 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,152000

77 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 6,152000

78 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 1,804080

79 L04AD01 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,503400

80 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 1,503400

81 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 3,541920

82 L04AD01 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,951600

83 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 2,951600

84 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 2,873599

85 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 0,626833

86 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 6,560833

87 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 0,921600

88 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 1,882399

89 N02AA01 MORPHYNUM SEVREDOL 10 mg COMPR. FILM. 10mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-TS 56 46,96 0,838571 0,752199 0,752199

90 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 0,752199

91 N02AA01 MORPHYNUM SEVREDOL 20 mg COMPR. FILM. 20mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-TS 56 67,34 1,202500 1,202500 1,202500

92 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 1,196333

93 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 2,394666

94 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 0,768000

95 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 1,568666

96 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 1,658000

97 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 0,861799

98 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 1,572999 1,572999

99 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 2,370000 2,370000

100 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 4,027599 4,027599

101 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 0,718166

102 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 0,861799

103 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 1,310833

104 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 1,572857 1,572857

105 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 1,975000

106 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 2,370000 2,370000

107 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 2,370000 2,370000

Pagina 11 din 41

Page 64: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

108 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 6,968000

109 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 3,356333

110 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 4,027500 4,027500

111 N02AA05 OXYCODONUM OXYCONTIN (R) 10 mg COMPR. FILM. ELIB. MODIF. 10 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 116,83 2,086250 0,861799 0,861799

112 N02AA05 OXYCODONUM OXYCONTIN (R) 20 mg COMPR. FILM. ELIB. MODIF. 20 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 214,65 3,833035 1,572999 1,572999

113 N02AA05 OXYCODONUM OXYCONTIN (R) 40 mg COMPR. FILM. ELIB. MODIF. 40 mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 395,50 7,062500 2,370000 2,370000

114 N02AA05 OXYCODONUM OXYCONTIN (R) 80 mg COMPR. FILM. ELIB. MODIF. 80mg MUNDIPHARMA GMBH AUSTRIA CUTIE X 4 BLIST. X 14 COMPR. FILM. ELIB. MODIF. P-TS 56 652,80 11,657142 4,027599 4,027599

115 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 2,295357

116 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 0,523928

117 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 1,815892

118 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

119 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 38,248000

120 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 38,186000

121 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 38,248000

122 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 38,248000

123 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 14,287200

124 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 13,814000

125 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 11,906000

126 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 13,942000

127 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 24,156000

128 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 24,144000

129 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 22,610000

130 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 24,156000

131 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 30,916000

132 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 30,916000

133 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 30,916000

134 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,82 0,291000 0,291000 0,291000

135 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 0,291000

136 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 0,349200 0,349200

137 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 0,349200 0,349200

138 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 3,85 0,385000 0,349200 0,349200

139 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 0,349200 0,349200

140 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 3,82 0,382000 0,349200 0,349200

141 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 0,349200 0,349200

142 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 0,349200 0,349200

143 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 0,349200 0,349200

144 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 0,630000

145 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 18,91 0,630333 0,630333 0,630333

146 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 0,629666

147 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 0,918333

148 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 1,101999

149 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 1,143333

150 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 0,349200 0,349200

151 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 0,755599

152 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 1,101999

153 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 1,101999

154 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 1,371999

155 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 1,371999

156 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 0,349200 0,349200

157 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 1,614720

158 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 1,345600

Pagina 12 din 41

Page 65: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

159 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 12,28 2,456000 1,614720 1,614720

160 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 0,986000

161 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 4,90 0,980000 0,980000 0,980000

162 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 1,614720

163 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 7,67 1,534000 1,534000 1,534000

164 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 1,116000

165 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 0,488200

166 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 0,314400

167 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

168 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 0,181200

169 R05DA04 CODEINUM FARMACOD COMPR. 15mg FARMACOM SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 3,02 0,151000 0,151000 0,151000

170 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3,02 0,151000 0,151000 0,151000

171 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 0,159500

172 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 0,181200

173 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 13,507000

174 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 28,127500

175 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 58,251071

176 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 0,136800

2 N03AA02 PHENOBARBITALUM FENOBARBITAL 100 mg COMPR. 100mg SC ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 10 COMPR. P-RF 10 1,14 0,114000 0,114000 0,114000

3 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 0,114000

4 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 2,192000

5 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 0,138500

6 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 13,546000

7 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 0,137800

8 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 0,218666

9 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 0,265200 0,265200

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 0,226200

11 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 0,226200

12 N03AF01 CARBAMAZEPINUM CARBEPSIL 200 COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,226200

13 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,42 0,221000 0,221000 0,221000

14 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 0,225000

15 N03AF01 CARBAMAZEPINUM FINLEPSIN COMPR. 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,226200

16 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 0,248000

17 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 0,226200

18 N03AF01 CARBAMAZEPINUM CARBEPSIL 400 COMPR. 400mg AC HELCOR SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 26,26 0,525200 0,525200 0,525200

19 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 0,525500

20 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 0,303200

21 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 0,412400

22 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 0,730600

23 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 0,413600

24 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 0,731800

25 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 0,265200 0,265200

26 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 0,248600

27 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 0,606480

28 N03AF01 CARBAMAZEPINUM FINLEPSIN 400 RETARD COMPR. FILM. ELIB. PREL. 400mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 25,27 0,505400 0,505400 0,505400

9. EPILEPSIE - G11

Pagina 13 din 41

Page 66: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

29 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 0,505400

30 N03AF01 CARBAMAZEPINUM FINLEPSIN 200 RETARD COMPR.FILM.ELIB.PREL 200mg AWD PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. AL-HARTIE/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 12,43 0,248600 0,248600 0,248600

31 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 22,510000

32 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 1,294600

33 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 2,366000

34 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 0,184920

35 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 0,268680

36 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 20,26 0,202600 0,184920 0,184920

37 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 0,231000

38 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 0,336500

39 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

40 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 0,268680

41 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 150 COMPR. FILM. GASTROREZ. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 COMPR.FILM. GASTROREZ. P-6L 100 15,41 0,154100 0,154100 0,154100

42 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 0,268000

43 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 300 COMPR. FILM. GASTROREZ. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 100 COMPR. FILM. GASTROREZ. P-6L 100 22,39 0,223900 0,223900 0,223900

44 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 600 COMPR. FILM. GASTROREZ. 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. FILM. GASTROREZ. P-6L 50 21,57 0,431400 0,431400 0,431400

45 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

46 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 0,403800

47 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 19,240000

48 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 17,770000

49 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 0,962000

50 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 0,962000

51 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 0,961333

52 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 1,116642

53 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 0,930535

54 N03AX09 LAMOTRIGINUM** LAMOTRIGINE TORRENT 100 mg COMPR. 100mg TORRENT PHARMA S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 28,24 0,941333 0,941333 0,941333

55 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 2,011000

56 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 1,776964

57 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 0,152799 0,152799

58 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 0,152799 0,152799

59 N03AX09 LAMOTRIGINUM** PLEXXO (R) 50 mg COMPR. 50mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 14,41 0,480333 0,480333 0,480333

60 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 0,480333

61 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 0,480666

62 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 0,576213

63 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 0,480178

64 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 0,961333

65 N03AX09 LAMOTRIGINUM** LAMOTRIN 25 mg COMPR. DISP. 25mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 3,82 0,127333 0,127333 0,127333

66 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 0,565000

67 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 0,009333

68 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 0,025333

69 N03AX11 TOPIRAMATUM** TOPAMAX 100 mg COMPR. FILM. 100mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 125,11 4,468214 2,675799 2,675799

70 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 2,675799 2,675799

71 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 2,675799 2,675799

72 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 60 159,80 2,663333 2,663333 2,663333

73 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 87,45 2,915000 2,675799 2,675799

74 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 2,673666 2,673666

75 N03AX11 TOPIRAMATUM** TOPIRAMAT BLUEFISH 100 mg COMPR. FILM. 100mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. AL/AL X 60 COMPR. FILM. P-RF 60 142,68 2,378000 2,378000 2,378000

76 N03AX11 TOPIRAMATUM** TOPIRAMAT BLUEFISH 100 mg COMPR. FILM. 100mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU 1 FLAC. PEID X 60 COMPR. FILM. P-RF 60 142,68 2,378000 2,378000 2,378000

77 N03AX11 TOPIRAMATUM** TOPIRAMAT EGIS 100 mg COMPR. FILM. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 133,79 2,229833 2,229833 2,229833

78 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 2,675799 2,675799

79 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 83,27 2,775666 2,675799 2,675799

Pagina 14 din 41

Page 67: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

80 N03AX11 TOPIRAMATUM** TOPRAN 200 mg COMPR. FILM. 200mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L 60 310,81 5,180166 5,180166 5,180166

81 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 5,302666

82 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 5,168333

83 N03AX11 TOPIRAMATUM** TOPAMAX 25 mg COMPR. FILM. 25mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 40,62 1,450714 0,963799 0,963799

84 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 0,899333 0,899333

85 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 0,963799 0,963799

86 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 55,59 0,926500 0,926500 0,926500

87 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 27,87 0,929000 0,929000 0,929000

88 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 0,889000 0,889000

89 N03AX11 TOPIRAMATUM** TOPIRAMAT BLUEFISH 25 mg COMPR. FILM. 25mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. AL/AL X 60 COMPR. FILM. P-RF 60 51,29 0,854833 0,854833 0,854833

90 N03AX11 TOPIRAMATUM** TOPIRAMAT EGIS 25 mg COMPR. FILM. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 48,19 0,803166 0,803166 0,803166

91 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 0,919000 0,919000

92 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 27,57 0,919000 0,919000 0,919000

93 N03AX11 TOPIRAMATUM** TOPAMAX 50 mg COMPR. FILM. 50mg JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. P-6L 28 73,20 2,614285 1,495999 1,495999

94 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 1,495999 1,495999

95 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 1,495999 1,495999

96 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 89,22 1,487000 1,487000 1,487000

97 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 51,21 1,707000 1,495999 1,495999

98 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 1,493666 1,493666

99 N03AX11 TOPIRAMATUM** TOPIRAMAT BLUEFISH 50 mg COMPR. FILM. 50mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. AL/AL X 60 COMPR. FILM. P-RF 60 84,54 1,409000 1,409000 1,409000

100 N03AX11 TOPIRAMATUM** TOPIRAMAT BLUEFISH 50 mg COMPR. FILM. 50mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU 1 FLAC. PEID X 60 COMPR. FILM. P-RF 60 84,54 1,409000 1,409000 1,409000

101 N03AX11 TOPIRAMATUM** TOPIRAMAT EGIS 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 74,80 1,246666 1,246666 1,246666

102 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 1,495999 1,495999

103 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 47,86 1,595333 1,495999 1,495999

104 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 0,144000

105 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 0,172800

106 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 0,172800

107 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 0,172800

108 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 0,172800

109 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 0,436000

110 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 0,523200

111 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 0,523200

112 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 0,523200

113 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 0,523200

114 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 0,523200

115 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 0,523200

116 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 0,576200

117 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 0,691440

118 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 0,691440

119 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 0,691440

120 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 0,691440

121 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 0,691440

122 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 0,691440

123 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 2,173666

124 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 2,061333

125 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 3,474666

126 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 3,289666

127 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 3,802333

128 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 3,495000

129 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 3,803666

130 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 3,910800

Pagina 15 din 41

Page 68: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

131 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 3,910800

132 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 3,372666

133 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 3,803666

134 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 3,803666

135 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 3,607000

136 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 3,607000

137 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 3,352000

138 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 3,910800

139 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 3,259000

140 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 3,803666

141 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 3,803666

142 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 3,803666

143 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 3,803928

144 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

145 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 0,886800

146 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 31,08 1,036000 0,886800 0,886800

147 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 0,886800

148 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 0,886800

149 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 0,886800

150 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 0,886800

151 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 0,886800

152 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 0,886800

153 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 0,886666

154 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 0,886800

155 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 0,739000

156 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 0,886800

157 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 0,886800

158 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 0,886800

159 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 0,886800

160 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 0,886800

161 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 59,70 1,990000 1,896799 1,896799

162 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 1,887666

163 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 1,896799

164 N03AX14 LEVETIRACETAMUM** KEPPRA 500 mg COMPR. FILM. 500mg UCB PHARMA LTD BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF 30 87,23 2,907666 1,896799 1,896799

165 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 1,896799

166 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 1,657666

167 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 1,896799

168 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 1,896799

169 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 1,890000

170 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 1,890333

171 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 1,668666

172 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 1,896799

173 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 1,580666

174 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 1,896799

175 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 1,896799

176 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 1,896799

177 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 1,896799

178 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 1,896799

179 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 2,617000

180 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 2,856000

181 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 3,140000

Pagina 16 din 41

Page 69: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

182 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 3,910800

183 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 0,886800

184 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 1,896799

185 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 3,133333

186 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 114,110000

187 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 136,836000

188 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 114,030000

189 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 ÎNCHIDERE SECURIZAT PENTRU COPI PRF 1 114,11 114,110000 114,110000 114,110000

190 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

191 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 5,440000

192 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 5,159107

193 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 7,547678

194 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 8,162857

195 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 3,836428

196 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 3,455714

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 25,33 0,506600 0,506600 0,506600

2 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 0,211400

3 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 0,588700

4 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 0,629199

5 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 0,524333

6 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM)** ZIMOX COMPR. 250mg+25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 19,21 0,640333 0,640333 0,640333

7 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM)** CREDANIL 25/250 COMPR. 250mg+25mg REMEDICA LTD. CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 19,31 0,965500 0,744600 0,744600

8 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 0,620500

9 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 0,744600

10 N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM)** DUODOPA GEL INT. FARA CONCENTRATIE SOLVAY PHARMACEUTICALS BV GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC S/P-RF 7 3.424,76 489,251428 489,251428 489,251428

11 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 4,144600

12 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 4,144600

13 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 4,144600

14 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 5,448900

15 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 4,144600

16 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF 100 414,46 4,144600 4,144600 4,144600

17 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

18 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

19 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 1,424666

20 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 1,424642

21 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 2,704000

22 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 2,703928

23 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 5,129666

24 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 5,129642

25 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 1,424642

26 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 2,703928

27 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 5,129642

28 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 1,320000

29 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 1,421785

Tratamentul se initiază de către medicul în specialitatea neurologie

Pagina 17 din 41

Page 70: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

30 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 1,424642

31 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

32 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 2,703928

33 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 2,700714

34 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 4,352142

35 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 5,129285

36 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 5,126785

37 N04BC04 ROPINIROLUM** ROPINIROL ACTAVIS 0,25 mg COMPR. FILM. 0,25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 21 COMPR. FILM. P-RF 21 6,32 0,300952 0,300952 0,300952

38 N04BC04 ROPINIROLUM** ROPINIROL ACTAVIS 1 mg COMPR. FILM. 1mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 21 COMPR. FILM. P-RF 21 23,00 1,095238 1,095238 1,095238

39 N04BC04 ROPINIROLUM** ROPINIROL ACTAVIS 2 mg COMPR. FILM. 2mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 21 COMPR. FILM. P-RF 21 30,92 1,472380 1,472380 1,472380

40 N04BC04 ROPINIROLUM** ROPINIROL TEVA 2 mg COMPR. FILM. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 21 COMPR. FILM. P-RF 21 35,77 1,703333 1,584000 1,584000

41 N04BC04 ROPINIROLUM** REQUIP-MODUTAB 2 mg COMPR. FILM. ELIB. PREL. 2mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. ELIB. PREL. P-RF 28 61,36 2,191428 1,584000 1,584000

42 N04BC04 ROPINIROLUM** REQUIP-MODUTAB 4 mg COMPR. FILM. ELIB. PREL. 4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. ELIB. PREL, P-RF 28 116,48 4,160000 2,900142 2,900142

43 N04BC04 ROPINIROLUM** REQUIP-MODUTAB 8 mg COMPR. FILM. ELIB. PREL. 8mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. ELIB. PREL. P-RF 28 220,96 7,891428 5,222570 5,222570

44 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 0,658333

45 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 0,581000

46 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL ZENTIVA 0,18 mg COMPR. 0,18 mg ZENTIVA, K.S. REPUBLICA SLOVACA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 17,43 0,581000 0,581000 0,581000

47 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 0,594799

48 N04BC05 PRAMIPEXOLUM** OPRYMEA 0,18mg COMPR. 0,18mg KRKA D.D. SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF 30 20,91 0,697000 0,594799 0,594799

49 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 0,594799

50 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 0,594799

51 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 0,594799

52 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 0,496000

53 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 0,594799

54 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 0,495666

55 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 30,20 1,006666 0,594799 0,594799

56 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 0,594799

57 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 0,594799

58 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 1,630666

59 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 2,032333

60 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 2,438799

61 N04BC05 PRAMIPEXOLUM** PRAMIPEXOL ZENTIVA 0,7 mg COMPR. 0,7 mg ZENTIVA, K.S. REPUBLICA SLOVACA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF 30 60,97 2,032333 2,032333 2,032333

62 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 2,438799

63 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 2,438666

64 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 2,438799

65 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 2,438799

66 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 2,438799

67 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 2,400666

68 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 2,438799

69 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 2,401000

70 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 30 107,98 3,599333 2,438799 2,438799

71 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 2,438799

72 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 5,812000 5,812000

73 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 10,469000 10,469000

74 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 21,678333 21,678333

75 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 40,995000 40,995000

76 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 60,311000

77 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 13,124642

78 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

79 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 14,521428

80 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 13,653928

Pagina 18 din 41

Page 71: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

81 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 17,056071

82 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 18,224285

83 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 20,407500

84 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 22,025714

85 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 0,726200

86 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 0,703700

87 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 17,453000

88 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 3,087999

89 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 3,087999

90 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 2,573500

91 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 2,713666

92 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 2,573333

93 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 2,573500

94 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 2,135800

95 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 0,104799

2 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

3 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 0,104799

4 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

5 L01BA01 METHOTREXATUM4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,881000

6 L01BA01 METHOTREXATUM4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,720666

7 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 400,810000

8 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

9 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 EMTHEXATE PF SOL. INJ. 25mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FIOLA X 2ML PR 1 67,79 67,790000 67,790000 67,790000

11 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 2,382000

12 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 78,670000

13 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 59,640000

14 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 122,500000

15 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 110,090000

16 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 124,210000

17 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

18 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 71,568000

19 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 109,540000

20 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 0,702100

21 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

22 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 0,686500

23 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg ICN POLFA RZESZOW S.A. POLONIA CUTIE X 1 FLAC. X 20 DRAJ. S/P-RF 20 16,56 0,828000 0,828000 0,828000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

12. SCLEROZA MULTIPLA - G14

11. MIASTENIA GRAVIS - G13

Pagina 19 din 41

Page 72: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT 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 0,652400

2 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 1,482500

3 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 8,810000

4 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 31,020000

5 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 20,480000

6 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 0,104799

7 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

8 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 0,104799

9 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 METHOTREXATUM4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,881000

11 L01BA01 METHOTREXATUM4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,720666

12 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 400,810000

13 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

14 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

15 L01BA01 METHOTREXATUM EMTHEXATE PF SOL. INJ. 25mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FIOLA X 2ML PR 1 67,79 67,790000 67,790000 67,790000

16 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 2,382000

17 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 78,670000

18 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 59,640000

19 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 122,500000

20 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 110,090000

21 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 124,210000

22 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

23 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 71,568000

24 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 109,540000

25 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 643,620000

26 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 0,702100

27 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 0,184920

2 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 0,268680

3 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 20,26 0,202600 0,184920 0,184920

4 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 0,231000

5 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 0,336500

6 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

7 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 0,268680

8 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 150 COMPR. FILM. GASTROREZ. 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 COMPR.FILM. GASTROREZ. P-6L 100 15,41 0,154100 0,154100 0,154100

9 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 0,268000

10 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 300 COMPR. FILM. GASTROREZ. 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 100 COMPR. FILM. GASTROREZ. P-6L 100 22,39 0,223900 0,223900 0,223900

11 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL 600 COMPR. FILM. GASTROREZ. 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. FILM. GASTROREZ. P-6L 50 21,57 0,431400 0,431400 0,431400

12 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

13 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 0,403800

14 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 19,240000

15 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 17,770000

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 20 din 41

Page 73: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

16 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 0,962000

17 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 0,962000

18 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 0,961333

19 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 1,116642

20 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 0,930535

21 N03AX09 LAMOTRIGINUM** LAMOTRIGINE TORRENT 100 mg COMPR. 100mg TORRENT PHARMA S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 28,24 0,941333 0,941333 0,941333

22 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 2,011000

23 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 1,776964

24 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 0,152799 0,152799

25 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 0,152799 0,152799

26 N03AX09 LAMOTRIGINUM** PLEXXO (R) 50 mg COMPR. 50mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 14,41 0,480333 0,480333 0,480333

27 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 0,480333

28 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 0,480666

29 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 0,576213

30 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 0,480178

31 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 0,961333

32 N03AX09 LAMOTRIGINUM** LAMOTRIN 25 mg COMPR. DISP. 25mg ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L 30 3,82 0,127333 0,127333 0,127333

33 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 0,565000

34 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 0,009333

35 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 0,025333

36 N04AA01 TRIHEXYPHENIDYLUM ROMPARKIN (R) 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 25,33 0,506600 0,506600 0,506600

37 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 0,162000

38 N05AD01 HALOPERIDOLUM HALOPERIDOL 1 mg COMPR. 1mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,72 0,257333 0,257333 0,257333

39 N05AD01 HALOPERIDOLUM HALOPERIDOL 2 mg COMPR. 2mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 10,80 0,360000 0,360000 0,360000

40 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 0,717600

41 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. OFT., 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 4,31 4,310000 4,310000 4,310000

42 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 6,660000 6,660000

43 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 8,904000

44 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 2,496000

45 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 17,313214

46 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 4,262000

47 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 5,823799

48 N05AE04 ZIPRASIDONUM** PRAMAXIMA 40 mg CAPS. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF 56 274,34 4,898928 4,898928 4,898928

49 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 4,948571

50 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 4,853166

51 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 7,167799

52 N05AE04 ZIPRASIDONUM** PRAMAXIMA 60 mg CAPS. 60mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF 56 371,47 6,633392 6,633392 6,633392

53 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 6,334821

54 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 5,973166

55 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 7,729399

56 N05AE04 ZIPRASIDONUM** PRAMAXIMA 80 mg CAPS. 80mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF 56 403,81 7,210892 7,210892 7,210892

57 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 7,210892

58 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 6,441166

59 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 64,190000

60 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 7,181000

61 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 0,379600

62 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 0,568000

63 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 32,700000

64 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 15,782000

65 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 9,298000

66 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 2,135800

Pagina 21 din 41

Page 74: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

67 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

68 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 0,996000

69 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 0,992857

70 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 28 135,95 4,855357 0,996000 0,996000

71 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 6,541599 6,541599

72 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 5,997428 5,997428

73 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 0,534285

74 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 0,534285

75 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 61,61 2,200357 0,534428 0,534428

76 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 0,996000

77 N05AH03 OLANZAPINUM** OLANZAPINA ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 135,34 4,833571 0,996000 0,996000

78 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 0,996000

79 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 0,996000

80 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 0,991333

81 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 0,830000

82 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 0,996000

83 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 0,996000

84 N05AH03 OLANZAPINUM** NYKOB 10 mg COMPR. FILM. 10mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 114,62 4,093571 0,996000 0,996000

85 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 0,996000

86 N05AH03 OLANZAPINUM** OLANZAPINA LILLY 10 mg COMPR. FILM. 10mg ELI LILLY ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. DIN AL X 28 COMPR. FILM. PRF 28 134,56 4,805714 0,996000 0,996000

87 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 0,996000

88 N05AH03 OLANZAPINUM** OLANZAPINA ACCORD 15 mg COMPR. FILM. 15mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 203,00 7,250000 6,541599 6,541599

89 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 6,541599 6,541599

90 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 6,541599 6,541599

91 N05AH03 OLANZAPINUM** NYKOB 15 mg COMPR. FILM. 15mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 171,62 6,129285 6,129285 6,129285

92 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 6,541599 6,541599

93 N05AH03 OLANZAPINUM** OLANZAPINA ACCORD 2,5 mg COMPR. FILM. 2,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 37,58 1,342142 1,342142 1,342142

94 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 5,997428 5,997428

95 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 20 mg COMPR. FILM. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/AL X 35 COMPR. FILM. P-RF 35 835,65 23,875714 5,997428 5,997428

96 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 5,997428 5,997428

97 N05AH03 OLANZAPINUM** NYKOB 20 mg COMPR. FILM. 20mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 228,83 8,172500 5,997428 5,997428

98 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 5,997428 5,997428

99 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 0,534428

100 N05AH03 OLANZAPINUM** OLANZAPINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 71,36 2,548571 0,534428 0,534428

101 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 0,534428

102 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 0,534428

103 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 0,534000

104 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 0,445357

105 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 5 mg COMPR. FILM. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/AL X 35 COMPR. FILM. P-RF 35 89,20 2,548571 0,534428 0,534428

106 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 0,534428

107 N05AH03 OLANZAPINUM** NYKOB 5 mg COMPR. FILM. 5mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-RF 28 60,36 2,155714 0,534428 0,534428

108 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 0,534428

109 N05AH03 OLANZAPINUM** OLANZAPINA LILLY 5 mg COMPR. FILM. 5mg ELI LILLY ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. DIN AL X 28 COMPR. FILM. PRF 28 70,95 2,533928 0,534428 0,534428

110 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 0,534428

111 N05AH03 OLANZAPINUM** OLANZAPINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-RF 28 107,05 3,823214 3,823214 3,823214

112 N05AH03 OLANZAPINUM** OLANZAPINA DR. REDDY'S 7,5 mg COMPR. FILM. 7,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/AL X 35 COMPR. FILM. P-RF 35 296,13 8,460857 4,587856 4,587856

113 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 0,996000

114 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 0,996000

115 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 0,996000

116 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 30 142,72 4,757333 0,996000 0,996000

117 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 0,996000

Pagina 22 din 41

Page 75: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

118 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 0,992857

119 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 0,996000

120 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 0,996000

121 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 47,21 1,686071 0,996000 0,996000

122 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 0,996000

123 N05AH03 OLANZAPINUM** NYKOB 10 mg COMPR. ORODISPERSABILE 10mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 114,62 4,093571 0,996000 0,996000

124 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 0,990357

125 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 0,996000

126 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 0,995357

127 N05AH03 OLANZAPINUM** OLANZAPINA LILLY 10 mg COMPR. ORODISPERSABILE 10mg ELI LILLY ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL X 28 COMPR. ORODIPSERSABILE PRF 28 136,15 4,862500 0,996000 0,996000

128 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 0,996000

129 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

130 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 6,541599 6,541599

131 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 6,541599 6,541599

132 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 28 201,43 7,193928 6,541599 6,541599

133 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 30 214,08 7,136000 6,541599 6,541599

134 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 6,541599 6,541599

135 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 6,541428 6,541428

136 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 6,541599 6,541599

137 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 28 170,10 6,075000 6,075000 6,075000

138 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 6,541599 6,541599

139 N05AH03 OLANZAPINUM** NYKOB 15 mg COMPR. ORODISPERSABILE 15mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 171,62 6,129285 6,129285 6,129285

140 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 28 167,86 5,995000 5,995000 5,995000

141 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 5,451333 5,451333

142 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 6,541599 6,541599

143 N05AH03 OLANZAPINUM** OLANZAPINA LILLY 15 mg COMPR. ORODISPERSABILE 15mg ELI LILLY ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL X 28 COMPR. ORODIPSERSABILE PRF 28 205,86 7,352142 6,541599 6,541599

144 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 28 201,43 7,193928 6,541599 6,541599

145 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 6,541599 6,541599

146 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 5,997428 5,997428

147 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 5,997428 5,997428

148 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 5,997428 5,997428

149 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 30 285,43 9,514333 5,997428 5,997428

150 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 5,997428 5,997428

151 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 5,996785 5,996785

152 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 4,997857

153 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 5,997428 5,997428

154 N05AH03 OLANZAPINUM** NYKOB 20 mg COMPR. ORODISPERSABILE 20mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 228,83 8,172500 5,997428 5,997428

155 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 28 167,86 5,995000 5,995000 5,995000

156 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 5,997000 5,997000

157 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 5,997428 5,997428

158 N05AH03 OLANZAPINUM** OLANZAPINA LILLY 20 mg COMPR. ORODISPERSABILE 20mg ELI LILLY ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL X 28 COMPR. ORODIPSERSABILE PRF 28 274,48 9,802857 5,997428 5,997428

159 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 28 231,65 8,273214 5,997428 5,997428

160 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 5,997428 5,997428

161 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 0,534428

162 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 0,534428

163 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 0,534285

164 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 75,25 2,508333 0,534428 0,534428

165 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 0,534428

166 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 0,534285

167 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 0,534428

168 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 0,534428

Pagina 23 din 41

Page 76: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

169 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 0,534428

170 N05AH03 OLANZAPINUM** NYKOB 5 mg COMPR. ORODISPERSABILE 5mg PHARMASWISS MEDICINES S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF 28 60,36 2,155714 0,534428 0,534428

171 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 0,533928

172 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 0,534428

173 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 0,534285

174 N05AH03 OLANZAPINUM** OLANZAPINA LILLY 5 mg COMPR. ORODISPERSABILE 5mg ELI LILLY ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL X 28 COMPR. ORODIPSERSABILE PRF 28 71,80 2,564285 0,534428 0,534428

175 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 0,534428

176 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 0,534428

177 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 893,610000

178 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 1.379,830000

179 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 1.716,380000

180 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 19,950000

181 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 7,408333

182 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 0,867799

183 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 0,867799

184 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 0,723166

185 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 0,867799

186 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 69,71 1,161833 0,867799 0,867799

187 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 0,867799

188 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 0,867799

189 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 0,845000

190 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 0,867799

191 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 0,867500

192 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 1,198833

193 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 1,438599

194 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 1,438500

195 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 0,903600

196 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 0,753000

197 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 0,903600

198 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 0,903600

199 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 98,66 1,644333 0,903600 0,903600

200 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 0,903600

201 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 0,903600

202 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 0,903600

203 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 0,903600

204 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 0,903600

205 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 0,566666

206 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 0,679999

207 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 0,566666

208 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 1,485199

209 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 1,237666

210 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 1,485199

211 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 1,485199

212 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 1,485199

213 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 1,485199

214 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 1,485199

215 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 1,485199

216 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 1,485199

217 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 7,408333

218 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 9,601666

219 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 12,386166

Pagina 24 din 41

Page 77: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

220 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 3,867333

221 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

222 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 0,672500

223 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 1,660666

224 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 1,660666

225 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 1,988000

226 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 1,992799

227 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 3,574333

228 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 0,417600 0,417600

229 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 8,34 0,417000 0,417000 0,417000

230 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 0,410333

231 N05AX08 RISPERIDONUM** RISPERIDONA ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 60 23,54 0,392333 0,392333 0,392333

232 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 0,417600 0,417600

233 N05AX08 RISPERIDONUM** RISPERIDONA FARMAL 1 mg COMPR. FILM. 1mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 50 23,94 0,478800 0,417600 0,417600

234 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 0,400333

235 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 0,417600 0,417600

236 N05AX08 RISPERIDONUM** RISPERIDONE TORRENT 1 mg COMPR. FILM. 1mg TORRENT PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PEJD-PVDC/AL X 10 COMPR. FILM. P-RF 20 6,96 0,348000 0,348000 0,348000

237 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 0,895599 0,895599

238 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 0,895599 0,895599

239 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 2 mg COMPR. FILM. 2mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 16,07 0,803500 0,803500 0,803500

240 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 0,778333

241 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 0,857500

242 N05AX08 RISPERIDONUM** RISPERIDONA ACCORD 2 mg COMPR. FILM. 2mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 44,78 0,746333 0,746333 0,746333

243 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 0,873000

244 N05AX08 RISPERIDONUM** RISPERIDONA FARMAL 2 mg COMPR. FILM. 2mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 50 44,47 0,889400 0,889400 0,889400

245 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 0,890000

246 N05AX08 RISPERIDONUM** RISPERIDONE TORRENT 2 mg COMPR. FILM. 2mg TORRENT PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PEJD-PVDC/AL X 10 COMPR. FILM. P-RF 20 16,21 0,810500 0,810500 0,810500

247 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 0,880000

248 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 1,384800

249 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 1,154000

250 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 3 mg COMPR. FILM. 3mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 27,18 1,359000 1,359000 1,359000

251 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 1,258000

252 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 1,372000

253 N05AX08 RISPERIDONUM** RISPERIDONA ACCORD 3 mg COMPR. FILM. 3mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 60 69,74 1,162333 1,162333 1,162333

254 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 1,381666

255 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 1,375500

256 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 1,246500

257 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 1,326400

258 N05AX08 RISPERIDONUM** RISPERIDONE TORRENT 3 mg COMPR. FILM. 3mg TORRENT PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PEJD-PVDC/AL X 10 COMPR. FILM. P-RF 20 27,50 1,375000 1,375000 1,375000

259 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 1,737400

260 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 1,904400

261 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 1,587000

262 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 1,680166

263 N05AX08 RISPERIDONUM** RISPERIDONE TEVA 4 mg COMPR. FILM. 4mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 35,38 1,769000 1,769000 1,769000

264 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 1,870500

265 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 1,888666

266 N05AX08 RISPERIDONUM** RISPERIDONA FARMAL 4 mg COMPR. FILM. 4mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 50 93,52 1,870400 1,870400 1,870400

267 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 1,848500

268 N05AX08 RISPERIDONUM** RISPERIDONE TORRENT 4 mg COMPR. FILM. 4mg TORRENT PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PEJD-PVDC/AL X 10 COMPR. FILM. P-RF 20 33,34 1,667000 1,667000 1,667000

269 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 1,747000

270 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 0,411333

Pagina 25 din 41

Page 78: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

271 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 0,417600 0,417600

272 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 0,895333

273 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 0,895333

274 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 1,384800

275 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA (R) 25 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 25mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. CU ELIB. PREL. + 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2 ML SOLV.+2 ACE STERILE PT. RECONSTITUIRE+ 1 AC PT.INJECTARE INTRAMUSCULARA S/P-RF 1 424,25 424,250000 424,250000 424,250000

276 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 424,250000

277 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA (R) 37,5 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 37,5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. CU ELIB. PREL. + 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2 ML SOLV.+2 ACE STERILE PT. RECONSTITUIRE+ 1 AC PT.INJECTARE INTRAMUSCULARA S/P-RF 1 597,43 597,430000 597,430000 597,430000

278 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 597,430000

279 N05AX08 RISPERIDONUM** RISPOLEPT CONSTA (R) 50 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 50mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. CU ELIB. PREL. + 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2 ML SOLV.+2 ACE STERILE PT. RECONSTITUIRE+ 1 AC PT.INJECTARE INTRAMUSCULARA S/P-RF 1 719,03 719,030000 719,030000 719,030000

280 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

281 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 52,140000

282 N05AX08 RISPERIDONUM** RISPOLEPT SOL. ORALA 1mg/ml JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SOL. ORALA + 1 PIPETA P-RF 1 156,63 156,630000 156,630000 156,630000

283 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 28 483,22 17,257857 17,257857 17,257857

284 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 28 483,22 17,257857 17,257857 17,257857

285 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 21,00 21,000000 21,000000 21,000000

286 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 0,237333

287 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 0,264285

288 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 0,459428

289 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 0,382857

290 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 1,199642

291 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 3,227857 3,227857

292 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 1,247500

293 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

294 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 0,623666

295 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 0,623666

296 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 0,755000

297 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 0,706000

298 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 0,847200

299 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 0,829285

300 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 0,829599

301 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 0,829599

302 N06AX16 VENLAFAXINUM** EFECTIN ER 150 mg CAPS. ELIB. PREL. 150mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 58,69 2,096071 0,829599 0,829599

303 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 0,829599

304 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 0,829599

305 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 0,829599

306 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 0,829599

307 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 0,825357

308 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 0,829599

309 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 0,829599

310 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 0,829599

311 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 24,38 0,812666 0,812666 0,812666

312 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 0,801333 0,801333

313 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 0,638928

314 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 0,639199

315 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 0,639199

316 N06AX16 VENLAFAXINUM** EFECTIN ER 75 mg CAPS. ELIB. PREL. 75mg WYETH LEDERLE PHARMA GMBH AUSTRIA CUTIE X 1 BLIST. ACLAR/PE/PVC/AL X 28 CAPS. ELIB. PREL. P-RF 28 35,58 1,270714 0,639199 0,639199

317 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 0,639199

318 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 0,639199

319 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 25,59 0,853000 0,639199 0,639199

320 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 0,639199

321 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 0,632857

Pagina 26 din 41

Page 79: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

322 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 0,639199

323 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 0,639199

324 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 0,639199

325 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 0,801333 0,801333

326 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 0,816666

327 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 0,639199

328 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 0,691333

329 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 0,532666

330 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 37,5 mg COMPR. FILM. 37,5 mg ACTAVIS S.R.L. ROMANIA CUTIE X 4 BLIST. AL/PVC X 14 COMPR. FILM. P-RF 56 38,11 0,680535 0,680535 0,680535

331 N06AX17 MILNACIPRANUM** IXEL CAPS. 25mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 71,52 1,277142 1,277142 1,277142

332 N06AX17 MILNACIPRANUM** IXEL CAPS. 50mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 4 BLIST. AL/PVC X 14 CAPS. P-RF 56 117,26 2,093928 2,093928 2,093928

333 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 3,763928

334 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

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 2,184799 2,184799

3 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 64,72 2,157333 2,157333 2,157333

4 N06DA02 DONEPEZILUM*** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 64,72 2,157333 2,157333 2,157333

5 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 2,176666 2,176666

6 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 2,184799 2,184799

7 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 2,184799 2,184799

8 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 2,184799 2,184799

9 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 2,184799 2,184799

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 2,184799 2,184799

11 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 61,14 2,183571 2,183571 2,183571

12 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 2,184799 2,184799

13 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 61,17 2,184642 2,184642 2,184642

14 N06DA02 DONEPEZILUM*** DONEPEZIL TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 231,98 7,732666 2,184799 2,184799

15 N06DA02 DONEPEZILUM*** DONEPEZIL ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 170,94 6,105000 2,184799 2,184799

16 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 2,041785

17 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 1,939000

18 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 1,938750

19 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 1,938833

20 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 1,838673

21 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 1,838700

22 N06DA02 DONEPEZILUM*** DONEPEZIL BLUEFISH 10 mg COMPR. FILM. 10mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 150,35 5,369642 2,184799 2,184799

23 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 1,820666

24 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 2,184799 2,184799

25 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 1,331428

26 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 1,511199 1,511199

27 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 47,72 1,590666 1,511199 1,511199

28 N06DA02 DONEPEZILUM*** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 47,72 1,590666 1,511199 1,511199

29 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 1,506000 1,506000

30 N06DA02 DONEPEZILUM*** PRIDIA 5 mg COMPR. FILM. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-RF 28 44,73 1,597500 1,511199 1,511199

31 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 1,511199 1,511199

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

Pagina 27 din 41

Page 80: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

32 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 1,511199 1,511199

33 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 1,511199 1,511199

34 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 41,75 1,491071 1,491071 1,491071

35 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 1,511199 1,511199

36 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 42,30 1,510714 1,510714 1,510714

37 N06DA02 DONEPEZILUM*** DONEPEZIL TEVA 5 mg COMPR. FILM. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF 30 175,19 5,839666 1,511199 1,511199

38 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 1,474642

39 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 1,425200

40 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 1,400535

41 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 1,400333

42 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 1,352040

43 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 1,352100

44 N06DA02 DONEPEZILUM*** DONEPEZIL ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 143,02 5,107857 1,511199 1,511199

45 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 1,259333

46 N06DA02 DONEPEZILUM*** DONEPEZIL BLUEFISH 5 mg COMPR. FILM. 5mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 52,03 1,858214 1,511199 1,511199

47 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 1,511199 1,511199

48 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 1,863928

49 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 2,184799 2,184799

50 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 28 143,78 5,135000 2,184799 2,184799

51 N06DA02 DONEPEZILUM*** COGNEZIL 10 mg COMPR. ORODISPERSABILE 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. ORODISPERSABILE P-RF 28 61,17 2,184642 2,184642 2,184642

52 N06DA02 DONEPEZILUM*** DONECTIL 10 mg COMPR. ORODISPERSABILE 10mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 128,38 4,279333 2,184799 2,184799

53 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 2,184799 2,184799

54 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 2,184799 2,184799

55 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 2,184799 2,184799

56 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 1,331428

57 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 1,511199 1,511199

58 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 28 130,00 4,642857 1,511199 1,511199

59 N06DA02 DONEPEZILUM*** COGNEZIL 5 mg COMPR. ORODISPERSABILE 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. ORODISPERSABILE P-RF 28 41,99 1,499642 1,499642 1,499642

60 N06DA02 DONEPEZILUM*** DONECTIL 5 mg COMPR. ORODISPERSABILE 5mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE P-RF 30 116,07 3,869000 1,511199 1,511199

61 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 1,511199 1,511199

62 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 1,511199 1,511199

63 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 1,511199 1,511199

64 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TEVA 1,5mg CAPS. 1,5mg TEVA PHARMA BV OLANDA CUTIE CU BLIST.PVC/ACLAR X 56 CAPS. P-RF/R 56 194,50 3,473214 1,368856 1,368856

65 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 1,368856 1,368856

66 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 1,263214

67 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 1,141250

68 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA ACTAVIS 1,5 mg CAPS. 1,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN PVC/AL X 56 CAPS. PR 56 63,88 1,140714 1,140714 1,140714

69 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 1,292678

70 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 1,353214

71 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TEVA 3mg CAPS. 3mg TEVA PHARMA BV OLANDA CUTIE CU BLIST.PVC/ACLAR X 56 CAPS. P-RF/R 56 215,96 3,856428 2,787000 2,787000

72 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 2,786071

73 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 2,687142

74 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 2,392500

75 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 2,327142

76 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA ACTAVIS 3 mg CAPS. 3mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN PVC/AL X 56 CAPS. PR 56 130,06 2,322500 2,322500 2,322500

77 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 2,553928

78 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TEVA 4,5mg CAPS. 4,5mg TEVA PHARMA BV OLANDA CUTIE CU BLIST.PVC/ACLAR X 56 CAPS. P-RF/R 56 323,93 5,784464 2,587500 2,587500

79 N06DA03 RIVASTIGMINUM*** EVERTAS 4,5 mg CAPS. 4,5mg ZENTIVA K.S. CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF/R 30 96,65 3,221666 2,587500 2,587500

80 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 2,156250

81 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA ACTAVIS 4,5 mg CAPS. 4,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN PVC/AL X 56 CAPS. PR 56 150,15 2,681250 2,587500 2,587500

82 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TEVA 6mg CAPS. 6mg TEVA PHARMA BV OLANDA CUTIE CU BLIST.PVC/ACLAR X 56 CAPS. P-RF/R 56 407,51 7,276964 3,299142 3,299142

Pagina 28 din 41

Page 81: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

83 N06DA03 RIVASTIGMINUM*** EVERTAS 6 mg CAPS. 6mg ZENTIVA K.S. CEHIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF/R 30 109,54 3,651333 3,299142 3,299142

84 N06DA03 RIVASTIGMINUM*** RIDAXIN 6 mg CAPS. 6mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 153,96 2,749285 2,749285 2,749285

85 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA ACTAVIS 6 mg CAPS. 6mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. DIN PVC/AL X 56 CAPS. PR 56 169,85 3,033035 3,033035 3,033035

86 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 1,353214

87 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 2,786071

88 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 2,587500

89 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 3,299142

90 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 19,635333

91 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 10,262799

92 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TORRENT 4,6 mg/24 ore PLASTURE TRANSDERMIC 4,6mg/24ore TORRENT PHARMA SRL ROMANIA CUTIE CU 30 PLICURI MULTILAMINATE, REZISTENTE LA ACTIUNEA COPIILOR, DIN HARTIE/PET/AL/PAN X 1 PLASTU PRF 30 256,57 8,552333 8,552333 8,552333

93 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 8,552333

94 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 10,262799

95 N06DA03 RIVASTIGMINUM*** RIVASTIGMINA TORRENT 9,5 mg/24 ore PLASTURE TRANSDERMIC 9,5mg/24ore TORRENT PHARMA SRL ROMANIA CUTIE CU 30 PLICURI MULTILAMINATE, REZISTENTE LA ACTIUNEA COPIILOR, DIN HARTIE/PET/AL/PAN X 1 PLASTU PRF 30 256,57 8,552333 8,552333 8,552333

96 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 420,260000

97 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 3,398799 3,398799

98 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 84,97 2,832333 2,832333 2,832333

99 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 4,531599 4,531599

100 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 30 113,29 3,776333 3,776333 3,776333

101 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 2,385600 2,385600

102 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 59,64 1,988000 1,988000 1,988000

103 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 254,220000

104 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 56 238,60 4,260714 4,247570 4,247570

105 N06DX01 MEMANTINUM*** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R 56 417,38 7,453214 4,247570 4,247570

106 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 56 277,49 4,955178 4,247570 4,247570

107 N06DX01 MEMANTINUM*** MARUXA COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE CU BLISTER DIN PVC/PVDC-AL X 56 COMPRIMATE FILMATE PR 56 198,22 3,539642 3,539642 3,539642

108 N06DX01 MEMANTINUM*** NEMDATINE 10mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 116,12 4,147142 4,147142 4,147142

109 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 56 232,16 4,145714 4,145714 4,145714

110 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 56 519,49 9,276607 9,276607 9,276607

111 N06DX01 MEMANTINUM*** NEMDATINE 20mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 265,89 9,496071 9,496071 9,496071

112 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 56 277,51 4,955535 4,247570 4,247570

113 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 352,220000 352,220000

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

1 H02AB04 METHYLPREDNISOLONUM5) 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 0,652400

2 H02AB04 METHYLPREDNISOLONUM5) 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

3 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 0,522600

4 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 15,890000

5 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 0,702100

6 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

7 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.

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

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

Pagina 29 din 41

Page 82: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

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 0,564800

2 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 0,564000

3 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 6,906000

4 H02AB04 METHYLPREDNISOLONUM5) 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 0,652400

5 H02AB04 METHYLPREDNISOLONUM5) 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

6 L01BA01 METHOTREXATUM4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,881000

7 L01BA01 METHOTREXATUM4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,720666

8 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 400,810000

9 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 89,660000

11 L01BA01 METHOTREXATUM EMTHEXATE PF SOL. INJ. 25mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FIOLA X 2ML PR 1 67,79 67,790000 67,790000 67,790000

12 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 2,382000

13 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 78,670000

14 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 59,640000

15 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 122,500000

16 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 110,090000

17 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 124,210000

18 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

19 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 71,568000

20 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 109,540000

21 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 30 182,03 6,067666 2,197200 2,197200

22 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 2,197200

23 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 1,831000

24 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 1,831000

25 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 2,197200

26 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 1,831000

27 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 30 190,22 6,340666 4,173199 4,173199

28 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 4,173199

29 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 3,477666

30 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 3,477666

31 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDA MEDAC 20 mg COMPR. FILM. 20mg MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE CU 1 FLACON DIN PEID X 30 COMPR.FILM PR 30 190,22 6,340666 4,173199 4,173199

32 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 3,477666

33 L04AD01 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,152000

34 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 6,152000

35 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 1,804080

36 L04AD01 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,503400

37 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 1,503400

38 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 3,541920

39 L04AD01 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,951600

40 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 2,951600

41 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 0,702100

42 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

43 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 2,385000

44 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 0,471600

45 M01AB05 DICLOFENACUM TRATUL 50 CAPS. MOI GASTROREZ. 50mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI GASTROREZ. P-6L 30 6,39 0,213000 0,136200 0,136200

46 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 8,21 0,410500 0,410500 0,410500

47 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 0,393000

48 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 0,492600 0,492600

49 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 0,427500

50 M01AB05 DICLOFENACUM RHEUMAVEK COMPR. FILM. GASTROREZ. 25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. PVC-AL/PVDC X 10 COMPR. FILM. GASTROREZ. P-6L 30 5,72 0,190666 0,190666 0,190666

Pagina 30 din 41

Page 83: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

51 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 0,136200

52 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 0,136200

53 M01AB05 DICLOFENACUM CLAFEN 50 mg COMPR. FILM. GASTROREZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. GASTROREZ. P-6L 20 3,04 0,152000 0,136200 0,136200

54 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2,27 0,113500 0,113500 0,113500

55 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 0,136200

56 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 0,190666

57 M01AB05 DICLOFENACUM N - DICLOFENAC DRAJ. GASTROREZ. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 DRAJ. GASTROREZ. P-6L 20 2,54 0,127000 0,127000 0,127000

58 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 0,132500

59 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 0,132666

60 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

61 M01AB05 DICLOFENACUM RHEUMAVEK SOL. INJ. 25mg/ml FARAN LABORATORIES S.A. GRECIA CUTIE X 5 FIOLE DE STICLA BRUNA PREVAZUTE CU INEL DE RUPERE X 3 ML P-RF 5 6,10 1,220000 0,972000 0,972000

62 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GMBH 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 0,972000

63 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 0,972000

64 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 5 6,10 1,220000 0,972000 0,972000

65 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH GERMANIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 10 12,22 1,222000 0,972000 0,972000

66 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 0,810000

67 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 0,656666

68 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 0,765600

69 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 0,695000

70 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 0,638000

71 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

72 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 0,564800

2 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 0,564000

3 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 6,906000

4 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 2,385000

5 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 0,471600

6 M01AB05 DICLOFENACUM TRATUL 50 CAPS. MOI GASTROREZ. 50mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI GASTROREZ. P-6L 30 6,39 0,213000 0,136200 0,136200

7 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 8,21 0,410500 0,410500 0,410500

8 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 0,393000

9 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 0,492600 0,492600

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 0,427500

11 M01AB05 DICLOFENACUM RHEUMAVEK COMPR. FILM. GASTROREZ. 25mg FARAN LABORATORIES S.A. GRECIA CUTIE X 3 BLIST. PVC-AL/PVDC X 10 COMPR. FILM. GASTROREZ. P-6L 30 5,72 0,190666 0,190666 0,190666

12 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 0,136200

13 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 0,136200

14 M01AB05 DICLOFENACUM CLAFEN 50 mg COMPR. FILM. GASTROREZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. GASTROREZ. P-6L 20 3,04 0,152000 0,136200 0,136200

15 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2,27 0,113500 0,113500 0,113500

16 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 0,136200

17 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 0,190666

18 M01AB05 DICLOFENACUM N - DICLOFENAC DRAJ. GASTROREZ. 50mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 20 DRAJ. GASTROREZ. P-6L 20 2,54 0,127000 0,127000 0,127000

19 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 0,132500

20 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 0,132666

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

Pagina 31 din 41

Page 84: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

21 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

22 M01AB05 DICLOFENACUM RHEUMAVEK SOL. INJ. 25mg/ml FARAN LABORATORIES S.A. GRECIA CUTIE X 5 FIOLE DE STICLA BRUNA PREVAZUTE CU INEL DE RUPERE X 3 ML P-RF 5 6,10 1,220000 0,972000 0,972000

23 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GMBH 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 0,972000

24 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 0,972000

25 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 5 6,10 1,220000 0,972000 0,972000

26 M01AB05 DICLOFENACUM DICLOFENAC AL I.M. SOL. INJ. 75mg/3ml ALIUD PHARMA GMBH GERMANIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 3ML SOL. INJ. P-RF 10 12,22 1,222000 0,972000 0,972000

27 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 0,810000

28 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 0,656666

29 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 0,765600

30 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 0,695000

31 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 0,638000

32 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

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 18,561000

2 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 15,467500

3 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 286,767000

4 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 571,172333

5 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 4,283333

6 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 4,021666

7 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 6,100666

8 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 3,406000

9 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 3.829,620000

11 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 2.400,540000

12 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 5.288,920000

13 H01CB02 OCTREOTIDUM**** SANDOSTATIN (R) SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 152,62 30,524000 30,524000 30,524000

14 H01CB03 LANREOTIDUM**** SOMATULINE (R) PR 30 mg LIOF. PT. SOL. INJ. + SOLV. 30mg BEAUFOUR 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 1.572,800000

15 H01CB03 LANREOTIDUM**** SOMATULINE® PR 30 mg LIOF. PT. SOL. INJ. + SOLV. 30mg IPSEN PHARMA FRANTA/GERMANIA 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 1.572,800000

16 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 5.089,120000

17 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 0,955600

18 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 31,873333

19 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 11,903333

20 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 0,104799

21 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

22 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 0,104799

23 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

24 H02AB09 HYDROCORTISONUM HYDROCORTISONE ROUSSEL COMPR. 10mg CN UNIFARM ROMANIA CUTIE X 1 FLAC. 25 COMPR. PRF 25 12,20 0,488000 0,488000 0,488000

25 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 3,910000

26 H02AB09 HYDROCORTISONUM HYDROCORTISONE 500 mg LIOF. PT. SOL. INJ. + SOLV. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA X 4 ML SOLV. P-RF 1 11,91 11,910000 11,910000 11,910000

27 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 20 ML, INCCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, C PR/PRF 1 11,91 11,910000 11,910000 11,910000

28 H02AB09 HYDROCORTISONUM HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA X 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CON PR/PRF 1 7,09 7,090000 4,692000 4,692000

29 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 4,266000

30 H03AA01 LEVOTHYROXINUM L-THYROXIN 100 BERLIN - CHEMIE COMPR. 100mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 12,48 0,124800 0,091200 0,091200

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

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 32 din 41

Page 85: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

31 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 0,091200

32 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 0,076000

33 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 0,091200

34 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 0,094900

35 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 0,114000

36 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 0,133000

37 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 0,188400

38 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 0,157000

39 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 0,188400

40 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 0,074160

41 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 0,061800

42 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 0,074160

43 H03AA01 LEVOTHYROXINUM L-THYROXIN 50 COMPR. 50mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L/S 100 8,40 0,084000 0,064560 0,064560

44 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 0,064560

45 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 0,053800

46 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

47 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 0,080700

48 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 0,123300

49 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 0,123300

50 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 0,192300

51 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 0,192300

52 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 33 din 41

Page 86: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

1 M01CC01 PENICILLAMINUM**4) CUPRENIL COMPR. FILM. 250mg CN UNIFARM ROMANIA CUTIE X 1FLAC. X 100 COMPR. FILM. P-RF 100 124,30 1,243000 1,243000 1,243000

2 M01CC01 PENICILLAMINUM**4) CUPRENIL COMPR. FILM. 250mg CN UNIFARM ROMANIA CUTIE X 30 CPR.FILM. P-RF 30 44,78 1,492666 1,491600 1,491600

Tratamentul se initiaza de catre medicul in specialitatea endocrinologie sau neurologie

1 A11CC07 PARICALCITOLUM** ZEMPLAR 1mcg CAPS. MOI 1mcg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI P-RF 28 468,00 16,714285 16,714285 16,714285

2 A11CC07 PARICALCITOLUM** ZEMPLAR 2mcg CAPS. MOI 2mcg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. P-RF 28 931,18 33,256428 33,256428 33,256428

3 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 29,954000

4 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 288,090000

5 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 36,403333

6 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 70,971666

7 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 788,230000

8 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 100,621666

9 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 1.193,316000

10 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 994,430000

11 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

12 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 159,895000

13 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 391,100000

14 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 87,711666

15 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 1.174,530000

16 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

17 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 201,383333

18 B03XA01 EPOETINUM BETA** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 143,93 23,988333 23,988333 23,988333

19 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 793,252500

20 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 97,890000

21 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 1.177,087500

22 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

23 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 2.208,610000

24 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 252,367500

25 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 329,737500

26 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 3.633,810000

27 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 406,690000

28 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 484,292500

29 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 638,987500

30 C09CA04 IRBESARTANUM** IRBESARTAN AUROBINDO 150 mg COMPR. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 27,21 0,971785 0,775713 0,775713

31 C09CA04 IRBESARTANUM** IRBESARTAN AUROBINDO 300 mg COMPR. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L 28 35,53 1,268928 1,243285 1,243285

32 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 0,646428

33 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 33,14 1,183571 0,775713 0,775713

34 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 0,647142

35 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 0,775713 0,775713

36 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 0,775713 0,775713

37 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 0,769333

38 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 0,775713 0,775713

39 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 0,769285

40 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 0,769285

19. BOALA WILSON - G23

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

Pagina 34 din 41

Page 87: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

41 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 44,88 1,602857 0,775713 0,775713

42 C09CA04 IRBESARTANUM** IRBESARTAN ZENTIVA 150mg COMPR. FILM. 150mg SANOFI-AVENTIS GROUPE FRANTA/GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 18,12 0,647142 0,647142 0,647142

43 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 1,036071

44 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 1,051071

45 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 1,243285 1,243285

46 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 1,047142

47 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 1,243285 1,243285

48 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 1,243285 1,243285

49 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 1,243285 1,243285

50 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 1,036071

51 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 60,29 2,153214 1,243285 1,243285

52 C09CA04 IRBESARTANUM** IRBESARTAN ZENTIVA 300mg COMPR. FILM. 300mg SANOFI-AVENTIS GROUPE FRANTA/GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 29,32 1,047142 1,047142 1,047142

53 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 0,577857

54 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 40,39 1,442500 0,693428 0,693428

55 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 0,104799

56 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

57 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 0,104799

58 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

59 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES S.A. SPANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S 5 902,02 180,404000 180,404000 180,404000

60 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES S.A. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 474,83 94,966000 94,966000 94,966000

61 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 0,522600

62 L04AD01 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,152000

63 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 6,152000

64 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 1,804080

65 L04AD01 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,503400

66 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 1,503400

67 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 3,541920

68 L04AD01 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,951600

69 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 2,951600

70 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 0,702100

71 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

72 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

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 27,370000

2 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 32,844000

3 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 50,950000

4 S01ED01 TIMOLOLUM NYOLOL GEL GEL OFT. 1mg/g NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLACON DIN PEID X 5 G GEL OFTALMIC , PREVAZUT CU PICURATOR P-6L 1 15,39 15,390000 15,390000 15,390000

5 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 3,110000

6 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 4,980000

7 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 5,976000

8 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 3,130000

9 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 5,410000

10 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

11 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 6,384000

Tratamentul se initiaza de catre medicul in specialitatea nefrologie. Medicamentele specifice se prescriu numai pentru pacientii inclusi in Programul National de supleere a functiei renale la bolnavii cu insuficienta

renala cronica.

21. GLAUCOM - G 26

Pagina 35 din 41

Page 88: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

12 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 15,320000

13 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 13,590000

14 S01ED05 CARTEOLOLUM CARTEOL 2% PICATURI OFT.-SOL. 2% S.I.F.I. SPA ITALIA CUTIE X 30 FLACOANE UNIDOZA DIN PEJD X 0,3 ML P-6L/S 1 33,74 33,740000 33,740000 33,740000

15 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 15,950000

16 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 81,850000

17 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT PIC. OFT.-SOL. FARA CONCENTRATIE MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DE TIP OCUMETER PLUS X 5ML PIC. OFT., SOL. P-6L 1 69,75 69,750000 69,750000 69,750000

18 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 36,580000

19 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 43,896000

20 S01ED51 COMBINATII (LATANOPROSTUM+TIMOLOLUM) XALCOM (R) SOL. OFT. FARA CONCENTRATIE PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 2,5 ML P-6L 1 82,84 82,840000 43,896000 43,896000

21 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 88,490000

22 S01EE01 LATANOPROSTUM XALAPROST 50 micrograme/ml PIC. OFT., SOL 50micrograme/ml ICN POLFA RZESZOW S.A. POLONIA CUTIE CU 1 FLAC. PEJD CU PICURATOR PEJD X 2,5 ML PIC. OFT., SOL. P-6L 1 50,73 50,730000 32,448000 32,448000

23 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 27,040000

24 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 27,770000

25 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 32,448000 32,448000

26 S01EE01 LATANOPROSTUM MONOPOST 50 micrograme/ml PIC. OFT., SOL., IN RECIPIENT UNIDOZA 50micrograme/ml LABORATOIRES THEA FRANTA/GERMANIA CUTIE CU 30 (6X5) RECIPIENTE UNIDOZA DIN PEID AMBALATE CATE 5 IN 6 PLICURI LAMINATE DIN PE-AL-COPOLI P6L 30 63,52 2,117333 2,117333 2,117333

27 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, P6L 1 51,47 51,470000 32,448000 32,448000

28 S01EE01 LATANOPROSTUM XALATAN (R) PICATURI OFT.-SOL. 0,005% PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON PICURATOR PE X 2,5 ML P-6L 1 75,25 75,250000 32,448000 32,448000

29 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 32,448000 32,448000

30 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 76,070000

31 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 68,270000 68,270000

32 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 72,03 72,030000 72,030000 72,030000

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 0,183800

2 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 0,832000

3 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 0,816800

4 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 0,736400

5 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 1,387000

6 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 1,327200

7 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 1,246200

8 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 1,236600

9 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 1,186000

11 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 1,423200

12 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 0,652400

13 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 1,482500

14 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 8,810000

15 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 31,020000

16 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 20,480000

17 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 0,104799

18 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

19 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 0,104799

20 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

21 J04BA02 DAPSONUM4) DISULONE COMPR. 100mg CN UNIFARM ROMANIA CUTIE X 100 COMPR. P-RF 100 32,97 0,329700 0,329700 0,329700

22 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 0,522600

23 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 15,890000

24 L01BA01 METHOTREXATUM4) METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 28,81 2,881000 2,881000 2,881000

22. PEMFIGUS - G 27

Pagina 36 din 41

Page 89: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

25 L01BA01 METHOTREXATUM4) METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 21,62 0,720666 0,720666 0,720666

26 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 400,810000

27 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

28 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

29 L01BA01 METHOTREXATUM EMTHEXATE PF SOL. INJ. 25mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FIOLA X 2ML PR 1 67,79 67,790000 67,790000 67,790000

30 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 2,382000

31 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 78,670000

32 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 59,640000

33 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 122,500000

34 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 110,090000

35 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 124,210000

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 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 78,67 78,670000 78,670000 78,670000

37 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 71,568000

38 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 109,540000

39 L04AD01 CICLOSPORINUM* EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 307,60 6,152000 6,152000 6,152000

40 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 6,152000

41 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 1,804080

42 L04AD01 CICLOSPORINUM* EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 75,17 1,503400 1,503400 1,503400

43 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 1,503400

44 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 3,541920

45 L04AD01 CICLOSPORINUM* EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 147,58 2,951600 2,951600 2,951600

46 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 2,951600

47 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 0,702100

48 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 3.492,210000

2 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 0,401000

2 J01AA02 DOXYCYCLINUM DOXICICLINA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,00 0,350000 0,350000 0,350000

3 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 0,361000

4 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 0,420000

5 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 0,149500

6 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 0,179400

7 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 4,017400

8 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 4,680000

9 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 4,017400

11 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 2,744800

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.

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

Pagina 37 din 41

Page 90: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

12 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 3,140000

13 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 0,289166

14 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 6,10 0,508333 0,508333 0,508333

15 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 0,218333

16 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400 SIROP 400000ui/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLACON X 60ML P-RF 1 9,51 9,510000 9,510000 9,510000

17 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 5,390000

18 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 4,519600

19 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 2,156000

20 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 3,477000

21 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 0,354500

22 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 0,425400

23 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 0,422000

24 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 11,460000

25 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 4,250000

26 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 5,100000

27 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 4,226666

28 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 5,100000

29 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 4,253333

30 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 4,253333

31 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 8,503999

32 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 8,503999

33 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 8,503999

34 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 8,503999

35 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 8,503999

36 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 8,503999

37 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 7,376666

38 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 7,086666

39 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 14,870000

40 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 14,870000

41 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 32,350000

42 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 16,360000

43 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 22,450000

44 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 34,360000

45 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 17,844000

46 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 48,580000

47 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 60,360000

48 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 3,731000

49 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 3,280500

50 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 0,571200

51 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 0,571200

52 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 0,571200

53 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 0,571200

54 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 0,571200

55 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 7,87 0,787000 0,571200 0,571200

56 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 0,571200

57 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 0,571200

58 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 0,571200

59 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 0,476000

60 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 0,778800

61 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 0,778800

62 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 0,778800

Pagina 38 din 41

Page 91: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT CNAS/

UT (RON) PT.

ADULTI

63 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 0,778800

64 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 15,12 1,512000 0,778800 0,778800

65 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 0,778800

66 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 0,778800

67 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 0,778800

68 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 0,778800

69 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 0,649000

70 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 3,850000

71 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 3,731000

72 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 84,70 12,100000 12,100000 12,100000

73 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 12,100000

74 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 27,63 9,210000 0,778800 0,778800

75 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 0,778800

76 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

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 3,277440

78 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 3,277440

79 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 3,277440

80 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 9,580000

81 J01MA02 CIPROFLOXACINUM UFEXIL 2 mg/ ml SOL. PERF. 2mg/ml DEMO SA GRECIA CUTIE X 10 PUNGI PP X 100 ML SOL. PERF. S 10 162,58 16,258000 10,498800 10,498800

82 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 8,749000

83 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 15,733000

84 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 6.662,76 2.220,920000 2.220,920000 2.220,920000

2 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN PEN PRE-UMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 PEN PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.784,50 2.392,250000 2.392,250000 2.392,250000

3 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.749,13 2.374,565000 2.374,565000 2.374,565000

IMUNOSUPRESOARE SELECTIVE - G31

25. 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)

Pagina 39 din 41

Page 92: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT 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 1.229,820000

2 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 6.043,000000

3 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 INOX PR 4 826,13 206,532500 206,532500 206,532500

4 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4.565,66 1.141,415000 1.141,415000 1.141,415000

5 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2.275,20 568,800000 568,800000 568,800000

6 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2.270,01 567,502500 567,502500 567,502500

7 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

8 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

9 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 6.662,76 2.220,920000 2.220,920000 2.220,920000

10 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN PEN PRE-UMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 PEN PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.784,50 2.392,250000 2.392,250000 2.392,250000

11 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.749,13 2.374,565000 2.374,565000 2.374,565000

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 INOX PR 4 826,13 206,532500 206,532500 206,532500

2 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4.565,66 1.141,415000 1.141,415000 1.141,415000

3 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2.275,20 568,800000 568,800000 568,800000

4 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2.270,01 567,502500 567,502500 567,502500

5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

6 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

7 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 6.662,76 2.220,920000 2.220,920000 2.220,920000

8 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN PEN PRE-UMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 PEN PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.784,50 2.392,250000 2.392,250000 2.392,250000

9 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.749,13 2.374,565000 2.374,565000 2.374,565000

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 INOX PR 4 826,13 206,532500 206,532500 206,532500

2 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4.565,66 1.141,415000 1.141,415000 1.141,415000

3 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2.275,20 568,800000 568,800000 568,800000

4 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2.270,01 567,502500 567,502500 567,502500

5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

6 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

7 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 6.662,76 2.220,920000 2.220,920000 2.220,920000

8 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN PEN PRE-UMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 PEN PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.784,50 2.392,250000 2.392,250000 2.392,250000

9 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.749,13 2.374,565000 2.374,565000 2.374,565000

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

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 40 din 41

Page 93: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

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

TARA

DET. APP AMBALAJ Prescriptie

cant/a

mbala

j

PRET

AMANU

NTUL

MAXIMA

L

(RON)

PRET

AMANUNTUL

MAXIMAL/UT

(RON)

VAL.SUPORT

ATAT CNAS/

UT(RON)-

LEGEA NR.

95/2006 ART

213 alin.(1) lit.

a) si f)

VAL.SUPORT

ATAT 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 INOX PR 4 826,13 206,532500 206,532500 206,532500

2 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4.565,66 1.141,415000 1.141,415000 1.141,415000

3 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2.275,20 568,800000 568,800000 568,800000

4 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2.270,01 567,502500 567,502500 567,502500

5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

6 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

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 INOX PR 4 826,13 206,532500 206,532500 206,532500

2 L04AB01 ETANERCEPTUM**** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4.565,66 1.141,415000 1.141,415000 1.141,415000

3 L04AB01 ETANERCEPTUM**** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2.275,20 568,800000 568,800000 568,800000

4 L04AB01 ETANERCEPTUM**** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2.270,01 567,502500 567,502500 567,502500

5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

6 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.469,17 1.117,292500 1.117,292500 1.117,292500

7 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 6.662,76 2.220,920000 2.220,920000 2.220,920000

8 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN PEN PRE-UMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 PEN PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.784,50 2.392,250000 2.392,250000 2.392,250000

9 L04AB04 ADALIMUMABUM**** HUMIRA 40 mg SOL. INJ. IN SERINGA PREUMPLUTA 40mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL P-RF/R 2 4.749,13 2.374,565000 2.374,565000 2.374,565000

NOTA:

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)

30. PSORIAZIS CRONIC SEVER - G 31f

Tratamentul se prescrie si monitorizeaza de catre medicul in specialitatea dermatologie (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 (P-RF).

- 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 41 din 41

Page 94: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

ANEXA 4

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara 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 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 0,980000

2 A03BA01 ATROPINUM SULFAT DE ATROPINA NYCOMED 1 mg/ml SOL. INJ. 1mg/ml NYCOMED GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ. S 5 2,99 0,598000 0,598000 0,598000

3 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 0,672000

4 A03DA02 COMBINATII PIAFEN COMPR. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6,49 0,324500 0,324500 0,324500

5 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 0,361500

6 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 2,446000

7 A05BAN3 COMBINATII ASPATOFORT (R) SOL. INJ. FARA CONCENTRATIE TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 10 ML P-RF 10 28,51 2,851000 2,851000 2,851000

8 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 7,655000

9 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 0,407142

11 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 0,084000

12 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 0,070000

13 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 2,960000

14 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. MOI P-RF 100 76,98 0,769800 0,769800 0,769800

15 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 0,275666

16 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 0,223333

17 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 5,050000

18 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 6,360000

19 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 1000 COMPR. FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 8,01 0,267000 0,267000 0,267000

20 A11CC20 COMBINATII FLUOR VIGANTOLETTEN 500 COMPR. FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 1 BLIST. AL/PVC X 30 COMPR. P-6L 30 6,44 0,214666 0,214666 0,214666

21 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 1,396000

22 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 0,574400

23 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 20 DRAJ. P-6L 100 52,14 0,521400 0,521400 0,521400

24 A11DBN1 COMBINATII MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 20 20,28 1,014000 1,012080 1,012080

25 A11DBN1 COMBINATII MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 100 84,34 0,843400 0,843400 0,843400

26 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 0,937600

27 A11DBN1 COMBINATII MILGAMMA (R) 100 DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 DRAJ. P-6L 30 49,86 1,662000 1,662000 1,662000

28 A11DBN1 COMBINATII MILGAMMA (R) 100 DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 DRAJ. P-6L 100 139,08 1,390800 1,390800 1,390800

29 A11DBN1 COMBINATII MILGAMMA (R) 100 DRAJ. FARA CONCENTRATIE 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 1,499166

30 A11DBN1 COMBINATII MILGAMMA (R) N SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 25 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 25 83,55 3,342000 3,342000 3,342000

31 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 3,704000

32 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 3,704000

33 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 0,533640

34 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 0,444700

35 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 2,530000

36 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 1,972000

37 A11GA01 ACIDUM ASCORBICUM VITAMINA C SALF 500mg/5ml SOL. INJ. 500mg/ml SALF / S.C. IMECO S.A. ITALIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 5 ML PRF 5 9,86 1,972000 1,972000 1,972000

38 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 2,366400

39 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 0,455500

40 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 0,455500

41 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 2,068000

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 OCTOMBRIE 2013

Pagina 1 din 6

Page 95: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara 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 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

43 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 0,389583

44 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 0,843500

45 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 1,012200

46 A14AA03 METANDIENONUM NAPOSIM 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,10 0,255000 0,255000 0,255000

47 A16AA01 LEVOCARNITINUM MIOCOR SOL. ORALA 10% ECOBI PHARMACEUTICI ITALIA CUTIE X 10 FLACOANE X 10ML P-6L 10 18,32 1,832000 1,832000 1,832000

48 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 2,198400 2,198400

49 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 2,901600

50 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 21,744000

51 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 1,346000

52 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 1,346000

53 B02BX02 CARBAZOCHROMI SALICYLAS ADRENOSTAZIN SOL. INJ. 0,3mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 5 ML P-RF 5 11,56 2,312000 2,312000 2,312000

54 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 0,386000

55 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 1 21,00 21,000000 21,000000 21,000000

56 B03ABN1 FERROCHOLINATUM FER-SOL SOL. ORALA IN PICATURI 24mg Fe/ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 15 ML + DISPOZITIV PT. PICURARE P-6L 1 3,34 3,340000 3,340000 3,340000

57 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 0,275700

58 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 0,330840

59 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 0,500666

60 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 0,595666

61 B03AE01 COMBINATII FERRO - FOLGAMMA (R) CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 CAPS. MOI P-RF 100 43,20 0,432000 0,432000 0,432000

62 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 0,486000

63 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 0,886500

64 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 1,396000

65 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 DRAJ. P-6L 100 84,34 0,843400 0,843400 0,843400

66 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 DRAJ. P-6L 20 20,28 1,014000 1,012080 1,012080

67 B03BA51 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 0,937600

68 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 DRAJ. P-6L 100 84,34 0,843400 0,843400 0,843400

69 B03BA51 COMBINATII MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 DRAJ. P-6L 20 20,28 1,014000 1,012080 1,012080

70 B03BA51 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 0,937600

71 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 320,638000

72 C04AE01 CODERGOCRINUM REDERGIN 1 mg/ml PICATURI ORALE-SOL. 0,1% LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLACON X 50 ML P-6L 1 11,82 11,820000 11,820000 11,820000

73 C04AE01 CODERGOCRINUM SECATOXIN SOL. ORALA IN PICATURI 1mg/ml IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 1 FLACON X 10 ML + PICATOR P-6L 1 2,20 2,200000 2,200000 2,200000

74 C05AA01 COMBINATII HEMORZON SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE CU 2 FOLII TERMOFORMATE PVC X 3 SUPOZ. P-6L 6 6,55 1,091666 1,091666 1,091666

75 C05AA01 COMBINATII HEMORZON UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-6L 1 11,56 11,560000 11,560000 11,560000

76 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 1,293000

77 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 30,910000

78 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 14,580000

79 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 22,310000

80 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 0,715333

81 C05CA54 TROXERUTINUM (COMBINATII) GINKOR FORT CAPS. FARA CONCENTRATIE IPSEN PHARMA FRANTA/GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 25,73 0,857666 0,857666 0,857666

82 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 0,236666

83 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 0,700000

84 C08CA06 NIMODIPINUM NIMOTOP (R) SOL. PERF. 10mg/50ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 CUTII X 1 FLACON DIN STICLA DE CULOARE BRUNA X 50 ML + 1 PERFUZOR DIN POLIETILENA S 5 303,73 60,746000 60,746000 60,746000

85 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 11,620000

86 D01AC08 KETOCONAZOLUM NIZORAL CREMA 2% JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 TUB X 15 G P-RF 1 9,12 9,120000 6,456000 6,456000

87 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 5,380000

88 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 7,940000

89 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 10,170000

90 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 7,400000

91 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 12,300000

Pagina 2 din 6

Page 96: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara 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

92 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 12,790000

93 D07CB01 COMBINATII NIDOFLOR CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 8,47 8,470000 8,470000 8,470000

94 D07CB01 COMBINATII PANDERM UNGUENT FARA CONCENTRATIE GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 7,66 7,660000 7,660000 7,660000

95 D07CC02 COMBINATII FLUOCINOLON N UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 18 G P-RF 1 8,20 8,200000 8,200000 8,200000

96 D07XB02 COMBINATII TRIAMCINOLON S CREMA FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 15 G P-RF 1 8,20 8,200000 8,200000 8,200000

97 D07XC01 COMBINATII DIPROSALIC SOL. CUT. FARA CONCENTRATIE SCHERING-PLOUGH EUROPE BELGIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR P-RF 1 16,15 16,150000 16,150000 16,150000

98 D07XC01 COMBINATII DIPROSALIC UNGUENT FARA CONCENTRATIE SCHERING-PLOUGH EUROPE BELGIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 10,75 10,750000 10,750000 10,750000

99 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 7,000000

100 D07XC04 COMBINATII TRAVOCORT CREMA FARA CONCENTRATIE INTENDIS GMBH GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 25,21 25,210000 25,210000 25,210000

101 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 21,020000

102 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 8,090000

103 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 32,500000

104 G01AF01 METRONIDAZOLUM FLAGYL OVULE 500mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST. X 5 OVULE P-RF 10 8,57 0,857000 0,857000 0,857000

105 G01AX12 CICLOPIROXUM DAFNEGIN OVULE 100mg POLICHEM SA LUXEMBURG CUTIE X 1 FOLIE. TERMOSUDATA DIN PVC/PE X 6 OVULE + 6 APLICATOARE DIN PE P-6L 6 38,11 6,351666 6,351666 6,351666

106 G01AXN1 COMBINATII COLPOSEPTINE (R) COMPR. VAG. FARA CONCENTRATIE LAB. THERAMEX MONACO CUTIE X 3 BLIST. X 6 COMPR. VAG. P-RF 18 17,64 0,980000 0,980000 0,980000

107 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 21,91 2,191000 2,191000 2,191000

108 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 3,151000

109 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 15,040000

110 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 82,512000

111 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 56,930000

112 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 0,289400

113 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 22,273440

114 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 21,994000

115 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 19,269600

116 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 18,561200

117 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 75,780000

118 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 127,270000

119 J01EB05 SULFAFURAZOLUM SULFAFURAZOL COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 9,72 0,486000 0,486000 0,486000

120 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 0,713000

121 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 0,811200

122 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 0,811200

123 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 0,676000

124 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 21,179000

125 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 139,918571

126 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 36,868928

127 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 2.439,990000

128 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 1,089000

129 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 0,526333

130 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 0,499000

131 M01AB55 COMBINATII NEODOLPASSE SOL. PERF. FARA CONCENTRATIE FRESENIUS KABI AUSTRIA GMBH AUSTRIA CUTIE X 10 FLACOANE X 250 ML S 10 219,12 21,912000 21,912000 21,912000

132 M01AB55 COMBINATII ACECLOFEN SUPOZ. FARA CONCENTRATIE ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL/PE X 3 SUPOZ. P-6L 6 4,61 0,768333 0,768333 0,768333

133 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 1,428500

134 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 1,401000

135 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 0,605666

136 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 0,228000

137 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 0,273600

138 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 0,273600

139 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 0,273600

140 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 0,273600

141 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 0,273600

Pagina 3 din 6

Page 97: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara 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

142 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 0,273600

143 M01AE01 IBUPROFENUM PROFINAL COMPR. FILM. 600mg GULF PHARMACEUTICAL IND. (JUPHAR) ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 13,33 0,666500 0,439200 0,439200

144 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 0,366000

145 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

146 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 9,89 9,890000 9,890000 9,890000

147 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 PP SI SIGILIU DIN PEJD P6L 1 14,61 14,610000 11,868000 11,868000

148 M01AE02 NAPROXENUM REUXEN 250 mg COMPR. 250mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 9,28 0,464000 0,464000 0,464000

149 M01AE02 NAPROXENUM REUXEN 500 mg COMPR. 500mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 16,78 0,839000 0,839000 0,839000

150 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 1,031000

151 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 0,870000

152 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 1,550000

153 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 1,313000

154 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 0,416666

155 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 29,446000

156 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 29,033000

157 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 0,221000

158 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 0,206000

159 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 0,486000

160 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 0,491000

161 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 0,243333

162 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 143,420000

163 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) PARADOREN 500mg/30mg COMPR. 30mg+500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 12,74 0,637000 0,637000 0,637000

164 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) ULTRACOD COMPR. 500mg+30mg ZENTIVA K.S. CEHIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-RF 30 29,15 0,971666 0,764400 0,764400

165 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM) PARADOREN 500mg/60mg COMPR. 60mg+500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 19,83 0,991500 0,991500 0,991500

166 N02BB02 METAMIZOLUM NATRIUM ALGOZONE COMPR. 500mg OZONE LABORATORIES LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6,80 0,340000 0,340000 0,340000

167 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 0,361200

168 N02BB02 METAMIZOLUM NATRIUM ALINDOR COMPR. 500mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 6,89 0,344500 0,344500 0,344500

169 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 0,342000

170 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 0,301000

171 N02BB02 METAMIZOLUM NATRIUM NOVOCALMIN COMPR. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 6,80 0,340000 0,340000 0,340000

172 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 0,326000

173 N02BB02 METAMIZOLUM NATRIUM FABOCALM COMPR. 500mg FABIOL S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,27 0,313500 0,313500 0,313500

174 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 0,344500

175 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 0,343500

176 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 0,309000

177 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 0,340000

178 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 1,184000

179 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 1,261666

180 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 1,208333

181 N05BA23 TOFISOPAMUM GRANDAXIN COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-RF 20 5,36 0,268000 0,268000 0,268000

182 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 0,558000

183 N05CD08 MIDAZOLAMUM DORMICUM (R) 7,5 mg COMPR. FILM. 7,5mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 10 10,57 1,057000 0,669600 0,669600

184 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 2,914000 2,914000

185 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 1 mg/ml SOL. INJ. 1mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 5 ML SOL. INJ. S/P-RF 10 33,06 3,306000 3,306000 3,306000

186 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 1 mg/ml SOL. INJ. 1mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 2 ML SOL. INJ. S/P-RF 10 23,88 2,388000 2,388000 2,388000

187 N05CD08 MIDAZOLAMUM MIDAZOLAM TORREX 5 mg/ml SOL. INJ. 5mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 10 FIOLE X 3 ML SOL. INJ. S/P-RF 10 64,04 6,404000 6,404000 6,404000

188 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 0,768333

189 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 1,594666

190 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 3,193333

191 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 6,414000

Pagina 4 din 6

Page 98: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara 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

192 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 7,641000

193 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 9,894666

194 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

195 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 14,761428

196 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 13,862857

197 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 13,862857

198 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 13,862857

199 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 19,850000

200 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 0,600333

201 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 0,666800

202 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 1,213400

203 N06BX02 PYRITINOLUM ENCEPHABOL (R) SUSPENSIE SUSP. ORALA 80,5mg/5ml MERCK KGAA GERMANIA CUTIE X 1 FLACON X 200 ML P-6L 1 40,59 40,590000 40,590000 40,590000

204 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 40,590000

205 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 0,117199

206 N06BX03 PIRACETAMUM N - PIRACETAM COMPR. 400mg MEDUMAN SA ROMANIA CUTIE X 1 FLAC. PE X 40 COMPR. P-6L 40 4,04 0,101000 0,101000 0,101000

207 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 0,116000

208 N06BX03 PIRACETAMUM PIRACETAM LAROPHARM 400 mg COMPR. 400mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6,01 0,300500 0,117199 0,117199

209 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 0,097666

210 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 0,111000

211 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 0,117199

212 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 0,117199

213 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 0,117199

214 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 0,336000

215 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 0,403200

216 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 0,117199

217 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 0,105500

218 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 0,117199

219 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 0,117199

220 N06BX03 PIRACETAMUM PIRACETAM 800 mg COMPR. FILM. 800mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 6,76 0,338000 0,264600 0,264600

221 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 0,221000

222 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 0,264600

223 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 0,220500

224 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 1,794000

225 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 0,082500

226 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 0,090199

227 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 0,075166

228 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 1,445000

229 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 0,578333

230 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 1,156666

231 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 6,560000

232 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 10,480000

233 R01AD07 TIXOCORTOLUM PIVALONE 1% SUSP. NAZALA 1% 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 10,480000

234 R01ADN1 COMBINATII BIORINIL SPRAY NAZ.,SUSP. FARA CONCENTRATIE 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 25,870000

235 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 2,100000

236 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 1,322857

237 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 20,020000

238 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 0,312666

239 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 1,482000

240 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 1.576,280000

241 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 915,380000

Pagina 5 din 6

Page 99: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

Nr. crt

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP

tara 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

242 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 1,510000

243 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 13,130000

244 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

245 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 5,960000

246 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 7,152000

247 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 3,53 3,530000 3,530000 3,530000

248 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 2,800000

249 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 0,359000

250 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 0,162500

251 R06AX02 CYPROHEPTADINUM CIPROHEPTADINA 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 0,163333

252 R06AX02 CYPROHEPTADINUM BIOHEPT SIROP 2mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE P-6L 1 5,79 5,790000 5,790000 5,790000

253 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 14,400000

254 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 7,090000

255 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 12,000000

256 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 12,000000

257 R06AX27 COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE) AERINAZE (vezi R06AX27) 2,5mg/120mg COMPR. FILM. ELIB. MODIF. 2,5mg/120mg SP EUROPE BELGIA CUTIE X 10 COMPR.FILM.ELIB.MODIF. ( BLIST.PCTFE/PVC/AL) P-RF 10 21,00 2,100000 2,100000 2,100000

258 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 30,390000

259 S01AA13 ACIDUM FUSIDICUM FUCITHALMIC 10mg/g GEL OFT. 10mg/g LEO PHARMACEUTICAL PRODUCTS DANEMARCA CUTIE X 1 TUB AL CU CANULA APLICATOARE X 5 G GEL OFTALMIC P-6L 1 14,96 14,960000 14,960000 14,960000

260 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 6,390000

261 S01AA30 COMBINATII ANTIBIOPTAL PICATURI OFT.-SOL. FARA CONCENTRATIE THEA FARMA SPA ITALIA CUTIE X 1 FLACON PICURATOR X 10 ML P-RF 1 13,13 13,130000 13,130000 13,130000

262 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 33,280000

263 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 32,020000

264 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 10,120000

265 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 14,500000

266 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 efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS; 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 aceste subliste .

Pagina 6 din 6

Page 100: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

Nr.

crt

Grupa

terapeut

ica

Denumire generica Denumire comerciala

Forma

farmaceuti

ca

Concentr

atie / U.T.Firma Tara Ambalaj

Pre

sc

rip

tie

cant/

amba

laj

Pret cu

ridicata

maximal /

ambalaj

Pret cu ridicata

maximal / U.T.

Pret cu ridicata

maximal de

decontare / U.T.

Pret cu

amanuntul

maximal /

ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare

/ U.T.

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE

A) SUBPROGRAMUL DE TRATAMENT SI MONITORIZARE A PERSOANELOR CU INFECTIE HIV/SIDA si TRATAMENTUL POSTEXPUNERE

1 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 24,49 2,040833 2,040833 33,10 2,758333 2,758333

2 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 72,18 2,005000 2,005000 91,26 2,535000 2,535000

3 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 14,14 14,140000 14,140000 19,11 19,110000 19,110000

4 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5,05 5,050000 5,050000 6,83 6,830000 6,830000

5 D01AC02 MICONAZOLUM MEDACTER CREMA 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 30G P-RF 1 6,34 6,340000 6,340000 8,57 8,570000 8,570000

6 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 15,58 15,580000 4,416000 21,06 21,060000 5,976000

7 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 5,62 5,620000 4,176000 7,60 7,600000 5,640000

8 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 3,68 3,680000 3,680000 4,98 4,980000 4,980000

9 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 5,42 5,420000 4,176000 7,33 7,330000 5,640000

10 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 4,97 4,970000 4,176000 6,72 6,720000 5,640000

11 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 3,48 3,480000 3,480000 4,70 4,700000 4,700000

12 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 4,97 4,970000 4,176000 6,72 6,720000 5,640000

13 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 4,41 0,735000 0,735000 5,96 0,993333 0,993333

14 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 4,23 1,410000 1,410000 5,72 1,906666 1,906666

15 G01AF04 MICONAZOLUM MEDACTER CREMA VAG. 2% FARAN LABORATORIES S.A. GRECIA CUTIE X 1 TUB X 78 G P-RF 1 14,33 14,330000 14,330000 19,37 19,370000 19,370000

16 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,59 0,279500 0,279500 7,55 0,377500 0,355332

17 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 242,55 0,242550 0,242550 296,11 0,296110 0,296110

18 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,70 0,285000 0,285000 7,70 0,385000 0,355332

19 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,25 0,262500 0,262500 7,10 0,355000 0,355000

20 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 5,55 0,555000 0,468216 7,50 0,750000 0,571608

21 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5,21 0,521000 0,468216 7,04 0,704000 0,571608

22 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4,58 0,458000 0,458000 6,19 0,619000 0,571608

23 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8,26 0,413000 0,413000 11,17 0,558500 0,558500

24 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 50 BLIST. AL/PVC X 10 CAPS. P-RF/S 500 195,09 0,390180 0,390180 238,17 0,476340 0,476340

25 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 100 349,30 3,493000 3,493000 418,89 4,188900 4,188900

26 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 3,64 3,640000 3,640000 4,92 4,920000 4,920000

27 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 3,94 3,940000 3,940000 5,33 5,330000 5,330000

28 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 100 376,06 3,760600 3,760600 448,06 4,480600 4,480600

29 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS (R) 1,5 g PULB. PT. SOL. INJ. 1g+500mg ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. PULB. PT. SOL. INJ. X 1,5 G P-RF/S 50 633,77 12,675400 12,675400 728,96 14,579200 14,579200

30 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 50 633,77 12,675400 12,675400 728,96 14,579200 14,579200

31 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 34,28 1,224285 1,224285 44,84 1,601428 1,601428

32 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 29,92 2,137142 1,203428 39,13 2,795000 1,626000

33 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 24,47 0,873928 0,686570 33,07 1,181071 0,928285

34 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 8,01 0,572142 0,572142 10,83 0,773571 0,773571

35 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 11,33 0,809285 0,686570 15,32 1,094285 0,928285

36 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 20,76 1,482857 0,686570 28,06 2,004285 0,928285

37 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 14,04 1,002857 1,002857 18,97 1,355000 1,355000

38 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 19,50 1,392857 1,203428 26,35 1,882142 1,626000

39 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 18,55 1,325000 1,203428 25,07 1,790714 1,626000

40 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 12,23 0,873571 0,686570 16,53 1,180714 0,928285

41 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 1,2 g PULB. PT. SOL. INJ./PERF. 1.2g ANTIBIOTICE SA ROMANIA CUTIE X 50 FLACOANE CU PULB. PT. SOL. INJ. / PERF. P-RF/S 50 246,03 4,920600 4,920600 300,35 6,007000 6,007000

42 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 1000 mg/200 mg PULB. PT. SOL. INJ./PERF. 1000mg/200mg ANTIBIOTICE SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA CARE CONTINE PULB. PT. SOL. INJ. / PERF. PRF 50 246,03 4,920600 4,920600 300,35 6,007000 6,007000

43 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 11,02 11,020000 10,380000 14,90 14,900000 14,028000

44 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 156,25mg/5ml PULB. PT. SUSP. ORALA 156,25mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 MG PULB. PT. 100 ML SUSP. ORALA P-RF 1 8,65 8,650000 8,650000 11,69 11,690000 11,690000

45 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 16,36 16,360000 16,360000 22,11 22,110000 22,110000

46 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 4,78 4,780000 4,780000 6,46 6,460000 6,460000

47 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 9,57 9,570000 9,570000 12,93 12,930000 12,930000

48 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 7,36 7,360000 5,736000 9,95 9,950000 7,752000

49 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 + PRF 1 4,79 4,790000 4,790000 6,47 6,470000 6,470000

50 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 7,36 7,360000 5,736000 9,95 9,950000 7,752000

51 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 14,72 14,720000 11,484000 19,89 19,890000 15,516000

52 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 26,22 26,220000 26,220000 34,30 34,300000 34,300000

53 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 250 mg/ 62,5 mg/5 ml PULB. PT.SUSP. ORALA 250 mg/ 62,5 mg/5 ml RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID CU PULB. PT. SUSP. ORALA MARCAT PT. 100ML+ MASURA DOZATOARE P-RF 1 16,80 16,800000 16,800000 22,71 22,710000 22,710000

54 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 17,77 17,770000 17,770000 24,02 24,020000 24,020000

55 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

SECŢIUNEA C2 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% din pret de decontare - conform denumirilor comune internaţionale corespunzătoare

medicamentelor de care beneficiaza asiguratii inclusi in programele nationale de sănătate cu scop curativ in tratamentul ambulatoriu si spitalicesc

DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOARE SI ORDINUL MS NR. 1275/2011 CU MODIFICARILE SI COMPLETARILE ULTERIOARE

VALABILĂ ÎNCEPÂND CU 01 OCTOMBRIE 2013

Pagina 1 din 42

Page 101: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

56 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

57 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

58 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 2g/0,25g PULB. PT. SOL. INJ./PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

59 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

60 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

61 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

62 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 4g/0,5g PULB. PT. SOL. INJ./PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

63 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

64 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

65 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAN ACTAVIS 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

66 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

67 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

68 J01DD04 CEFTRIAXONUM OFRAMAX 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ./PERF. S 50 456,00 9,120000 4,826400 535,19 10,703800 6,313200

69 J01DD04 CEFTRIAXONUM CEFTRIAXONA-MIP 1 g PULB. PT. SOL. INJ./PERF. 1g MIP PHARMA GMBH GERMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 50 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 10 40,22 4,022000 4,022000 52,61 5,261000 5,261000

70 J01DD04 CEFTRIAXONUM SEFTRION 1 g PULB. PT. SOL. INJ./PERF. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERFZ. S/P-RF 1 10,31 10,310000 4,826400 13,94 13,940000 6,313200

71 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 133,84 13,384000 4,826400 163,39 16,339000 6,313200

72 J01DD04 CEFTRIAXONUM OFRAMAX 250 mg PULB. PT. SOL. INJ./PERF. 250mg TERAPIA SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF. S 50 246,03 4,920600 4,920600 300,35 6,007000 6,007000

73 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT. SOL.INJ./PERF. S/P-RF 10 54,63 5,463000 5,463000 69,07 6,907000 6,907000

74 J01DD04 CEFTRIAXONUM CEFTRIAXONA-MIP 2 g PULB. PT. SOL. INJ./PERF. 2g MIP PHARMA GMBH GERMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 50 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 10 74,07 7,407000 7,407000 93,65 9,365000 9,365000

75 J01DD04 CEFTRIAXONUM CEFORT 2 g PULB. PT. SOL. INJ./PERF. 2g ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 228,45 22,845000 8,888400 278,89 27,889000 11,238000

76 J01DD04 CEFTRIAXONUM MEDAXONE 2 g PULB. PT. SOL. INJ./PERF. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLACOANE X 2 G PULB. PT. SOL. INJ./PERF. S/P-RF 10 210,87 21,087000 8,888400 257,43 25,743000 11,238000

77 J01DD04 CEFTRIAXONUM SEFTRION 500 mg PULB. PT. SOL. INJ./PERF. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERFZ. S/P-RF 1 7,74 7,740000 7,740000 10,46 10,460000 10,460000

78 J01DD04 CEFTRIAXONUM ROCEPHIN (R) PULB. PT. SOL. PERF. 2g ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPCITATEA DE 50ML CONTINAND PULB. PT. SOL. PERFUZ. S/P-RF 1 44,01 44,010000 8,888400 57,56 57,560000 11,238000

79 J01DD04 CEFTRIAXONUM SEFTRION 2 g PULB. PT. SOL. PERF. 2g EIPICO MED SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. P-RF 1 12,94 12,940000 8,888400 17,49 17,490000 11,238000

80 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 15,95 1,595000 1,595000 21,56 2,156000 2,156000

81 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 26,58 2,658000 2,658000 34,77 3,477000 3,477000

82 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 154,50 15,450000 8,448000 188,61 18,861000 11,412000

83 J01DD12 CEFOPERAZONUM LYZONE 2 g PULB. PT. SOL. INJ. 2g MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. S/P-RF 1 20,07 20,070000 13,932000 27,12 27,120000 18,828000

84 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 187,44 18,744000 13,932000 228,83 22,883000 18,828000

85 J01DD12 CEFOPERAZONUM CEFOZON 500 mg PULB. PT. SOL. INJ. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. S/P-RF 1 3,88 3,880000 3,880000 5,24 5,240000 5,240000

86 J01DD12 CEFOPERAZONUM CEFOZON 2 g PULB. PT. SOL. INJ./PERF. I.M./I.V. 2g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA A 20 ML CU PULB. PT. SOL. INJ./PERF. I.M./I.V. S/P-RF 1 11,61 11,610000 11,610000 15,69 15,690000 15,690000

87 J01DD12 CEFOPERAZONUM CEFOZON 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ. I.M./PERF. I.V. S/P-RF 1 7,04 7,040000 7,040000 9,51 9,510000 9,510000

88 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 18,67 18,670000 18,670000 25,24 25,240000 22,273440

89 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 1.667,86 16,678600 16,678600 1.856,12 18,561200 18,561200

90 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 10 180,16 18,016000 18,016000 219,94 21,994000 21,994000

91 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 50 848,93 16,978600 16,978600 963,48 19,269600 19,269600

92 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 59,93 59,930000 59,930000 75,78 75,780000 75,780000

93 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 1 104,25 104,250000 104,250000 127,27 127,270000 127,270000

94 J01DH02 MEROPENEMUM MERONEM IV 1 g PULB. PT. SOL. INJ. I.V./PERF. 1g ASTRAZENECA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ. I.V./PERF. S 10 1.030,68 103,068000 64,903200 1.161,59 116,159000 75,322800

95 J01DH02 MEROPENEMUM MERONEM IV 500 mg PULB. PT. SOL. INJ. I.V./PERF. 500mg ASTRAZENECA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 20 ML PULB. PT. SOL. INJ. I.V./PERF. S 10 539,60 53,960000 36,430800 626,31 62,631000 44,287200

96 J01DH02 MEROPENEMUM LODITER 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 40 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 72,84 72,840000 64,903200 92,10 92,100000 75,322800

97 J01DH02 MEROPENEMUM MEROPENEM ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA PRF 10 680,43 68,043000 64,903200 779,82 77,982000 75,322800

98 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 540,86 54,086000 54,086000 627,69 62,769000 62,769000

99 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 10 680,43 68,043000 64,903200 779,82 77,982000 75,322800

100 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 72,84 72,840000 64,903200 92,10 92,100000 75,322800

101 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 1 57,22 57,220000 57,220000 72,35 72,350000 72,350000

102 J01DH02 MEROPENEMUM LODITER 500 mg PULB. PT. SOL. INJ./PERF. 500mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 37,77 37,770000 36,430800 49,40 49,400000 44,287200

103 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 303,59 30,359000 30,359000 369,06 36,906000 36,906000

104 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 1 31,46 31,460000 31,460000 41,15 41,150000 41,150000

105 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 10 361,25 36,125000 36,125000 431,91 43,191000 43,191000

106 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 37,77 37,770000 36,430800 49,40 49,400000 44,287200

107 J01DH02 MEROPENEMUM MEROPENEM ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA PRF 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

108 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

109 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

110 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

111 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

112 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 10 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 10 445,46 44,546000 35,102400 523,70 52,370000 42,852000

113 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN HOSPIRA 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 5 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. PERF. PR 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

114 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S/P-RF 10 296,98 29,698000 29,698000 362,55 36,255000 36,255000

115 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 5,21 0,260500 0,260500 7,04 0,352000 0,352000

116 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 5,47 0,273500 0,273500 7,40 0,370000 0,370000

117 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 5,71 0,285500 0,285500 7,72 0,386000 0,386000

118 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,71 0,285500 0,285500 7,72 0,386000 0,386000

119 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SIROP 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 6,07 6,070000 6,070000 8,20 8,200000 8,200000

120 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 3,52 3,520000 3,520000 4,76 4,760000 4,760000

121 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 7,29 0,455625 0,455625 9,85 0,615625 0,615625

122 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 18,91 1,891000 1,891000 25,56 2,556000 2,556000

123 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 23,71 3,387142 1,561714 32,05 4,578571 2,110285

124 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 21,73 3,621666 1,561714 29,37 4,895000 2,110285

125 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 21,14 1,510000 0,719142 28,57 2,040714 0,972000

126 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 23,85 1,703571 0,719142 32,23 2,302142 0,972000

127 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 10,85 0,775000 0,719142 14,67 1,047857 0,972000

128 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 12,35 0,882142 0,719142 16,69 1,192142 0,972000

Pagina 2 din 42

Page 102: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

129 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 8,39 0,599285 0,599285 11,34 0,810000 0,810000

130 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 12,35 0,882142 0,719142 16,69 1,192142 0,972000

131 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 18,22 1,301428 1,301428 24,62 1,758571 1,758571

132 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 23,73 1,695000 1,561714 32,08 2,291428 2,110285

133 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 33,14 1,657000 1,561714 43,35 2,167500 2,110285

134 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 29,01 2,072142 1,561714 37,95 2,710714 2,110285

135 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 24,13 1,723571 1,561714 32,62 2,330000 2,110285

136 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 24,13 1,723571 1,561714 32,62 2,330000 2,110285

137 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 25,34 3,620000 1,561714 33,15 4,735714 2,110285

138 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 27,85 5,570000 1,561714 36,43 7,286000 2,110285

139 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 20,78 2,968571 1,561714 28,09 4,012857 2,110285

140 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 17,24 17,240000 16,812000 23,30 23,300000 22,728000

141 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 18,11 18,110000 16,812000 24,48 24,480000 22,728000

142 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 29,92 29,920000 29,920000 39,14 39,140000 39,140000

143 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 14,01 14,010000 14,010000 18,94 18,940000 18,940000

144 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 19,39 19,390000 16,812000 26,21 26,210000 22,728000

145 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 34,29 34,290000 28,128000 44,85 44,850000 38,016000

146 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 47,03 47,030000 46,872000 61,52 61,520000 61,308000

147 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 23,44 23,440000 23,440000 31,68 31,680000 31,680000

148 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 39,06 39,060000 39,060000 51,09 51,090000 51,090000

149 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 41,12 41,120000 41,120000 53,78 53,780000 53,780000

150 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 29,04 4,840000 3,774000 37,99 6,331666 5,100000

151 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-RF 6 18,87 3,145000 3,145000 25,50 4,250000 4,250000

152 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 18,76 3,126666 3,126666 25,36 4,226666 4,226666

153 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 18,88 3,146666 3,146666 25,52 4,253333 4,253333

154 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 37,31 6,218333 3,774000 48,80 8,133333 5,100000

155 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 18,88 3,146666 3,146666 25,52 4,253333 4,253333

156 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 15,73 5,243333 5,243333 21,26 7,086666 7,086666

157 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 18,98 6,326666 6,292000 25,65 8,550000 8,503999

158 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 18,97 6,323333 6,292000 25,64 8,546666 8,503999

159 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 18,97 6,323333 6,292000 25,64 8,546666 8,503999

160 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 16,37 5,456666 5,456666 22,13 7,376666 7,376666

161 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 18,98 6,326666 6,292000 25,65 8,550000 8,503999

162 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 29,18 9,726666 6,292000 38,17 12,723333 8,503999

163 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 37,31 12,436666 6,292000 48,80 16,266666 8,503999

164 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 34,11 11,370000 11,370000 44,61 14,870000 14,870000

165 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 34,11 11,370000 11,370000 44,61 14,870000 14,870000

166 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 5 132,49 26,498000 26,498000 161,75 32,350000 32,350000

167 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 12,10 12,100000 12,100000 16,36 16,360000 16,360000

168 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 16,61 16,610000 16,610000 22,45 22,450000 22,450000

169 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 26,27 26,270000 26,270000 34,36 34,360000 34,360000

170 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 37,14 37,140000 37,140000 48,58 48,580000 48,580000

171 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 18,63 18,630000 13,644000 25,18 25,180000 17,844000

172 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 46,15 46,150000 46,150000 60,36 60,360000 60,360000

173 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 5,28 0,528000 0,528000 7,13 0,713000 0,713000

174 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 7,09 0,709000 0,600000 9,58 0,958000 0,811200

175 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 31,71 0,634200 0,600000 41,48 0,829600 0,811200

176 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 5,00 0,500000 0,500000 6,76 0,676000 0,676000

177 J01GB06 AMIKACINUM BIODACYNA SOL. INJ. 1g/4ml CN UNIFARM S.A. ROMANIA CUTIE CU 1 FL.X 1G SOL.INJ. P-RF 1 9,47 9,470000 9,470000 12,80 12,800000 12,800000

178 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 5,15 5,150000 5,150000 6,96 6,960000 6,960000

179 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 14,81 1,481000 1,008000 20,02 2,002000 1,363200

180 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 8,40 0,840000 0,840000 11,36 1,136000 1,136000

181 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 51,89 2,594500 2,594500 65,61 3,280500 3,280500

182 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 28,52 2,852000 2,852000 37,31 3,731000 3,731000

183 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

184 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

185 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

186 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 5,13 0,513000 0,422400 6,93 0,693000 0,571200

187 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 4,85 0,485000 0,422400 6,56 0,656000 0,571200

188 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

189 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 3,52 0,352000 0,352000 4,76 0,476000 0,476000

190 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 9,10 0,455000 0,422400 12,30 0,615000 0,571200

191 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 9,10 0,455000 0,422400 12,30 0,615000 0,571200

192 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 5,82 0,582000 0,422400 7,87 0,787000 0,571200

193 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 6,83 0,683000 0,576000 9,23 0,923000 0,778800

194 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

195 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 6,50 0,650000 0,576000 8,78 0,878000 0,778800

196 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

197 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 9,78 0,978000 0,576000 13,22 1,322000 0,778800

198 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 4,80 0,480000 0,480000 6,49 0,649000 0,649000

199 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

200 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

201 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 12,16 0,608000 0,576000 16,43 0,821500 0,778800

Pagina 3 din 42

Page 103: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

202 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 11,19 1,119000 0,576000 15,12 1,512000 0,778800

203 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 29,43 2,943000 2,943000 38,50 3,850000 3,850000

204 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 28,52 2,852000 2,852000 37,31 3,731000 3,731000

205 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 66,99 9,570000 9,570000 84,70 12,100000 12,100000

206 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 66,99 9,570000 9,570000 84,70 12,100000 12,100000

207 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 20,44 6,813333 0,576000 27,63 9,210000 0,778800

208 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 20,44 6,813333 0,576000 27,63 9,210000 0,778800

209 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 12,42 2,484000 2,484000 16,79 3,358000 3,277440

210 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 111,86 2,237200 2,237200 136,56 2,731200 2,731200

211 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 12,42 2,484000 2,484000 16,79 3,358000 3,277440

212 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 3,54 3,540000 2,684640 4,79 4,790000 3,277440

213 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 7,09 7,090000 7,090000 9,58 9,580000 9,580000

214 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 128,87 12,887000 12,887000 157,33 15,733000 15,733000

215 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 69,19 6,919000 6,919000 87,49 8,749000 8,749000

216 J01MA02 CIPROFLOXACINUM UFEXIL 2 mg/ ml SOL. PERF. 2mg/ml DEMO SA GRECIA CUTIE X 10 PUNGI PP X 100 ML SOL. PERF. S 10 133,17 13,317000 8,302800 162,58 16,258000 10,498800

217 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 14,29 14,290000 14,290000 19,31 19,310000 18,879600

218 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 20,61 2,061000 2,061000 27,86 2,786000 2,786000

219 J01MA06 NORFLOXACINUM EPINOR COMPR. FILM. 400mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 5,70 0,407142 0,407142 7,70 0,550000 0,550000

220 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 13,02 0,651000 0,488570 17,60 0,880000 0,660000

221 J01MA06 NORFLOXACINUM NORFLOX - 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 4,58 0,458000 0,458000 6,19 0,619000 0,619000

222 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 13,02 0,651000 0,488570 17,60 0,880000 0,660000

223 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 11,64 0,582000 0,488570 15,73 0,786500 0,660000

224 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 13,02 0,651000 0,488570 17,60 0,880000 0,660000

225 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 20,76 2,965714 2,206285 28,06 4,008571 2,982857

226 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 19,81 2,830000 2,206285 26,78 3,825714 2,982857

227 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 12,87 1,838571 1,838571 17,40 2,485714 2,485714

228 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 12,88 1,840000 1,840000 17,41 2,487142 2,487142

229 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACCORD 250 mg COMPR. FILM. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. PRF 7 12,87 1,838571 1,838571 17,40 2,485714 2,485714

230 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 25,88 3,697142 3,697142 33,85 4,835714 4,835714

231 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 25,73 3,675714 3,675714 33,65 4,807142 4,807142

232 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA BLUEFISH 500 mg COMPR. FILM. 500mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/PVC X 7 COMPR. FILM. PRF 7 23,65 3,378571 3,378571 31,96 4,565714 4,565714

233 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA BLUEFISH 500 mg COMPR. FILM. 500mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. PRF 7 23,65 3,378571 3,378571 31,96 4,565714 4,565714

234 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACCORD 500 mg COMPR. FILM. 500mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. PRF 7 25,54 3,648571 3,648571 33,40 4,771428 4,771428

235 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 39,82 5,688571 4,054285 52,08 7,440000 5,478857

236 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 25,89 3,698571 3,698571 33,86 4,837142 4,837142

237 J01MA12 LEVOFLOXACINUM LEVOFLOXACIN KABI 5 mg/ml SOL. PERF. 5mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 25 FLAC. PEJD KABIPAC X 100 ML CONTINAD 100 ML SOL. PERF. (500MG LEVOFLOXACINA) S 25 1.687,14 67,485600 67,485600 1.877,13 75,085200 75,085200

238 J01MA12 LEVOFLOXACINUM EVOLOX 5 mg/ml SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 74,25 74,250000 74,250000 93,88 93,880000 90,102240

239 J01MA12 LEVOFLOXACINUM EVOLOX 5 mg/ml SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 37,79 37,790000 37,790000 49,43 49,430000 46,752000

240 J01MA12 LEVOFLOXACINUM LEVOFLOXACIN KABI 5 mg/ml SOL. PERF. 5mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEJD KABIPAC X 100 ML CONTINAD 50 ML SOL. PERF. (250MG LEVOFLOXACINA) S 1 37,79 37,790000 37,790000 49,43 49,430000 46,752000

241 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 5 mg/ml SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA X 100 ML SOL. PERF. S 1 74,10 74,100000 74,100000 93,69 93,690000 90,102240

242 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 5 mg/ml SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA X 50 ML SOL. PERF. S 1 37,71 37,710000 37,710000 49,33 49,330000 46,752000

243 J01MA12 LEVOFLOXACINUM LEVOFLOXACIN KABI 5 mg/ml SOL. PERF. 5mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEJD KABIPAC X 100 ML CONTINAD 100 ML SOL. PERF. (500MG LEVOFLOXACINA) S 1 74,25 74,250000 74,250000 93,88 93,880000 90,102240

244 J01MA12 LEVOFLOXACINUM LEVOFLOXACIN KABI 5 mg/ml SOL. PERF. 5mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 25 FLAC. PEJD KABIPAC X 100 ML CONTINAD 50 ML SOL. PERF. (250MG LEVOFLOXACINA) S 25 858,58 34,343200 34,343200 974,00 38,960000 38,960000

245 J01MA12 LEVOFLOXACINUM TAVANIC I.V. 500 mg SOL. PERF. 5mg/ml TERAPIA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF. P-RF/S 1 112,19 112,190000 80,982720 136,96 136,960000 90,102240

246 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg COMPR. FILM. 400mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 63,98 12,796000 12,796000 80,90 16,180000 16,180000

247 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 63,98 12,796000 12,796000 80,90 16,180000 16,180000

248 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER PHARMA AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 594,69 118,938000 118,938000 686,36 137,272000 137,272000

249 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 594,69 118,938000 118,938000 686,36 137,272000 137,272000

250 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 1g TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 48,56 48,560000 48,560000 63,52 63,520000 63,520000

251 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 500mg TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 24,28 24,280000 24,280000 32,82 32,820000 32,820000

252 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 1000 mg PULB. PT. SOL. PERF. 1000mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 456,00 45,600000 45,600000 535,19 53,519000 53,519000

253 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 500 mg PULB. PT. SOL. PERF. 500mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 234,30 23,430000 23,430000 286,03 28,603000 28,603000

254 J01XA01 VANCOMYCINUM VANCOMICINA ACTAVIS 1000mg PULB. PT.CONC. PT.SOL. PERF. 1000mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CONTINAND 1000 MG VANCOMICINA P-PR 1 48,45 48,450000 48,450000 63,37 63,370000 63,370000

255 J01XA01 VANCOMYCINUM VANCOMICINA KABI 1000 mg PULB. PT.CONC. PT.SOL. PERF. 1000mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 48,39 48,390000 48,390000 63,30 63,300000 63,300000

256 J01XA01 VANCOMYCINUM VANCOMICINA KABI 500 mg PULB. PT.CONC. PT.SOL. PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 24,17 24,170000 24,170000 32,67 32,670000 32,670000

257 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF.PT.SOL.PERF./INJ 1g LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. LIOF. PT. SOL. PERF./INJ. S/P-RF 1 56,90 56,900000 54,720000 71,94 71,940000 64,222800

258 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 109,84 109,840000 109,840000 134,09 134,090000 134,090000

259 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 10 173,48 17,348000 17,348000 211,79 21,179000 21,179000

260 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 5,71 0,190333 0,190333 7,72 0,257333 0,257333

261 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 5,25 0,262500 0,228400 7,09 0,354500 0,308800

262 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 79,29 6,607500 6,607500 100,25 8,354166 8,354166

263 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 6,74 6,740000 6,740000 9,11 9,110000 9,110000

264 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 6,59 6,590000 6,590000 8,91 8,910000 8,910000

265 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 77,74 6,478333 6,478333 98,29 8,190833 8,190833

266 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 36,98 3,698000 3,698000 48,37 4,837000 4,837000

267 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 37,40 3,740000 3,740000 48,92 4,892000 4,892000

268 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 20 228,10 11,405000 4,437600 278,47 13,923500 5,804400

269 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

270 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

271 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

272 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

273 J02AA01 AMPHOTERICINUM B 4) ABELCET 5mg/ml CONC. PT. SUSPENSIE INJ. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10 FLACOANE X 20ML CONCENTRAT PENTRU SUSPENSIE INJECTABILA P-RF 10 3.701,00 370,100000 370,100000 4.072,25 407,225000 407,225000

274 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 5,08 0,508000 0,508000 6,87 0,687000 0,687000

Pagina 4 din 42

Page 104: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

275 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 5,94 0,594000 0,594000 8,03 0,803000 0,803000

276 J02AB02 KETOCONAZOLUM NIZORAL 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 15,15 1,515000 0,609600 20,48 2,048000 0,824400

277 J02AB02 KETOCONAZOLUM KETOCONAZOL ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6,78 0,678000 0,609600 9,17 0,917000 0,824400

278 J02AB02 KETOCONAZOLUM KETOSTIN 200 mg COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 9,34 0,934000 0,609600 12,62 1,262000 0,824400

279 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 23,31 3,330000 3,330000 31,51 4,501428 4,501428

280 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 6,98 3,490000 3,490000 9,43 4,715000 4,715000

281 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,996000 25,61 6,402500 5,401714

282 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 65,37 4,085625 3,996000 82,66 5,166250 5,166250

283 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 193,65 6,916071 3,996000 236,41 8,443214 5,401714

284 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,856000 9,68 9,680000 7,908000

285 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 10,02 10,020000 5,856000 13,54 13,540000 7,908000

286 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,27 9,270000 5,856000 12,53 12,530000 7,908000

287 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13,95 13,950000 5,856000 18,86 18,860000 7,908000

288 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 18,56 18,560000 5,856000 25,08 25,080000 7,908000

289 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

290 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

291 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,07 6,070000 5,856000 8,20 8,200000 7,908000

292 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 7,44 7,440000 5,856000 10,06 10,060000 7,908000

293 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,856000 14,58 14,580000 7,908000

294 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 9,57 9,570000 5,856000 12,94 12,940000 7,908000

295 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 48,24 12,060000 5,856000 63,10 15,775000 7,908000

296 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

297 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 4,88 4,880000 4,880000 6,59 6,590000 6,590000

298 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,856000 9,03 9,030000 7,908000

299 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 16,65 16,650000 5,856000 22,51 22,510000 7,908000

300 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 30,10 4,300000 4,300000 39,37 5,624285 5,624285

301 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

302 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,998857 19,58 2,797142 2,701714

303 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,998857 41,93 5,990000 2,701714

304 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 21,91 3,130000 1,998857 29,61 4,230000 2,701714

305 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 43,23 6,175714 1,998857 56,54 8,077142 2,701714

306 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 12,35 1,764285 1,764285 16,69 2,384285 2,384285

307 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 47,19 6,741428 1,998857 61,72 8,817142 2,701714

308 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 14,09 1,761250 1,761250 19,04 2,380000 2,380000

309 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

310 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

311 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,998857 19,12 2,731428 2,701714

312 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 11,66 1,665714 1,665714 15,76 2,251428 2,251428

313 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, PREVAZUT CU CAPAC DIN AL CU FILET + 1 LINGURITA DOZATOAR PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

314 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

315 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

316 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

317 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 50 ML SOL. PERF. S 10 182,90 18,290000 18,290000 223,28 22,328000 22,328000

318 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

319 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

320 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

321 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 25 443,47 17,738800 17,738800 521,53 20,861200 20,861200

322 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

323 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 10 761,71 76,171000 76,171000 868,42 86,842000 86,842000

324 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 10 330,71 33,071000 20,737200 398,62 39,862000 25,316400

325 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

326 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

327 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

328 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 200 ML SOL. PERF. S 10 770,66 77,066000 77,066000 878,17 87,817000 87,817000

329 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 100 ML SOL. PERF. S 20 796,39 39,819500 20,737200 906,22 45,311000 25,316400

330 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 100 ML SOL. PERF. S 10 454,59 45,459000 20,737200 533,65 53,365000 25,316400

331 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 50 ML SOL. PERF. S 20 362,55 18,127500 18,127500 433,33 21,666500 21,666500

332 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

333 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 20 631,41 31,570500 20,737200 726,39 36,319500 25,316400

334 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

335 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 25 781,76 31,270400 20,737200 890,27 35,610800 25,316400

336 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 35,03 35,030000 20,737200 45,82 45,820000 25,316400

337 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 20 360,77 18,038500 18,038500 431,39 21,569500 21,569500

338 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 10 181,93 18,193000 18,193000 222,10 22,210000 22,210000

339 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,033440

340 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

341 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 60,84 4,056000 3,214399 76,92 5,128000 4,204000

342 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

343 J02AC02 ITRACONAZOLUM SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

344 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

345 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

346 J02AC02 ITRACONAZOLUM ITRACONAZOL LPH 100 mg CAPS. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

347 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,55 3,503333 3,503333

Pagina 5 din 42

Page 105: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

348 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

349 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

350 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

351 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

352 J02AC04 POSACONAZOLUM** NOXAFIL SP 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.488,19 2.488,190000 2.488,190000 2.750,28 2.750,280000 2.750,280000

353 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 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

354 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 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

355 J02AX06 ANIDULAFUNGINUM ECALTA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1FLAC.DIN STICLA A 30ML X 100MG PULB. S 1 1.458,70 1.458,700000 1.458,700000 1.628,13 1.628,130000 1.628,130000

356 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 100 mg COMPR. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1500 159,50 0,106333 0,106333 194,72 0,129813 0,129813

357 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1500 395,00 0,263333 0,263333 468,70 0,312466 0,312466

358 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. S 1500 434,58 0,289720 0,289720 511,84 0,341226 0,341226

359 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN PE X 50 CAPS. PRF 50 13,72 0,274400 0,274400 18,54 0,370800 0,370800

360 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 5,54 0,277000 0,277000 7,49 0,374500 0,374500

361 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 314,54 0,209693 0,209693 381,00 0,254000 0,254000

362 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 485,00 0,323333 0,323333 566,80 0,377866 0,377866

363 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 580,00 0,580000 0,580000 670,35 0,670350 0,670350

364 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 15,85 0,792500 0,577200 21,42 1,071000 0,780000

365 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,577200 20,23 1,011500 0,780000

366 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 704,14 0,704140 0,577200 805,66 0,805660 0,780000

367 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,577200 21,42 1,071000 0,780000

368 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 14,41 1,441000 1,441000 19,48 1,948000 1,948000

369 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 10,22 0,511000 0,511000 13,81 0,690500 0,690500

370 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 12,75 0,637500 0,577200 17,23 0,861500 0,780000

371 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,577200 17,15 0,857500 0,780000

372 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,62 0,481000 0,481000 13,00 0,650000 0,650000

373 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 14,23 1,423000 1,423000 19,23 1,923000 1,923000

374 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 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

375 J05AB04 RIBAVIRINUM REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 1.085,34 7,752428 7,752428 1.221,17 8,722642 8,722642

376 J05AB04 RIBAVIRINUM REBETOL 200 mg CAPS. 200mg SP EUROPE BELGIA CUTIE X 140CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 1.085,34 7,752428 7,752428 1.221,17 8,722642 8,722642

377 J05AB04 RIBAVIRINUM COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 2.406,37 14,323630 9,302914 2.661,10 15,839880 10,467170

378 J05AB06 GANCICLOVIRUM CYMEVENE LIOF. PT. SOL. INJ. 500mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 92,79 92,790000 92,790000 117,33 117,330000 117,330000

379 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 43,54 4,354000 4,354000 56,95 5,695000 5,695000

380 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

381 J05AB15 BRIVUDINUM BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF 7 272,43 38,918571 38,918571 332,58 47,511428 47,511428

382 J05AE01 SAQUINAVIRUM INVIRASE 200mg CAPS. 200mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 270 CAPS. P-RF/R 270 1.020,66 3,780222 3,780222 1.150,67 4,261740 4,261740

383 J05AE01 SAQUINAVIRUM INVIRASE 500 mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 120 COMPR. FILM. P-RF/R 120 1.013,90 8,449166 8,449166 1.143,30 9,527500 9,527500

384 J05AE03 RITONAVIRUM** NORVIR 100 mg COMPR. FILM. 100mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 3 FLAC. PEID X 30 COMPR.FILM. P-RF/R 90 565,59 6,284333 6,284333 654,64 7,273777 7,273777

385 J05AE03 RITONAVIRUM** NORVIR 100 mg COMPR. FILM. 100mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 COMPR.FILM. P-RF/R 30 196,38 6,546000 6,546000 239,74 7,991333 7,991333

386 J05AE03 RITONAVIRUM** NORVIR 100 mg COMPR. FILM. 100mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR.FILM. P-RF/R 60 387,06 6,451000 6,451000 460,05 7,667500 7,667500

387 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 200mg/50mg COMPR. FILM. 200mg/50mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 120 COMPR. FILM. P-RF/R 120 1.564,58 13,038166 13,038166 1.743,54 14,529500 14,529500

388 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 80mg/ml+20mg/ml SOL. ORALA 80mg/ml+20mg/ml ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 5 FLAC. MULTIDOZA DIN TPE X 60 ML + 5 SERINGI GRADATE A 5 ML P-RF/R 5 1.487,86 297,572000 297,572000 1.659,92 331,984000 331,984000

389 J05AE07 FOSAMPRENAVIRUM** TELZIR 700mg COMPR. FILM. 700mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN HDPE X 60 COMPR. FILM. PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII P-RF/R 60 1.219,58 20,326333 20,326333 1.367,49 22,791500 22,791500

390 J05AE07 FOSAMPRENAVIRUM** TELZIR 50mg/ml SUSP. ORALA 50mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN HDPE X 225 ML SUSP. ORALA PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII + P-RF/R 1 384,56 384,560000 384,560000 457,32 457,320000 457,320000

391 J05AE08 ATAZANAVIRUM REYATAZ 150 mg CAPS. 150mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 60 CAPS. (BLIST. AL/AL 6X1) P-RF/R 60 1.579,88 26,331333 26,331333 1.760,22 29,337000 29,337000

392 J05AE08 ATAZANAVIRUM REYATAZ 300 mg CAPS. 300mg BRISTOL-MYERS SQUIBB PHARMA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 CAPS. P-RF/R 30 1.691,40 56,380000 56,380000 1.881,78 62,726000 62,726000

393 J05AE09 TIPRANAVIRUM** APTIVUS 250mg CAPS. MOI 250mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLAC. DIN PEID X 120 CAPS. MOI P-RF/R 120 2.969,40 24,745000 24,745000 3.274,80 27,290000 27,290000

394 J05AE10 DARUNAVIRUM** PREZISTA 300mg COMPR. FILM. 300mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 120 COMPR. FILM. P-RF/R 120 2.768,37 23,069750 23,069750 3.055,68 25,464000 25,464000

395 J05AE10 DARUNAVIRUM** PREZISTA 400mg COMPR. FILM. 400mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 2.015,15 33,585833 33,585833 2.234,67 37,244500 37,244500

396 J05AE10 DARUNAVIRUM** PREZISTA 600mg COMPR. FILM. 600mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 2.841,59 47,359833 47,359833 3.135,49 52,258166 52,258166

397 J05AF01 ZIDOVUDINUM RETROVIR (R) CAPS. 100mg VIIV HEALTHCARE UK LIMITED UK CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-RF 100 354,20 3,542000 3,542000 424,23 4,242300 4,242300

398 J05AF01 ZIDOVUDINUM RETROVIR® SOL. ORALA 1% VIIV HEALTHCARE UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA BRUNA X 200 ML + 1 ADAPTOR DE DOZARE + 1 SERINGA PT. ADM. ORALA A 10 ML S/P-RF 1 43,52 43,520000 43,520000 56,92 56,920000 56,920000

399 J05AF02 DIDANOSINUM VIDEX EC 250 mg CAPS. GASTROREZ. 250mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 421,93 14,064333 14,064333 498,05 16,601666 16,601666

400 J05AF02 DIDANOSINUM VIDEX EC 400 mg CAPS. GASTROREZ. 400mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 657,08 21,902666 21,902666 754,37 25,145666 25,145666

401 J05AF04 STAVUDINUM ZERIT 30 mg CAPS. 30mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS. P-RF/R 56 487,42 8,703928 8,703928 569,44 10,168571 10,168571

402 J05AF04 STAVUDINUM ZERIT 40 mg CAPS. 40mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS. P-RF/R 56 502,69 8,976607 8,976607 586,08 10,465714 10,465714

403 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM. P-RF/R 60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

404 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 476,54 7,942333 6,385399 557,58 9,293000 7,723200

405 J05AF05 LAMIVUDINUM LAMIVUDINA AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PVC-ACLAR/AL X 60 COMPR. FILM. PR 60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

406 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 319,27 10,642333 10,642333 386,16 12,872000 12,872000

407 J05AF05 LAMIVUDINUM EPIVIR 10mg/ml SOL. ORALA 10mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON PEID X 240ML SOL. ORALA + 1 SERINGA DOZATOARE + 1 ADAPTOR P-RF/R 1 131,82 131,820000 131,820000 160,92 160,920000 160,920000

408 J05AF06 ABACAVIRUM ZIAGEN 300 mg COMPR. FILM. 300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 60 COMPR. FILM. P-RF/R 60 787,53 13,125500 13,125500 896,56 14,942666 14,942666

409 J05AF06 ABACAVIRUM ZIAGEN 20 mg/ml SOL. ORALA 20mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON PEID X 240 ML SOL. ORALA + SERINGA DOZATOARE PP X 10 ML + ADAPTOR PE P-RF/R 1 209,91 209,910000 209,910000 256,26 256,260000 256,260000

410 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 1.097,01 36,567000 36,567000 1.233,89 41,129666 41,129666

411 J05AF09 EMTRICITABINUM EMTRIVA 200mg CAPS. 200mg GILEAD SCIENCE INTERNATIONAL LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 CAPS. P-RF/R 30 656,22 21,874000 21,874000 753,43 25,114333 25,114333

412 J05AG01 NEVIRAPINUM VIRAMUNE 200mg COMPR. 200mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 6 BLIST. X 10 COMPR. PR 60 625,14 10,419000 8,336800 719,55 11,992500 9,850200

413 J05AG01 NEVIRAPINUM NEVIRAPINA 200mg COMPR. 200mg TEVA PHARMA B.V. OLANDA BLISTERE DIN PVC/PE/PVDC - AL X 60 COMP. P-RF/R 60 416,84 6,947333 6,947333 492,51 8,208500 8,208500

414 J05AG01 NEVIRAPINUM VIRAMUNE 100mg COMPR. ELIB. PREL. 100mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU UN FLACON DIN PEID X 90 COMPR. CU ELIB. PRELUNGITA PR 90 731,60 8,128888 8,128888 835,60 9,284444 9,284444

415 J05AG01 NEVIRAPINUM VIRAMUNE 400mg COMPR. ELIB. PREL. 400mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU UN FLACON DIN PEID X 30 COMPR. CU ELIB. PRELUNGITA PR 30 966,78 32,226000 32,226000 1.091,94 36,398000 36,398000

416 J05AG01 NEVIRAPINUM VIRAMUNE 50mg COMPR. ELIB. PREL. 50mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE CU UN FLACON DIN PEID X 180 COMPR. CU ELIB. PRELUNGITA PR 180 731,60 4,064444 4,064444 835,60 4,642222 4,642222

417 J05AG01 NEVIRAPINUM VIRAMUNE 50mg/ml SUSP. ORALA 50mg/5ml BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLACON PEID X 240 ML + O SERINGA X 5 ML + UN DISPOZITIV DE ADAPTARE A SERINGII LA FLACON PR 1 186,84 186,840000 186,840000 228,10 228,100000 228,100000

418 J05AG03 EFAVIRENZUM STOCRIN 50 mg COMPR. FILM. 50mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30COMPR. FILM. PREVAZUT CU UN SIST. DE INCHIDERE SECURIZAT PT. COPII P-RF/R 30 12,04 0,401333 0,401333 16,27 0,542333 0,542333

419 J05AG03 EFAVIRENZUM STOCRIN 600 mg COMPR. FILM. 600mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PREVAZUT CU UN SIST. DE INCHIDERE SECURIZAT PT. COPII P-RF/R 30 67,45 2,248333 2,248333 85,28 2,842666 2,842666

420 J05AG04 ETRAVIRINUM INTELENCE COMPR. 100mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. PEID X 120 COMPR. P-RF/R 120 1.947,00 16,225000 16,225000 2.160,38 18,003166 18,003166

Pagina 6 din 42

Page 106: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

421 J05AR01 COMBINATII (LAMIVUDINUM+ZIDOVUDINUM)** LAMIVUDINA/ZIDOVUDINA TEVA COMPR. FILM. 150 mg/300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN OPA/AL/PVC X 60 COMPRIMATE FILMATE P-RF 60 677,93 11,298833 11,298833 777,10 12,951666 12,951666

422 J05AR01 ZIDOVUDINUM+LAMIVUDINUM** COMBIVIR 150mg/300mg COMPR. FILM. 150mg/300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM. P-RF/R 60 1.026,84 17,114000 13,558600 1.157,41 19,290166 15,541999

423 J05AR02 ABACAVIRUM+LAMIVUDINUM** KIVEXA 600mg/300mg COMPR. FILM. 600mg/300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM.( BLIST.ALB-OPAC PVC-PVDC/AL ) P-RF/R 30 1.328,77 44,292333 44,292333 1.486,51 49,550333 49,550333

424 J05AR04 ABACAVIRUM+LAMIVUDINUM+ZIDOVUDINUM** TRIZIVIR 300mg/150mg/300mg COMPR. FILM. 300mg/150mg/300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 60 COMPR. FILM. (BLIST. OPACE DIN PVC/ACLAR) P-RF/R 60 1.675,67 27,927833 27,927833 1.864,63 31,077166 31,077166

425 J05AR04 ABACAVIRUM+LAMIVUDINUM+ZIDOVUDINUM** TRIZIVIR 300mg/150mg/300mg COMPR. FILM. 300mg/150mg/300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 1.675,67 27,927833 27,927833 1.864,63 31,077166 31,077166

426 J05AX07 ENFUVIRTIDUM** FUZEON 90mg/ml PULB. + SOLV. PT. SOL. INJ. 90mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 60 FLAC. PULB. PT. SOL. INJ. + 60 FLAC. SOLV. + 60 SERINGI X 3 ML + 60 SERINGI X 1 ML, 180 T P-RF/R 60 6.090,78 101,513000 101,513000 6.677,11 111,285166 111,285166

427 J05AX08 RALTEGRAVIRUM ISENTRESS 400mg COMPR. FILM. 400 mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILMATE P-RF/R 60 3.480,67 58,011166 58,011166 3.832,08 63,868000 63,868000

428 J05AX09 MARAVIROCUM CELSENTRI 150mg COMPR. FILM. 150mg PFIZER LIMITED MAREA BRITANIE CUTIE X 60 COMPR. FILM.( BLIST. PVC/AL) P-RF/R 60 3.352,86 55,881000 55,881000 3.692,77 61,546166 61,546166

429 J05AX09 MARAVIROCUM CELSENTRI 300mg COMPR. FILM. 300mg PFIZER LIMITED MAREA BRITANIE CUTIE X 60 COMPR. FILM.( BLIST. PVC/AL) P-RF/R 60 3.352,86 55,881000 55,881000 3.692,77 61,546166 61,546166

430 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 872,00 872,000000 872,000000 988,63 988,630000 988,630000

431 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 451,00 451,000000 451,000000 529,74 529,740000 529,740000

432 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 6.114,44 6.114,440000 6.114,440000 6.702,89 6.702,890000 6.702,890000

433 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 3.072,10 3.072,100000 3.072,100000 3.386,74 3.386,740000 3.386,740000

434 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 1.550,55 1.550,550000 1.550,550000 1.728,25 1.728,250000 1.728,250000

435 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 663,61 663,610000 663,610000 761,48 761,480000 761,480000

436 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.749,51 1.749,510000 1.749,510000 1.945,12 1.945,120000 1.945,120000

437 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 889,76 889,760000 889,760000 1.007,99 1.007,990000 1.007,990000

438 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.469,04 3.469,040000 3.469,040000 3.819,40 3.819,400000 3.819,400000

439 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 100 ML SOL. PERF. S 1 1.751,89 1.751,890000 1.751,890000 1.947,71 1.947,710000 1.947,710000

440 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 50 ML SOL. PERF. S 1 890,95 890,950000 890,950000 1.009,28 1.009,280000 1.009,280000

441 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 7.459,41 7.459,410000 7.459,410000 8.168,91 8.168,910000 8.168,910000

442 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 25ML SOL. PERF.(2,5G/25ML) S 1 459,88 459,880000 459,880000 539,42 539,420000 539,420000

443 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 25 ML SOL. PERF. S 1 460,47 460,470000 460,470000 540,07 540,070000 540,070000

444 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 188,56 188,560000 188,560000 230,20 230,200000 230,200000

445 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 200 ML SOL. PERF. S 1 3.473,78 3.473,780000 3.473,780000 3.824,57 3.824,570000 3.824,570000

446 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 2.050,80 2.050,800000 2.050,800000 2.273,52 2.273,520000 2.273,520000

447 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 222,29 222,290000 222,290000 271,37 271,370000 271,370000

448 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 535,20 535,200000 535,200000 621,52 621,520000 621,520000

449 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL.PERF. S 1 99,02 99,020000 99,020000 125,20 125,200000 125,200000

450 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL.PERF. S 1 472,05 472,050000 472,050000 552,68 552,680000 552,680000

451 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL.PERF. S 1 1.798,20 1.798,200000 1.798,200000 1.998,19 1.998,190000 1.998,190000

452 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL.PERF. S 1 914,10 914,100000 914,100000 1.034,52 1.034,520000 1.034,520000

453 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 2.261,30 2.261,300000 2.261,300000 2.502,97 2.502,970000 2.502,970000

454 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 640,45 640,450000 640,450000 736,24 736,240000 736,240000

455 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 1.166,70 1.166,700000 1.166,700000 1.309,85 1.309,850000 1.309,850000

456 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.040,40 1.040,400000 1.040,400000 1.172,19 1.172,190000 1.172,190000

457 J06BB16 PALIVIZUMABUM** SYNAGIS 100 mg PULB. + SOLV. PT. SOL. INJ. 100mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + FIOLA X 1 ML SOLV. P-RF 1 3.499,13 3.499,130000 3.499,130000 3.852,21 3.852,210000 3.852,210000

458 J06BB16 PALIVIZUMABUM** SYNAGIS 50 mg PULB. + SOLV. PT. SOL. INJ. 50mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + FIOLA X 1 ML SOLV. P-RF 1 2.119,02 2.119,020000 2.119,020000 2.347,88 2.347,880000 2.347,880000

459 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 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

460 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 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

461 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 1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

462 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 1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

463 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 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

464 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 1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

465 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 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

466 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 1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

467 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 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

468 P01BC02 MEFLOQUINUM4 ELOQUINE 250 mg COMPR. 250mg CN UNIFARM ROMANIA CUTIE X 10 BLIST. X 10 COMPR. X 100 140,58 1,405800 1,405800 171,62 1,716200 1,716200

469 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 10,49 10,490000 10,490000 14,18 14,180000 14,180000

470 S01AA23 NETILMICINUM NETTACIN (R) PICATURI OFT.-SOL. 0,3% S.I.F.I. SPA ITALIA CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML P-RF 15 21,41 1,427333 1,427333 28,94 1,929333 1,929333

471 S01AA23 NETILMICINUM NETTAVISC 3mg/g UNG. OFT. 3mg/g S.I.F.I. SPA ITALIA CUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR P-RF 1 24,05 24,050000 12,588000 32,50 32,500000 17,016000

472 S01BA01 DEXAMETHASONUM OZURDEX IMPLANT 700 micrograme ALLERGAN PHARMACEUTICALS IRELAND IRLANDA CUTIE CU1 IMPLANT STERIL DE TIP FILAMENT CU ELIBERARE PRELUNGITĂ CONŢINÂND DEXAMETAZONĂ 700 MICR P-RF 1 4.694,69 4.694,690000 4.694,690000 5.155,37 5.155,370000 5.155,370000

473 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 7,49 7,490000 7,490000 10,12 10,120000 10,120000

474 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 4,11 4,110000 4,110000 5,55 5,550000 5,550000

475 S01BA01 DEXAMETHASONUM MAXIDEX (R) PICATURI OFT.-SUSP. 0,1% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML P-RF 1 6,33 6,330000 4,932000 8,55 8,550000 6,660000

476 S03AAN2 NORFLOXACINUM NORFLOX PICATURI OFT./AURIC.-SOL. 0,3% CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 FLACON PEJD X 5 ML P-RF 1 3,52 3,520000 3,520000 4,76 4,760000 4,760000

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE B) SUBPROGRAMUL DE TRATAMENT AL BOLNAVILOR CU TUBERCULOZA

1 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 6,74 0,337000 0,337000 9,11 0,455500 0,455500

2 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 6,74 0,337000 0,337000 9,11 0,455500 0,455500

3 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 7,65 1,530000 1,530000 10,34 2,068000 2,068000

4 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 5,16 1,032000 1,032000 6,98 1,396000 1,396000

5 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,94 0,064666 0,053316 2,62 0,087333 0,069744

6 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 44,43 0,044430 0,044430 58,12 0,058120 0,058120

7 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,74 0,091333 0,053316 3,71 0,123666 0,069744

8 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 1,90 0,095000 0,053316 2,57 0,128500 0,069744

9 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 1,96 0,098000 0,053316 2,65 0,132500 0,069744

10 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 23,71 3,387142 1,561714 32,05 4,578571 2,110285

11 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 21,73 3,621666 1,561714 29,37 4,895000 2,110285

12 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 21,14 1,510000 0,719142 28,57 2,040714 0,972000

Pagina 7 din 42

Page 107: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

13 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 23,85 1,703571 0,719142 32,23 2,302142 0,972000

14 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 10,85 0,775000 0,719142 14,67 1,047857 0,972000

15 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 12,35 0,882142 0,719142 16,69 1,192142 0,972000

16 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 8,39 0,599285 0,599285 11,34 0,810000 0,810000

17 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 12,35 0,882142 0,719142 16,69 1,192142 0,972000

18 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 18,22 1,301428 1,301428 24,62 1,758571 1,758571

19 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 23,73 1,695000 1,561714 32,08 2,291428 2,110285

20 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 33,14 1,657000 1,561714 43,35 2,167500 2,110285

21 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 29,01 2,072142 1,561714 37,95 2,710714 2,110285

22 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 24,13 1,723571 1,561714 32,62 2,330000 2,110285

23 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 24,13 1,723571 1,561714 32,62 2,330000 2,110285

24 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 25,34 3,620000 1,561714 33,15 4,735714 2,110285

25 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 27,85 5,570000 1,561714 36,43 7,286000 2,110285

26 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 20,78 2,968571 1,561714 28,09 4,012857 2,110285

27 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 17,24 17,240000 16,812000 23,30 23,300000 22,728000

28 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 18,11 18,110000 16,812000 24,48 24,480000 22,728000

29 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 29,92 29,920000 29,920000 39,14 39,140000 39,140000

30 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 14,01 14,010000 14,010000 18,94 18,940000 18,940000

31 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 19,39 19,390000 16,812000 26,21 26,210000 22,728000

32 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 34,29 34,290000 28,128000 44,85 44,850000 38,016000

33 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 47,03 47,030000 46,872000 61,52 61,520000 61,308000

34 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 23,44 23,440000 23,440000 31,68 31,680000 31,680000

35 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 39,06 39,060000 39,060000 51,09 51,090000 51,090000

36 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 41,12 41,120000 41,120000 53,78 53,780000 53,780000

37 J01GA01 STREPTOMYCINUM STREPTOMICINA SULFAT BP PULB. PT. SOL. INJ. 1g ANTIBIOTICE S.A. ROMANIA CUTIE X 50 FL.PULB.PT. SOL.INJ. A 1 G PRF 50 139,72 2,794400 2,794400 170,57 3,411400 3,411400

38 J01GA01 STREPTOMYCINUM STREVITAL 1 g PULB. PT. SOL. INJ. 1g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CONTINAND PULB. PT. SOL. INJ. S 100 277,91 2,779100 2,779100 339,27 3,392700 3,392700

39 J01GA01 STREPTOMYCINUM STREVITAL 1 g PULB. PT. SOL. INJ. 1g ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. DIN STICLA CONTINAND PULB. PT. SOL. INJ. S 50 139,72 2,794400 2,794400 170,57 3,411400 3,411400

40 J01GB04 KANAMYCINUM PAN - KANAMYCINE PULB. PT. SOL. INJ. 1g LAB. PANPHARMA FRANTA CUTIE X 50 FLAC. X 1 G P-RF/S 50 81,11 1,622200 1,622200 102,56 2,051200 2,051200

41 J01GB06 AMIKACINUM BIODACYNA SOL. INJ. 1g/4ml CN UNIFARM S.A. ROMANIA CUTIE CU 1 FL.X 1G SOL.INJ. P-RF 1 9,47 9,470000 9,470000 12,80 12,800000 12,800000

42 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 5,15 5,150000 5,150000 6,96 6,960000 6,960000

43 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 14,81 1,481000 1,008000 20,02 2,002000 1,363200

44 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 8,40 0,840000 0,840000 11,36 1,136000 1,136000

45 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 51,89 2,594500 2,594500 65,61 3,280500 3,280500

46 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 28,52 2,852000 2,852000 37,31 3,731000 3,731000

47 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

48 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

49 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

50 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 5,13 0,513000 0,422400 6,93 0,693000 0,571200

51 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 4,85 0,485000 0,422400 6,56 0,656000 0,571200

52 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 5,05 0,505000 0,422400 6,83 0,683000 0,571200

53 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 3,52 0,352000 0,352000 4,76 0,476000 0,476000

54 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 9,10 0,455000 0,422400 12,30 0,615000 0,571200

55 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 9,10 0,455000 0,422400 12,30 0,615000 0,571200

56 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 250 mg COMPR. FILM. 250mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 5,82 0,582000 0,422400 7,87 0,787000 0,571200

57 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 6,83 0,683000 0,576000 9,23 0,923000 0,778800

58 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

59 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 6,50 0,650000 0,576000 8,78 0,878000 0,778800

60 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

61 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 9,78 0,978000 0,576000 13,22 1,322000 0,778800

62 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 4,80 0,480000 0,480000 6,49 0,649000 0,649000

63 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

64 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 9,78 0,978000 0,576000 13,22 1,322000 0,778800

65 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 12,16 0,608000 0,576000 16,43 0,821500 0,778800

66 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ALKALOID 500 mg COMPR. FILM. 500mg ALKALOID D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. FILM. P-RF 10 11,19 1,119000 0,576000 15,12 1,512000 0,778800

67 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 29,43 2,943000 2,943000 38,50 3,850000 3,850000

68 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 28,52 2,852000 2,852000 37,31 3,731000 3,731000

69 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 66,99 9,570000 9,570000 84,70 12,100000 12,100000

70 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 66,99 9,570000 9,570000 84,70 12,100000 12,100000

71 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 20,44 6,813333 0,576000 27,63 9,210000 0,778800

72 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 20,44 6,813333 0,576000 27,63 9,210000 0,778800

73 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 12,42 2,484000 2,484000 16,79 3,358000 3,277440

74 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF. 100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 111,86 2,237200 2,237200 136,56 2,731200 2,731200

75 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 12,42 2,484000 2,484000 16,79 3,358000 3,277440

76 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 3,54 3,540000 2,684640 4,79 4,790000 3,277440

77 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 7,09 7,090000 7,090000 9,58 9,580000 9,580000

78 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 128,87 12,887000 12,887000 157,33 15,733000 15,733000

79 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 69,19 6,919000 6,919000 87,49 8,749000 8,749000

80 J01MA02 CIPROFLOXACINUM UFEXIL 2 mg/ ml SOL. PERF. 2mg/ml DEMO SA GRECIA CUTIE X 10 PUNGI PP X 100 ML SOL. PERF. S 10 133,17 13,317000 8,302800 162,58 16,258000 10,498800

81 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 14,29 14,290000 14,290000 19,31 19,310000 18,879600

82 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg COMPR. FILM. 400mg BAYER HEALTHCARE AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 63,98 12,796000 12,796000 80,90 16,180000 16,180000

83 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. ALB OPAC PP/AL X 5 COMPR. FILM. P-RF 5 63,98 12,796000 12,796000 80,90 16,180000 16,180000

84 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER PHARMA AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 594,69 118,938000 118,938000 686,36 137,272000 137,272000

85 J01MA14 MOXIFLOXACINUM AVELOX (R) 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER HEALTHCARE AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 594,69 118,938000 118,938000 686,36 137,272000 137,272000

Pagina 8 din 42

Page 108: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

86 J04AB01 CICLOSERINUM HELPOCERIN CAPS. 250mg HELP PHARMACEUTICALS LTD. GRECIA CUTIE X 5 BLIST. X 10 CAPS. S/P-RF 50 190,37 3,807400 3,807400 232,40 4,648000 4,648000

87 J04AB01 CICLOSERINUM CICLOSERINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 10 FOLII TERMOSUDATE DIN AL/AL X 10 CAPS. P-RF 100 425,06 4,250600 4,250600 501,47 5,014700 5,014700

88 J04AB02 RIFAMPICINUM SINERDOL 150 mg CAPS. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 163,52 0,163520 0,163520 199,62 0,199620 0,199620

89 J04AB02 RIFAMPICINUM SINERDOL 300 mg CAPS. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. S 1000 530,00 0,530000 0,530000 615,85 0,615850 0,615850

90 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 100 mg COMPR. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1500 159,50 0,106333 0,106333 194,72 0,129813 0,129813

91 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1500 395,00 0,263333 0,263333 468,70 0,312466 0,312466

92 J04AD01 PROTIONAMIDUM PETEHA 250 mg COMPR. 250 mg S.C. PHARMA S.A. ROMANIA CUTIE X 100 COMPR. PR 100 98,56 0,985600 0,985600 124,62 1,246200 1,246200

93 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. S 1500 434,58 0,289720 0,289720 511,84 0,341226 0,341226

94 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN PE X 50 CAPS. PRF 50 13,72 0,274400 0,274400 18,54 0,370800 0,370800

95 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 5,54 0,277000 0,277000 7,49 0,374500 0,374500

96 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 314,54 0,209693 0,209693 381,00 0,254000 0,254000

97 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1500 485,00 0,323333 0,323333 566,80 0,377866 0,377866

98 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1000 580,00 0,580000 0,580000 670,35 0,670350 0,670350

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILEC) SUBPROGRAMUL DE SUPRAVEGHERE SI CONTROL AL BOLILOR TRANSMISIBILE PRIORITATRE PREV-TRAT GRIPEI

1 J05AH01 ZANAMIVIRUM RELENZA 5 mg PULB. UNIDOZA DE INHALAT 5mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 5 BLIST. TIP ROTADISK X 4 DOZE + DISPOZITIV DE ADMINISTRARE DISKHALER P-RF 5 59,59 11,918000 11,918000 75,34 15,068000 15,068000

2 J05AH02 OSELTAMIVIRUM TAMIFLU 30mg CAPS. 30mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1BLISTER PVC/PE/PVDC/ALX 10 CAPSULE P-RF 10 37,94 3,794000 3,794000 49,62 4,962000 4,962000

3 J05AH02 OSELTAMIVIRUM TAMIFLU 45mg CAPS. 45mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 BLISTER PVC/PE/PVDC/ALX 10 CAPSULE P-RF 10 67,34 6,734000 6,734000 85,15 8,515000 8,515000

4 J05AH02 OSELTAMIVIRUM TAMIFLU 75 mg CAPS. 75mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1BLISTER PVC/PE/PVDC/AL X 10 CAPSULE P-RF 10 60,15 6,015000 6,015000 76,06 7,606000 7,606000

5 J05AH02 OSELTAMIVIRUM TAMIFLU 12 mg/ml PULB. PT. SUSP. ORALA 12mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. A 100ML X 30 G PULB. PT. SUSP. ORALA + ADAPTOR, SERINGA SI CUPA PT. MASURARE P-RF 1 60,15 60,150000 60,150000 76,06 76,060000 76,060000

P3: PROGRAMUL NATIONAL DE ONCOLOGIE

1 G03HA01 CYPROTERONUM ANDROCUR COMPR. 50mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 1 FLAC. X 50 COMPR. P-RF 50 132,97 2,659400 2,659400 162,33 3,246600 3,246600

2 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 19,33 0,386600 0,386600 26,13 0,522600 0,522600

3 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 11,76 11,760000 11,760000 15,89 15,890000 15,890000

4 L01AA06 IFOSFAMIDUM HOLOXAN 1 g PULB. PT. SOL. PERF. 1g BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. PERF. S 1 92,66 92,660000 92,660000 117,16 117,160000 117,160000

5 L01AB01 BUSULFANUM BUSILVEX 6mg/ml CONC. PT. SOL. PERF. 6mg/ml PIERRE FABRE MEDICAMENT FRANTA CUTIE X 8 FLAC. X 10 ML CONC. PT. SOL. INJ. S 8 9.151,91 1.143,988750 1.143,988750 10.013,75 1.251,718750 1.251,718750

6 L01AD02 LOMUSTINUM4) CECENU CAPS. 40mg CN UNIFARM S.A. ROMANIA CUTIE X 1 FLACON X 20 CAPSULE PR 20 1.858,81 92,940500 92,940500 2.064,26 103,213000 103,213000

7 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 100 mg CAPS. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 479,26 95,852000 94,452000 560,54 112,108000 112,108000

8 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 100 mg CAPS. 100mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 675,04 135,008000 94,452000 773,95 154,790000 112,108800

9 L01AX03 TEMOZOLOMIDUM** TEMODAL 100 mg CAPS. 100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 589,30 117,860000 94,452000 680,49 136,098000 112,108800

10 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 100 mg CAPS. 100mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE PRF 5 675,04 135,008000 94,452000 773,95 154,790000 112,108800

11 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 100 mg CAPS. 100mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 495,60 99,120000 94,452000 578,35 115,670000 112,108800

12 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERI PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

13 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

14 L01AX03 TEMOZOLOMIDUM** NOGRON 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 629,66 125,932000 94,452000 724,48 144,896000 112,108800

15 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 100 mg CAPS. 100mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 472,26 94,452000 94,452000 552,91 110,582000 110,582000

16 L01AX03 TEMOZOLOMIDUM** TEMODAL 140mg CAPS. 140mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 825,68 165,136000 165,136000 938,14 187,628000 187,628000

17 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 140 mg CAPS. 140mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE PRF 5 1.648,19 329,638000 170,160000 1.834,68 366,936000 194,630400

18 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 140 mg CAPS. 140mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 709,00 141,800000 141,800000 810,96 162,192000 162,192000

19 L01AX03 TEMOZOLOMIDUM** NOGRON 140 mg CAPS. 140mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 929,60 185,920000 170,160000 1.051,42 210,284000 194,630400

20 L01AX03 TEMOZOLOMIDUM** TEMODAL 180 mg CAPS. 180mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 1.019,21 203,842000 203,842000 1.149,09 229,818000 229,818000

21 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 180 mg CAPS. 180mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 903,00 180,600000 180,600000 1.022,42 204,484000 204,484000

22 L01AX03 TEMOZOLOMIDUM** NOGRON 180 mg CAPS. 180mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 1.247,53 249,506000 216,720000 1.397,96 279,592000 245,380800

23 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 20 mg CAPS. 20mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 115,47 23,094000 22,298400 140,96 28,192000 28,192000

24 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 20 mg CAPS. 20mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 141,91 28,382000 22,298400 173,24 34,648000 28,195200

25 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 20 mg CAPS. 20mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE PRF 5 141,91 28,382000 22,298400 173,24 34,648000 28,195200

26 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERI PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

27 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

28 L01AX03 TEMOZOLOMIDUM** NOGRON 20 mg CAPS. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 131,91 26,382000 22,298400 161,04 32,208000 28,195200

29 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 20 mg CAPS. 20mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 107,00 21,400000 21,400000 130,63 26,126000 26,126000

30 L01AX03 TEMOZOLOMIDUM** TEMODAL 20 mg CAPS. 20mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI P-RF/R 5 140,39 28,078000 22,298400 171,39 34,278000 28,195200

31 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 250 mg CAPS. 250mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 1.557,48 311,496000 310,096800 1.735,81 347,162000 347,162000

32 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 250 mg CAPS. 250mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS. P-RF/R 5 2.539,46 507,892000 310,096800 2.806,17 561,234000 347,162400

33 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 250 mg CAPS. 250mg SUN PHARMACEUTICAL INDUSTRIES EUROPE B.V. OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE PRF 5 2.539,46 507,892000 310,096800 2.806,17 561,234000 347,162400

34 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 250 mg CAPS. 250mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 1.292,07 258,414000 258,414000 1.446,51 289,302000 289,302000

35 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 250 mg CAPS. 250mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 1.550,35 310,070000 310,070000 1.728,03 345,606000 345,606000

36 L01AX03 TEMOZOLOMIDUM** TEMODAL 2,5mg/ml PULB. PT. SOL. PERF. 2,5mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. PERF. P-RF/R 1 582,04 582,040000 582,040000 672,57 672,570000 672,570000

37 L01AX04 DACARBAZINUM DACARBAZINE MEDAC 500 mg PULB. PT. SOL. INJ. 500mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC.X 500MG PULB. PT. SOL. INJ. PR/PRF 1 66,94 66,940000 66,940000 84,64 84,640000 84,640000

38 L01AX04 DACARBAZINUM DACARBAZIN MEDAC 200mg PULB. PT. SOL. INJ./PERF. 200mg CN UNIFARM S.A. ROMANIA CUTIE X 10 FLACOANE PR 10 795,44 79,544000 79,544000 905,18 90,518000 90,518000

39 L01BA01 METHOTREXATUM METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 21,32 2,132000 2,132000 28,81 2,881000 2,881000

40 L01BA01 METHOTREXATUM METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 16,00 0,533333 0,533333 21,62 0,720666 0,720666

41 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 5 197,47 39,494000 39,494000 241,07 48,214000 48,214000

42 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 70,91 70,910000 70,910000 89,66 89,660000 89,660000

43 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 1 332,72 332,720000 332,720000 400,81 400,810000 400,810000

44 L01BA01 METHOTREXATUM BENDATREXAT SOL INJ. 25mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC. X 2 ML PR 1 65,37 65,370000 64,332000 82,65 82,650000 81,348000

45 L01BA01 METHOTREXATUM EMTHEXATE PF SOL. INJ. 25mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FIOLA X 2ML PR 1 53,61 53,610000 53,610000 67,79 67,790000 67,790000

46 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 17,62 1,762000 1,762000 23,82 2,382000 2,382000

Pagina 9 din 42

Page 109: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

47 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 87,07 87,070000 87,070000 110,09 110,090000 110,090000

48 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 62,22 62,220000 62,220000 78,67 78,670000 78,670000

49 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 1 100,34 100,340000 100,340000 122,50 122,500000 122,500000

50 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 45,60 45,600000 45,600000 59,64 59,640000 59,640000

51 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 86,63 86,630000 86,630000 109,54 109,540000 109,540000

52 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 62,22 62,220000 62,220000 78,67 78,670000 78,670000

53 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 59,16 59,160000 54,720000 74,80 74,800000 71,568000

54 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 1 101,74 101,740000 101,740000 124,21 124,210000 124,210000

55 L01BA04 PEMETREXEDUM**** ALIMTA 500mg PULB. PT. CONC. PT. SOL. PERF. 500mg ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 5.045,07 5.045,070000 5.045,070000 5.537,28 5.537,280000 5.537,280000

56 L01BB04 CLADRIBINUM LITAK 2 mg/ml SOL. INJ. 2mg/ml LIPOMED GMBH GERMANIA CUTIE X 1 FLACON X 5 ML S 1 1.435,80 1.435,800000 1.435,800000 1.603,17 1.603,170000 1.603,170000

57 L01BB05 FLUDARABINUM**** FLUDARA ORAL 10 mg COMPR. FILM. 10mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM. P-RF/S 20 1.094,66 54,733000 54,733000 1.231,33 61,566500 61,566500

58 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 5 FLAC. CU LIOF. PT. SOL. INJ./PERF. S 5 513,08 102,616000 102,616000 597,41 119,482000 119,482000

59 L01BB05 FLUDARABINUM FLUDARABINA ACTAVIS 25 mg/ml PULB. PT. SOL. INJ./PERF. 25mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA (CAPACITATE 5ML) CU PULB. PT. SOL. INJ/PERF CONTINAND 50MG FLUDA S 1 340,13 340,130000 123,139200 408,89 408,890000 143,378400

60 L01BC01 CYTARABINUM ALEXAN 20mg/ml SOL. INJ. 20mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 2 ML SOL. INJ. S 1 4,62 4,620000 4,620000 6,24 6,240000 6,240000

61 L01BC01 CYTARABINUM ALEXAN 20mg/ml SOL. INJ. 20mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FLACOANE DIN STICLA X 5 ML SOL. INJ. S 10 97,56 9,756000 9,756000 123,36 12,336000 12,336000

62 L01BC01 CYTARABINUM ALEXAN 50mg/ml SOL. INJ. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML. SOL. INJ. S 1 76,34 76,340000 60,600000 96,52 96,520000 76,620000

63 L01BC01 CYTARABINUM ALEXAN 50mg/ml SOL. INJ. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 10 ML. SOL. INJ. S 1 45,22 45,220000 30,300000 59,15 59,150000 39,636000

64 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE GALBENA X 20 ML SOL. INJ. SAU PERF. PR 1 99,23 99,230000 99,230000 125,47 125,470000 125,470000

65 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE ROSIE X 10 ML SOL. INJ. SAU PERF. PR 1 50,50 50,500000 50,500000 63,85 63,850000 63,850000

66 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE ALBASTRA X 5 ML SOL. INJ. SAU PERF. PR 1 25,25 25,250000 25,250000 33,03 33,030000 33,030000

67 L01BC01 CYTARABINUM DEPOCYTE 50mg SUSP. INJ. 50mg PACIRA LIMITED MAREA BRITANIE CUTIE X 1 FLAC. X 50MG SUSP.INJ. (MONODOZA 5ML) S 1 6.970,59 6.970,590000 6.970,590000 7.636,10 7.636,100000 7.636,100000

68 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 5 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 3,50 3,500000 3,500000 4,73 4,730000 4,730000

69 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 14,14 14,140000 14,140000 19,11 19,110000 19,110000

70 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 7,09 7,090000 7,090000 9,58 9,580000 9,580000

71 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 90,11 90,110000 90,110000 113,94 113,940000 113,940000

72 L01BC02 FLUOROURACILUM EFUDIX UNGUENT 50 mg/g ICN HUNGARY CO. LTD. UNGARIA CUTIE X 1 TUB X 20 G UNGUENT S/P-RF 1 92,03 92,030000 92,030000 116,36 116,360000 116,360000

73 L01BC05 GEMCITABINUM** GEMCITABINA EBEWE PHARMA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU UN FLAC. DIN STICLA INCOLORA CU INVELIS PROTECTOR ,,ONCO-SAFE" A 20 ML CONC. PT. SOL. PERF. S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

74 L01BC05 GEMCITABINUM** GEMCITABINA EBEWE PHARMA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU UN FLAC. DIN STICLA INCOLORA CU INVELIS PROTECTOR ,,ONCO-SAFE" A 100 ML CONC. PT. SOL. PERF S 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

75 L01BC05 GEMCITABINUM** GEMSOL 40 mg/ml CONC. PT. SOL. PERF. 40 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLACON STICLA INCOLORA SIST. ,,ONCO-SAFE" A 50 ML CONC .SOL. PERF. X 2000 MG PR 1 367,76 367,760000 367,760000 439,01 439,010000 439,010000

76 L01BC05 GEMCITABINUM** GEMSOL 40 mg/ml CONC. PT. SOL. PERF. 40 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLACOANE STICLA INCOLORA SIST. ,,ONCO-SAFE" A 25 ML CONC .SOL. PERF. X 1000 MG PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

77 L01BC05 GEMCITABINUM** GEMSOL 40 mg/ml CONC. PT. SOL. PERF. 40 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLACON STICLA INCOLORA FARA SIST. ,,ONCO-SAFE" A 5 ML CONC .SOL. PERF. X 200 MG PR 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

78 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML X 2 G GEMCITABINA PR 1 518,45 518,450000 441,312000 603,26 603,260000 526,812000

79 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML X 1 G GEMCITABINA PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

80 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 5 ML X 200 MG GEMCITABINA PR 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

81 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML X 2 G GEMCITABINA PR 1 367,76 367,760000 367,760000 439,01 439,010000 439,010000

82 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML X 1 G GEMCITABINA PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

83 L01BC05 GEMCITABINUM** GEMZAR 1000 mg PULB. PT. SOL. PERF. 1000 mg LILLY FRANCE SAS FRANTA CUTIE X 1FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S 1 285,80 285,800000 217,632000 348,91 348,910000 265,680000

84 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 1000 mg PULB. PT. SOL. PERF. 1000mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 1000 MG PULB. PT. SOL. PERF. S 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

85 L01BC05 GEMCITABINUM** GEMCITABINA ATB 1000 mg PULB. PT. SOL. PERF. 1000mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML PULB. PT. SOL. PERF. PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

86 L01BC05 GEMCITABINUM** DAPLAX 1 g PULB. PT. SOL. PERF. 1g DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. CONTINAND 1000MG GEMCITABINA S 1 185,76 185,760000 185,760000 226,77 226,770000 226,770000

87 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 2000 mg PULB. PT. SOL. PERF. 2000mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2000 MG PULB. PT. SOL. PERF. S 1 367,77 367,770000 367,770000 439,02 439,020000 439,020000

88 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 200 mg PULB. PT. SOL. PERF. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 MG PULB. PT. SOL. PERF. S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

89 L01BC05 GEMCITABINUM** DAPLAX 200 mg PULB. PT. SOL. PERF. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. CONTINAND 200MG GEMCITABINA S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

90 L01BC05 GEMCITABINUM** GEMZAR (R) 200 mg PULB. PT. SOL. PERF. 200mg LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. PERF. S 1 62,79 62,790000 49,848000 79,39 79,390000 65,208000

91 L01BC05 GEMCITABINUM** GEMCITABINA ATB 200 mg PULB. PT. SOL. PERF. 200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML PULB. PT. SOL. PERF. PR 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

92 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML CU PULB. PT. SOL. PERF. CARE CONTINE 1500MG GEMCITABINA S 1 279,50 279,500000 279,500000 341,21 341,210000 341,210000

93 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 200MG GEMCITABINA S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

94 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 2000MG GEMCITABINA S 1 367,76 367,760000 367,760000 439,01 439,010000 439,010000

95 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 1000MG GEMCITABINA S 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

96 L01BC05 GEMCITABINUM** GEMCITABINE MYLAN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml MYLAN S.A.S. FRANTA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML PULB. PT SOL. PERF. CARE CONTINE 1000 MG GEMCITABINA S 1 285,80 285,800000 217,632000 348,91 348,910000 265,680000

97 L01BC05 GEMCITABINUM** GEMCITABINE MYLAN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml MYLAN S.A.S. FRANTA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML PULB. PT SOL. PERF. CARE CONTINE 200 MG GEMCITABINA S 1 62,79 62,790000 49,848000 79,39 79,390000 65,208000

98 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML CU PULB. PT. SOL. PERF. CARE CONTINE 200MG GEMCITABINA S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

99 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. CARE CONTINE 1000MG GEMCITABINA S 1 181,36 181,360000 181,360000 221,40 221,400000 221,400000

100 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML CU PULB. PT. SOL. PERF. CARE CONTINE 2000MG GEMCITABINA S 1 368,80 368,800000 368,800000 440,14 440,140000 440,140000

101 L01BC06 CAPECITABINUM XELODA 150 mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 BLIST. DIN PVC/PE/PVDC X 10 COMPR. FILM. P-RF/R 60 240,10 4,001666 4,001666 293,12 4,885333 4,885333

102 L01BC06 CAPECITABINUM XELODA 500 mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 12 BLIST. DIN PVC/PE/PVDC X 10 COMPR. FILM. P-RF/R 120 1.478,14 12,317833 12,317833 1.649,33 13,744416 13,744416

103 L01CA01 VINBLASTINUM4) VINBLASTIN RICHTER 5mg PULB+SOLV. PT. SOL. INJ. 5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 FLAC. X 10 FIOLE SOLVENT X 5ML PR 10 235,23 23,523000 23,523000 287,17 28,717000 28,717000

104 L01CA01 VINBLASTINUM4) VINBLASTINA TEVA 1 mg/ml SOL INJ. 1mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL. INJ. PR 1 29,63 29,630000 29,630000 38,75 38,750000 38,750000

105 L01CA02 VINCRISTINUM SINDOVIN 1 mg LIOF. PT. SOL. INJ./PERF. I.V. 1mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. INJ./PERF. I.V. S 1 25,54 25,540000 25,540000 33,40 33,400000 33,400000

106 L01CA04 VINORELBINUM NAVELBINE 20 mg CAPS. MOI 20mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 1 BLIST. PVC-PVDC/AL-PETP X 1 CAPS. MOALE P-RF 1 195,08 195,080000 195,080000 238,15 238,150000 238,150000

107 L01CA04 VINORELBINUM NAVELBINE 30 mg CAPS. MOI 30mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE X 1 BLIST. PVC-PVDC/AL-PETP X 1 CAPS. MOALE P-RF 1 292,59 292,590000 292,590000 357,19 357,190000 357,190000

108 L01CA04 VINORELBINUM VINORELBIN EBEWE 10 mg/ ml CONC. PT. SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. X 1 ML CONC. PT. SOL. INJ/PERF. S 1 72,14 72,140000 72,140000 91,21 91,210000 91,210000

109 L01CA04 VINORELBINUM VINORELBIN EBEWE 10 mg/ ml CONC. PT. SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. INJ/PERF. S 1 352,01 352,010000 352,010000 421,84 421,840000 421,840000

110 L01CA04 VINORELBINUM VINORELBIN ACTAVIS 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 1 ML CONC. PT. SOL. PERF. S 1 72,15 72,150000 72,150000 91,23 91,230000 91,230000

111 L01CA04 VINORELBINUM VINORELBIN ACTAVIS 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 448,89 448,890000 422,412000 527,44 527,440000 506,208000

112 L01CA04 VINORELBINUM TELBINE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 352,01 352,010000 352,010000 421,84 421,840000 421,840000

113 L01CA04 VINORELBINUM TELBINE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF. S 1 72,14 72,140000 72,140000 91,21 91,210000 91,210000

114 L01CA04 VINORELBINUM NAVELBINE (R) SOL. INJ. 10mg/ml LAB. PIERRE FABRE FRANTA CUTIE X 10 FIOLE X 1 ML S 10 1.020,92 102,092000 86,568000 1.150,95 115,095000 109,452000

115 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10 CAPS. P-RF 10 311,36 31,136000 31,136000 377,53 37,753000 37,753000

116 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10 CAPS. P-RF 20 308,57 15,428500 15,428500 374,49 18,724500 18,724500

117 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 39,04 39,040000 38,352000 51,07 51,070000 50,172000

118 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 32,83 32,830000 32,830000 42,94 42,940000 42,940000

119 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML CONC. PT. SOL. PERF. S 1 61,07 61,070000 61,070000 77,22 77,220000 77,220000

Pagina 10 din 42

Page 110: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

120 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 31,96 31,960000 31,960000 41,81 41,810000 41,810000

121 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 5 4.934,31 986,862000 986,862000 5.416,56 1.083,312000 1.083,312000

122 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 30 MG CONC. PT. SOL. PERF. S 1 114,92 114,920000 114,920000 140,30 140,300000 132,744000

123 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 1 832,08 832,080000 509,402400 945,12 945,120000 564,405600

124 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 16,7 ML CONC. PT. SOL. PERF. S 1 338,86 338,860000 338,860000 407,51 407,510000 407,510000

125 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 5 503,92 100,784000 100,784000 587,42 117,484000 117,484000

126 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 106,15 106,150000 106,150000 129,59 129,590000 129,590000

127 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 43,33 ML CONC. PT. SOL. PERF. S 1 909,41 909,410000 909,410000 1.029,41 1.029,410000 1.029,410000

128 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 1 559,41 559,410000 509,402400 647,91 647,910000 564,405600

129 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 300 MG CONC. PT. SOL. PERF. S 1 1.100,65 1.100,650000 1.100,650000 1.237,86 1.237,860000 1.237,860000

130 L01CD01 PACLITAXELUM** PACLITAXEL ACCORD 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA A 50 ML CARE CONTINE 300 MG PACLITAXEL S 1 1.100,51 1.100,510000 1.100,510000 1.237,71 1.237,710000 1.237,710000

131 L01CD01 PACLITAXELUM** PACLITAXEL ACCORD 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA A 5 ML CARE CONTINE 30 MG PACLITAXEL S 1 114,66 114,660000 114,660000 139,98 139,980000 132,744000

132 L01CD01 PACLITAXELUM** PACLITAXEL ACCORD 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA A 16,7 ML CARE CONTINE 100 MG PACLITAXEL S 1 356,77 356,770000 356,770000 427,03 427,030000 420,981600

133 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 5 2.122,51 424,502000 424,502000 2.351,69 470,338000 470,338000

134 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 1 448,50 448,500000 448,500000 527,02 527,020000 527,020000

135 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 1.100,68 1.100,680000 1.100,680000 1.237,89 1.237,890000 1.237,890000

136 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 16,67 ML CONC. PT. SOL. PERF. S 1 356,99 356,990000 356,990000 427,27 427,270000 420,981600

137 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA X 16,7 ML CONC. PT. SOL. PERF. S 5 1.574,25 314,850000 314,850000 1.754,09 350,818000 350,818000

138 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 150 MG CONC. PT. SOL. PERF. S 1 559,30 559,300000 509,402400 647,79 647,790000 564,405600

139 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 MG CONC. PT. SOL. PERF. S 1 356,96 356,960000 356,960000 427,24 427,240000 420,981600

140 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 1.010,86 1.010,860000 1.010,860000 1.139,99 1.139,990000 1.139,990000

141 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 114,95 114,950000 114,950000 140,33 140,330000 132,744000

142 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 114,95 114,950000 114,950000 140,33 140,330000 132,744000

143 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 16,6 ML CONC. PT. SOL. PERF. S 1 356,99 356,990000 356,990000 427,27 427,270000 420,981600

144 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 1.100,68 1.100,680000 1.100,680000 1.237,89 1.237,890000 1.237,890000

145 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 4 FLAC. X 16,7 ML S 4 1.265,52 316,380000 316,380000 1.417,57 354,392500 354,392500

146 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 10 FLAC. X 5 ML S 10 979,86 97,986000 97,986000 1.106,20 110,620000 110,620000

147 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML S 1 1.010,91 1.010,910000 1.010,910000 1.140,04 1.140,040000 1.140,040000

148 L01CD02 DOCETAXELUM** TAXOTERE 20 mg CONC. + SOLV. PT. SOL. PERF. 20mg AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 0,5 ML CONC. SOL. PERF. + 1 FLACON X 1,5 ML SOLV. S 1 227,82 227,820000 177,696000 278,12 278,120000 216,936000

149 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/0,5 ml CONC. + SOLV. PT. SOL. PERF. 20mg/0,5ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. DIN POLISTIREN TERMOFORMAT CU 1 FLAC. DIN STICLA INCOLORA X 0,5 ML CONC. PT. SOL. S 1 364,79 364,790000 177,696000 435,77 435,770000 216,936000

150 L01CD02 DOCETAXELUM** DOCETAXEL TEVA 20mg/0,5ml CONC. + SOLV. PT. SOL. PERF. 20mg/0,5ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 0,5 ML CONCENTRAT PT. SOL.PERF.+1 FLAC.X1,5ML SOLV. S 1 148,08 148,080000 148,080000 180,78 180,780000 180,780000

151 L01CD02 DOCETAXELUM** TAXOTERE 80 mg CONC. + SOLV. PT. SOL. PERF. 80mg AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 2 ML CONC. SOL. PERF. + 1 FLACON X 6 ML SOLV. S 1 1.043,54 1.043,540000 826,560000 1.175,61 1.175,610000 946,728000

152 L01CD02 DOCETAXELUM** DOCETAXEL TEVA 80mg/2ml CONC. + SOLV. PT. SOL. PERF. 80mg/2ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 2 ML CONCENTRAT PT. SOL.PERF.+1 FLAC.X 6ML SOLV. S 1 787,79 787,790000 787,790000 896,84 896,840000 896,840000

153 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 80 mg/2 ml CONC. + SOLV. PT. SOL. PERF. 80mg/2ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. DIN POLISTIREN TERMOFORMAT CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PE S 1 1.369,45 1.369,450000 826,560000 1.530,85 1.530,850000 946,728000

154 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC ONCO-SAFE X 16 ML CONC. PT. SO P-RF/R 1 1.542,65 1.542,650000 1.542,650000 1.719,64 1.719,640000 1.719,640000

155 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 16 ML CONC. PT. SOL. PERF. S/P-RF 1 1.545,58 1.545,580000 1.545,580000 1.722,83 1.722,830000 1.722,830000

156 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 8 ML CONC. PT. SOL. PERF. S/P-RF 1 787,78 787,780000 787,780000 896,83 896,830000 896,830000

157 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PERF. S/P-RF 1 208,43 208,430000 177,696000 254,45 254,450000 216,936000

158 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 8 ML CONC. PT. SOL. PERF. P-RF/R 1 924,39 924,390000 826,560000 1.045,74 1.045,740000 946,728000

159 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PERF. P-RF/R 1 261,95 261,950000 177,696000 319,79 319,790000 216,936000

160 L01CD02 DOCETAXELUM** TAXOTERE 160 mg/8ml CONC. PT. SOL. PERF. 160 mg/8 ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON DIN STICLA CU 8 ML CONC. PT. SOL. PERF.X 160MG PR 1 2.361,67 2.361,670000 1.851,180000 2.612,37 2.612,370000 2.063,568000

161 L01CD02 DOCETAXELUM** DOCETAXEL KABI 120 mg/6 ml CONC. PT. SOL. PERF. 20 mg/1 ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FL DIN STICLA INCOLORA X 6 ML CONCENTRAT PENTRU SOL. PERFUZABILA PR 1 1.359,59 1.359,590000 1.359,590000 1.520,11 1.520,110000 1.520,110000

162 L01CD02 DOCETAXELUM** TAXOTERE 20 mg/1ml CONC. PT. SOL. PERF. 20mg/1ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 1 ML CONC. PT. SOL. PERF. PR 1 287,07 287,070000 177,696000 350,45 350,450000 216,936000

163 L01CD02 DOCETAXELUM** DOCIRENA 20 mg/1 ml CONC. PT. SOL. PERF. 20mg/1ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP SI SIGILIU DETASABIL A 1 ML CONC. PT. SOL. PERF. PR 1 208,43 208,430000 177,696000 254,45 254,450000 216,936000

164 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE PORTOCALIE, A 8 ML CONC. PT. SOL. PERF. CARE CONTINE 160 MG DOCETAXEL PR 1 1.545,58 1.545,580000 1.545,580000 1.722,83 1.722,830000 1.722,830000

165 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE ROSIE, A 4 ML CONC. PT. SOL. PERF. CARE CONTINE 80 MG DOCETAXEL PR 1 688,80 688,800000 688,800000 788,94 788,940000 788,940000

166 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE PORTOCALIE, A 1 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOCETAXEL PR 1 148,08 148,080000 148,080000 180,78 180,780000 180,780000

167 L01CD02 DOCETAXELUM** DOCETAXEL KABI 80 mg/4 ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FL DIN STICLA INCOLORA X 4 ML CONCENTRAT CE CONTINE 80 MG DOCETAXEL PR 1 916,40 916,400000 826,560000 1.037,03 1.037,030000 946,728000

168 L01CD02 DOCETAXELUM** DOCETAXEL KABI 180 mg/9 ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FL DIN STICLA INCOLORA X 9 ML CONCENTRAT CE CONTINE 180 MG DOCETAXEL PR 1 2.024,40 2.024,400000 2.024,400000 2.244,75 2.244,750000 2.244,750000

169 L01CD02 DOCETAXELUM** DOCETAXEL KABI 160 mg/8 ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FL DIN STICLA INCOLORA X 8 ML CONCENTRAT CE CONTINE 160 MG DOCETAXEL PR 1 1.706,08 1.706,080000 1.706,080000 1.897,78 1.897,780000 1.897,780000

170 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 7 ML CONC. PT. SOL. PERF. CARE CONTINE 140 MG DOCETA PR 1 2.373,51 2.373,510000 2.373,510000 2.625,28 2.625,280000 2.625,280000

171 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 4 ML CONC. PT. SOL. PERF. CARE CONTINE 80 MG DOCETAX PR 1 924,39 924,390000 826,560000 1.045,74 1.045,740000 946,728000

172 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 1 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOCETAX PR 1 261,95 261,950000 177,696000 319,79 319,790000 216,936000

173 L01CD02 DOCETAXELUM** DOCETAXEL KABI 20mg/ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA X 1ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA X 20MG DOCETAXEL PR 1 256,30 256,300000 177,696000 312,89 312,890000 216,936000

174 L01CD02 DOCETAXELUM** DOCIRENA 80 mg/4 ml CONC. PT. SOL. PERF. 80mg/4ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP SI SIGILIU DETASABIL A 4 ML CONC. PT. SOL. PERF. PR 1 787,78 787,780000 787,780000 896,83 896,830000 896,830000

175 L01CD02 DOCETAXELUM** TAXOTERE 80 mg/4ml CONC. PT. SOL. PERF. 80mg/4ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON DIN STICLA X 4 ML CONC. PT. SOL. PERF. PR 1 1.195,82 1.195,820000 826,560000 1.341,60 1.341,600000 946,728000

176 L01CD02 DOCETAXELUM** TAXEGIS 20 mg CONC. SI SOLV. PT. SOL. PERF. 20mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 BLIST. X 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU 0,5 ML CONC. PT. S PR 1 148,08 148,080000 148,080000 180,78 180,780000 180,780000

177 L01CD02 DOCETAXELUM** TAXEGIS 80 mg CONC. SI SOLV. PT. SOL. PERF. 80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 BLIST. X 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU 2 ML CONC. PT. SO PR 1 787,78 787,780000 787,780000 896,83 896,830000 896,830000

178 L01DA01 DACTINOMICINUM4) COSMEGEN LYOVAC 0,5 mg PULB. PT. SOL. INJ. 0,5mg CN UNIFARM S.A. ROMANIA CUTIE X 1 FLACON PULBERE LIOFILIZATA PENTRU SOLUTIE PERFUZABILA PR 1 128,87 128,870000 128,870000 157,32 157,320000 157,320000

179 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML CONC. PT. SOL. PERF. PR 1 66,23 66,230000 66,230000 83,74 83,740000 83,740000

180 L01DB01 DOXORUBICINUM DOXORUBICIN "EBEWE" 2mg/ml CONC. PT. SOL. PERF. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 25 ML CONC. PT. SOL. PERF. (50 MG DOXORUBICINA) S 1 110,17 110,170000 107,076000 134,49 134,490000 134,490000

181 L01DB01 DOXORUBICINUM DOXORUBICINA ACCORD 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 100 ML CONC. PT. SOL. PERF. CONTINAND 200 MG DOXORUBICINA PR 1 225,68 225,680000 225,680000 275,51 275,510000 275,510000

182 L01DB01 DOXORUBICINUM DOXORUBICINA ACCORD 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML CONC. PT. SOL. PERF. CONTINAND 50 MG DOXORUBICINA PR 1 89,23 89,230000 89,230000 112,82 112,820000 112,820000

183 L01DB01 DOXORUBICINUM DOXORUBICINA ACCORD 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 5 ML CONC. PT. SOL. PERF. CONTINAND 10 MG DOXORUBICINA PR 1 28,22 28,220000 28,220000 36,91 36,910000 36,910000

184 L01DB01 DOXORUBICINUM CAELYX 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE X 1 FLACON DIN STICLA X 10 ML S 1 1.445,08 1.445,080000 1.445,080000 1.613,29 1.613,290000 1.613,290000

185 L01DB01 DOXORUBICINUM DOXORUBICIN "EBEWE" 2mg/ml CONC. PT. SOL. PERF. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML CONC. PT. SOL. PERF. (10 MG DOXORUBICINA) S 1 28,22 28,220000 28,220000 36,91 36,910000 36,910000

186 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 100 ML CONC. PT. SOL. PERF. CARE CONTINE 200 MG DOXORUBICINA PR 1 269,92 269,920000 269,920000 329,52 329,520000 329,520000

187 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 75 ML CONC. PT. SOL. PERF. CARE CONTINE 150 MG DOXORUBICINA PR 1 261,57 261,570000 261,570000 319,32 319,320000 319,320000

188 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 50 ML CONC. PT. SOL. PERF. CARE CONTINE 100 MG DOXORUBICINA PR 1 208,14 208,140000 208,140000 254,10 254,100000 254,100000

189 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 25 ML CONC. PT. SOL. PERF. CARE CONTINE 50 MG DOXORUBICINA PR 1 105,66 105,660000 105,660000 128,99 128,990000 128,990000

190 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 10 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOXORUBICINA PR 1 62,33 62,330000 62,330000 78,81 78,810000 78,810000

191 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. PR 1 101,03 101,030000 101,030000 123,34 123,340000 123,340000

192 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. PR 1 27,42 27,420000 27,420000 35,86 35,860000 35,860000

Pagina 11 din 42

Page 111: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

193 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. A 5 ML CONC. PT. SOL. PERF. CARE CONTINE 10 MG DOXORUBICINA PR 1 27,18 27,180000 27,180000 35,55 35,550000 35,550000

194 L01DB01 DOXORUBICINUM DOXORUBICINA TEVA 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. CONC. PT. SOL. PERF. X 50 MG CLORHIDRAT DE DOXORUBICINA S 1 89,23 89,230000 89,230000 112,82 112,820000 112,820000

195 L01DB01 DOXORUBICINUM DOXORUBICINA TEVA 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. CONC. PT. SOL. PERF. X 20 MG CLORHIDRAT DE DOXORUBICINA S 1 63,03 63,030000 63,030000 79,70 79,700000 79,700000

196 L01DB01 DOXORUBICINUM CAELYX 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml JANSSEN CILAG INTERNATIONALL NV BELGIA CUTIE X 1 FLACON DIN STICLA X 25 ML S 1 3.567,70 3.567,700000 2.455,548000 3.926,95 3.926,950000 2.699,442000

197 L01DB01 DOXORUBICINUM MYOCET 50mg PULB. + AMESTC. PT. CONC. PT.DISP.LIPOZOM.PT.PERF 50mg CEPHALON EUROPE FRANTA CUTIE X 2 SETURI X 3 FLAC. (1 FLAC PULB. + 1 FLAC.LIPOZOMI +1 FLAC. SOL.TAMP.) S 2 4.092,58 2.046,290000 2.046,290000 4.499,07 2.249,535000 2.249,535000

198 L01DB01 DOXORUBICINUM SINDROXOCIN 2mg/ml PULB. PT. SOL. PERF. 2mg/ml ACTAVIS S.R.L ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 8 ML CONTINAND 10 MG CLORHIDRAT DE DOXORUBICIN S 1 27,18 27,180000 27,180000 35,55 35,550000 35,550000

199 L01DB01 DOXORUBICINUM SINDROXOCIN 2mg/ml PULB. PT. SOL. PERF. 2mg/ml ACTAVIS S.R.L ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML X 50 MG CLORHIDRAT DE DOXORUBICINA S 1 105,66 105,660000 105,660000 128,99 128,990000 128,990000

200 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 25 ML S 1 231,77 231,770000 165,624000 282,94 282,940000 202,188000

201 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 454,46 454,460000 260,400000 533,51 533,510000 317,892000

202 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 48,67 48,670000 45,636000 63,66 63,660000 59,688000

203 L01DB03 EPIRUBICINUM EPISINDAN 10 mg LIOF. PT. SOL. INJ. 10mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. CU LIOF. PT. SOL. INJ. S 1 42,74 42,740000 42,740000 55,90 55,900000 55,900000

204 L01DB03 EPIRUBICINUM EPISINDAN 50 mg LIOF. PT. SOL. INJ. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. CU LIOF. PT. SOL. INJ. S 1 233,65 233,650000 165,624000 285,24 285,240000 202,188000

205 L01DB03 EPIRUBICINUM EPIRUBICINA KABI 2 mg/ml SOL. INJ./PERF. 2 mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 100 ML SOL. INJ./PERF. X 200 MG PR 1 396,30 396,300000 396,300000 470,12 470,120000 470,120000

206 L01DB03 EPIRUBICINUM EPIRUBICINA KABI 2 mg/ml SOL. INJ./PERF. 2 mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML SOL. INJ./PERF. X 50 MG PR 1 138,02 138,020000 138,020000 168,49 168,490000 168,490000

207 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 100 ML SOL. INJ./PERF. X 200 MG EPIRUBICINA S 1 771,75 771,750000 475,560000 879,36 879,360000 564,144000

208 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 50 ML SOL. INJ./PERF. X 100 MG EPIRUBICINA S 1 450,99 450,990000 260,400000 529,73 529,730000 317,892000

209 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 25 ML SOL. INJ./PERF. X 50 MG EPIRUBICINA S 1 198,48 198,480000 165,624000 242,30 242,300000 202,188000

210 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOL. INJ./PERF. X 20 MG EPIRUBICINA S 1 80,83 80,830000 80,830000 102,20 102,200000 102,200000

211 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 5 ML SOL. INJ./PERF. X 10 MG EPIRUBICINA S 1 39,99 39,990000 39,990000 52,31 52,310000 52,310000

212 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 100ML SOL. INJ. X 200MG (200MG/100ML) S 1 397,31 397,310000 397,310000 471,22 471,220000 471,220000

213 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 50 ML SOL. INJ. X 100MG (100MG/50ML) S 1 217,00 217,000000 217,000000 264,91 264,910000 264,910000

214 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 25 ML SOL. INJ. X 50MG (50MG/25ML) S 1 197,39 197,390000 165,624000 240,97 240,970000 202,188000

215 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 100 ML SOL. INJ. /PERFZ. S 1 773,38 773,380000 475,560000 881,13 881,130000 564,144000

216 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 75 ML SOL. INJ. /PERFZ. S 1 588,06 588,060000 588,060000 679,14 679,140000 679,140000

217 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOL. INJ./PERF. X 200 MG EPIRUBICINA S 1 771,75 771,750000 475,560000 879,36 879,360000 564,144000

218 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 50 ML SOL. INJ./PERF. X 100 MG EPIRUBICINA S 1 450,99 450,990000 260,400000 529,73 529,730000 317,892000

219 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 25 ML SOL. INJ./PERF. X 50 MG EPIRUBICINA S 1 198,48 198,480000 165,624000 242,30 242,300000 202,188000

220 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOL. INJ./PERF. X 20 MG EPIRUBICINA S 1 80,83 80,830000 80,830000 102,20 102,200000 102,200000

221 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 5 ML SOL. INJ./PERF. X 10 MG EPIRUBICINA S 1 39,99 39,990000 39,990000 52,31 52,310000 52,310000

222 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 10 ML SOL. INJ. X 20MG (20MG/10ML) S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

223 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 25 ML SOL. INJ. /PERFZ. S 1 204,65 204,650000 165,624000 249,84 249,840000 202,188000

224 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 5 ML SOL. INJ. X 10MG (10MG/5ML) S 1 38,03 38,030000 38,030000 49,74 49,740000 49,740000

225 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 10 ML SOL. INJ. /PERFZ. S 1 83,38 83,380000 83,380000 105,42 105,420000 105,420000

226 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 5 ML SOL. INJ. /PERFZ. S 1 42,50 42,500000 42,500000 55,59 55,590000 55,590000

227 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 203,33 203,330000 203,330000 248,22 248,220000 248,220000

228 L01DB06 IDARUBICINUM ZAVEDOS 5 mg PULB. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 143,35 143,350000 143,350000 175,00 175,000000 175,000000

229 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 1 555,48 555,480000 555,480000 643,62 643,620000 643,620000

230 L01DC01 BLEOMYCINUM SULFAS BLEOMYCIN MEDAC 15000 UI PULB. PT. SOL. INJ. 15000UI MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CU PULB. PT. SOL. INJ. PR 1 105,44 105,440000 105,440000 128,72 128,720000 128,720000

231 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

232 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 19,75 19,750000 19,750000 26,70 26,700000 26,700000

233 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 20 ML CONC. PT. SOL. PERF. PR 1 11,00 11,000000 11,000000 14,87 14,870000 14,868000

234 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 67,91 67,910000 67,910000 85,86 85,860000 85,860000

235 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

236 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML CONC. PT. SOL. PERF. S 1 9,17 9,170000 9,170000 12,39 12,390000 12,390000

237 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML X 10 MG CONC. SOL. PERF. S 1 18,81 18,810000 11,004000 25,42 25,420000 14,868000

238 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML X 50 MG CONC. SOL. PERF. S 1 48,45 48,450000 37,884000 63,37 63,370000 49,560000

239 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 25 mg/50 ml CONC. PT. SOL. PERF. 25mg/50ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML COND. PT. SOL. PERF. S 1 22,06 22,060000 22,060000 29,81 29,810000 29,810000

240 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF. 50mg/100ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT. SOL. PERF. S 1 31,57 31,570000 31,570000 41,30 41,300000 41,300000

241 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 5 ML CONC. PT. SOL. PERF. S 1 21,86 21,860000 21,624000 29,55 29,550000 29,220000

242 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 45 ML CONC. PT. SOL. PERF. S 1 178,07 178,070000 158,400000 217,39 217,390000 193,380000

243 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL. PERF. S 1 47,45 47,450000 47,450000 62,06 62,060000 62,060000

244 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 18,05 18,050000 18,050000 24,39 24,390000 24,390000

245 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 45 ML CONC. PT. SOL. PERF. S 1 132,81 132,810000 132,810000 162,14 162,140000 162,140000

246 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE GALBENA X 60 ML CONC. PT. SOL. PERF. X 600 MG CARBOPLATINA PR 1 174,90 174,900000 174,900000 213,52 213,520000 213,520000

247 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ROSIE X 45 ML CON. PT. SOL. PERF. X 450 MG CARBOPLATINA PR 1 132,00 132,000000 132,000000 161,15 161,150000 161,150000

248 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ALBASTRA X 15 ML CONC. PT. SOL. PERF. X 150 MG CARBOPLATINA PR 1 47,42 47,420000 47,420000 62,03 62,030000 62,030000

249 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE VERDE X 5 ML CON. PT. SOL. PERF. X 50 MG CARBOPLATINA PR 1 18,02 18,020000 18,020000 24,35 24,350000 24,350000

250 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 15 ML CONC. PT. SOL. PERF. S 1 62,52 62,520000 56,904000 79,05 79,050000 74,436000

251 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 15 ML CONC. PT. SOL. PERF. S 1 50,00 50,000000 50,000000 63,22 63,220000 63,220000

252 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 45 ML CONC. PT. SOL. PERF. S 1 133,04 133,040000 133,040000 162,41 162,410000 162,410000

253 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 40 ML CONC. PT. SOL. PERF PR 1 1.396,48 1.396,480000 759,336000 1.560,32 1.560,320000 873,456000

254 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 20 ML CONC. PT. SOL. PERF PR 1 523,31 523,310000 362,700000 608,56 608,560000 441,120000

255 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 10 ML CONC. PT. SOL. PERF PR 1 264,15 264,150000 173,196000 322,48 322,480000 211,440000

256 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 100 MG/20 ML CONC. PT. SOL. PERF. S 1 493,70 493,700000 362,700000 576,28 576,280000 441,120000

257 L01XA03 OXALIPLATINUM OXALIPLATINA TEVA 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML CONC. PT. SOL. PERF. PR 1 331,41 331,410000 331,410000 399,39 399,390000 399,390000

258 L01XA03 OXALIPLATINUM OXALIPLATINA TEVA 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML CONC. PT. SOL. PERF. PR 1 165,76 165,760000 165,760000 202,36 202,360000 202,360000

259 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 200 MG/40 ML CONC. PT. SOL. PERF. S 1 957,36 957,360000 759,336000 1.081,67 1.081,670000 873,456000

260 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA FARA FOLIE PROTECTOARE DIN PLASTIC A 40 ML CONC. PT. SOL. PERF. PR 1 632,78 632,780000 632,780000 727,88 727,880000 727,880000

261 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 40 ML CONC. PT. SOL. PERF. C PR 1 632,78 632,780000 632,780000 727,88 727,880000 727,880000

262 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 20 ML CONC. PT. SOL. PERF. CARE CONTINE 100 MG OXALIPLATINA PR 1 615,78 615,780000 362,700000 709,35 709,350000 441,120000

263 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CONC. PT. SOL. PERF. CARE CONTINE 50 MG OXALIPLATINA PR 1 322,26 322,260000 173,196000 389,41 389,410000 211,440000

264 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 40 ML CONC. PT. SOL. PERF. CARE CONTINE 200 MG OXALIPLATINA PR 1 1.396,51 1.396,510000 759,336000 1.560,35 1.560,350000 873,456000

265 L01XA03 OXALIPLATINUM OXALIPLATIN ACCORD 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 20 ML CONC. PT. SOL. PERF. X 100 MG OXALIPLATINA S 1 615,78 615,780000 362,700000 709,35 709,350000 441,120000

Pagina 12 din 42

Page 112: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

266 L01XA03 OXALIPLATINUM OXALIPLATIN ACCORD 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CONC. PT. SOL. PERF. X 50 MG OXALIPLATINA S 1 322,25 322,250000 173,196000 389,40 389,400000 211,440000

267 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 20 ML CONC. PT. SOL. PERF. C PR 1 331,40 331,400000 331,400000 399,38 399,380000 399,380000

268 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 10 ML CONC. PT. SOL. PERF. C PR 1 165,75 165,750000 165,750000 202,35 202,350000 202,350000

269 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 50 MG/10 ML CONC. PT. SOL. PERF. S 1 255,01 255,010000 173,196000 311,32 311,320000 211,440000

270 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml ACTAVIS S.R.L. ROMANIA CUTIE 1 FLAC. X 50 MG LIOF. PT. SOL. PERF. S 1 322,26 322,260000 173,196000 389,41 389,410000 211,440000

271 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 MG LIOF. PT. SOL. PERF. S 1 615,78 615,780000 362,700000 709,35 709,350000 441,120000

272 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml PULB. PT. SOL. INJ. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCLORA CU CAPACITATEA DE 50 ML X 100 MG OXALIPLATINA PR 1 331,40 331,400000 331,400000 399,38 399,380000 399,380000

273 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml PULB. PT. SOL. INJ. 5mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCLORA CU CAPACITATEA DE 30 ML X 50 MG OXALIPLATINA PR 1 165,75 165,750000 165,750000 202,35 202,350000 202,350000

274 L01XA03 OXALIPLATINUM OXALIPLATIN STADA 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 MG OXALIPLATINA PR 1 302,25 302,250000 302,250000 367,60 367,600000 367,600000

275 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 50 MG OXALIPLATI PR 1 457,29 457,290000 173,196000 536,60 536,600000 211,440000

276 L01XA03 OXALIPLATINUM REZIDOL 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 MG OXALIPLATINA S 1 331,40 331,400000 331,400000 399,38 399,380000 399,380000

277 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 150 MG OXALIPLAT PR 1 1.609,04 1.609,040000 1.609,040000 1.792,01 1.792,010000 1.792,010000

278 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 100 MG OXALIPLAT PR 1 871,57 871,570000 362,700000 988,16 988,160000 441,120000

279 L01XA03 OXALIPLATINUM REZIDOL 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 MG OXALIPLATINA S 1 165,75 165,750000 165,750000 202,35 202,350000 202,350000

280 L01XA03 OXALIPLATINUM OXALIPLATIN STADA 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 MG OXALIPLATINA PR 1 144,33 144,330000 144,330000 176,20 176,200000 176,200000

281 L01XB01 PROCARBAZINUM4) NATULAN CAPS. 50 mg CN UNIFARM S.A. ROMANIA CUTIE X 50CAPSULE PRF 50 669,00 13,380000 13,380000 767,36 15,347200 15,347200

282 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 5.509,03 5.509,030000 5.509,030000 6.043,00 6.043,000000 6.043,000000

283 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 2.221,55 1.110,775000 1.110,775000 2.459,64 1.229,820000 1.229,820000

284 L01XC03 TRASTUZUMABUM**** HERCEPTIN 150mg PULB. PT. CONC. PT. SOL. PERF. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 2.621,74 2.621,740000 2.621,740000 2.895,85 2.895,850000 2.895,850000

285 L01XC06 CETUXIMABUM**** ERBITUX 5mg/ml SOL. PERF. 5mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN STICLA X 20 ML SOL. PERF. S 1 871,19 871,190000 871,190000 987,75 987,750000 987,750000

286 L01XC07 BEVACIZUMABUM**** AVASTIN 25mg/ml CONC. PT. SOL. PERF. 25mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 4 ML CONC. PT. SOL. PERF. S 1 1.332,54 1.332,540000 1.332,540000 1.490,62 1.490,620000 1.490,620000

287 L01XC07 BEVACIZUMABUM**** AVASTIN 25mg/ml CONC. PT. SOL. PERF. 25mg/ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA X 16 ML CONC. PT. SOL. PERF. S 1 5.246,58 5.246,580000 5.246,580000 5.756,93 5.756,930000 5.756,930000

288 L01XE01 IMATINIBUM**** NIBIX 100 mg CAPS. 100mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 120 CAPS. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

289 L01XE01 IMATINIBUM**** GLIVEC 100 mg CAPS. 100mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 120 CAPS. PR 120 8.091,78 67,431500 52,699900 8.858,20 73,818333 57,824500

290 L01XE01 IMATINIBUM**** IMATINIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTER DIN AL/PVC/ACLAR X 120 CAPSULE PR 120 5.269,99 43,916583 43,916583 5.782,45 48,187083 48,187083

291 L01XE01 IMATINIBUM**** NEOXELL 100 mg COMPR. FILM. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

292 L01XE01 IMATINIBUM**** IMATINIB ZENTIVA 100 mg COMPR. FILM. 100mg ZENTIVA, K.S. REPUBLICA SLOVACA CUTIE CU 12 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

293 L01XE01 IMATINIBUM**** MEAXIN 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

294 L01XE01 IMATINIBUM**** MEAXIN 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

295 L01XE01 IMATINIBUM**** IMATINIB TEVA 100 mg COMPR. FILM. 100mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. OPA/AL/PVC/AL A CATE 120 X 1 COMPRIMAT PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

296 L01XE01 IMATINIBUM**** IMATINIB GLENMARK 100 mg COMPR. FILM. 100mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

297 L01XE01 IMATINIBUM**** IMAKREBIN 100 mg COMPR. FILM. 100mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

298 L01XE01 IMATINIBUM**** IMATINIB TEVA 400 mg COMPR. FILM. 400 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. OPA/AL/PVC/AL A CATE 30 X 1 COMPRIMAT PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

299 L01XE01 IMATINIBUM**** NEOXELL 400 mg COMPR. FILM. 400mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

300 L01XE01 IMATINIBUM**** MEAXIN 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

301 L01XE01 IMATINIBUM**** MEAXIN 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

302 L01XE01 IMATINIBUM**** IMATINIB GLENMARK 400 mg COMPR. FILM. 400mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

303 L01XE03 ERLOTINIBUM**** TARCEVA 100 mg COMPR. FILM. 100mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF/R 30 6.304,73 210,157666 210,157666 6.910,31 230,343666 230,343666

304 L01XE03 ERLOTINIBUM**** TARCEVA 150 mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF/R 30 8.391,10 279,703333 279,703333 9.184,46 306,148666 306,148666

305 L01XE03 ERLOTINIBUM**** TARCEVA 25 mg COMPR. FILM. 25mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF/R 30 1.911,34 63,711333 63,711333 2.121,51 70,717000 70,717000

306 L01XE04 SUNITINIBUM**** SUTENT 12,5 mg CAPS. 12,5mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 5.042,42 168,080666 168,080666 5.534,39 184,479666 184,479666

307 L01XE04 SUNITINIBUM**** SUTENT 25mg CAPS. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 10.054,84 335,161333 335,161333 10.997,94 366,598000 366,598000

308 L01XE04 SUNITINIBUM**** SUTENT 50 mg CAPS. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS. P-RF/R 30 20.079,69 669,323000 669,323000 21.925,04 730,834666 730,834666

309 L01XE05 SORAFENIBUM**** NEXAVAR 200 mg COMPR. FILM. 200mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 4 BLIST. AL/PP X 28 COMPR.FILM. P-RF/R 112 14.588,00 130,250000 130,250000 15.939,09 142,313303 142,313303

310 L01XE06 DASATINIBUM**** SPRYCEL 100mg COMPR. FILM. 100 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-RF/R 30 16.311,93 543,731000 543,731000 17.818,18 593,939333 593,939333

311 L01XE06 DASATINIBUM**** SPRYCEL 20mg COMPR. FILM. 20 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 7.697,81 128,296833 128,296833 8.428,77 140,479500 140,479500

312 L01XE06 DASATINIBUM**** SPRYCEL 50mg COMPR. FILM. 50 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 15.365,65 256,094166 256,094166 16.786,73 279,778833 279,778833

313 L01XE06 DASATINIBUM**** SPRYCEL 70mg COMPR. FILM. 70 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-RF/R 60 15.365,65 256,094166 256,094166 16.786,73 279,778833 279,778833

314 L01XE09 TEMSIROLIMUSUM TORISEL 25mg/ml CONC. + SOLV. PT. SOL. PERF. 25mg/ml WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 1 FLAC. X 1,2ML CONCENTRAT + 1 FLAC. X 1,8 SOLVENT S 1 3.737,17 3.737,170000 3.737,170000 4.111,67 4.111,670000 4.111,670000

315 L01XX02 ASPARAGINAZUM ASPARAGINASE 10000 MEDAC LIOF. PT. SOL. INJ./PERF. 10000ui MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 FLAC. DIN STICLA X 10 000 UI LIOF. PT. SOL. INJ./PERF. S 1 314,90 314,900000 314,900000 381,39 381,390000 381,390000

316 L01XX02 ASPARAGINAZUM ASPARAGINASE 5000 MEDAC LIOF. PT. SOL. INJ./PERF. 5000ui MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 FLAC. DIN STICLA X 5000 UI LIOF. PT. SOL. INJ./PERF. S 1 262,42 262,420000 262,420000 320,36 320,360000 320,360000

317 L01XX05 HYDROXYCARBAMIDUM HYDREA CAPS. 500mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. P-RF 100 65,72 0,657200 0,657200 83,10 0,831000 0,831000

318 L01XX14 TRETINOINUM4 VESANOID 10 mg CAPS. MOI 10mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 100 CAPS. MOI PRF 100 690,07 6,900700 6,900700 790,33 7,903300 7,903300

319 L01XX17 TOPOTECAMUM HYCAMTIN 1 mg CAPS. 1mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X BLIST. PVC/PCTFE/AL X 10 CAPS. P-RF 10 1.582,86 158,286000 158,286000 1.763,47 176,347000 176,347000

320 L01XX17 TOPOTECAMUM TOPOTECAN TEVA 1 mg/1ml CONC. PT. SOL. PERF. 1mg/1ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA TRANSPARENTA A 1ML P-RF/R 1 170,26 170,260000 170,260000 207,85 207,850000 207,850000

321 L01XX17 TOPOTECAMUM TOPOTECAN EBEWE 1 mg/ml CONC. PT. SOL. PERF. 1mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 4 ML CONC. PT. SOL. PERF. PR 1 649,10 649,100000 649,100000 745,67 745,670000 745,670000

322 L01XX17 TOPOTECAMUM TOPOTECAN TEVA 4 mg/4ml CONC. PT. SOL. PERF. 4mg/4ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA TRANSPARENTA A 4ML P-RF/R 1 649,09 649,090000 649,090000 745,66 745,660000 745,660000

323 L01XX17 TOPOTECAMUM POTACTASOL 4mg PULB. PT. CONC. PT. SOL. PERF. 1 mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1FL DIN STICLA X 4 MG PULBERE PENTRU CONCENTRAT PENTRU SOLU_IE PERFUZABILA PR 1 649,10 649,100000 649,100000 745,67 745,670000 745,670000

324 L01XX17 TOPOTECAMUM TOPOTECAN ATB 1 mg PULB. PT. CONC. PT. SOL. PERF. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML X 1 MG TOPOTECAN PR 1 170,26 170,260000 170,260000 207,85 207,850000 207,850000

325 L01XX17 TOPOTECAMUM TOPOTECAN KABI 4 mg PULB. PT. CONC. PT. SOL. PERF. 4 mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 5 FLAC. DIN STICLA INCOLORA, CU FOLIE PROTECTOARE DIN PLASTIC X 4 MG PULB. PT. CONC. PT. SO PR 5 3.116,22 623,244000 623,244000 3.434,83 686,966000 686,966000

326 L01XX17 TOPOTECAMUM TOPOTECAN KABI 4 mg PULB. PT. CONC. PT. SOL. PERF. 4 mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA, CU FOLIE PROTECTOARE DIN PLASTIC X 4 MG PULB. PT. CONC. PT. SO PR 1 647,24 647,240000 647,240000 743,64 743,640000 743,640000

327 L01XX17 TOPOTECAMUM TOPOTECAN ACCORD 4 mg PULB. PT. CONC. PT. SOL. PERF. 4mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. CONC. PT. SOL. PERF. S 1 647,70 647,700000 647,700000 744,14 744,140000 744,140000

328 L01XX17 TOPOTECAMUM TOPOTECAN ATB 4 mg PULB. PT. CONC. PT. SOL. PERF. 4mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML X 4 MG TOPOTECAN PR 1 649,09 649,090000 649,090000 745,66 745,660000 745,660000

329 L01XX17 TOPOTECAMUM HYCAMTIN 4 mg PULB.CONC.SOL.PERF. 4mg SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 982,46 982,460000 747,892800 1.109,03 1.109,030000 824,359200

330 L01XX19 IRINOTECANUM IRINOTECAN KABI 20 mg/ml CONC. PT. SOL. PERF. 20 mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLACON STICLA BRUNA DE 6 ML X 5 ML CONC. PT. SOL. PERF. PR 1 312,84 312,840000 312,840000 379,15 379,150000 379,150000

331 L01XX19 IRINOTECANUM IRINOTECAN KABI 20 mg/ml CONC. PT. SOL. PERF. 20 mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLACON STICLA BRUNA DE 6 ML X 2 ML CONC. PT. SOL. PERF. PR 1 119,02 119,020000 119,020000 145,30 145,300000 145,300000

332 L01XX19 IRINOTECANUM IRINOTECAN KABI 20 mg/ml CONC. PT. SOL. PERF. 20 mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLACON STICLA BRUNA DE 30 ML X 25 ML CONC. PT. SOL. PERF. PR 1 936,01 936,010000 936,010000 1.058,40 1.058,400000 1.058,400000

333 L01XX19 IRINOTECANUM IRINOTECAN KABI 20 mg/ml CONC. PT. SOL. PERF. 20 mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLACON STICLA BRUNA DE 20 ML X 15 ML CONC. PT. SOL. PERF. PR 1 507,64 507,640000 507,640000 591,48 591,480000 591,480000

334 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 ML CONC. PT. SOL. INJ. S 1 402,16 402,160000 375,408000 476,50 476,500000 454,980000

335 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 2 ML CONC. PT. SOL. INJ. S 1 163,74 163,740000 142,824000 199,89 199,890000 174,360000

336 L01XX19 IRINOTECANUM IRINOTECAN ATB 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 5 ML X 5 ML CONC. PT. SOL. PERF. INCHIS CU DOP D PR 1 426,10 426,100000 375,408000 502,60 502,600000 454,980000

337 L01XX19 IRINOTECANUM LUDIRADOL 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 6 ML X 100 MG IRINOTECAN PR 1 355,85 355,850000 355,850000 426,03 426,030000 426,030000

338 L01XX19 IRINOTECANUM IRINOTECAN HOSPIRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. STICLA BRUNA X 25 ML CONC. PT. SOL. PERF. S 1 1.753,18 1.753,180000 1.123,212000 1.949,12 1.949,120000 1.270,080000

Pagina 13 din 42

Page 113: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

339 L01XX19 IRINOTECANUM IRINOTECAN HOSPIRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. STICLA BRUNA X 5 ML CONC. PT. SOL. PERF. S 1 374,64 374,640000 374,640000 446,51 446,510000 446,510000

340 L01XX19 IRINOTECANUM IRINOTECAN HOSPIRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. STICLA BRUNA X 2 ML CONC. PT. SOL. PERF. S 1 152,48 152,480000 142,824000 186,15 186,150000 174,360000

341 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25 ML CONC. PT. SOL. INJ. S 1 2.010,90 2.010,900000 1.123,212000 2.230,03 2.230,030000 1.270,080000

342 L01XX19 IRINOTECANUM CAMPTO CONC. PT. SOL. PERF. 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PP X 15 ML CONC. PT. SOL. PERF. S 1 2.129,33 2.129,330000 609,168000 2.359,12 2.359,120000 709,776000

343 L01XX19 IRINOTECANUM CAMPTO CONC. PT. SOL. PERF. 20mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PP X 5 ML CONC. PT. SOL. PERF. S 1 639,39 639,390000 375,408000 735,09 735,090000 454,980000

344 L01XX19 IRINOTECANUM IRINOTRCAN MEDAC 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA BRUNA X 15 ML CONC. PR. SOL. PERF. S 1 1.394,57 1.394,570000 609,168000 1.558,23 1.558,230000 709,776000

345 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL.PERF. S 1 1.295,74 1.295,740000 609,168000 1.450,51 1.450,510000 709,776000

346 L01XX19 IRINOTECANUM IRINOTECAN EBEWE 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA + DOP CAUCIUC FARA PLASTIC DE PROTECTIE TIP ONCO-SAFE A 15 ML CONC S 1 1.345,75 1.345,750000 609,168000 1.505,02 1.505,020000 709,776000

347 L01XX19 IRINOTECANUM IRINOTECAN EBEWE 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA + DOP CAUCIUC FARA PLASTIC DE PROTECTIE TIP ONCO-SAFE A 5 ML CONC. S 1 416,85 416,850000 375,408000 492,52 492,520000 454,980000

348 L01XX19 IRINOTECANUM IRINOTRCAN MEDAC 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA BRUNA X 5 ML CONC. PR. SOL. PERF. S 1 426,18 426,180000 375,408000 502,69 502,690000 454,980000

349 L01XX19 IRINOTECANUM IRINOTRCAN MEDAC 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA BRUNA X 2 ML CONC. PR. SOL. PERF. S 1 167,11 167,110000 142,824000 204,01 204,010000 174,360000

350 L01XX23 MITOTANUM LYSODREN 500mg COMPR. 500mg LABORATOIRE HRA PHARMA FRANTA CUTIE X 1 FLAC. DIN PEID X 100 COMPR. P-RF/R 100 2.567,46 25,674600 25,674600 2.836,68 28,366800 28,366800

351 L01XX32 BORTEZOMIBUM**** VELCADE 3,5 mg PULB. PT. SOL. INJ. 3,5mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. X 10ML X 3,5 MG PULB. PT. SOL. INJ., INTRODUS INTR-UN BLISTER TRANSPARENT P-RF/R 1 4.587,17 4.587,170000 4.587,170000 5.038,17 5.038,170000 5.038,170000

352 L02AB01 MEGESTROLUM MEGESIN 160 mg COMPR. 160mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-RF 30 97,75 3,258333 3,258333 123,59 4,119666 4,119666

353 L02AE02 LEUPRORELINUM** ELIGARD 22,5 mg LIOF. SI SOLV. PT. SOL. INJ. 22,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 SET X 2 SERINGI DIN PP PREUMPLUTE (O SERINGA A SI O SERINGA B), IN PUNGI LAMINATE S 1 1.020,28 1.020,280000 1.020,280000 1.150,26 1.150,260000 1.150,260000

354 L02AE02 LEUPRORELINUM** ELIGARD 7,5 mg LIOF. SI SOLV. PT. SOL. INJ. 7,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 SET X 2 SERINGI DIN PP PREUMPLUTE (O SERINGA A SI O SERINGA B), IN PUNGI LAMINATE S 1 369,22 369,220000 369,220000 440,60 440,600000 440,600000

355 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 1 877,79 877,790000 877,790000 994,94 994,940000 994,940000

356 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 1 359,23 359,230000 359,230000 429,71 429,710000 429,710000

357 L02AE02 LEUPRORELINUM** ELIGARD 45 mg PULB+SOLV.PT.SOL.INJ 45mg ASTELLAS PHARMA EUROPE BV OLANDA O CUTIE X 1 SET X 2 TAVITE TERMOFORMATE CE CONTIN 2 SERINGI PREUMPLUTE (O SERINGA A SI O SERINGA B) S 1 2.030,80 2.030,800000 2.030,800000 2.251,73 2.251,730000 2.251,730000

358 L02AE03 GOSERELINUM** ZOLADEX LA 10,8 mg IMPLANT 10,8 mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC DIN PET-AL-PE X 1 SERINGA PREUMPLUTA CU 10,8 MG IMPLANT+AC DIN INOX CU SIST. DE PROT S 1 1.040,75 1.040,750000 1.040,750000 1.172,57 1.172,570000 1.172,570000

359 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 1 365,48 365,480000 365,480000 436,52 436,520000 436,520000

360 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 7 110,27 15,752857 15,752857 134,62 19,231428 19,231428

361 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 B S/P-RF 1 1.051,98 1.051,980000 1.051,980000 1.184,81 1.184,810000 1.184,810000

362 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 B S/P-RF 1 369,20 369,200000 369,200000 440,58 440,580000 440,580000

363 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 28 543,42 19,407857 18,903428 630,48 22,517142 22,517142

364 L02BA01 TAMOXIFENUM TAMOXIFEN SANDOZ 10 COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-RF/S 100 39,78 0,397800 0,397800 52,03 0,520300 0,520300

365 L02BA03 FULVESTRANTUM** FASLODEX 250mg SOL. INJ. 250mg/5ml ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 5 ML + 1 AC P-RF 1 1.551,89 1.551,890000 1.551,890000 1.729,71 1.729,710000 1.729,710000

366 L02BB01 FLUTAMIDUM FLUTAN COMPR. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 113,97 1,139700 1,139700 139,14 1,391400 1,391400

367 L02BB01 FLUTAMIDUM FLUTASIN 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA BRUNA X 30 COMPR. P-RF 30 30,83 1,027666 1,027666 40,32 1,344000 1,344000

368 L02BB01 FLUTAMIDUM FLUTAMIDE CSC 250 mg COMPR. FILM. 250mg CSC PHARMACEUTICALS HANDELS GMBH AUSTRIA CUTIE X 3 BLIST AL/PVC-PVDC X 10 COMPR. FILM. P-RF 30 33,52 1,117333 1,117333 43,84 1,461333 1,461333

369 L02BB03 BICALUTAMIDUM YONISTIB 150 mg COMPR. FILM. 150mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 394,41 14,086071 14,086071 468,06 16,716428 16,716428

370 L02BB03 BICALUTAMIDUM BICALUTAMID TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 356,54 12,733571 12,733571 426,78 15,242142 15,242142

371 L02BB03 BICALUTAMIDUM BICALUTAMIDA ALVOGEN 150 mg COMPR. FILM. 150mg ALVOGEN ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM P6L 28 381,97 13,641785 13,641785 454,50 16,232142 16,232142

372 L02BB03 BICALUTAMIDUM CASODEX 150 mg COMPR. FILM. 150mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L 28 590,67 21,095357 15,249428 681,98 24,356428 18,256714

373 L02BB03 BICALUTAMIDUM BICALUTAMIDA SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLISTERE PVC-ACLAR/AL X 30 COMPR. FILM. P-6L 30 415,88 13,862666 13,862666 491,46 16,382000 16,382000

374 L02BB03 BICALUTAMIDUM BICALUTAMIDA KABI 150 mg COMPR. FILM. 150mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM. P6L 28 355,82 12,707857 12,707857 425,99 15,213928 15,213928

375 L02BB03 BICALUTAMIDUM BICALUTAMIDA KABI 50 mg COMPR. FILM. 50 mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 (2X14) COMPR. FILM. P6L 28 140,25 5,008928 5,008928 171,22 6,115000 6,115000

376 L02BB03 BICALUTAMIDUM BICALUTAMIDA KABI 50 mg COMPR. FILM. 50 mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 (1X14) COMPR. FILM. P6L 14 71,40 5,100000 5,100000 90,28 6,448571 6,448571

377 L02BB03 BICALUTAMIDUM BICALUTAMIDA RANBAXY 50 mg COMPR. FILM. 50 mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID CU CAPAC PP X 28 COMPR.FILM. P6L 28 168,59 6,021071 5,983999 205,82 7,350714 7,305199

378 L02BB03 BICALUTAMIDUM BICALUTAMIDA RANBAXY 50 mg COMPR. FILM. 50 mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P6L 28 168,59 6,021071 5,983999 205,82 7,350714 7,305199

379 L02BB03 BICALUTAMIDUM BICALUTAMIDA SANDOZ 50 mg COMPR. FILM. 50mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 149,60 4,986666 4,986666 182,63 6,087666 6,087666

380 L02BB03 BICALUTAMIDUM YONISTIB 50 mg COMPR. FILM. 50mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 187,29 6,688928 5,983999 228,65 8,166071 7,305199

381 L02BB03 BICALUTAMIDUM BICALUTAMIDA ACCORD 50 mg COMPR. FILM. 50mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 141,19 5,042500 5,042500 172,37 6,156071 6,156071

382 L02BB03 BICALUTAMIDUM BICALUTAMIDA ALVOGEN 50 mg COMPR. FILM. 50mg ALVOGEN ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM P6L 28 152,77 5,456071 5,456071 186,50 6,660714 6,660714

383 L02BB03 BICALUTAMIDUM CALUMID COMPR. FILM. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 15 COMPR. FILM. P-6L 30 200,69 6,689666 5,983999 245,00 8,166666 7,305199

384 L02BB03 BICALUTAMIDUM CASODEX 50 mg COMPR. FILM. 50mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. TIP CALENDAR AL/PVC X 14 COMPR. FILM. P-6L 28 288,09 10,288928 5,983999 351,70 12,560714 7,305199

385 L02BB03 BICALUTAMIDUM BICATLON 50mg COMPR. FILM. 50mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. AL/PVC X 28 COMPR. FILM. P-6L 28 186,27 6,652500 5,983999 227,40 8,121428 7,305199

386 L02BB03 BICALUTAMIDUM BICALUTAMIDA ATB 50 mg COMPR. FILM. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PR 30 179,30 5,976666 5,976666 218,89 7,296333 7,296333

387 L02BG01 AMINOGLUTETHIMIDUM ROGLUTEN (R) 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 40 COMPR. P-RF 40 124,00 3,100000 3,100000 151,38 3,784500 3,784500

388 L02BG03 ANASTROZOLUM ANASTROZOL ATB 1 mg COMPR. FILM. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P -6L 30 91,40 3,046666 3,046666 115,56 3,852000 3,852000

389 L02BG03 ANASTROZOLUM KYARESTA 1 mg COMPR. FILM. 1mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR. FILM. P-6L 28 95,19 3,399642 3,399642 120,36 4,298571 4,298570

390 L02BG03 ANASTROZOLUM EGISTROZOL 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE- PVDC/AL X 30 COMPR.FILM. PR 30 113,17 3,772333 3,399857 138,16 4,605333 4,298570

391 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 100 COMPR. FILM. P-6L 100 338,93 3,389300 3,389300 407,58 4,075800 4,075800

392 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 98 COMPR. FILM. P-6L 98 332,75 3,395408 3,395408 400,85 4,090306 4,090306

393 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 84 COMPR. FILM. P-6L 84 285,45 3,398214 3,398214 348,48 4,148571 4,148571

394 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 169,90 3,398000 3,398000 207,42 4,148400 4,148400

395 L02BG03 ANASTROZOLUM ARIMIDEX 1 mg COMPR. FILM. 1mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. TIP CALENDAR AL/PVC X 14 COMPR. FILM. P-6L 28 128,99 4,606785 3,399857 157,47 5,623928 4,298570

396 L02BG03 ANASTROZOLUM ANASTROZOLE MEDICO UNO 1 mg COMPR. FILM. 1mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 85,12 3,040000 3,040000 107,63 3,843928 3,843928

397 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 103,80 3,460000 3,399857 126,72 4,224000 4,224000

398 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-6L 28 96,88 3,460000 3,399857 122,50 4,375000 4,298570

399 L02BG03 ANASTROZOLUM ENZAMIDEX 1mg COMPR. FILM. 1mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 91,46 3,048666 3,048666 115,64 3,854666 3,854666

400 L02BG03 ANASTROZOLUM ANAROMAT 1 mg COMPR. FILM. 1mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PR 28 89,60 3,200000 3,200000 113,29 4,046071 4,046071

401 L02BG03 ANASTROZOLUM ANASTROZOL BLUEFISH 1 mg COMPR. FILM. 1mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-6L 28 80,01 2,857500 2,857500 101,17 3,613214 3,613214

402 L02BG03 ANASTROZOLUM OZOLAN 1 mg COMPR. FILM. 1mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-6L 28 95,20 3,400000 3,399857 120,37 4,298928 4,298570

403 L02BG03 ANASTROZOLUM ANASTRAZE 1 mg COMPR. FILM. 1mg SANDOZ SRL ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-6L 28 94,64 3,380000 3,380000 119,66 4,273571 4,273571

404 L02BG03 ANASTROZOLUM ANASTROZOL KABI 1 mg COMPR. FILM. 1mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 (2X14) COMPR. FILM. P6L 28 79,33 2,833214 2,833214 100,30 3,582142 3,582142

405 L02BG03 ANASTROZOLUM ANASTROZOL KABI 1 mg COMPR. FILM. 1mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 (1X14) COMPR. FILM. P6L 14 40,38 2,884285 2,884285 52,82 3,772857 3,772857

406 L02BG03 ANASTROZOLUM EGISTROZOL 1 mg COMPR. FILM. 1mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PE- PVDC/AL X 90 COMPR.FILM. PR 90 338,63 3,762555 3,399857 407,26 4,525111 4,298570

407 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 20 COMPR. FILM. P-6L 20 69,20 3,460000 3,399857 87,50 4,375000 4,298570

408 L02BG03 ANASTROZOLUM AXASTROL 1 mg COMPR. FILM. 1mg AS GRINDEKS LETONIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-6L 28 106,54 3,805000 3,399857 130,06 4,645000 4,298570

409 L02BG03 ANASTROZOLUM ELOZA 1 mg COMPR. FILM. 1mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 91,40 3,046666 3,046666 115,56 3,852000 3,852000

410 L02BG03 ANASTROZOLUM ANASTROZOL TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 107,55 3,841071 3,399857 131,30 4,689285 4,298570

411 L02BG03 ANASTROZOLUM ANASTROZOL TEVA 1 mg COMPR. FILM. 1mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 113,18 3,772666 3,399857 138,17 4,605666 4,298570

Pagina 14 din 42

Page 114: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

412 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 300 COMPR. FILM. P-6L/S 300 956,79 3,189300 3,189300 1.081,05 3,603500 3,603500

413 L02BG04 LETROZOLUM LETROZOL TERAPIA 2,5 mg COMPR. FILM. 2,5 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC - AL X 30 COMPR. FILM. P6L 30 198,16 6,605333 2,607199 241,92 8,064000 3,296800

414 L02BG04 LETROZOLUM LORTANDA 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 65,18 2,172666 2,172666 82,42 2,747333 2,747333

415 L02BG04 LETROZOLUM LETROZOL POLPHARMA 2,5 mg COMPR. FILM. 2,5mg PHARMACEUTICALS WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. DIN PVC/AL X 30 COMPR. FILM. P-6L 30 255,63 8,521000 2,607199 312,07 10,402333 3,296800

416 L02BG04 LETROZOLUM LETRALAN 2,5 mg COMPR. FILM. 2,5mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 197,34 6,578000 2,607199 240,91 8,030333 3,296800

417 L02BG04 LETROZOLUM FEMARA 2,5 mg COMPR. FILM. 2,5mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 473,58 15,786000 2,607199 554,35 18,478333 3,296800

418 L02BG04 LETROZOLUM LETROZOL ATB 2,5 mg COMPR. FILM. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVDC-PE-PVC/AL X 10 COMPR. FILM. P6L 30 121,00 4,033333 2,607199 147,72 4,924000 3,296800

419 L02BG04 LETROZOLUM LETROZOL BLUEFISH 2,5 mg COMPR. FILM. 2,5mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L 30 165,03 5,501000 2,607199 201,47 6,715666 3,296800

420 L02BG04 LETROZOLUM LETROZOL KABI 2,5 mg COMPR. FILM. 2,5mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P6L 14 101,54 7,252857 2,607199 123,96 8,854285 3,296800

421 L02BG04 LETROZOLUM LETROZOL KABI 2,5 mg COMPR. FILM. 2,5mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P6L 10 72,53 7,253000 2,607199 91,71 9,171000 3,296800

422 L02BG04 LETROZOLUM ZOTROL 2,5 mg COMPR. FILM. 2,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC/AL X 30 COMPR. FILM. P-6L 30 164,45 5,481666 2,607199 200,76 6,692000 3,296800

423 L02BG04 LETROZOLUM LETROZOL ALVOGEN 2,5 mg COMPR. FILM. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 117,00 3,900000 2,607199 142,83 4,761000 3,296800

424 L02BG04 LETROZOLUM ZEQUIPRA 2,5 mg COMPR. FILM. 2,5mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. AL-PVC/PVC-PE-PVDC X 30 COMPR. FILM. P-6L 30 78,22 2,607333 2,607199 98,90 3,296666 3,296666

425 L02BG04 LETROZOLUM LETROZOL KABI 2,5 mg COMPR. FILM. 2,5mg FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 199,46 7,123571 2,607199 243,50 8,696428 3,296800

426 L02BG04 LETROZOLUM LETROZOLE MEDICO UNO 2,5mg COMPR. FILM. 2,5mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 166,18 5,935000 2,607199 202,87 7,245357 3,296800

427 L02BG04 LETROZOLUM LETROZOL TEVA 2,5 mg COMPR. FILM. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 228,64 7,621333 2,607199 279,12 9,304000 3,296800

428 L02BG04 LETROZOLUM ETRUZIL 2,5 mg COMPR. FILM. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. DIN PVC/AL X 30 COMPR. FILM. P-6L 30 196,59 6,553000 2,607199 240,00 8,000000 3,296800

429 L02BG04 LETROZOLUM LETROZOL SANOFI-AVENTIS 2,5 mg COMPR. FILM. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 165,05 5,501666 2,607199 201,49 6,716333 3,296800

430 L02BG04 LETROZOLUM LETROZOL POLIPHARMA 2,5 mg COMPR. FILM. 2,5mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 164,45 5,481666 2,607199 200,76 6,692000 3,296800

431 L02BG04 LETROZOLUM LEZRA 2,5 mg COMPR. FILM. 2,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P-6L 30 77,28 2,576000 2,576000 97,71 3,257000 3,257000

432 L02BG04 LETROZOLUM TROZEL 2,5 mg COMPR. FILM. 2,5mg MEDICAMENTA A.S. CEHIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 78,22 2,607333 2,607199 98,90 3,296666 3,296666

433 L02BG04 LETROZOLUM LETROZOL STADA 2,5 mg COMPR. FILM. 2,5mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. PVC/AL X 100 (10X10) COMPR. FILM. P6L 100 280,55 2,805500 2,607199 342,50 3,425000 3,296800

434 L02BG06 EXEMESTANUM AROSTANIL 25 mg COMPR. FILM. 25 mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 154,58 5,152666 2,705200 188,71 6,290333 3,420400

435 L02BG06 EXEMESTANUM EXEMESTAN ACCORD 25 mg COMPR. FILM. 25mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 201,38 6,712666 2,705200 245,85 8,195000 3,420400

436 L02BG06 EXEMESTANUM EXEMESTAN TEVA 25 mg COMPR. FILM. 25mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM P-RF 30 201,62 6,720666 2,705200 246,14 8,204666 3,420400

437 L02BG06 EXEMESTANUM EXEMESTAN MEDISON PHARMA 25 mg COMPR. FILM. 25mg MEDISON PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF 30 201,50 6,716666 2,705200 245,99 8,199666 3,420400

438 L02BG06 EXEMESTANUM EXEMESTAN ACTAVIS 25 mg COMPR. FILM. 25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. PRF 30 183,66 6,122000 2,705200 224,21 7,473666 3,420400

439 L02BG06 EXEMESTANUM EXESTRALAN 25 mg COMPR. FILM. 25mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 185,49 6,183000 2,705200 226,45 7,548333 3,420400

440 L02BG06 EXEMESTANUM EXEMESTAN ALVOGEN 25 mg COMPR. FILM. 25mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 183,67 6,122333 2,705200 224,23 7,474333 3,420400

441 L02BG06 EXEMESTANUM INPLAVIA 25 mg COMPR. FILM. 25mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X 30 (30X1) COMPR. FILM. PRF 30 176,84 5,894666 2,705200 215,89 7,196333 3,420400

442 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM PRF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

443 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM PRF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

444 L02BG06 EXEMESTANUM EXEMESTAN TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF 30 185,48 6,182666 2,705200 226,44 7,548000 3,420400

445 L02BG06 EXEMESTANUM EXEMESTAN GLENMARK 2 5mg COMPR. FILM. 25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

446 L02BG06 EXEMESTANUM EXEMESTAN POLIPHARMA 25 mg COMPR. FILM. 25mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 30 154,58 5,152666 2,705200 188,71 6,290333 3,420400

447 L02BG06 EXEMESTANUM ESCEPRAN 25 mg COMPR. FILM. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF 30 67,63 2,254333 2,254333 85,51 2,850333 2,850333

448 L02BG06 EXEMESTANUM AROMASIN 25 mg DRAJ. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/PVC-AL X 15 DRAJ. P-RF 30 310,19 10,339666 2,705200 376,26 12,542000 3,420400

449 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 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

450 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 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

451 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 1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

452 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 1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

453 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 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

454 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 1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

455 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 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

456 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 1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

457 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 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

458 L03AA13 PEGFILGRASTIMUM*** NEULASTA 6mg SOL. INJ. 6 mg AMGEN EUROPE B.V. OLANDA CUTIE CU 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. IN BLISTER, CU PROTECTIE A ACULUI PR 1 3.307,67 3.307,670000 3.307,670000 3.643,51 3.643,510000 3.643,510000

459 L03AA13 PEGFILGRASTIMUM*** NEULASTA 6mg SOL. INJ. 6mg AMGEN EUROPE B.V. OLANDA CUTIE X BLISTER X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 3.307,67 3.307,670000 3.307,670000 3.643,51 3.643,510000 3.643,510000

460 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 S/P-RF 1 69,15 69,150000 69,150000 87,43 87,430000 87,430000

461 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 S/P-RF 1 150,08 150,080000 150,080000 183,22 183,220000 183,220000

462 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 1 363,48 363,480000 363,480000 434,34 434,340000 434,340000

463 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 1 621,78 621,780000 621,780000 715,89 715,890000 715,890000

464 M05BA02 ACIDUM CLODRONICUM** BONEFOS (R) 800 mg COMPR. FILM. 800mg BAYER SCHERING PHARMA AG FINLANDA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 586,00 9,766666 9,766666 676,89 11,281500 11,281500

465 M05BA02 ACIDUM CLODRONICUM** BONEFOS® 800 mg COMPR. FILM. 800mg BAYER OY FINLANDA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 60 586,00 9,766666 9,766666 676,89 11,281500 11,281500

466 M05BA02 ACIDUM CLODRONICUM** SINDRONAT (R) 300 mg/5 ml CONC. PT. SOL. PERF. 300mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 5 ML S 1 20,75 20,750000 20,750000 28,04 28,040000 28,040000

467 M05BA02 ACIDUM CLODRONICUM** BONEFOS (R) 60 mg/ml CONC. PT. SOL. PERF. 60mg/ml BAYER SCHERING PHARMA AG FINLANDA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 154,06 30,812000 24,900000 188,08 37,616000 33,648000

468 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 6 ML S/P-RF 1 529,92 529,920000 529,920000 615,76 615,760000 615,760000

469 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 110,73 110,730000 110,730000 135,18 135,180000 135,180000

470 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 185,79 185,790000 183,444000 226,81 226,810000 223,956000

471 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 361,86 361,860000 285,384000 432,58 432,580000 348,396000

472 M05BA03 ACIDUM PAMIDRONICUM** AREDIA (R) 15 mg LIOF.+ SOLV. PT. SOL. PERF. 15mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 FLAC. DIN STICLA X 15 MG LIOF. PT. SOL. PERF. + 4 FIOLE DIN STICLA X 5 ML SOLV. S/P-RF 4 595,85 148,962500 132,876000 687,63 171,907500 162,216000

473 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 30mg pulbere pentru solutie perfuzabila PULB. PT. SOL. PERF. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. PR 1 152,87 152,870000 152,870000 186,63 186,630000 186,630000

474 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 60mg pulbere pentru solutie perfuzabila PULB. PT. SOL.PERF. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. PR 1 237,82 237,820000 237,820000 290,33 290,330000 290,330000

475 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 65,80 65,800000 35,592000 83,20 83,200000 46,560000

476 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 29,66 29,660000 29,660000 38,80 38,800000 38,800000

477 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 56,52 56,520000 35,592000 71,46 71,460000 46,560000

478 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-6L 1 70,97 70,970000 35,592000 89,74 89,740000 46,560000

479 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 40,44 40,440000 35,592000 52,90 52,900000 46,560000

480 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 57,19 57,190000 35,592000 72,31 72,310000 46,560000

481 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 50 mg COMPR. FILM. 50 mg SANDOZ PHARMACEUTICALS GMBH GERMANIA CUTIE CU BLIST. DIN PA/AL/PVC/AL CU 28 COMPRIMATE FILMATE PR 28 519,62 18,557857 18,557857 604,54 21,590714 21,590714

482 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 50 mg COMPR. FILM. 50 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 28 COMPRIMATE FILMATE PR 28 637,14 22,755000 22,269428 732,63 26,165357 25,908857

483 M05BA06 ACIDUM IBANDRONICUM** HOLMEVIS 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. PR 28 637,16 22,755714 22,269428 732,65 26,166071 25,908857

484 M05BA06 ACIDUM IBANDRONICUM** IASIBON 50 mg COMPR. FILM. 50mg PHARMATHEN S.A. GRECIA CUTIE CU BLIST. PA/ALL/PVC/ALU X 28 COMPR. FILM PR 28 629,47 22,481071 22,269428 724,27 25,866785 25,866785

Pagina 15 din 42

Page 115: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

485 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 50mg COMPR. FILM. 50mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X BLIST. AL/PVC X 28 COMPR. FILM. S 28 964,08 34,431428 22,269428 1.089,00 38,892857 25,908857

486 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC GLENMARK 50 mg COMPR. FILM. 50mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 28 COMPR. FILM. PR 28 562,00 20,071428 20,071428 650,73 23,240357 23,240357

487 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 6 mg CONC. PT. SOL. PERF. 6mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC SI CAPSA DE CULOARE TURCOAZ (ALBASTRU VERZUI PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

488 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 6 ML CONC. PT. SOL. PERF. S 1 901,37 901,370000 715,668000 1.020,64 1.020,640000 825,864000

489 M05BA06 ACIDUM IBANDRONICUM** IASIBON 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml PHARMATHEN S.A. GRECIA CUTIE CU 1 FLAC. DIN STICLA X 6ML CONC. PT. SOL. PERF. PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

490 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 INJECTARE P6L 1 232,02 232,020000 179,712000 283,25 283,250000 219,396000

491 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 1 196,40 196,400000 179,712000 239,77 239,770000 219,396000

492 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 1 222,35 222,350000 179,712000 271,45 271,450000 219,396000

493 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 1 354,51 354,510000 179,712000 424,57 424,570000 219,396000

494 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 1 149,76 149,760000 149,760000 182,83 182,830000 182,830000

495 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TEVA 4 mg/5 ml CONC. PT. SOL. PERF. 4 mg/5 ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA CU 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA PR 1 377,14 377,140000 356,400000 449,23 449,230000 435,096000

496 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/100 ml CONC. PT. SOL. PERF. 4mg/100ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 100 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

497 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. DIN STICLA CU CAPACITATEA DE 5 ML CU CONC. PT. SOL. PERF. PR 1 297,00 297,000000 297,000000 362,58 362,580000 362,580000

498 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 FLAC. DIN STICLA INCOLORA SI TRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF. PR 4 1.418,88 354,720000 354,720000 1.584,73 396,182500 396,182500

499 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA SI TRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

500 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ACTAVIS 4mg/5ml CONC. PT. SOL. PERF. 4mg/5ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLACON PLASTIC TRANSPARENT, INCOLOR CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PER PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

501 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 4 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 4 2.807,00 701,750000 356,400000 3.097,78 774,445000 435,096000

502 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 1 724,40 724,400000 356,400000 827,75 827,750000 435,096000

503 M05BA08 ACIDUM ZOLEDRONICUM** OSPORIL 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

504 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TERAPIA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. TRANSPARENT DIN STICLA CU CAPACITATEA DE 6 ML INCHIS CU DOP DIN CAUCIUC DE CULOARE PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

505 M05BA08 ACIDUM ZOLEDRONICUM** FAYTON 4 mg/ 5 ml CONC. PT. SOL. PERF. 4mg/5ml GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN COPOLIMER CICLOOLEFINIC SI CAPAC PP CU CAPACITATEA DE 5 ML CARE CONTINE CONC. P PR 1 676,00 676,000000 356,400000 774,99 774,990000 435,096000

506 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC RICHTER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON TRANSPARENT, INCOLOR DIN POLIMER CICLO-OLEFENIC INCHIS CU DOP GRI INCHIS DIN CAUCIUC CU STRAT FLUOROPOLIMERIC, CAPSA DIN AL SI SISTEM "FLIP-OFF" DIN PLASTIC ROSU X 5ML CONC. PT. SOL. PERF. PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

507 M05BA08 ACIDUM ZOLEDRONICUM** DESINOBON 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR DE 5 ML DIN COPOLIMER CICLOOLEFINIC CU DOP DE CAUC PR 1 452,56 452,560000 356,400000 531,44 531,440000 435,096000

508 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DIN CAUCIUC BROMOB PR 1 459,66 459,660000 356,400000 539,18 539,180000 435,096000

509 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON CU CAPACITATE DE 5ML DIN PLASTIC CU DOP BROMOBUTIL, ACOPERIT CU UN STRAT DE FLUOROP PR 1 452,56 452,560000 356,400000 531,44 531,440000 435,096000

510 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 4 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 4 1.417,59 354,397500 354,397500 1.583,33 395,832500 395,832500

511 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

512 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 5 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

513 M05BA08 ACIDUM ZOLEDRONICUM** ZOMETA 4 mg PULB. + SOLV. SOL. PERF. 4mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. 4MG PULB. PT. SOL. PERF. + 1 FIOLA X 5 ML SOLV. PR 1 1.098,45 1.098,450000 356,400000 1.235,46 1.235,460000 435,096000

514 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ZENTIVA 4 mg/5 ml SOL. PERF. 4mg/5ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CARE CONTINE CONC. PT. SOL. PERF. PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

515 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 5 mg SOL. PERF. 5mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PLASTIC (PP) TRANSPARENTA, PREVAZUTA CU UN PERFUZOR SI UN CONECTOR CU MEMBRANA DIN CAUCIUC, CE CONTINE 100 ML SOL. PERF. PR 1 920,00 920,000000 920,000000 1.040,95 1.040,950000 1.040,950000

516 M05BA08 ACIDUM ZOLEDRONICUM** ACLASTA 5mg/100ml SOL. PERF. 5mg/100ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 100 ML + 1 CAPAC AL/PP CU COMPONENTA FLIP. PR 1 1.399,70 1.399,700000 1.104,000000 1.563,83 1.563,830000 1.249,140000

517 V03AF01 MESNUM UROMITEXAN (R) 400 mg SOL. INJ. 400mg/4ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 3 SUPORTURI TERMOFORMATE DIN PLASTIC X 5 FIOLE DE STICLA INCOLORA X 4 ML S 15 44,87 2,991333 2,991333 58,69 3,912666 3,912666

518 V03AF03 CALCII FOLINAS CALCIUM FOLINAT "EBEWE" 15 mg CAPS. 15mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X1 FLAC. X 20 CAPS. P-6L 20 29,11 1,455500 1,455500 38,08 1,904000 1,904000

519 V03AF03 CALCII FOLINAS FOLINAT DE CALCIU TEVA 10 mg/ml SOL. INJ. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. X 10 ML SOL. INJ. P-RF/S 1 29,50 29,500000 29,500000 38,59 38,590000 38,590000

520 V03AF03 CALCII FOLINAS FOLCASIN (R) 100 mg/10 ml SOL. INJ. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON X 10 ML S/P-RF 1 29,47 29,470000 29,470000 38,55 38,550000 38,550000

521 V03AF03 CALCII FOLINAS FOLCASIN (R) 30 mg/10 ml SOL. INJ. 3mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON X 10 ML S/P-RF 1 13,53 13,530000 12,055200 18,29 18,290000 15,242400

522 V03AF03 CALCII FOLINAS CALCIUMFOLINAT "EBEWE" 10 mg/ml SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 3 ML P-RF 5 50,23 10,046000 10,046000 63,51 12,702000 12,702000

523 V03AF03 CALCII FOLINAS CALCIUMFOLINAT "EBEWE" 10 mg/ml SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 10 ML P-RF 5 142,16 28,432000 28,432000 173,55 34,710000 34,710000

P4: PROGRAMUL NATIONAL DE BOLI NEUROLOGICE Subprogramul de tratament al sclerozei multiple

1 L03AB07 INTERFERONUM BETA 1A**** AVONEX 30 mcg BIO-SET PULB. + SOLV. PT. SOL. INJ. 30mcg (6 mil. UI) BIOGEN IDEC LIMITED MAREA BRITANIE CUTIE X (1 FLAC. DIN STICLA X 30 MCG PULBERE + 1 SERINGA PRE-UMPLUTA + 1 ML SOLV. + 4 FIOLE PREVAZUT P-RF/R 4 3.085,23 771,307500 771,307500 3.401,05 850,262500 850,262500

2 L03AB07 INTERFERONUM BETA 1A**** REBIF 44 micrograme SOL. INJ. 44mcg SERONO EUROPE LTD. MAREA BRITANIE CUTIE X 12 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. P-RF/R 12 4.183,50 348,625000 348,625000 4.598,17 383,180833 383,180833

3 L03AB08 INTERFERONUM BETA 1-B**** EXTAVIA 250 mcg/ ml PULB+SOLV.PT.SOL.INJ 250mcg/ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 15 FLAC. CU PULBERE + 15 SERINGI PREUMPLUTE CU SOLVENT P-RF/R 15 3.506,14 233,742666 233,742666 3.859,85 257,323333 257,323333

4 L03AB08 INTERFERONUM BETA 1-B**** BETAFERON 250mcg/ml PULB. + SOLV. PT. SOL. INJ. 250mcg/ml BAYER SCHERING AG GERMANIA CUTIE X 15 AMBALAJE MULTIPLE CE CONTIN FIECARE CATE 1 FLAC. CU PULB., O SERINGA PREUMPLUTA CU SOLV. P-RF/P 15 3.301,14 220,076000 220,076000 3.636,40 242,426666 242,426666

5 L03AX13 GLATIRAMER ACETAT**** COPAXONE SOL. INJ. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 28 BLIST. PVC X 1 SERINGA PREUMPLUTA X 1 ML PREVAZUTA CU AC FIX S/P-RF 28 3.083,08 110,110000 110,110000 3.398,71 121,382500 121,382500

6 L04AA23 NATALIZUMABUM**** TYSABRI 300mg CONC. PT. SOL. PERF. 20mg/ml ELAN PHARMA INTERNATIONAL LTD IRLANDA CUTIE X 1 FLAC. X 15ML CONC. PT. SOL. PERF S 1 6.951,95 6.951,950000 6.951,950000 7.615,78 7.615,780000 7.615,780000

7 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

8 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 62,39 0,623900 0,623900 78,89 0,788900 0,788900

P5: PROGRAMUL NATIONAL DE DIABET ZAHARAT Tratamentul medicamentos al bolnavilor cu diabet zaharat

1 A10AB01 INSULINE UMANE HUMULIN R SOL. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. X 10 ML SOL. INJ. P-RF 1 43,32 43,320000 43,320000 56,66 56,660000 56,660000

2 A10AB01 INSULINE UMANE HUMULIN R SOL. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 90,98 18,196000 18,196000 115,03 23,006000 23,006000

3 A10AB01 INSULINE UMANE ACTRAPID PENFILL 100 UI/ml SOL. INJ. IN CARTUS 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 99,04 19,808000 19,502400 125,23 25,046000 24,660000

4 A10AB01 INSULINE UMANE INSUMAN RAPID 100UI/ml SOL. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SOL. INJ. P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

5 A10AB01 INSULINE UMANE INSUMAN RAPID 100UI/ml SOL. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SOL. INJ. P-RF 5 105,39 21,078000 21,078000 128,66 25,732000 25,732000

6 A10AB01 INSULINE UMANE INSUMAN RAPID 100 UI/ml SoloStar SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS DIN STICLA INCOLORA X 3 ML SOL. INJ. P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

7 A10AB04 INSULINUM LISPRO** HUMALOG 100 U/ml SOL. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SOL.INJ. P-RF 5 128,96 25,792000 25,792000 157,44 31,488000 31,488000

8 A10AB04 INSULINUM LISPRO** HUMALOG KWIKPEN100U/ml SOL. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PRE-UMPLUTE X 3 ML SOL. INJ. P-RF 5 156,50 31,300000 30,950400 191,06 38,212000 37,785600

9 A10AB05 INSULINUM ASPART** NOVORAPID PENFILL 100 U/ml SOL. INJ. IN CARTUS 100Uml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 130,56 26,112000 26,112000 159,39 31,878000 31,878000

10 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN CARTUS 100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 108,80 21,760000 21,760000 132,82 26,564000 26,564000

11 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE (SOLOSTAR) X 3 ML SOL. INJ. P-RF 5 108,80 21,760000 21,760000 132,82 26,564000 26,564000

12 A10AC01 INSULINE UMANE HUMULIN N SUSP. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 90,98 18,196000 18,196000 115,03 23,006000 23,006000

13 A10AC01 INSULINE UMANE HUMULIN N SUSP. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SUSP. INJ. P-RF 1 43,32 43,320000 43,320000 56,66 56,660000 56,660000

14 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

15 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SUSP. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SUSP. INJ. P-RF 5 111,21 22,242000 22,242000 135,77 27,154000 27,154000

16 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SoloStar SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

Pagina 16 din 42

Page 116: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

17 A10AC04 INSULINUM LISPRO** HUMALOG BASAL KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) X 3 ML SUSP. INJ. P-RF 5 156,50 31,300000 31,300000 191,06 38,212000 38,212000

18 A10AD01 INSULINE UMANE HUMULIN M3 SUSP. INJ. 100ui/ml LILLY FRANCE S.A.S FRANTA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 90,98 18,196000 18,196000 115,03 23,006000 23,006000

19 A10AD01 INSULINE UMANE HUMULIN M3 SUSP. INJ. 100ui/ml LILLY FRANCE S.A.S FRANTA CUTIE X 1 FLACON DIN STICLA INCOLORA X 10 ML SUSP. INJ. P-RF 1 43,32 43,320000 43,320000 56,66 56,660000 56,660000

20 A10AD01 INSULINE UMANE INSUMAN COMB 50 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

21 A10AD01 INSULINE UMANE MIXTARD 30 PENFILL 100 UI/ml SUSP. INJ. IN CARTUS 100UI/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 105,07 21,014000 19,502400 128,27 25,654000 24,660000

22 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

23 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SUSP. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SUSP. INJ. P-RF 5 137,51 27,502000 27,502000 167,87 33,574000 33,574000

24 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SoloStar SUSP. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS DIN STICLA INCOLORA X 3 ML SUSP. INJ. P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

25 A10AD04 INSULINUM LISPRO** HUMALOG MIX25 SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SUSP.INJ. P-RF 5 136,03 27,206000 27,206000 166,07 33,214000 33,214000

26 A10AD04 INSULINUM LISPRO** HUMALOG MIX50 SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 134,73 26,946000 26,946000 164,48 32,896000 32,896000

27 A10AD04 INSULINUM LISPRO** HUMALOG MIX50 KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML SUSP. INJ. P-RF 5 156,50 31,300000 31,300000 191,06 38,212000 38,212000

28 A10AD04 INSULINUM LISPRO** HUMALOG MIX25 KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML SUSP. INJ. P-RF 5 156,50 31,300000 31,300000 191,06 38,212000 38,212000

29 A10AD05 INSULINUM ASPART** NOVOMIX 30 PENFILL 100 U/ml SUSP. INJ. IN CARTUS 100U/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 140,58 28,116000 28,116000 171,62 34,324000 34,324000

30 A10AE04 INSULINUM GLARGINE** LANTUS 100UI/ml SOL. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA X 3 ML SOL. INJ. P-RF 5 203,05 40,610000 40,610000 247,88 49,576000 49,576000

31 A10AE04 INSULINUM GLARGINE** LANTUS 100UI/ml SOL. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA X 10 ML SOL. INJ. P-RF 1 146,86 146,860000 146,860000 179,29 179,290000 179,290000

32 A10AE04 INSULINUM GLARGINE** LANTUS SoloStar SOL. INJ. IN STILOU INJECTOR PREUMPLUT 100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE X 3 ML P-RF 5 200,05 40,010000 40,010000 244,22 48,844000 48,844000

33 A10AE05 INSULINUM DETEMIR** LEVEMIR PENFILL 100 U/ml SOL. INJ. IN CARTUS 100U/ml NOVO NORDISK A/S DANEMARCA CUTIE X 5 CARTUSE X 3 ML P-RF 5 245,54 49,108000 49,108000 299,76 59,952000 59,952000

34 A10BA02 METFORMINUM METFORMIN ARENA 1000 MG COMPR. 1000mg ARENA GROUP S.A. ROMANIA FLACON DIN PE X 200 COMPR. P-RF/S 200 25,16 0,125800 0,125800 32,91 0,164550 0,164550

35 A10BA02 METFORMINUM METFORMIN ARENA 1000 MG COMPR. 1000mg ARENA GROUP S.A. ROMANIA CUTIE X 10 BLIST. AL/PVC X 5 COMPR. P-RF 50 6,30 0,126000 0,126000 8,52 0,170400 0,170400

36 A10BA02 METFORMINUM METFORMIN ARENA 500 MG COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 60 COMPR. P-RF 60 3,58 0,059666 0,059666 4,84 0,080666 0,080666

37 A10BA02 METFORMINUM METFORMIN ARENA 850 MG COMPR. 850mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 COMPR. P-RF 15 1,69 0,112666 0,112666 2,28 0,152000 0,152000

38 A10BA02 METFORMINUM GLUCOPHAGE XR COMPR. ELIB. PREL. 500mg MERCK SANTE S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 15 COMPR. ELIB. PREL. P-RF 30 11,34 0,378000 0,071599 15,33 0,511000 0,096799

39 A10BA02 METFORMINUM GLUCOPHAGE XR COMPR. ELIB. PREL. 500mg MERCK SANTE S.A.S. FRANTA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. ELIB. PREL. P-RF 30 11,34 0,378000 0,071599 15,33 0,511000 0,096799

40 A10BA02 METFORMINUM METFOGAMMA 1000mg COMPR. FILM. 1000mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 8 BLIST. AL/PVC X 15 COMPR. FILM P-RF/S 120 15,93 0,132750 0,132750 21,53 0,179416 0,179416

41 A10BA02 METFORMINUM GLUCOPHAGE 1000 mg COMPR. FILM. 1000mg MERCK SANTE FRANTA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-6L 60 20,74 0,345666 0,150960 28,03 0,467166 0,197460

42 A10BA02 METFORMINUM METFORMIN BLUEFISH 1000 mg COMPR. FILM. 1000mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 12,24 0,204000 0,150960 16,55 0,275833 0,197460

43 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 90 20,25 0,225000 0,150960 27,37 0,304111 0,197460

44 A10BA02 METFORMINUM SIOFOR 1000 COMPR. FILM. 1000mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC/AL X 15 COMPR. FILM. P-RF 60 13,42 0,223666 0,150960 18,14 0,302333 0,197460

45 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 60 13,50 0,225000 0,150960 18,24 0,304000 0,197460

46 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 6,75 0,225000 0,150960 9,12 0,304000 0,197460

47 A10BA02 METFORMINUM METFORMIN AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P6L 60 13,28 0,221333 0,150960 17,95 0,299166 0,197460

48 A10BA02 METFORMINUM METFORMIN AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 6,64 0,221333 0,150960 8,98 0,299333 0,197460

49 A10BA02 METFORMINUM METFORMIN BLUEFISH 500 mg COMPR. FILM. 500mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 2,07 0,069000 0,069000 2,80 0,093333 0,093333

50 A10BA02 METFORMINUM METFORMIN BLUEFISH 500 mg COMPR. FILM. 500mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-6L 20 1,38 0,069000 0,069000 1,86 0,093000 0,093000

51 A10BA02 METFORMINUM DIPIMET 500 mg COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 30 2,85 0,095000 0,071599 3,85 0,128333 0,096799

52 A10BA02 METFORMINUM MEGUAN (R) 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 3,24 0,162000 0,071599 4,38 0,219000 0,096799

53 A10BA02 METFORMINUM METFORMIN AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P6L 60 5,10 0,085000 0,071599 6,89 0,114833 0,096799

54 A10BA02 METFORMINUM METFORMIN AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 2,55 0,085000 0,071599 3,45 0,115000 0,096799

55 A10BA02 METFORMINUM MEGUAN (R) 850 mg COMPR. FILM. 850mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 5,65 0,282500 0,131200 7,64 0,382000 0,177600

56 A10BA02 METFORMINUM METFORMIN BLUEFISH 850 mg COMPR. FILM. 850mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 6,59 0,109833 0,109833 8,91 0,148500 0,148500

57 A10BA02 METFORMINUM METFORMIN BLUEFISH 850 mg COMPR. FILM. 850mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 3,28 0,109333 0,109333 4,44 0,148000 0,148000

58 A10BA02 METFORMINUM METFORMIN BLUEFISH 850 mg COMPR. FILM. 850mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-6L 20 2,19 0,109500 0,109500 2,96 0,148000 0,148000

59 A10BA02 METFORMINUM SIOFOR 850 mg COMPR. FILM. 850mg BERLIN-CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE CU 4 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 60 13,45 0,224166 0,131200 18,18 0,303000 0,177600

60 A10BA02 METFORMINUM METFORMIN BLUEFISH 850 mg COMPR. FILM. 850mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 100 COMPR. FILM. P-6L 100 10,96 0,109600 0,109600 14,82 0,148200 0,148200

61 A10BA02 METFORMINUM METFOGAMMA 850 COMPR. FILM. 850mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 12 BLIST. AL/PVC X 10 COMPR. FILM. P-RF/S 120 13,54 0,112833 0,112833 18,30 0,152500 0,152500

62 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 90 10,90 0,121111 0,121111 14,73 0,163666 0,163666

63 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 60 7,27 0,121166 0,121166 9,82 0,163666 0,163666

64 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 3,64 0,121333 0,121333 4,92 0,164000 0,164000

65 A10BA02 METFORMINUM METFORMIN AUROBINDO 850 mg COMPR. FILM. 850mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P6L 60 7,18 0,119666 0,119666 9,71 0,161833 0,161833

66 A10BA02 METFORMINUM METFORMIN AUROBINDO 850 mg COMPR. FILM. 850mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 3,60 0,120000 0,120000 4,87 0,162333 0,162333

67 A10BA02 METFORMINUM GLUCOPHAGE 850 mg COMPR. FILM. 850mg MERCK SANTE FRANTA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM. P6L 100 18,70 0,187000 0,131200 25,27 0,252700 0,177600

68 A10BA03 BUFORMINUM SILUBIN RETARD DRAJ. RET. 100mg PHARMAFARM S.A. ROMANIA CUTIE X 4 BLLIST. X 15 DRAJ.RET. P-RF 60 14,14 0,235666 0,235666 19,11 0,318500 0,318500

69 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ATB 1,75 MG COMPR. 1,75 mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,41 0,047000 0,047000 1,91 0,063666 0,063666

70 A10BB01 GLIBENCLAMIDUM MANINIL 1,75 mg COMPR. 1,75mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 FLAC. X 120 COMPR. P-RF/S 120 8,75 0,072916 0,056400 11,82 0,098500 0,076399

71 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 100 COMPR. P-RF/S 100 8,60 0,086000 0,056400 11,62 0,116200 0,076399

72 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,52 0,050666 0,050666 2,05 0,068333 0,068333

73 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 55,56 0,055560 0,055560 70,25 0,070250 0,070250

74 A10BB01 GLIBENCLAMIDUM MANINIL 3,5 mg COMPR. 3,5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 FLAC. X 120 COMPR. P-RF/S 120 6,34 0,052833 0,040399 8,57 0,071416 0,054799

75 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 100 COMPR. P-RF/S 100 10,64 0,106400 0,040399 14,38 0,143800 0,054799

76 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ATB 3,5 MG COMPR. 3,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,01 0,033666 0,033666 1,37 0,045666 0,045666

77 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4,15 0,138333 0,040399 5,61 0,187000 0,054799

78 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 76,44 0,076440 0,040399 96,65 0,096650 0,054799

79 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4,24 0,141333 0,141333 5,73 0,191000 0,191000

80 A10BB07 GLIPIZIDUM GLIPIZIDA ATB 5mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 11,49 0,383000 0,383000 15,53 0,517666 0,517666

81 A10BB07 GLIPIZIDUM GLUCOTROL XL 10 mg COMPR. FILM. ELIB. MODIF. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 30 COMPR. FILM. CU E P-RF 30 35,35 1,178333 1,178333 46,24 1,541333 1,541333

82 A10BB07 GLIPIZIDUM GLUCOTROL XL 5mg COMPR. FILM. ELIB. MODIF. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 30 COMPR. FILM. CU EL P-RF 30 17,67 0,589000 0,459600 23,88 0,796000 0,621199

83 A10BB08 GLIQUIDONUM GLURENORM COMPR. 30mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 20,38 0,339666 0,339666 27,55 0,459166 0,459166

84 A10BB09 GLICLAZIDUM ESQUEL (R) 80 mg COMPR. 80mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P-RF 30 9,71 0,323666 0,291300 13,13 0,437666 0,393900

85 A10BB09 GLICLAZIDUM DIABREZIDE COMPR. 80mg L. MOLTENI ITALIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 20 COMPR. P-RF 40 9,71 0,242750 0,242750 13,13 0,328250 0,328250

86 A10BB09 GLICLAZIDUM GLYCLADA 60 mg COMPR. CU ELIB. MODIF. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. CU ELIB. MODIF. PRF 60 21,90 0,365000 0,365000 29,60 0,493333 0,493333

87 A10BB09 GLICLAZIDUM DIAPREL MR COMPR. ELIB. MODIF. 30mg LES LABORATOIRES SERVIER FRANTA CUTIE X 2 BLIST. X 30 COMPR. ELIB. MODIF. P-RF 60 18,67 0,311166 0,240799 25,24 0,420666 0,325600

88 A10BB09 GLICLAZIDUM DIAPREL MR 60 mg COMPR. ELIB. MODIF. 60mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF. P-RF 60 34,89 0,581500 0,438000 45,64 0,760666 0,592000

89 A10BB09 GLICLAZIDUM GLYCLADA 30 mg COMPR. ELIB. PREL. 30mg KRKA SLOVENIA CUTIE X 6 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P-6L 60 12,10 0,201666 0,201666 16,36 0,272666 0,272666

Pagina 17 din 42

Page 117: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

90 A10BB09 GLICLAZIDUM GLYCLADA 30 mg COMPR. ELIB. PREL. 30mg KRKA SLOVENIA CUTIE X 4 BLIST. PVC/AL X 15 COMPR. CU ELIB. PREL. P-6L 60 12,10 0,201666 0,201666 16,36 0,272666 0,272666

91 A10BB09 GLICLAZIDUM GLICLAZIDA ATB 30 mg COMPR. ELIB. PREL. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF 30 6,02 0,200666 0,200666 8,14 0,271333 0,271333

92 A10BB12 GLIMEPIRIDUM GLIMERAN 1 mg COMPR. 1mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 2,36 0,078666 0,078666 3,19 0,106333 0,106333

93 A10BB12 GLIMEPIRIDUM AMARYL 1mg COMPR. 1mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 3,64 0,121333 0,094399 4,92 0,164000 0,127600

94 A10BB12 GLIMEPIRIDUM GLIMERAN 1 mg COMPR. 1mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,36 0,078666 0,078666 3,19 0,106333 0,106333

95 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 3,08 0,102666 0,094399 4,16 0,138666 0,127600

96 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ACCORD 1 mg COMPR. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 3,06 0,102000 0,094399 4,14 0,138000 0,127600

97 A10BB12 GLIMEPIRIDUM MEGLIMID 1 mg COMPR. 1mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,73 0,224333 0,094399 9,09 0,303000 0,127600

98 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ACCORD 2 mg COMPR. 2mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 5,36 0,178666 0,158800 7,24 0,241333 0,214399

99 A10BB12 GLIMEPIRIDUM AMARYL 2 mg COMPR. 2mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 6,10 0,203333 0,158800 8,24 0,274666 0,214399

100 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 2 mg COMPR. 2mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 5,08 0,169333 0,158800 6,87 0,229000 0,214399

101 A10BB12 GLIMEPIRIDUM GLIMERAN 2 mg COMPR. 2mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,97 0,132333 0,132333 5,36 0,178666 0,178666

102 A10BB12 GLIMEPIRIDUM MEGLIMID 2 mg COMPR. 2mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 13,35 0,445000 0,158800 18,04 0,601333 0,214399

103 A10BB12 GLIMEPIRIDUM GLIMERAN 2 mg COMPR. 2mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 3,97 0,132333 0,132333 5,36 0,178666 0,178666

104 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 2 mg COMPR. 2mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 3,97 0,132333 0,132333 5,36 0,178666 0,178666

105 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ACCORD 3 mg COMPR. 3mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 9,94 0,331333 0,294000 13,44 0,448000 0,397600

106 A10BB12 GLIMEPIRIDUM AMARYL 3 mg COMPR. 3mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 11,31 0,377000 0,294000 15,28 0,509333 0,397600

107 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 3 mg COMPR. 3mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 9,43 0,314333 0,294000 12,74 0,424666 0,397600

108 A10BB12 GLIMEPIRIDUM GLIMERAN 3 mg COMPR. 3mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,35 0,245000 0,245000 9,94 0,331333 0,331333

109 A10BB12 GLIMEPIRIDUM GLIMERAN 3 mg COMPR. 3mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 7,35 0,245000 0,245000 9,94 0,331333 0,331333

110 A10BB12 GLIMEPIRIDUM MEGLIMID 3 mg COMPR. 3mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 18,49 0,616333 0,294000 24,99 0,833000 0,397600

111 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 3 mg COMPR. 3mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 7,35 0,245000 0,245000 9,94 0,331333 0,331333

112 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ACCORD 4mg COMPR. 4mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 10,64 0,354666 0,311200 14,38 0,479333 0,420799

113 A10BB12 GLIMEPIRIDUM GLIMERAN 4 mg COMPR. 4mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 3 BLIST AL/PVC X 10 COMPR. P-RF 30 7,78 0,259333 0,259333 10,52 0,350666 0,350666

114 A10BB12 GLIMEPIRIDUM AMARYL 4 mg COMPR. 4mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 11,61 0,387000 0,311200 15,69 0,523000 0,420799

115 A10BB12 GLIMEPIRIDUM GLIMERAN 4 mg COMPR. 4mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 COMPR. P-RF 30 7,78 0,259333 0,259333 10,52 0,350666 0,350666

116 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 4 mg COMPR. 4mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 10,62 0,354000 0,311200 14,36 0,478666 0,420799

117 A10BB12 GLIMEPIRIDUM AMARYL 6 mg COMPR. 6mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-RF 30 19,08 0,636000 0,636000 25,79 0,859666 0,859666

118 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) BIDIAB 400 mg/2,5 mg CAPS. 400mg+2,5mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 5 CAPS. P-RF 20 7,63 0,381500 0,381199 10,31 0,515500 0,515200

119 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) BIDIAB 400 mg/2,5 mg CAPS. 400mg+2,5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 5 CAPS. P-RF/S 500 178,17 0,356340 0,356340 217,51 0,435020 0,435020

120 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE® 500 mg/2,5 mg COMPR. FILM. 500mg/2,5mg MERCK SANTE FRANTA/GERMANIA CUTIE X 3 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

121 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE® 500 mg/5 mg COMPR. FILM. 500mg/5mg MERCK SANTE FRANTA/GERMANIA CUTIE X 3 BLIST. PVC/AL X 20 COMPR. FILM. P-RF 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

122 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE (R) 500 mg/5 mg COMPR. FILM. 500mg/5mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P-RF 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

123 A10BD02 COMBINATII(GLIBENCLAMIDUM+METFORMINUM) GLIBOMET (R) COMPR. FILM. 400mg/2,5mg LAB. GUIDOTTI SPA ITALIA CUTIE X 3 BLIST. X 20 COMPR. FILM. P-RF 60 19,06 0,317666 0,317666 25,76 0,429333 0,429333

124 A10BD02 COMBINATII(GLIBENCLAMIDUM+METFORMINUM) GLUCOVANCE (R) 500 mg/2,5 mg COMPR. FILM. 500mg/2,5mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P-RF 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

125 A10BD05 COMBINATII ( PIOGLITAZONUM + METFORMINUM)*** COMPETACT COMPR. FILM. 15mg/850mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 56 COMPR. FILM. ( BLIST. AL/AL ) P-RF 56 159,72 2,852142 2,852142 194,99 3,481964 3,481964

126 A10BF01 ACARBOSUM GLUCOBAY® 100 COMPR. 100mg BAYER PHARMA AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 51,89 0,432416 0,432416 65,61 0,546750 0,546750

127 A10BF01 ACARBOSUM GLUCOBAY (R) 100 COMPR. 100mg BAYER HEALTHCARE AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 51,89 0,432416 0,432416 65,61 0,546750 0,546750

128 A10BF01 ACARBOSUM GLUCOBAY (R) 50 COMPR. 50mg BAYER HEALTHCARE AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 39,95 0,332916 0,332916 52,25 0,435416 0,435416

129 A10BF01 ACARBOSUM GLUCOBAY® 50 COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 39,95 0,332916 0,332916 52,25 0,435416 0,435416

130 A10BG03 PIOGLITAZONUM*** ZIPION 15 mg COMPR. 15 mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. PRF 30 56,24 1,874666 1,465714 71,11 2,370333 1,917000

131 A10BG03 PIOGLITAZONUM*** ACTOS 15mg COMPR. 15mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 28 COMPR. (BLIST. AL/AL) P-RF 28 100,29 3,581785 1,465714 122,43 4,372500 1,917000

132 A10BG03 PIOGLITAZONUM*** PIOGLITAZONE ACCORD 15 mg COMPR. 15mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 69,84 2,328000 1,465714 88,30 2,943333 1,917000

133 A10BG03 PIOGLITAZONUM*** PIOGLITAZONE ACCORD 15 mg COMPR. 15mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. PRF 28 65,18 2,327857 1,465714 82,42 2,943571 1,917000

134 A10BG03 PIOGLITAZONUM*** LISPECIP 15 mg COMPR. 15mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 40,47 1,349000 1,349000 52,93 1,764333 1,764333

135 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 15 mg COMPR. 15mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. PRF 30 69,84 2,328000 1,465714 88,30 2,943333 1,917000

136 A10BG03 PIOGLITAZONUM*** GLIDIPION 15 mg COMPR. 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. (BLIST. TIP CALENDAR) PRF 28 34,20 1,221428 1,221428 44,73 1,597500 1,597500

137 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 15 mg COMPR. 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X 30 COMPR. PRF 30 64,41 2,147000 1,465714 81,44 2,714666 1,917000

138 A10BG03 PIOGLITAZONUM*** ZIPION 30 mg COMPR. 30 mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. PRF 30 84,33 2,811000 2,811000 106,63 3,554333 3,554333

139 A10BG03 PIOGLITAZONUM*** GLIDIPION 30 mg COMPR. 30mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. (BLIST. TIP CALENDAR) PRF 28 67,20 2,400000 2,400000 84,97 3,034642 3,034642

140 A10BG03 PIOGLITAZONUM*** LISPECIP 30 mg COMPR. 30mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 82,84 2,761333 2,761333 104,74 3,491333 3,491333

141 A10BG03 PIOGLITAZONUM*** PIOGLITAZONE ACCORD 30 mg COMPR. 30mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 107,02 3,567333 2,880000 130,65 4,355000 3,641570

142 A10BG03 PIOGLITAZONUM*** PIOGLITAZONE ACCORD 30 mg COMPR. 30mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. PRF 28 99,88 3,567142 2,880000 126,29 4,510357 3,641570

143 A10BG03 PIOGLITAZONUM*** ACTOS 30mg COMPR. 30mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 28 COMPR.(BLIST. AL/AL) P-RF 28 150,92 5,390000 2,880000 184,24 6,580000 3,641570

144 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 30 mg COMPR. 30mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. PRF 30 107,02 3,567333 2,880000 130,65 4,355000 3,641570

145 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 30 mg COMPR. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X 30 COMPR. PRF 30 98,49 3,283000 2,880000 124,53 4,151000 3,641570

146 A10BG03 PIOGLITAZONUM*** ZIPION 45 mg COMPR. 45 mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. PRF 30 143,75 4,791666 3,840000 175,49 5,849666 4,855285

147 A10BG03 PIOGLITAZONUM*** ACTOS 45mg COMPR. 45mg TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD MAREA BRITANIE CUTIE X 28 COMPR.(BLIST. AL/AL) P-RF 28 206,41 7,371785 3,840000 251,99 8,999642 4,855285

148 A10BG03 PIOGLITAZONUM*** GLIDIPION 45 mg COMPR. 45mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. (BLIST. TIP CALENDAR) PRF 28 89,60 3,200000 3,200000 113,29 4,046071 4,046071

149 A10BG03 PIOGLITAZONUM*** LISPECIP 45 mg COMPR. 45mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PRF 30 116,90 3,896666 3,840000 142,71 4,757000 4,757000

150 A10BG03 PIOGLITAZONUM*** PIOGLITAZONE ACCORD 45 mg COMPR. 45mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 143,75 4,791666 3,840000 175,49 5,849666 4,855285

151 A10BG03 PIOGLITAZONUM*** PIOGLITAZONE ACCORD 45 mg COMPR. 45mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 28 COMPR. PRF 28 134,17 4,791785 3,840000 163,79 5,849642 4,855285

152 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 45 mg COMPR. 45mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X 30 COMPR. PRF 30 130,18 4,339333 3,840000 158,92 5,297333 4,855285

153 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 45 mg COMPR. 45mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30 COMPR. PRF 30 136,24 4,541333 3,840000 166,32 5,544000 4,855285

154 A10BH01 SITAGLIPTINUM*** JANUVIA 100mg COMPR. FILM. 100mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC/PE/PVDC/AL) P-RF 28 160,75 5,741071 5,741071 196,24 7,008571 7,008571

155 A10BX02 REPAGLINIDUM RENEOS 0,5 mg COMPR. 0,5 mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. OPA-AL-PVC/AL X 90 COMPR. PRF 90 20,20 0,224444 0,224444 27,30 0,303333 0,303333

156 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 0,5 mg COMPR. 0,5mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 15,20 0,506666 0,269333 20,54 0,684666 0,364000

157 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 0,5 mg COMPR. 0,5mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 270 COMPR. FILM. P-RF 270 131,98 0,488814 0,269333 161,12 0,596740 0,364000

158 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 0,5 mg COMPR. 0,5mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 120 COMPR. FILM. P-RF 120 59,73 0,497750 0,269333 75,52 0,629333 0,364000

159 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 0,5 mg COMPR. 0,5mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-RF 90 45,59 0,506555 0,269333 59,63 0,662555 0,364000

160 A10BX02 REPAGLINIDUM RENEOS 1 mg COMPR. 1 mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. OPA-AL-PVC/AL X 90 COMPR. PRF 90 20,20 0,224444 0,224444 27,30 0,303333 0,303333

161 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 1 mg COMPR. 1mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 270 COMPR. FILM. P-RF 270 175,06 0,648370 0,269333 213,71 0,791518 0,364000

162 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 1 mg COMPR. 1mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 120 COMPR. FILM. P-RF 120 79,22 0,660166 0,269333 100,16 0,834666 0,364000

Pagina 18 din 42

Page 118: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

163 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 1 mg COMPR. 1mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-RF 90 59,40 0,660000 0,269333 75,11 0,834555 0,364000

164 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 1 mg COMPR. 1mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 20,15 0,671666 0,269333 27,24 0,908000 0,364000

165 A10BX02 REPAGLINIDUM RENEOS 2 mg COMPR. 2 mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 90 COMPR. PRF 90 20,20 0,224444 0,224444 27,30 0,303333 0,303333

166 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 2 mg COMPR. 2mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 120 COMPR. FILM. P-RF 120 96,81 0,806750 0,269333 122,41 1,020083 0,364000

167 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 2 mg COMPR. 2mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 90 COMPR. FILM. P-RF 90 72,61 0,806777 0,269333 91,81 1,020111 0,364000

168 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 2 mg COMPR. 2mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-RF 30 24,64 0,821333 0,269333 33,30 1,110000 0,364000

169 A10BX02 REPAGLINIDUM REPAGLINIDA FARMAL 2 mg COMPR. 2mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 270 COMPR. FILM. P-RF 270 213,89 0,792185 0,269333 261,12 0,967111 0,364000

170 A10BX04 EXENATIDUM*** BYDUREON 2 mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 2 mg ELI LILLY NEDERLAND BV OLANDA AMBALAJ CU 4 X 1 DISPOZITIV DE ADMINISTRAREA UNICA (1FL X2MG PULB.+1SERINGA PREUMPLUTAX0,65ML SOLVEN PRF 4 468,95 117,237500 117,237500 549,31 137,327500 137,327500

171 A10BX04 EXENATIDUM*** BYETTA 10mcg/doza SOL. INJ. IN STILOU INJECTOR PREUMPLUT 10mcg/doza ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT (60 DOZE) P-RF 1 393,64 393,640000 393,640000 467,22 467,220000 467,220000

172 A10BX04 EXENATIDUM*** BYETTA 5mcg/doza SOL. INJ. IN STILOU INJECTOR PREUMPLUT 5mcg/doza ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT (60 DOZE) P-RF 1 336,72 336,720000 336,720000 405,17 405,170000 405,170000

173 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 20 DRAJ. P-6L 100 39,86 0,398600 0,398600 52,14 0,521400 0,521400

174 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-6L 50 21,25 0,425000 0,425000 28,72 0,574400 0,574400

175 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 35,84 0,716800 0,716800 46,88 0,937600 0,937600

176 A11DBN1 COMBINATII** MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 100 66,70 0,667000 0,667000 84,34 0,843400 0,843400

177 A11DBN1 COMBINATII** MILGAMMA (R) N CAPS. MOI FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L 20 15,00 0,750000 0,750000 20,28 1,014000 1,012080

178 A11DBN1 COMBINATII** MILGAMMA (R) 100 DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 DRAJ. P-6L 60 71,14 1,185666 1,185666 89,95 1,499166 1,499166

179 A11DBN1 COMBINATII** MILGAMMA (R) 100 DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 DRAJ. P-6L 100 113,93 1,139300 1,139300 139,08 1,390800 1,390800

180 A11DBN1 COMBINATII** MILGAMMA (R) 100 DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 DRAJ. P-6L 30 38,12 1,270666 1,270666 49,86 1,662000 1,662000

181 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 13,70 2,740000 2,740000 18,52 3,704000 3,704000

182 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 13,70 2,740000 2,740000 18,52 3,704000 3,704000

183 A11DBN1 COMBINATII** MILGAMMA (R) N SOL. INJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 25 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF 25 66,08 2,643200 2,643200 83,55 3,342000 3,342000

184 B03BA51 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 35,84 0,716800 0,716800 46,88 0,937600 0,937600

185 B03BA51 COMBINATII** MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 2 BLIST. PVC/PVDC X 10 DRAJ. P-6L 20 15,00 0,750000 0,750000 20,28 1,014000 1,012080

186 B03BA51 COMBINATII** MILGAMMA (R) (vezi B03BA51) DRAJ. FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. PVC/PVDC X 10 DRAJ. P-6L 100 66,70 0,667000 0,667000 84,34 0,843400 0,843400

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.1: HEMOFILIE SI TALASEMIE

1 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 1000 PULB+SOLV. PT. SOL. INJ. 100UI/ml BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 10 ML S P-PR 1 1.475,99 1.475,990000 1.475,990000 1.646,98 1.646,980000 1.646,980000

2 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 250 PULB+SOLV. PT. SOL. INJ. 50UI/ml BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 5 ML SO P-PR 1 375,37 375,370000 375,370000 447,30 447,300000 447,300000

3 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 500 PULB+SOLV. PT. SOL. INJ. 50UI/ml BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 10 ML S P-PR 1 753,00 753,000000 753,000000 858,92 858,920000 858,920000

4 B02BD02 FACTOR VIII DE COAGULARE** FANHDI 100ui/ml PULB+SOLV.PT.SOL.INJ 1000ui INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. CU PULB. X 1 SERINGA PREUMPLUTA X 10 ML SOLV. + 1 CANULA + 2 TAMPOANE CU ALCOOL S 1 1.765,78 1.765,780000 1.765,780000 1.962,85 1.962,850000 1.962,850000

5 B02BD02 FACTOR VIII DE COAGULARE** FANHDI 25 ui/ml PULB+SOLV.PT.SOL.INJ 250ui INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. CU PULB. X 1 SERINGA PREUMPLUTA X 10 ML SOLVENT + 1 CANULA + 2 TAMPOANE ALCOOL S 1 463,88 463,880000 463,880000 543,78 543,780000 543,780000

6 B02BD02 FACTOR VIII DE COAGULARE** FANHDI 50 ui/ml PULB+SOLV.PT.SOL.INJ 500ui INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. CU PULB. X 1 SERINGA PREUMPLUTA X 10 ML SOLV. + 1 CANULA + 2 TAMPOANE CU ALCOOL S 1 897,84 897,840000 897,840000 1.016,80 1.016,800000 1.016,800000

7 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 100 UI/ml PULB. + SOLV. PT. SOL. INJ. 100 UI/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 1000 UI PULB. PT.SOL. INJ. + 1 FL. SOLVENT X 10ML + CUTIE CU SET DE RECONSTITUIRE PR 1 1.419,30 1.419,300000 1.419,300000 1.585,19 1.585,190000 1.585,190000

8 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 50 UI/ml PULB. + SOLV. PT. SOL. INJ. 50 UI/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU 500 U.I. PULB. + 1 FL. SOLVENT X 10ML + CUTIE CU SET DE RECONSTITUIRE SI ADM. PR 1 724,65 724,650000 724,650000 828,02 828,020000 828,020000

9 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 50 UI/ml PULB. + SOLV. PT. SOL. INJ. 50 UI/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU 250 U.I. PULB. + 1 FL.SOLVENT X 5ML+ CUTIE CU SET DE RECONSTITUIRE SI ADM. PR 1 377,32 377,320000 377,320000 449,43 449,430000 449,430000

10 B02BD02 MOROCTOCOG ALFA** REFACTO 1000UI PULB. + SOL. PT. SOL. INJ. 1000 UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STER P-RF/R 1 2.441,69 2.441,690000 2.441,690000 2.699,59 2.699,590000 2.699,590000

11 B02BD02 MOROCTOCOG ALFA** REFACTO 2000UI PULB. + SOL. PT. SOL. INJ. 2000 UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STER P-RF/R 1 4.853,37 4.853,370000 4.853,370000 5.328,32 5.328,320000 5.328,320000

12 B02BD02 MOROCTOCOG ALFA** REFACTO 250UI PULB. + SOL. PT. SOL. INJ. 250 UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STER P-RF/R 1 632,91 632,910000 632,910000 728,02 728,020000 728,020000

13 B02BD02 MOROCTOCOG ALFA** REFACTO 500UI PULB. + SOL. PT. SOL. INJ. 500 UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STER P-RF/R 1 1.235,86 1.235,860000 1.235,860000 1.385,24 1.385,240000 1.385,240000

14 B02BD02 OCTOCOG ALFA** RECOMBINATE 1000 UI PULB+SOLV. PT. SOL. INJ. 1000UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. CU AC STERIL DUBLU SI 1 AC FILTRU STERI S/P-RF 1 2.301,15 2.301,150000 2.301,150000 2.546,40 2.546,400000 2.546,400000

15 B02BD02 OCTOCOG ALFA** RECOMBINATE 250 UI PULB+SOLV. PT. SOL. INJ. 250UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. CU AC STERIL DUBLU SI 1 AC FILTRU STERI S/P-RF 1 597,46 597,460000 597,460000 689,38 689,380000 689,380000

16 B02BD02 OCTOCOG ALFA** RECOMBINATE 500 UI PULB+SOLV. PT. SOL. INJ. 500UI BAXTER AG AUSTRIA CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. CU AC STERIL DUBLU SI 1 AC FILTRU STERI S/P-RF 1 1.165,59 1.165,590000 1.165,590000 1.308,64 1.308,640000 1.308,640000

17 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 1000UI PULB+SOLV.PT.SOL.INJ 1000UI BAYER HEALTHCARE AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTIN P-RF/R 1 2.630,24 2.630,240000 2.630,240000 2.905,11 2.905,110000 2.905,110000

18 B02BD02 OCTOCOG ALFA** ADVATE 1000UI PULB+SOLV.PT.SOL.INJ 1000UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 3.035,05 3.035,050000 3.035,050000 3.346,35 3.346,350000 3.346,350000

19 B02BD02 OCTOCOG ALFA** ADVATE 1500UI PULB+SOLV.PT.SOL.INJ 1500UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 4.766,25 4.766,250000 4.766,250000 5.233,36 5.233,360000 5.233,360000

20 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 2000UI PULB+SOLV.PT.SOL.INJ 2000UI BAYER HEALTHCARE AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 5,0ML SOL. + AMBALAJ SUPL. CE CONTIN P-RF/R 1 5.541,15 5.541,150000 5.541,150000 6.078,00 6.078,000000 6.078,000000

21 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 250UI PULB+SOLV.PT.SOL.INJ 250UI BAYER HEALTHCARE AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTIN P-RF/R 1 718,85 718,850000 718,850000 821,70 821,700000 821,700000

22 B02BD02 OCTOCOG ALFA** ADVATE 500UI PULB+SOLV.PT.SOL.INJ 500 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 1.608,75 1.608,750000 1.608,750000 1.791,69 1.791,690000 1.791,690000

23 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 500UI PULB+SOLV.PT.SOL.INJ 500UI BAYER HEALTHCARE AG GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTIN P-RF/R 1 1.396,36 1.396,360000 1.396,360000 1.560,18 1.560,180000 1.560,180000

24 B02BD02 OCTOCOG ALFA** ADVATE 2000UI PULB+SOLV.PT.SOL.INJ. 2000 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML SOLVENT + 1 DISPOZITIV BAXJECT II P-RF/R 1 6.345,00 6.345,000000 6.345,000000 6.954,20 6.954,200000 6.954,200000

25 B02BD02 OCTOCOG ALFA** ADVATE 250UI PULB+SOLV.PT.SOL.INJ. 250 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II P-RF/R 1 781,26 781,260000 781,260000 889,72 889,720000 889,720000

26 B02BD02 OCTOCOG ALFA** ADVATE 3000UI PULB+SOLV.PT.SOL.INJ. 3000 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML SOLVENT + 1 DISPOZITIV BAXJECT II P-RF/R 1 9.502,50 9.502,500000 9.502,500000 10.395,88 10.395,880000 10.395,880000

27 B02BD03 COMPLEX DE ANTIINHIBITORI AI COAGULARII** FEIBA NF 1000 U FEIBA LIOF. + SOLV. PT. SOL. INJ./PERF. 1000 U/20 ml BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. SOLV. + 1 TRUSA DE RECONSTITUIRE SI ADM. S 1 2.766,50 2.766,500000 2.766,500000 3.053,64 3.053,640000 3.053,640000

28 B02BD03 COMPLEX DE ANTIINHIBITORI AI COAGULARII** FEIBA NF 500 U FEIBA LIOF. + SOLV. PT. SOL. INJ./PERF. 500 U/20ml BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADM. S 1 1.407,44 1.407,440000 1.407,440000 1.572,26 1.572,260000 1.572,260000

29 B02BD04 FACTOR IX DE COAGULARE** OCTANINE F 250 LIOF. + SOLV. PT. SOL. PERF. 250 UI OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA A 30 ML CU LIOF. + 1 FLAC. X 5 ML SOLV. + 1 SERIN S 1 492,34 492,340000 492,340000 574,80 574,800000 574,800000

30 B02BD04 FACTOR IX DE COAGULARE** OCTANINE F 1000 UI PULB. + SOLV. PT. SOL. PERF. 1000UI OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. + 1 FLAC. DIN STICLA CU 10 ML SOLV. PT. SOL. PER S 1 1.629,80 1.629,800000 1.629,800000 1.814,63 1.814,630000 1.814,630000

31 B02BD04 FACTOR IX DE COAGULARE** OCTANINE F 500 UI PULB. + SOLV. SOL. PERF. 500 UI OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. + 1 FLAC. DIN STICLA CU 5 ML SOLV. PT. SOL. PERF S 1 829,90 829,900000 829,900000 942,74 942,740000 942,740000

32 B02BD04 FACTOR IX DE COAGULARE** IMMUNINE 1200 UI PULB.+SOLV. PT. SOL. INJ./PERF. 1200UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./ PERF. + 1 FLAC. X 10 ML SOLV. + 1 SET DE RECONSTITUIRE SI ADMI S 1 1.586,83 1.586,830000 1.586,830000 1.767,79 1.767,790000 1.767,790000

33 B02BD04 FACTOR IX DE COAGULARE** IMMUNINE 600 UI PULB.+SOLV. PT. SOL. INJ./PERF. 600UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./ PERF. + 1 FLAC. X 5 ML SOLV. + 1 SET DE RECONSTITUIRE SI ADMIN S 1 891,90 891,900000 891,900000 1.010,32 1.010,320000 1.010,320000

34 B02BD04 NONACOG ALPHA** BENEFIX 1000UI PULB+SOLV.PT.SOL.INJ 1000UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. P-RF 1 2.519,23 2.519,230000 2.519,230000 2.784,11 2.784,110000 2.784,110000

35 B02BD04 NONACOG ALPHA** BENEFIX 2000UI PULB+SOLV.PT.SOL.INJ 2000UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. S 1 5.008,46 5.008,460000 5.008,460000 5.497,37 5.497,370000 5.497,370000

36 B02BD04 NONACOG ALPHA** BENEFIX 250UI PULB+SOLV.PT.SOL.INJ 250UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. P-RF 1 712,99 712,990000 712,990000 815,31 815,310000 815,310000

37 B02BD04 NONACOG ALPHA** BENEFIX 500UI PULB+SOLV.PT.SOL.INJ 500UI WYETH EUROPA LTD MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF. P-RF 1 1.274,61 1.274,610000 1.274,610000 1.427,47 1.427,470000 1.427,470000

38 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 1000 UI LIOF. + SOLV. PT. SOL. INJ./PERF. 1000UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. X 10 ML SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADMINISTRARE S 1 1.107,58 1.107,580000 1.107,580000 1.245,41 1.245,410000 1.245,410000

39 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 250 UI LIOF. + SOLV. PT. SOL. INJ./PERF. 250UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. X 5 ML SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADMINISTRARE S 1 296,35 296,350000 296,350000 361,79 361,790000 361,790000

40 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 500 UI LIOF. + SOLV. PT. SOL. INJ./PERF. 500UI BAXTER AG AUSTRIA CUTIE X 1 FLAC. LIOF. + 1 FLAC. X 5 ML SOLV. + 1 TRUSA MEDICALA PT. RECONSTITUIRE SI ADMINISTRARE S 1 568,81 568,810000 568,810000 658,15 658,150000 658,150000

41 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** HAEMATE P 500 UI LIOF. SI SOLV. PT. SOL. INJ./PERF. 500UI+1200UI CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA A 30 ML CU LIOF. + 1 FLAC. X 10 ML SOLV. + 1 SET DE RECONSTIT. P-RF 1 1.337,63 1.337,630000 1.337,630000 1.496,17 1.496,170000 1.496,170000

42 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** WILATE 450 U.I./400 U.I. PULB+SOLV. PT. SOL. INJ. 450U.I./400U.I. OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + SOLV. + DISPOZITIV PT. RECONSTITUIRE S S 1 996,20 996,200000 996,200000 1.124,01 1.124,010000 1.124,010000

43 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** WILATE 900 U.I./800 U.I. PULB+SOLV. PT. SOL. INJ. 900U.I./800U.I. OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + SOLV. + DISPOZITIV PT. RECONSTITUIRE S S 1 1.962,39 1.962,390000 1.962,390000 2.177,16 2.177,160000 2.177,160000

44 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 2mg (100 KUI) PULB. + SOLV. PT. SOL. INJ. 100 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 5.431,43 5.431,430000 5.431,430000 5.958,41 5.958,410000 5.958,410000

Pagina 19 din 42

Page 119: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

45 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 5mg (250 KUI) PULB. + SOLV. PT. SOL. INJ. 250 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 13.793,54 13.793,540000 13.793,540000 15.073,11 15.073,110000 15.073,110000

46 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1mg (50 KUI) PULB. + SOLV. PT. SOL. INJ. 50 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 2.730,72 2.730,720000 2.730,720000 3.014,63 3.014,630000 3.014,630000

47 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 10 110,64 11,064000 11,064000 135,07 13,507000 13,507000

48 V03AC03 DEFERASIROXUM**** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 687,54 24,555000 24,555000 787,57 28,127500 28,127500

49 V03AC03 DEFERASIROXUM**** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 1.461,36 52,191428 52,191428 1.631,03 58,251071 58,251071

50 V03AC03 DEFERASIROXUM**** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 2.660,12 95,004285 95,004285 2.937,68 104,917142 104,917142

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.2: EPIDERMOLIZA BULOASA

1 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 59,11 1,970333 1,970333 74,74 2,491333 2,491333

2 D06AA04 TETRACYCLINUM TETRACICLINA ATB 30 mg/g UNGUENT 30mg/g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB AL X 12 G UNGUENT P-RF 1 5,70 5,700000 5,700000 7,70 7,700000 7,700000

3 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 11,24 11,240000 11,240000 15,19 15,190000 15,190000

4 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 11,24 11,240000 11,240000 15,19 15,190000 15,190000

5 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA BORCAN X 500 G CREMA PRF 1 83,51 83,510000 83,510000 105,59 105,590000 105,590000

6 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 16,08 16,080000 16,080000 21,74 21,740000 21,740000

7 D07CC01 COMBINATII TRIDERM® CREMA 0,5mg+10mg+1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB AL X 15 G P-RF 1 11,28 11,280000 11,280000 15,24 15,240000 15,240000

8 D07CC01 COMBINATII DIPROGENTA 0,5 mg/1 mg pe gram CREMA 0,5mg/1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 9,26 9,260000 9,260000 12,51 12,510000 12,510000

9 D07CC01 COMBINATII TRIDERM UNGUENT 0,5mg+10mg+1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 11,28 11,280000 11,280000 15,24 15,240000 15,240000

10 D07CC01 COMBINATII DIPROGENTA 0,5 mg/1 mg pe gram UNGUENT 0,5mg/1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-RF 1 9,26 9,260000 9,260000 12,51 12,510000 12,510000

11 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 17,62 17,620000 17,620000 23,82 23,820000 23,820000

12 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 50 BLIST. AL/PVC X 10 CAPS. P-RF/S 500 52,21 0,104420 0,104420 66,02 0,132040 0,132040

13 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 2,21 0,110500 0,110500 2,99 0,149500 0,149500

14 J01AA07 TETRACYCLINUM TETRACICLINA ATB 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 4,79 0,239500 0,125304 6,47 0,323500 0,158448

15 N03AB02 PHENYTOINUM FENITOINA RICHTER 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 2,05 0,102500 0,102500 2,77 0,138500 0,138500

16 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 53,57 10,714000 10,714000 67,73 13,546000 13,546000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.3: HIPERTENSIUNE PULMONARA

1 C02KX01 BOSENTANUM** TRACLEER 125 mg COMPR. FILM. 125mg ACTELION REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM. P-RF/R 56 9.529,79 170,174821 170,174821 10.425,63 186,171964 186,171964

2 C02KX01 BOSENTANUM** TRACLEER 62,5 mg COMPR. FILM. 62,5mg ACTELION REGISTRATION LTD. MAREA BRITANIE CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM. P-RF/R 56 9.200,67 164,297678 164,297678 10.066,89 179,765892 179,765892

3 G04BE03 SILDENAFILUM** REVATIO 20 mg COMPR. FILM. 20mg PFIZER LIMITED MAREA BRITANIE CUTIE X 6 BLIST. AL/PVC X 15 COMPR. FILM. P-RF/R 90 1.873,53 20,817000 20,817000 2.080,30 23,114444 23,114444

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.4: MUCOVISCIDOZA

1 A09AA02 PANCREATINUM** MEZYM FORTE 25000 CAPS. CU MINI-COMPR. GASTROREZ. 356,100mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 FLACON DIN PP X 20 CAPS. CU MINI-COMPR. GASTROREZ. OTC 20 42,40 2,120000 2,120000 42,40 2,120000 2,120000

2 A09AA02 PANCREATINUM** KREON 10000 CAPS. GASTROREZ. 150mg SOLVAY PHARMACEUTICALS BV GERMANIA FLACON DIN PEID CU 20 CAPS. GASTROREZ. OTC 20 21,60 1,080000 1,080000 21,60 1,080000 1,080000

3 A09AA02 PANCREATINUM** KREON 25000 CAPS. GASTROREZ. 300mg SOLVAY PHARMACEUTICALS BV GERMANIA FLACON DIN PEID CU 20 CAPS. GASTROREZ. OTC 20 33,00 1,650000 1,650000 33,00 1,650000 1,650000

4 A09AA02 PANCREATINUM** KREON 40000 CAPS. GASTROREZ. 400mg ABBOTT PRODUCTS GMBH GERMANIA CUTIE X UN FLACON DIN PEID CU 50 CAPS. GASTROREZ. P-6L 50 111,16 2,223200 2,223200 135,70 2,714000 2,714000

5 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 23,71 3,387142 1,561714 32,05 4,578571 2,110285

6 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 21,73 3,621666 1,561714 29,37 4,895000 2,110285

7 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 21,14 1,510000 0,719142 28,57 2,040714 0,972000

8 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 250 mg COMPR. FILM. 250mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 23,85 1,703571 0,719142 32,23 2,302142 0,972000

9 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 10,85 0,775000 0,719142 14,67 1,047857 0,972000

10 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 12,35 0,882142 0,719142 16,69 1,192142 0,972000

11 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 8,39 0,599285 0,599285 11,34 0,810000 0,810000

12 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 12,35 0,882142 0,719142 16,69 1,192142 0,972000

13 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 18,22 1,301428 1,301428 24,62 1,758571 1,758571

14 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 23,73 1,695000 1,561714 32,08 2,291428 2,110285

15 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 33,14 1,657000 1,561714 43,35 2,167500 2,110285

16 J01FA09 CLARITHROMYCINUM LEKOKLAR (R) 500 mg COMPR. FILM. 500mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 7 COMPR. FILM. P-RF 14 29,01 2,072142 1,561714 37,95 2,710714 2,110285

17 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 24,13 1,723571 1,561714 32,62 2,330000 2,110285

18 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 24,13 1,723571 1,561714 32,62 2,330000 2,110285

19 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 25,34 3,620000 1,561714 33,15 4,735714 2,110285

20 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 27,85 5,570000 1,561714 36,43 7,286000 2,110285

21 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 20,78 2,968571 1,561714 28,09 4,012857 2,110285

22 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 17,24 17,240000 16,812000 23,30 23,300000 22,728000

23 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 18,11 18,110000 16,812000 24,48 24,480000 22,728000

24 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 29,92 29,920000 29,920000 39,14 39,140000 39,140000

25 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 14,01 14,010000 14,010000 18,94 18,940000 18,940000

26 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 19,39 19,390000 16,812000 26,21 26,210000 22,728000

27 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 34,29 34,290000 28,128000 44,85 44,850000 38,016000

28 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN PEID CU 68,3 G GRANULE PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 47,03 47,030000 46,872000 61,52 61,520000 61,308000

29 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 23,44 23,440000 23,440000 31,68 31,680000 31,680000

30 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 39,06 39,060000 39,060000 51,09 51,090000 51,090000

31 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 41,12 41,120000 41,120000 53,78 53,780000 53,780000

32 J01GB01 TOBRAMYCINUM** TOBI (R) SOL. INHAL. 300mg/5ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 PLICURI DIN AL; FIECARE PLIC CONTINE 7 FIOLE GEMENE DIN PEJD X 5 ML SOL. DE INHALAT PRIN N P-RF 28 8.112,06 289,716428 289,716428 8.880,31 317,153928 317,153928

33 R05CB13 DORNAZA ALFA** PULMOZYME SOL. INHAL. 1mg/ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 6 FIOLE UNIDOZA PE X 2,5 ML SOL. INHAL. PRIN NEBULIZATOR, INTRODUSE IN PUNGA AL S/P-RF 6 551,59 91,931666 91,931666 639,38 106,563333 106,563333

Pagina 20 din 42

Page 120: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNE

P6.5.1: TRATAMENTUL MEDICAMENTOS AL BOLNAVILOR CU BOLI NEUROLOGICE INFLAMATOR-IMUNE

1 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 872,00 872,000000 872,000000 988,63 988,630000 988,630000

2 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 451,00 451,000000 451,000000 529,74 529,740000 529,740000

3 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 6.114,44 6.114,440000 6.114,440000 6.702,89 6.702,890000 6.702,890000

4 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 3.072,10 3.072,100000 3.072,100000 3.386,74 3.386,740000 3.386,740000

5 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 1.550,55 1.550,550000 1.550,550000 1.728,25 1.728,250000 1.728,250000

6 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 663,61 663,610000 663,610000 761,48 761,480000 761,480000

7 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.749,51 1.749,510000 1.749,510000 1.945,12 1.945,120000 1.945,120000

8 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 889,76 889,760000 889,760000 1.007,99 1.007,990000 1.007,990000

9 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.469,04 3.469,040000 3.469,040000 3.819,40 3.819,400000 3.819,400000

10 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 100 ML SOL. PERF. S 1 1.751,89 1.751,890000 1.751,890000 1.947,71 1.947,710000 1.947,710000

11 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 50 ML SOL. PERF. S 1 890,95 890,950000 890,950000 1.009,28 1.009,280000 1.009,280000

12 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 7.459,41 7.459,410000 7.459,410000 8.168,91 8.168,910000 8.168,910000

13 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 25ML SOL. PERF.(2,5G/25ML) S 1 459,88 459,880000 459,880000 539,42 539,420000 539,420000

14 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 25 ML SOL. PERF. S 1 460,47 460,470000 460,470000 540,07 540,070000 540,070000

15 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 188,56 188,560000 188,560000 230,20 230,200000 230,200000

16 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 200 ML SOL. PERF. S 1 3.473,78 3.473,780000 3.473,780000 3.824,57 3.824,570000 3.824,570000

17 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 2.050,80 2.050,800000 2.050,800000 2.273,52 2.273,520000 2.273,520000

18 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 222,29 222,290000 222,290000 271,37 271,370000 271,370000

19 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 535,20 535,200000 535,200000 621,52 621,520000 621,520000

20 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL.PERF. S 1 99,02 99,020000 99,020000 125,20 125,200000 125,200000

21 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL.PERF. S 1 472,05 472,050000 472,050000 552,68 552,680000 552,680000

22 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL.PERF. S 1 1.798,20 1.798,200000 1.798,200000 1.998,19 1.998,190000 1.998,190000

23 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL.PERF. S 1 914,10 914,100000 914,100000 1.034,52 1.034,520000 1.034,520000

24 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 2.261,30 2.261,300000 2.261,300000 2.502,97 2.502,970000 2.502,970000

25 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 640,45 640,450000 640,450000 736,24 736,240000 736,240000

26 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 1.166,70 1.166,700000 1.166,700000 1.309,85 1.309,850000 1.309,850000

27 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.040,40 1.040,400000 1.040,400000 1.172,19 1.172,190000 1.172,190000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNE

P6.5.2: TRATAMENTUL MEDICAMENTOS AL BOLNAVILOR CU BOLI NEUROLOGICE DEGENERATIVE-SCLEROZA LATERALA AMIOTROFICA

1 N07XX02 RILUZOLUM** RILUTEK 50 mg COMPR. FILM. 50mg AVENTIS PHARMA SA FRANTA CUTIE X 4 BLIST. X 14 COMPR. PR 56 535,66 9,565357 9,565357 622,02 11,107500 11,107500

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.6: OSTEOGENEZA IMPERFECTA

1 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 6 ML S/P-RF 1 529,92 529,920000 529,920000 615,76 615,760000 615,760000

2 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 110,73 110,730000 110,730000 135,18 135,180000 135,180000

3 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 185,79 185,790000 183,444000 226,81 226,810000 223,956000

4 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 361,86 361,860000 285,384000 432,58 432,580000 348,396000

5 M05BA03 ACIDUM PAMIDRONICUM AREDIA (R) 15 mg LIOF.+ SOLV. PT. SOL. PERF. 15mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 4 FLAC. DIN STICLA X 15 MG LIOF. PT. SOL. PERF. + 4 FIOLE DIN STICLA X 5 ML SOLV. S/P-RF 4 595,85 148,962500 132,876000 687,63 171,907500 162,216000

6 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 30mg pulbere pentru solutie perfuzabila PULB. PT. SOL. PERF. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. PR 1 152,87 152,870000 152,870000 186,63 186,630000 186,630000

7 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 60mg pulbere pentru solutie perfuzabila PULB. PT. SOL.PERF. 60mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. PR 1 237,82 237,820000 237,820000 290,33 290,330000 290,330000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.7: SINDROM PRADER WILLI

1 H01AC01 SOMATROPINUM** ZOMACTON LIOF. + 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 1 363,94 363,940000 363,940000 434,84 434,840000 434,840000

2 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 1 474,75 474,750000 474,750000 555,63 555,630000 555,630000

3 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 1.482,36 1.482,360000 1.482,360000 1.653,92 1.653,920000 1.653,920000

4 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 1 409,15 409,150000 409,150000 484,12 484,120000 484,120000

5 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 1 667,50 667,500000 667,500000 765,73 765,730000 765,730000

6 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 1.176,67 1.176,670000 801,000000 1.320,72 1.320,720000 918,876000

7 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 1.549,07 1.549,070000 801,000000 1.726,64 1.726,640000 918,876000

8 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 1 789,53 789,530000 490,980000 898,74 898,740000 580,944000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.8: BOALA FABRY

Pagina 21 din 42

Page 121: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

1 A16AB04 AGALSIDASUM BETA** FABRAZYME 35 mg PULB. PT. CONC. PT. SOL. PERF. 35mg GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. CU PULB. PT. CONC. PT. SOL. PERF. PR 1 13.797,28 13.797,280000 13.797,280000 15.077,20 15.077,200000 15.077,200000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.9: BOALA POMPE

1 A16AB07 ALGLUCOSIDASUM ALPHA** MYOZYME 50mg PULB. PT. CONC. PT. SOL. PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. CU 50MG PULB. PT. CONC. PT. SOL. PERF. PR 1 2.264,71 2.264,710000 2.264,710000 2.506,69 2.506,690000 2.506,690000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.10: TIROZINEMIE

1 A16AX04 NITISINONUM ORFADIN 10mg CAPS. 10mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS. P-RF/R 60 12.802,92 213,382000 213,382000 13.993,35 233,222500 233,222500

2 A16AX04 NITISINONUM ORFADIN 2mg CAPS. 2mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS. P-RF/R 60 3.522,06 58,701000 58,701000 3.877,20 64,620000 64,620000

3 A16AX04 NITISINONUM ORFADIN 5mg CAPS. 5mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS. P-RF/R 60 7.014,11 116,901833 116,901833 7.683,54 128,059000 128,059000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.12: MUCOPOLIZAHARIDOZĂ TIP II (SINDROM HUNTER)

1 A16AB09 IDURSULFASUM** ELAPRASE 2mg/ml CONC. PT. SOL. PERF. 2mg/ml SHIRE HUMAN GENETIC THERAPIES AB SUEDIA CUTIE X 4 FLAC. X 3 ML CONC. PT. SOL. PERF. S 4 49.871,94 12.467,985000 12.467,985000 54.398,63 13.599,657500 13.599,657500

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.13: MUCOPOLIZAHARIDOZĂ TIP I (SINDROM HURLER)

1 A16AB05 LARONIDAZUM** ALDURAZYME 100UI/ml CONC. PT. SOL. PERF. 100U/ml GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. X 5 ML S 1 2.802,88 2.802,880000 2.802,880000 3.093,29 3.093,290000 3.093,290000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.14: AFIBRINOGENEMIE CONGENITALA

1 B02BB01 FIBRINOGEN UMAN** HAEMOCOMPLETTAN P 1 g PULB. PT. SOL. INJ./PERF. 1g CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ/PERF. S 1 1.302,70 1.302,700000 1.302,700000 1.458,09 1.458,090000 1.458,090000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.15: Sindrom de imunodeficienţă primară

1 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 872,00 872,000000 872,000000 988,63 988,630000 988,630000

2 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 451,00 451,000000 451,000000 529,74 529,740000 529,740000

3 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 6.114,44 6.114,440000 6.114,440000 6.702,89 6.702,890000 6.702,890000

4 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 3.072,10 3.072,100000 3.072,100000 3.386,74 3.386,740000 3.386,740000

5 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 1.550,55 1.550,550000 1.550,550000 1.728,25 1.728,250000 1.728,250000

6 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 663,61 663,610000 663,610000 761,48 761,480000 761,480000

7 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.749,51 1.749,510000 1.749,510000 1.945,12 1.945,120000 1.945,120000

8 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 889,76 889,760000 889,760000 1.007,99 1.007,990000 1.007,990000

9 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.469,04 3.469,040000 3.469,040000 3.819,40 3.819,400000 3.819,400000

10 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 100 ML SOL. PERF. S 1 1.751,89 1.751,890000 1.751,890000 1.947,71 1.947,710000 1.947,710000

11 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 50 ML SOL. PERF. S 1 890,95 890,950000 890,950000 1.009,28 1.009,280000 1.009,280000

12 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 7.459,41 7.459,410000 7.459,410000 8.168,91 8.168,910000 8.168,910000

13 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 25ML SOL. PERF.(2,5G/25ML) S 1 459,88 459,880000 459,880000 539,42 539,420000 539,420000

14 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 25 ML SOL. PERF. S 1 460,47 460,470000 460,470000 540,07 540,070000 540,070000

15 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 188,56 188,560000 188,560000 230,20 230,200000 230,200000

16 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 200 ML SOL. PERF. S 1 3.473,78 3.473,780000 3.473,780000 3.824,57 3.824,570000 3.824,570000

17 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 2.050,80 2.050,800000 2.050,800000 2.273,52 2.273,520000 2.273,520000

18 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 222,29 222,290000 222,290000 271,37 271,370000 271,370000

19 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 535,20 535,200000 535,200000 621,52 621,520000 621,520000

20 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL.PERF. S 1 99,02 99,020000 99,020000 125,20 125,200000 125,200000

21 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL.PERF. S 1 472,05 472,050000 472,050000 552,68 552,680000 552,680000

22 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL.PERF. S 1 1.798,20 1.798,200000 1.798,200000 1.998,19 1.998,190000 1.998,190000

23 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL.PERF. S 1 914,10 914,100000 914,100000 1.034,52 1.034,520000 1.034,520000

24 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 2.261,30 2.261,300000 2.261,300000 2.502,97 2.502,970000 2.502,970000

25 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 640,45 640,450000 640,450000 736,24 736,240000 736,240000

26 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 1.166,70 1.166,700000 1.166,700000 1.309,85 1.309,850000 1.309,850000

27 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.040,40 1.040,400000 1.040,400000 1.172,19 1.172,190000 1.172,190000

P7: PROGRAM NATIONAL DE BOLI ENDOCRINE Tratamentul medicamentos al bolnavilor cu osteoporoza, gusa datorata carentei de iod si proliferarii maligne

1 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 25,70 0,514000 0,514000 33,62 0,672400 0,672400

2 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 16,99 0,566333 0,566333 22,97 0,765666 0,765666

Pagina 22 din 42

Page 122: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

3 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 23,23 0,774333 0,774333 31,40 1,046666 1,046666

4 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 26,00 0,866666 0,866666 34,01 1,133666 1,133666

5 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 108,79 10,879000 10,879000 132,81 13,281000 13,281000

6 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 203,78 20,378000 20,378000 248,78 24,878000 24,878000

7 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. MOI P-RF 100 60,88 0,608800 0,608800 76,98 0,769800 0,769800

8 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 21,75 21,750000 21,750000 29,40 29,400000 29,400000

9 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 12,29 12,290000 12,290000 16,61 16,610000 16,610000

10 G03CA03 ESTRADIOLUM CLIMARA PLASTURE TRANSDERM. 50mcg/24ore BAYER SCHERING PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L 4 25,48 6,370000 6,370000 33,33 8,332500 8,332500

11 G03CX01 TIBOLONUM LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 57,59 2,056785 2,056785 72,82 2,600714 2,600714

12 G03XC01 RALOXIFENUM EVISTA 60mg COMPR. FILM. 60mg DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR) P-RF 28 98,84 3,530000 3,530000 124,97 4,463214 4,463214

13 H01AB01 TIREOTROPINUM ALFA THYROGEN 0,9 mg PULB. PT. SOL. INJ. 0,9mg GENZYME EUROPE BV OLANDA CUTIE X 2 FLACOANE S 2 3.064,97 1.532,485000 1.532,485000 3.378,97 1.689,485000 1.689,485000

14 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 24,13 0,482600 0,482600 32,62 0,652400 0,652400

15 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 21,94 1,097000 1,097000 29,65 1,482500 1,482500

16 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 6,52 6,520000 6,520000 8,81 8,810000 8,810000

17 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 22,95 22,950000 22,950000 31,02 31,020000 31,020000

18 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 15,15 15,150000 15,150000 20,48 20,480000 20,480000

19 H03AA01 LEVOTHYROXINUM EUTHYROX 100mcg COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 8,65 0,086500 0,067440 11,69 0,116900 0,091200

20 H03AA01 LEVOTHYROXINUM L-THYROXIN 100 BERLIN - CHEMIE COMPR. 100mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 9,23 0,092300 0,067440 12,48 0,124800 0,091200

21 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 5,62 0,056200 0,056200 7,60 0,076000 0,076000

22 H03AA01 LEVOTHYROXINUM EUTHYROX 100µg COMPR. 100µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 8,65 0,086500 0,067440 11,69 0,116900 0,091200

23 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 7,02 0,070200 0,070200 9,49 0,094900 0,094900

24 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 8,43 0,084300 0,084300 11,40 0,114000 0,114000

25 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 9,84 0,098400 0,098400 13,30 0,133000 0,133000

26 H03AA01 LEVOTHYROXINUM EUTHYROX 200mcg COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 17,86 0,178600 0,139440 24,14 0,241400 0,188400

27 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 11,62 0,116200 0,116200 15,70 0,157000 0,157000

28 H03AA01 LEVOTHYROXINUM EUTHYROX 200µg COMPR. 200µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-6L 100 17,86 0,178600 0,139440 24,14 0,241400 0,188400

29 H03AA01 LEVOTHYROXINUM EUTHYROX 25mcg COMPR. 25mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 7,04 0,070400 0,054840 9,51 0,095100 0,074160

30 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 4,57 0,045700 0,045700 6,18 0,061800 0,061800

31 H03AA01 LEVOTHYROXINUM EUTHYROX 25µg COMPR. 25µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 7,04 0,070400 0,054840 9,51 0,095100 0,074160

32 H03AA01 LEVOTHYROXINUM EUTHYROX 50mcg COMPR. 50mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 6,12 0,061200 0,047760 8,27 0,082700 0,064560

33 H03AA01 LEVOTHYROXINUM L-THYROXIN 50 COMPR. 50mcg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L/S 100 6,21 0,062100 0,047760 8,40 0,084000 0,064560

34 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 3,98 0,039800 0,039800 5,38 0,053800 0,053800

35 H03AA01 LEVOTHYROXINUM EUTHYROX 50µg COMPR. 50µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 6,12 0,061200 0,047760 8,27 0,082700 0,064560

36 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 5,97 0,059700 0,059700 8,07 0,080700 0,080700

37 H03AAN1 LEVOTIROXINUM+KALII IODIDUM JODTHYROX (R) 100/130,8 COMPR. FARA CONCENTRATIE MERCK KGAA GERMANIA CUTIE X 2 BLIST. PP/AL X 25 COMPR. P-6L 50 10,92 0,218400 0,218400 14,76 0,295200 0,295200

38 H03BB01 CARBIMAZOLUM CARBIMAZOLE 5 COMPR. FILM. 5mg REMEDICA LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 100 12,48 0,124800 0,124800 16,87 0,168700 0,168700

39 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 15,54 0,310800 0,310800 21,00 0,420000 0,420000

40 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L 50 18,88 0,377600 0,377600 25,52 0,510400 0,510400

41 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L 100 22,83 0,228300 0,228300 30,86 0,308600 0,308600

42 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF 100 9,12 0,091200 0,091200 12,33 0,123300 0,123300

43 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 9,12 0,091200 0,091200 12,33 0,123300 0,123300

44 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-RF 100 14,23 0,142300 0,142300 19,23 0,192300 0,192300

45 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-RF 100 14,23 0,142300 0,142300 19,23 0,192300 0,192300

46 H05AA02 TERIPARATIDUM** FORSTEO 20µg/80µg SOL. INJ. 20µg/80µl ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 ΜG/80ΜL) P-RF 1 1.473,60 1.473,600000 1.473,600000 1.644,38 1.644,380000 1.644,380000

47 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 23,94 4,788000 4,788000 32,36 6,472000 6,472000

48 H05BA01 CALCITONINUM (SOMON) MIACALCIC (R) SOL. INJ. 50ui/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 26,35 5,270000 5,270000 34,46 6,892000 6,892000

49 M05BA04 ACIDUM ALENDRONICUM** ACID ALENDRONIC ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 36,90 1,317857 1,317857 48,27 1,723928 1,723928

50 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 36,90 9,225000 5,694000 48,27 12,067500 7,692000

51 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 36,44 9,110000 5,694000 47,66 11,915000 7,692000

52 M05BA04 ACIDUM ALENDRONICUM** FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. AL/AL X 2 COMPR. P-6L 2 28,39 14,195000 5,694000 37,13 18,565000 7,692000

53 M05BA04 ACIDUM ALENDRONICUM** ACID ALENDRONIC ACCORD 70 mg COMPR. 70mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA -AL-PVC/AL X 4 COMPR. P-6L 4 36,90 9,225000 5,694000 48,27 12,067500 7,692000

54 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 36,67 9,167500 5,694000 47,97 11,992500 7,692000

55 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 12 108,06 9,005000 5,694000 131,92 10,993333 7,692000

56 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 9,49 4,745000 4,745000 12,82 6,410000 6,410000

57 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 18,33 9,165000 5,694000 24,78 12,390000 7,692000

58 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 65,80 65,800000 35,592000 83,20 83,200000 46,560000

59 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 29,66 29,660000 29,660000 38,80 38,800000 38,800000

60 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 56,52 56,520000 35,592000 71,46 71,460000 46,560000

61 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-6L 1 70,97 70,970000 35,592000 89,74 89,740000 46,560000

62 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 40,44 40,440000 35,592000 52,90 52,900000 46,560000

63 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 57,19 57,190000 35,592000 72,31 72,310000 46,560000

64 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 50 mg COMPR. FILM. 50 mg SANDOZ PHARMACEUTICALS GMBH GERMANIA CUTIE CU BLIST. DIN PA/AL/PVC/AL CU 28 COMPRIMATE FILMATE PR 28 519,62 18,557857 18,557857 604,54 21,590714 21,590714

65 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 50 mg COMPR. FILM. 50 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 28 COMPRIMATE FILMATE PR 28 637,14 22,755000 22,269428 732,63 26,165357 25,908857

66 M05BA06 ACIDUM IBANDRONICUM** HOLMEVIS 50 mg COMPR. FILM. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. PR 28 637,16 22,755714 22,269428 732,65 26,166071 25,908857

67 M05BA06 ACIDUM IBANDRONICUM** IASIBON 50 mg COMPR. FILM. 50mg PHARMATHEN S.A. GRECIA CUTIE CU BLIST. PA/ALL/PVC/ALU X 28 COMPR. FILM PR 28 629,47 22,481071 22,269428 724,27 25,866785 25,866785

68 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 50mg COMPR. FILM. 50mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X BLIST. AL/PVC X 28 COMPR. FILM. S 28 964,08 34,431428 22,269428 1.089,00 38,892857 25,908857

69 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC GLENMARK 50 mg COMPR. FILM. 50mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 28 COMPR. FILM. PR 28 562,00 20,071428 20,071428 650,73 23,240357 23,240357

70 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 6 mg CONC. PT. SOL. PERF. 6mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC SI CAPSA DE CULOARE TURCOAZ (ALBASTRU VERZUI PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

71 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 FLACON X 6 ML CONC. PT. SOL. PERF. S 1 901,37 901,370000 715,668000 1.020,64 1.020,640000 825,864000

72 M05BA06 ACIDUM IBANDRONICUM** IASIBON 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml PHARMATHEN S.A. GRECIA CUTIE CU 1 FLAC. DIN STICLA X 6ML CONC. PT. SOL. PERF. PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

73 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 INJECTARE P6L 1 232,02 232,020000 179,712000 283,25 283,250000 219,396000

74 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 1 196,40 196,400000 179,712000 239,77 239,770000 219,396000

75 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 1 222,35 222,350000 179,712000 271,45 271,450000 219,396000

Pagina 23 din 42

Page 123: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

76 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 1 354,51 354,510000 179,712000 424,57 424,570000 219,396000

77 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 1 149,76 149,760000 149,760000 182,83 182,830000 182,830000

78 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT BLUEFISH 35 mg COMPR. FILM. 35 mg BLUEFISH PHARMACEUTICALS AB SUEDIA CUTIE CU BLIST. DIN PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L 4 27,36 6,840000 3,177000 35,79 8,947500 4,293000

79 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT SODIC ZENTIVA 35mg COMPR. FILM. 35mg ZENTIVA KS REPUBLICA SLOVACA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE P-6L 4 10,59 2,647500 2,647500 14,31 3,577500 3,577500

80 M05BA07 ACIDUM RISEDRONICUM** OSTEORON 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L 4 20,98 5,245000 3,177000 28,35 7,087500 4,293000

81 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 21,00 5,250000 3,177000 28,38 7,095000 4,293000

82 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 27,91 6,977500 3,177000 36,50 9,125000 4,293000

83 M05BA07 ACIDUM RISEDRONICUM** RISENDROS 35 mg COMPR. FILM. 35mg ZENTIVA A.S. CEHIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L 4 10,59 2,647500 2,647500 14,31 3,577500 3,577500

84 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 53,23 13,307500 3,177000 67,31 16,827500 4,293000

85 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 34,61 8,652500 3,177000 45,27 11,317500 4,293000

86 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT TEVA 35 mg COMPR. FILM. 35mg TEVA PHARMACEUTICAL S.R.L. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 34,61 8,652500 3,177000 45,27 11,317500 4,293000

87 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 52,51 26,255000 26,255000 66,39 33,195000 33,195000

88 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TEVA 4 mg/5 ml CONC. PT. SOL. PERF. 4 mg/5 ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA CU 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA PR 1 377,14 377,140000 356,400000 449,23 449,230000 435,096000

89 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/100 ml CONC. PT. SOL. PERF. 4mg/100ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 100 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

90 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml DR. REDDY'S LABORATORIES ROMANIA CUTIE CU 1 FLAC. DIN STICLA CU CAPACITATEA DE 5 ML CU CONC. PT. SOL. PERF. PR 1 297,00 297,000000 297,000000 362,58 362,580000 362,580000

91 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 4 FLAC. DIN STICLA INCOLORA SI TRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF. PR 4 1.418,88 354,720000 354,720000 1.584,73 396,182500 396,182500

92 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA SI TRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

93 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ACTAVIS 4mg/5ml CONC. PT. SOL. PERF. 4mg/5ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 FLACON PLASTIC TRANSPARENT, INCOLOR CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PER PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

94 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 4 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 4 2.807,00 701,750000 356,400000 3.097,78 774,445000 435,096000

95 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE CU 1 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 1 724,40 724,400000 356,400000 827,75 827,750000 435,096000

96 M05BA08 ACIDUM ZOLEDRONICUM** OSPORIL 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

97 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TERAPIA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml TERAPIA SA ROMANIA CUTIE CU 1 FLAC. TRANSPARENT DIN STICLA CU CAPACITATEA DE 6 ML INCHIS CU DOP DIN CAUCIUC DE CULOARE PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

98 M05BA08 ACIDUM ZOLEDRONICUM** FAYTON 4 mg/ 5 ml CONC. PT. SOL. PERF. 4mg/5ml GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN COPOLIMER CICLOOLEFINIC SI CAPAC PP CU CAPACITATEA DE 5 ML CARE CONTINE CONC. P PR 1 676,00 676,000000 356,400000 774,99 774,990000 435,096000

99 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC RICHTER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON TRANSPARENT, INCOLOR DIN POLIMER CICLO-OLEFENIC INCHIS CU DOP GRI INCHIS DIN CAUCIUC CU STRAT FLUOROPOLIMERIC, CAPSA DIN AL SI SISTEM "FLIP-OFF" DIN PLASTIC ROSU X 5ML CONC. PT. SOL. PERF. PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

100 M05BA08 ACIDUM ZOLEDRONICUM** DESINOBON 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR DE 5 ML DIN COPOLIMER CICLOOLEFINIC CU DOP DE CAUC PR 1 452,56 452,560000 356,400000 531,44 531,440000 435,096000

101 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DIN CAUCIUC BROMOB PR 1 459,66 459,660000 356,400000 539,18 539,180000 435,096000

102 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLACON CU CAPACITATE DE 5ML DIN PLASTIC CU DOP BROMOBUTIL, ACOPERIT CU UN STRAT DE FLUOROP PR 1 452,56 452,560000 356,400000 531,44 531,440000 435,096000

103 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 4 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 4 1.417,59 354,397500 354,397500 1.583,33 395,832500 395,832500

104 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

105 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 5 ML CONC. PT. SOL. PERF. PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

106 M05BA08 ACIDUM ZOLEDRONICUM** ZOMETA 4 mg PULB. + SOLV. SOL. PERF. 4mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. 4MG PULB. PT. SOL. PERF. + 1 FIOLA X 5 ML SOLV. PR 1 1.098,45 1.098,450000 356,400000 1.235,46 1.235,460000 435,096000

107 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ZENTIVA 4 mg/5 ml SOL. PERF. 4mg/5ml ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CARE CONTINE CONC. PT. SOL. PERF. PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

108 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 5 mg SOL. PERF. 5mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 1 PUNGA DIN PLASTIC (PP) TRANSPARENTA, PREVAZUTA CU UN PERFUZOR SI UN CONECTOR CU MEMBRANA DIN CAUCIUC, CE CONTINE 100 ML SOL. PERF. PR 1 920,00 920,000000 920,000000 1.040,95 1.040,950000 1.040,950000

109 M05BA08 ACIDUM ZOLEDRONICUM** ACLASTA 5mg/100ml SOL. PERF. 5mg/100ml NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 100 ML + 1 CAPAC AL/PP CU COMPONENTA FLIP. PR 1 1.399,70 1.399,700000 1.104,000000 1.563,83 1.563,830000 1.249,140000

110 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 71,05 17,762500 17,762500 89,84 22,460000 22,460000

111 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 36,16 18,080000 18,080000 47,30 23,650000 23,650000

112 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 71,05 17,762500 17,762500 89,84 22,460000 22,460000

113 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 36,16 18,080000 18,080000 47,30 23,650000 23,650000

114 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 82,84 5,917142 5,917142 104,74 7,481428 7,481428

115 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 28 143,02 5,107857 5,107857 174,60 6,235714 6,235714

V09FX03  NATRII IODIDUM (131I) 

V10XA01 NATRII IODIDUM (131I) 

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.1: TRANSPLANT MEDULAR

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 14,09 1,409000 1,409000 19,04 1,904000 1,904000

2 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 24,64 2,464000 2,464000 33,31 3,331000 3,331000

3 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 33,45 6,690000 6,690000 43,75 8,750000 8,750000

4 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 17,60 3,520000 3,520000 23,79 4,758000 4,758000

5 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 17,60 3,520000 3,520000 23,79 4,758000 4,758000

6 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 33,43 6,686000 6,686000 43,73 8,746000 8,746000

7 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 42,41 0,706833 0,706833 55,47 0,924500 0,924500

8 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

9 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

10 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

11 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 41,43 0,690500 0,690500 54,19 0,903166 0,903166

12 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 27,43 1,371500 1,371500 35,88 1,794000 1,794000

13 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 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

14 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 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

15 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 77,10 77,100000 77,100000 97,49 97,490000 97,490000

16 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 66,80 6,680000 6,680000 84,46 8,446000 8,446000

17 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 80,20 16,040000 16,040000 101,41 20,282000 20,282000

18 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 9,47 1,894000 1,894000 12,80 2,560000 2,560000

19 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 2mg (100 KUI) PULB. + SOLV. PT. SOL. INJ. 100 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 5.431,43 5.431,430000 5.431,430000 5.958,41 5.958,410000 5.958,410000

20 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 5mg (250 KUI) PULB. + SOLV. PT. SOL. INJ. 250 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 13.793,54 13.793,540000 13.793,540000 15.073,11 15.073,110000 15.073,110000

21 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1mg (50 KUI) PULB. + SOLV. PT. SOL. INJ. 50 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 2.730,72 2.730,720000 2.730,720000 3.014,63 3.014,630000 3.014,630000

22 J01CR03 TICARCILLINUM + ACIDUM CLAVULANICUM TIMENTIN 3,2 g PULB. PT. SOL. INJ./PERF. 3,2g BEECHAM GROUP PLC MAREA BRITANIE CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S/P-RF 10 212,62 21,262000 21,262000 259,57 25,957000 25,957000

23 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

24 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

25 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

26 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 2g/0,25g PULB. PT. SOL. INJ./PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

Pagina 24 din 42

Page 124: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

27 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

28 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

29 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

30 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 4g/0,5g PULB. PT. SOL. INJ./PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

31 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

32 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

33 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAN ACTAVIS 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

34 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

35 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

36 J01DH02 MEROPENEMUM MERONEM IV 1 g PULB. PT. SOL. INJ. I.V./PERF. 1g ASTRAZENECA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ. I.V./PERF. S 10 1.030,68 103,068000 64,903200 1.161,59 116,159000 75,322800

37 J01DH02 MEROPENEMUM MERONEM IV 500 mg PULB. PT. SOL. INJ. I.V./PERF. 500mg ASTRAZENECA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 20 ML PULB. PT. SOL. INJ. I.V./PERF. S 10 539,60 53,960000 36,430800 626,31 62,631000 44,287200

38 J01DH02 MEROPENEMUM LODITER 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 40 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 72,84 72,840000 64,903200 92,10 92,100000 75,322800

39 J01DH02 MEROPENEMUM MEROPENEM ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA PRF 10 680,43 68,043000 64,903200 779,82 77,982000 75,322800

40 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 540,86 54,086000 54,086000 627,69 62,769000 62,769000

41 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 10 680,43 68,043000 64,903200 779,82 77,982000 75,322800

42 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 72,84 72,840000 64,903200 92,10 92,100000 75,322800

43 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 1 57,22 57,220000 57,220000 72,35 72,350000 72,350000

44 J01DH02 MEROPENEMUM LODITER 500 mg PULB. PT. SOL. INJ./PERF. 500mg TERAPIA S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CONTINAND PULB. PT. SOL. INJ./PERF. PR 1 37,77 37,770000 36,430800 49,40 49,400000 44,287200

45 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 303,59 30,359000 30,359000 369,06 36,906000 36,906000

46 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 1 31,46 31,460000 31,460000 41,15 41,150000 41,150000

47 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 10 361,25 36,125000 36,125000 431,91 43,191000 43,191000

48 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 37,77 37,770000 36,430800 49,40 49,400000 44,287200

49 J01DH02 MEROPENEMUM MEROPENEM ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA PRF 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

50 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

51 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

52 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

53 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

54 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 10 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 10 445,46 44,546000 35,102400 523,70 52,370000 42,852000

55 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN HOSPIRA 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 5 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. PERF. PR 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

56 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S/P-RF 10 296,98 29,698000 29,698000 362,55 36,255000 36,255000

57 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 1g TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 48,56 48,560000 48,560000 63,52 63,520000 63,520000

58 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 500mg TEVA PHARM. WORKS PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 24,28 24,280000 24,280000 32,82 32,820000 32,820000

59 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 1000 mg PULB. PT. SOL. PERF. 1000mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 456,00 45,600000 45,600000 535,19 53,519000 53,519000

60 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 500 mg PULB. PT. SOL. PERF. 500mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 234,30 23,430000 23,430000 286,03 28,603000 28,603000

61 J01XA01 VANCOMYCINUM VANCOMICINA ACTAVIS 1000mg PULB. PT.CONC. PT.SOL. PERF. 1000mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CONTINAND 1000 MG VANCOMICINA P-PR 1 48,45 48,450000 48,450000 63,37 63,370000 63,370000

62 J01XA01 VANCOMYCINUM VANCOMICINA KABI 1000 mg PULB. PT.CONC. PT.SOL. PERF. 1000mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 48,39 48,390000 48,390000 63,30 63,300000 63,300000

63 J01XA01 VANCOMYCINUM VANCOMICINA KABI 500 mg PULB. PT.CONC. PT.SOL. PERF. 500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P PR 1 24,17 24,170000 24,170000 32,67 32,670000 32,670000

64 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF.PT.SOL.PERF./INJ 1g LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. LIOF. PT. SOL. PERF./INJ. S/P-RF 1 56,90 56,900000 54,720000 71,94 71,940000 64,222800

65 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 109,84 109,840000 109,840000 134,09 134,090000 134,090000

66 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

67 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

68 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

69 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

70 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 23,31 3,330000 3,330000 31,51 4,501428 4,501428

71 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 6,98 3,490000 3,490000 9,43 4,715000 4,715000

72 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,996000 25,61 6,402500 5,401714

73 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 65,37 4,085625 3,996000 82,66 5,166250 5,166250

74 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 193,65 6,916071 3,996000 236,41 8,443214 5,401714

75 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,856000 9,68 9,680000 7,908000

76 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 10,02 10,020000 5,856000 13,54 13,540000 7,908000

77 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,27 9,270000 5,856000 12,53 12,530000 7,908000

78 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13,95 13,950000 5,856000 18,86 18,860000 7,908000

79 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 18,56 18,560000 5,856000 25,08 25,080000 7,908000

80 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

81 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

82 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,07 6,070000 5,856000 8,20 8,200000 7,908000

83 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 7,44 7,440000 5,856000 10,06 10,060000 7,908000

84 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,856000 14,58 14,580000 7,908000

85 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 9,57 9,570000 5,856000 12,94 12,940000 7,908000

86 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 48,24 12,060000 5,856000 63,10 15,775000 7,908000

87 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

88 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 4,88 4,880000 4,880000 6,59 6,590000 6,590000

89 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,856000 9,03 9,030000 7,908000

90 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 16,65 16,650000 5,856000 22,51 22,510000 7,908000

91 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 30,10 4,300000 4,300000 39,37 5,624285 5,624285

92 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

93 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,998857 19,58 2,797142 2,701714

94 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,998857 41,93 5,990000 2,701714

95 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 21,91 3,130000 1,998857 29,61 4,230000 2,701714

96 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 43,23 6,175714 1,998857 56,54 8,077142 2,701714

97 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 12,35 1,764285 1,764285 16,69 2,384285 2,384285

98 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 47,19 6,741428 1,998857 61,72 8,817142 2,701714

99 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 14,09 1,761250 1,761250 19,04 2,380000 2,380000

Pagina 25 din 42

Page 125: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

100 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

101 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

102 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,998857 19,12 2,731428 2,701714

103 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 11,66 1,665714 1,665714 15,76 2,251428 2,251428

104 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, PREVAZUT CU CAPAC DIN AL CU FILET + 1 LINGURITA DOZATOAR PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

105 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

106 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

107 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

108 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 50 ML SOL. PERF. S 10 182,90 18,290000 18,290000 223,28 22,328000 22,328000

109 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

110 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

111 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

112 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 25 443,47 17,738800 17,738800 521,53 20,861200 20,861200

113 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

114 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 10 761,71 76,171000 76,171000 868,42 86,842000 86,842000

115 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 10 330,71 33,071000 20,737200 398,62 39,862000 25,316400

116 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

117 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

118 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

119 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 200 ML SOL. PERF. S 10 770,66 77,066000 77,066000 878,17 87,817000 87,817000

120 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 100 ML SOL. PERF. S 20 796,39 39,819500 20,737200 906,22 45,311000 25,316400

121 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 100 ML SOL. PERF. S 10 454,59 45,459000 20,737200 533,65 53,365000 25,316400

122 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 50 ML SOL. PERF. S 20 362,55 18,127500 18,127500 433,33 21,666500 21,666500

123 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

124 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 20 631,41 31,570500 20,737200 726,39 36,319500 25,316400

125 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

126 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 25 781,76 31,270400 20,737200 890,27 35,610800 25,316400

127 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 35,03 35,030000 20,737200 45,82 45,820000 25,316400

128 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 20 360,77 18,038500 18,038500 431,39 21,569500 21,569500

129 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 10 181,93 18,193000 18,193000 222,10 22,210000 22,210000

130 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,033440

131 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

132 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

133 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

134 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

135 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

136 J02AC04 POSACONAZOLUM** NOXAFIL SP 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.488,19 2.488,190000 2.488,190000 2.750,28 2.750,280000 2.750,280000

137 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 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

138 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 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

139 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 15,85 0,792500 0,577200 21,42 1,071000 0,780000

140 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,577200 20,23 1,011500 0,780000

141 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 704,14 0,704140 0,577200 805,66 0,805660 0,780000

142 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,577200 21,42 1,071000 0,780000

143 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 14,41 1,441000 1,441000 19,48 1,948000 1,948000

144 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 10,22 0,511000 0,511000 13,81 0,690500 0,690500

145 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 12,75 0,637500 0,577200 17,23 0,861500 0,780000

146 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,577200 17,15 0,857500 0,780000

147 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,62 0,481000 0,481000 13,00 0,650000 0,650000

148 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 14,23 1,423000 1,423000 19,23 1,923000 1,923000

149 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 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

150 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 43,54 4,354000 4,354000 56,95 5,695000 5,695000

151 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

152 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 872,00 872,000000 872,000000 988,63 988,630000 988,630000

153 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 451,00 451,000000 451,000000 529,74 529,740000 529,740000

154 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 6.114,44 6.114,440000 6.114,440000 6.702,89 6.702,890000 6.702,890000

155 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 3.072,10 3.072,100000 3.072,100000 3.386,74 3.386,740000 3.386,740000

156 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 1.550,55 1.550,550000 1.550,550000 1.728,25 1.728,250000 1.728,250000

157 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 663,61 663,610000 663,610000 761,48 761,480000 761,480000

158 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.749,51 1.749,510000 1.749,510000 1.945,12 1.945,120000 1.945,120000

159 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 889,76 889,760000 889,760000 1.007,99 1.007,990000 1.007,990000

160 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.469,04 3.469,040000 3.469,040000 3.819,40 3.819,400000 3.819,400000

161 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 100 ML SOL. PERF. S 1 1.751,89 1.751,890000 1.751,890000 1.947,71 1.947,710000 1.947,710000

162 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 50 ML SOL. PERF. S 1 890,95 890,950000 890,950000 1.009,28 1.009,280000 1.009,280000

163 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 7.459,41 7.459,410000 7.459,410000 8.168,91 8.168,910000 8.168,910000

164 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 25ML SOL. PERF.(2,5G/25ML) S 1 459,88 459,880000 459,880000 539,42 539,420000 539,420000

165 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 25 ML SOL. PERF. S 1 460,47 460,470000 460,470000 540,07 540,070000 540,070000

166 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 188,56 188,560000 188,560000 230,20 230,200000 230,200000

167 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 200 ML SOL. PERF. S 1 3.473,78 3.473,780000 3.473,780000 3.824,57 3.824,570000 3.824,570000

168 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 2.050,80 2.050,800000 2.050,800000 2.273,52 2.273,520000 2.273,520000

169 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 222,29 222,290000 222,290000 271,37 271,370000 271,370000

170 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 535,20 535,200000 535,200000 621,52 621,520000 621,520000

171 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL.PERF. S 1 99,02 99,020000 99,020000 125,20 125,200000 125,200000

172 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL.PERF. S 1 472,05 472,050000 472,050000 552,68 552,680000 552,680000

Pagina 26 din 42

Page 126: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

173 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL.PERF. S 1 1.798,20 1.798,200000 1.798,200000 1.998,19 1.998,190000 1.998,190000

174 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL.PERF. S 1 914,10 914,100000 914,100000 1.034,52 1.034,520000 1.034,520000

175 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 2.261,30 2.261,300000 2.261,300000 2.502,97 2.502,970000 2.502,970000

176 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 640,45 640,450000 640,450000 736,24 736,240000 736,240000

177 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 1.166,70 1.166,700000 1.166,700000 1.309,85 1.309,850000 1.309,850000

178 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.040,40 1.040,400000 1.040,400000 1.172,19 1.172,190000 1.172,190000

179 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 19,33 0,386600 0,386600 26,13 0,522600 0,522600

180 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 11,76 11,760000 11,760000 15,89 15,890000 15,890000

181 L01AA06 IFOSFAMIDUM HOLOXAN 1 g PULB. PT. SOL. PERF. 1g BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. PERF. S 1 92,66 92,660000 92,660000 117,16 117,160000 117,160000

182 L01AB01 BUSULFANUM BUSILVEX 6mg/ml CONC. PT. SOL. PERF. 6mg/ml PIERRE FABRE MEDICAMENT FRANTA CUTIE X 8 FLAC. X 10 ML CONC. PT. SOL. INJ. S 8 9.151,91 1.143,988750 1.143,988750 10.013,75 1.251,718750 1.251,718750

183 L01BA01 METHOTREXATUM METHOTREXATE PCH 10mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 10COMPR. P6L 10 21,32 2,132000 2,132000 28,81 2,881000 2,881000

184 L01BA01 METHOTREXATUM METHOTREXATE PCH 2,5mg COMPR. 2,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X30 COMPRIMATE P6L 30 16,00 0,533333 0,533333 21,62 0,720666 0,720666

185 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 5 197,47 39,494000 39,494000 241,07 48,214000 48,214000

186 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 70,91 70,910000 70,910000 89,66 89,660000 89,660000

187 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 1 332,72 332,720000 332,720000 400,81 400,810000 400,810000

188 L01BA01 METHOTREXATUM BENDATREXAT SOL INJ. 25mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC. X 2 ML PR 1 65,37 65,370000 64,332000 82,65 82,650000 81,348000

189 L01BA01 METHOTREXATUM EMTHEXATE PF SOL. INJ. 25mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FIOLA X 2ML PR 1 53,61 53,610000 53,610000 67,79 67,790000 67,790000

190 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 17,62 1,762000 1,762000 23,82 2,382000 2,382000

191 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 87,07 87,070000 87,070000 110,09 110,090000 110,090000

192 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 62,22 62,220000 62,220000 78,67 78,670000 78,670000

193 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 1 100,34 100,340000 100,340000 122,50 122,500000 122,500000

194 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 45,60 45,600000 45,600000 59,64 59,640000 59,640000

195 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 86,63 86,630000 86,630000 109,54 109,540000 109,540000

196 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 62,22 62,220000 62,220000 78,67 78,670000 78,670000

197 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 59,16 59,160000 54,720000 74,80 74,800000 71,568000

198 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 1 101,74 101,740000 101,740000 124,21 124,210000 124,210000

199 L01BB05 FLUDARABINUM FLUDARA ORAL 10 mg COMPR. FILM. 10mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM. P-RF/S 20 1.094,66 54,733000 54,733000 1.231,33 61,566500 61,566500

200 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 5 FLAC. CU LIOF. PT. SOL. INJ./PERF. S 5 513,08 102,616000 102,616000 597,41 119,482000 119,482000

201 L01BB05 FLUDARABINUM FLUDARABINA ACTAVIS 25 mg/ml PULB. PT. SOL. INJ./PERF. 25mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA (CAPACITATE 5ML) CU PULB. PT. SOL. INJ/PERF CONTINAND 50MG FLUDA S 1 340,13 340,130000 123,139200 408,89 408,890000 143,378400

202 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10 CAPS. P-RF 10 311,36 31,136000 31,136000 377,53 37,753000 37,753000

203 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10 CAPS. P-RF 20 308,57 15,428500 15,428500 374,49 18,724500 18,724500

204 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 39,04 39,040000 38,352000 51,07 51,070000 50,172000

205 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 32,83 32,830000 32,830000 42,94 42,940000 42,940000

206 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML CONC. PT. SOL. PERF. S 1 61,07 61,070000 61,070000 77,22 77,220000 77,220000

207 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 31,96 31,960000 31,960000 41,81 41,810000 41,810000

208 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 203,33 203,330000 203,330000 248,22 248,220000 248,220000

209 L01DB06 IDARUBICINUM ZAVEDOS 5 mg PULB. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 143,35 143,350000 143,350000 175,00 175,000000 175,000000

210 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 1 555,48 555,480000 555,480000 643,62 643,620000 643,620000

211 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

212 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 19,75 19,750000 19,750000 26,70 26,700000 26,700000

213 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 20 ML CONC. PT. SOL. PERF. PR 1 11,00 11,000000 11,000000 14,87 14,870000 14,868000

214 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 67,91 67,910000 67,910000 85,86 85,860000 85,860000

215 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

216 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML CONC. PT. SOL. PERF. S 1 9,17 9,170000 9,170000 12,39 12,390000 12,390000

217 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML X 10 MG CONC. SOL. PERF. S 1 18,81 18,810000 11,004000 25,42 25,420000 14,868000

218 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML X 50 MG CONC. SOL. PERF. S 1 48,45 48,450000 37,884000 63,37 63,370000 49,560000

219 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 25 mg/50 ml CONC. PT. SOL. PERF. 25mg/50ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML COND. PT. SOL. PERF. S 1 22,06 22,060000 22,060000 29,81 29,810000 29,810000

220 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF. 50mg/100ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT. SOL. PERF. S 1 31,57 31,570000 31,570000 41,30 41,300000 41,300000

221 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 5 ML CONC. PT. SOL. PERF. S 1 21,86 21,860000 21,624000 29,55 29,550000 29,220000

222 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 45 ML CONC. PT. SOL. PERF. S 1 178,07 178,070000 158,400000 217,39 217,390000 193,380000

223 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL. PERF. S 1 47,45 47,450000 47,450000 62,06 62,060000 62,060000

224 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 18,05 18,050000 18,050000 24,39 24,390000 24,390000

225 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 45 ML CONC. PT. SOL. PERF. S 1 132,81 132,810000 132,810000 162,14 162,140000 162,140000

226 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE GALBENA X 60 ML CONC. PT. SOL. PERF. X 600 MG CARBOPLATINA PR 1 174,90 174,900000 174,900000 213,52 213,520000 213,520000

227 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ROSIE X 45 ML CON. PT. SOL. PERF. X 450 MG CARBOPLATINA PR 1 132,00 132,000000 132,000000 161,15 161,150000 161,150000

228 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ALBASTRA X 15 ML CONC. PT. SOL. PERF. X 150 MG CARBOPLATINA PR 1 47,42 47,420000 47,420000 62,03 62,030000 62,030000

229 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI ONCOLOGY PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE VERDE X 5 ML CON. PT. SOL. PERF. X 50 MG CARBOPLATINA PR 1 18,02 18,020000 18,020000 24,35 24,350000 24,350000

230 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 15 ML CONC. PT. SOL. PERF. S 1 62,52 62,520000 56,904000 79,05 79,050000 74,436000

231 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 15 ML CONC. PT. SOL. PERF. S 1 50,00 50,000000 50,000000 63,22 63,220000 63,220000

232 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 45 ML CONC. PT. SOL. PERF. S 1 133,04 133,040000 133,040000 162,41 162,410000 162,410000

233 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 5.509,03 5.509,030000 5.509,030000 6.043,00 6.043,000000 6.043,000000

234 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 2.221,55 1.110,775000 1.110,775000 2.459,64 1.229,820000 1.229,820000

235 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 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

236 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 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

237 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 1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

238 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 1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

239 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 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

240 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 1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

241 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 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

242 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 1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

243 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 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

244 L04AA04 IMUNOGLOBULINA ANTI-LIMFOCITE** ATG-FRESENIUS CONC. PT. SOL. PERF. 20mg/ml FRESENIUS BIOTECH GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 1.158,60 1.158,600000 1.158,600000 1.301,02 1.301,020000 1.301,020000

245 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

Pagina 27 din 42

Page 127: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

246 L04AA06 MYCOPHENOLATUM** MYCOPHENOLATE MOFETIL MEDICO UNO 500 MG COMPR. FILM. 500mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 292,89 5,857800 5,857800 357,56 7,151200 7,151200

247 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

248 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

249 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

250 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

251 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

252 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

253 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOPHENOLATE MOFETIL ACCORD 250 mg CAPS. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL CU 100 CAPS. P-RF/R 100 292,89 2,928900 2,928900 357,56 3,575600 3,575600

254 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

255 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

256 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

257 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. DIN AL-PA-PVC/AL X 50 COMPR. FILM. PR 50 302,36 6,047200 6,047200 367,72 7,354400 7,354400

258 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

259 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

260 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOFENOLAT MOFETIL ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

261 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

262 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

263 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

264 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 INOX PR 4 722,92 180,730000 180,730000 826,13 206,532500 206,532500

265 L04AB01 ETANERCEPTUM** ENBREL 50 mg PULB+SOLV.PT.SOL.INJ 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. PULB. PT. SOL. INJ. + 4 SERINGI PREUMPLUTE CU SOLVENT + 4 ADAPTOARE PT. FLAC. + 8 TA P-RF/R 4 4.153,67 1.038,417500 1.038,417500 4.565,66 1.141,415000 1.141,415000

266 L04AB01 ETANERCEPTUM** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 FLAC. + 4 SERINGI PREUMPLUTE CU SOLV. + 8 TAMPOANE CU ALCOOL P-RF/R 4 2.052,34 513,085000 513,085000 2.275,20 568,800000 568,800000

267 L04AB01 ETANERCEPTUM** ENBREL 25mg SOL. INJ. IN SERINGA PREUMPLUTA 25mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 2.047,58 511,895000 511,895000 2.270,01 567,502500 567,502500

268 L04AB01 ETANERCEPTUM** ENBREL 50mg SOL. INJ. IN SERINGA PREUMPLUTA 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.065,15 1.016,287500 1.016,287500 4.469,17 1.117,292500 1.117,292500

269 L04AB01 ETANERCEPTUM** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg WYETH EUROPA LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 8 TAMPOANE CU ALCOOL P-RF/R 4 4.065,15 1.016,287500 1.016,287500 4.469,17 1.117,292500 1.117,292500

270 L04AD01 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

271 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 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

272 L04AD01 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

273 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

274 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 59,45 1,189000 1,189000 75,17 1,503400 1,503400

275 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

276 L04AD01 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

277 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 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

278 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

279 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

280 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

281 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

282 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

283 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

284 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

285 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

286 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

287 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

288 L04AD02 TACROLIMUSUM** TACNI 5 mg CAPS. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPS. PR 50 1.114,65 22,293000 22,293000 1.253,12 25,062400 25,062400

289 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

290 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

291 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

292 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

293 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

294 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 2,83 0,283000 0,258600 3,82 0,382000 0,349200

295 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,31 0,215500 0,215500 5,82 0,291000 0,291000

296 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,31 0,215500 0,215500 5,82 0,291000 0,291000

297 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,66 0,333000 0,258600 9,00 0,450000 0,349200

298 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 2,85 0,285000 0,258600 3,85 0,385000 0,349200

299 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 2,85 0,285000 0,258600 3,85 0,385000 0,349200

300 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

301 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

302 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

303 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

304 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 4,66 0,466000 0,466000 6,30 0,630000 0,630000

305 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 13,98 0,466000 0,466000 18,89 0,629666 0,629666

306 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 13,99 0,466333 0,466333 18,91 0,630333 0,630333

307 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 20,38 0,679333 0,679333 27,55 0,918333 0,918333

308 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 24,72 0,824000 0,815200 33,41 1,113666 1,102000

309 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 26,22 0,874000 0,874000 34,30 1,143333 1,143333

310 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 7,88 0,262666 0,258600 10,65 0,355000 0,349200

311 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 7,17 0,717000 0,559200 9,69 0,969000 0,755599

312 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 31,78 1,059333 0,815200 41,57 1,385666 1,102000

313 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 16,30 1,630000 0,815200 22,03 2,203000 1,102000

314 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 40,67 1,355666 1,048800 53,20 1,773333 1,372000

315 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 20,85 2,085000 1,048800 28,18 2,818000 1,372000

316 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 2,84 0,284000 0,258600 3,84 0,384000 0,349200

317 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 110,22 1,102200 1,102200 134,56 1,345600 1,345600

318 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 7,27 1,454000 1,322640 9,83 1,966000 1,614720

Pagina 28 din 42

Page 128: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

319 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 9,09 1,818000 1,322640 12,28 2,456000 1,614720

320 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 9,69 1,938000 1,322640 13,10 2,620000 1,614720

321 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 3,65 0,730000 0,730000 4,93 0,986000 0,986000

322 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 5,67 1,134000 1,134000 7,67 1,534000 1,534000

323 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 3,63 0,726000 0,726000 4,90 0,980000 0,980000

324 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 4,13 0,826000 0,826000 5,58 1,116000 1,116000

325 R05CB13 DORNAZA ALFA** PULMOZYME SOL. INHAL. 1mg/ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 6 FIOLE UNIDOZA PE X 2,5 ML SOL. INHAL. PRIN NEBULIZATOR, INTRODUSE IN PUNGA AL S/P-RF 6 551,59 91,931666 91,931666 639,38 106,563333 106,563333

326 V03AC03 DEFERASIROXUM** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 687,54 24,555000 24,555000 787,57 28,127500 28,127500

327 V03AC03 DEFERASIROXUM** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 1.461,36 52,191428 52,191428 1.631,03 58,251071 58,251071

328 V03AC03 DEFERASIROXUM** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 2.660,12 95,004285 95,004285 2.937,68 104,917142 104,917142

329 V03AF01 MESNUM UROMITEXAN (R) 400 mg SOL. INJ. 400mg/4ml BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 3 SUPORTURI TERMOFORMATE DIN PLASTIC X 5 FIOLE DE STICLA INCOLORA X 4 ML S 15 44,87 2,991333 2,991333 58,69 3,912666 3,912666

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.2: TRANSPLANT DE CORD

1 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 66,80 6,680000 6,680000 84,46 8,446000 8,446000

2 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 80,20 16,040000 16,040000 101,41 20,282000 20,282000

3 C01CA24 EPINEPHRINUM ADRENALINA 1 mg SOL. INJ. 1mg/ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE X 1 ML S 100 137,50 1,375000 1,375000 167,86 1,678600 1,678600

4 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

5 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

6 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

7 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 2g/0,25g PULB. PT. SOL. INJ./PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

8 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

9 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

10 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

11 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 4g/0,5g PULB. PT. SOL. INJ./PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

12 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

13 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

14 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAN ACTAVIS 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

15 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

16 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

17 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 154,50 15,450000 8,448000 188,61 18,861000 11,412000

18 J01DD12 CEFOPERAZONUM LYZONE 2 g PULB. PT. SOL. INJ. 2g MEDICAROM GROUP S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. S/P-RF 1 20,07 20,070000 13,932000 27,12 27,120000 18,828000

19 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 187,44 18,744000 13,932000 228,83 22,883000 18,828000

20 J01DD12 CEFOPERAZONUM CEFOZON 500 mg PULB. PT. SOL. INJ. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. S/P-RF 1 3,88 3,880000 3,880000 5,24 5,240000 5,240000

21 J01DD12 CEFOPERAZONUM CEFOZON 2 g PULB. PT. SOL. INJ./PERF. I.M./I.V. 2g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA A 20 ML CU PULB. PT. SOL. INJ./PERF. I.M./I.V. S/P-RF 1 11,61 11,610000 11,610000 15,69 15,690000 15,690000

22 J01DD12 CEFOPERAZONUM CEFOZON 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ. I.M./PERF. I.V. S/P-RF 1 7,04 7,040000 7,040000 9,51 9,510000 9,510000

23 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

24 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF. S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

25 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

26 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF. S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

27 J01DH51 IMIPENEMUM + CILASTATINUM TIENAM I.V. PULB. PT. SOL. PERF. 500mg/500mg MERCK SHARP & DOHME ROMANIA TAVA DIN PLASTIC X 10 FLAC. DIN STICLA INCOLORA CU PULB.PT. SOL. PERF. S/P-RF 10 445,46 44,546000 35,102400 523,70 52,370000 42,852000

28 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN HOSPIRA 500 mg/500 mg PULB. PT. SOL. PERF. 500mg/500mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE CU 5 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. PERF. PR 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

29 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF. 500mg/500mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. S/P-RF 10 296,98 29,698000 29,698000 362,55 36,255000 36,255000

30 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

31 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

32 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

33 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

34 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 23,31 3,330000 3,330000 31,51 4,501428 4,501428

35 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 6,98 3,490000 3,490000 9,43 4,715000 4,715000

36 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,996000 25,61 6,402500 5,401714

37 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 65,37 4,085625 3,996000 82,66 5,166250 5,166250

38 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 193,65 6,916071 3,996000 236,41 8,443214 5,401714

39 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,856000 9,68 9,680000 7,908000

40 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 10,02 10,020000 5,856000 13,54 13,540000 7,908000

41 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,27 9,270000 5,856000 12,53 12,530000 7,908000

42 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13,95 13,950000 5,856000 18,86 18,860000 7,908000

43 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 18,56 18,560000 5,856000 25,08 25,080000 7,908000

44 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

45 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

46 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,07 6,070000 5,856000 8,20 8,200000 7,908000

47 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 7,44 7,440000 5,856000 10,06 10,060000 7,908000

48 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,856000 14,58 14,580000 7,908000

49 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 9,57 9,570000 5,856000 12,94 12,940000 7,908000

50 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 48,24 12,060000 5,856000 63,10 15,775000 7,908000

51 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

52 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 4,88 4,880000 4,880000 6,59 6,590000 6,590000

53 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,856000 9,03 9,030000 7,908000

54 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 16,65 16,650000 5,856000 22,51 22,510000 7,908000

55 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 30,10 4,300000 4,300000 39,37 5,624285 5,624285

56 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

57 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,998857 19,58 2,797142 2,701714

Pagina 29 din 42

Page 129: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

58 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,998857 41,93 5,990000 2,701714

59 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 21,91 3,130000 1,998857 29,61 4,230000 2,701714

60 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 43,23 6,175714 1,998857 56,54 8,077142 2,701714

61 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 12,35 1,764285 1,764285 16,69 2,384285 2,384285

62 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 47,19 6,741428 1,998857 61,72 8,817142 2,701714

63 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 14,09 1,761250 1,761250 19,04 2,380000 2,380000

64 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

65 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

66 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,998857 19,12 2,731428 2,701714

67 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 11,66 1,665714 1,665714 15,76 2,251428 2,251428

68 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, PREVAZUT CU CAPAC DIN AL CU FILET + 1 LINGURITA DOZATOAR PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

69 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

70 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

71 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

72 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 50 ML SOL. PERF. S 10 182,90 18,290000 18,290000 223,28 22,328000 22,328000

73 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

74 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

75 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

76 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 25 443,47 17,738800 17,738800 521,53 20,861200 20,861200

77 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

78 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 10 761,71 76,171000 76,171000 868,42 86,842000 86,842000

79 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 10 330,71 33,071000 20,737200 398,62 39,862000 25,316400

80 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

81 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

82 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

83 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 200 ML SOL. PERF. S 10 770,66 77,066000 77,066000 878,17 87,817000 87,817000

84 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 100 ML SOL. PERF. S 20 796,39 39,819500 20,737200 906,22 45,311000 25,316400

85 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 100 ML SOL. PERF. S 10 454,59 45,459000 20,737200 533,65 53,365000 25,316400

86 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 50 ML SOL. PERF. S 20 362,55 18,127500 18,127500 433,33 21,666500 21,666500

87 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

88 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 20 631,41 31,570500 20,737200 726,39 36,319500 25,316400

89 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

90 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 25 781,76 31,270400 20,737200 890,27 35,610800 25,316400

91 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 35,03 35,030000 20,737200 45,82 45,820000 25,316400

92 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 20 360,77 18,038500 18,038500 431,39 21,569500 21,569500

93 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 10 181,93 18,193000 18,193000 222,10 22,210000 22,210000

94 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,033440

95 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

96 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

97 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

98 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

99 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

100 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

101 L04AA04 IMUNOGLOBULINA ANTI-LIMFOCITE** ATG-FRESENIUS CONC. PT. SOL. PERF. 20mg/ml FRESENIUS BIOTECH GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 1.158,60 1.158,600000 1.158,600000 1.301,02 1.301,020000 1.301,020000

102 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

103 L04AA06 MYCOPHENOLATUM** MYCOPHENOLATE MOFETIL MEDICO UNO 500 MG COMPR. FILM. 500mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 292,89 5,857800 5,857800 357,56 7,151200 7,151200

104 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

105 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

106 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

107 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

108 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

109 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

110 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOPHENOLATE MOFETIL ACCORD 250 mg CAPS. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL CU 100 CAPS. P-RF/R 100 292,89 2,928900 2,928900 357,56 3,575600 3,575600

111 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

112 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

113 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

114 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. DIN AL-PA-PVC/AL X 50 COMPR. FILM. PR 50 302,36 6,047200 6,047200 367,72 7,354400 7,354400

115 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

116 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

117 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOFENOLAT MOFETIL ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

118 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

119 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

120 L04AD01 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

121 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 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

122 L04AD01 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

123 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

124 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 59,45 1,189000 1,189000 75,17 1,503400 1,503400

125 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

126 L04AD01 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

127 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 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

128 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

129 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

130 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

Pagina 30 din 42

Page 130: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

131 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

132 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

133 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

134 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

135 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

136 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

137 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

138 L04AD02 TACROLIMUSUM** TACNI 5 mg CAPS. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPS. PR 50 1.114,65 22,293000 22,293000 1.253,12 25,062400 25,062400

139 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

140 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

141 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

142 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

143 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.3: TRANSPLANT HEPATIC

1 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 42,41 0,706833 0,706833 55,47 0,924500 0,924500

2 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

3 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

4 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

5 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 41,43 0,690500 0,690500 54,19 0,903166 0,903166

6 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 27,43 1,371500 1,371500 35,88 1,794000 1,794000

7 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 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

8 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 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

9 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 77,10 77,100000 77,100000 97,49 97,490000 97,490000

10 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 49,00 4,900000 4,900000 64,09 6,409000 6,409000

11 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 93,99 9,399000 9,399000 118,84 11,884000 11,884000

12 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 10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

13 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 30,69 15,345000 15,345000 40,14 20,070000 20,070000

14 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 66,80 6,680000 6,680000 84,46 8,446000 8,446000

15 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 80,20 16,040000 16,040000 101,41 20,282000 20,282000

16 B01AC11 ILOPROSTUM** ILOMEDIN 20 CONC. PT. SOL. PERF. 20mcg/ml BAYER SCHERING PHARMA AG GERMANIA CUTIE X 5 FIOLE STICLA INCOLORA X 1 ML CONC. PT. SOL. PERFZ. S/P-RF 5 764,66 152,932000 152,932000 871,63 174,326000 174,326000

17 B01AC11 ILOPROSTUM** VENTAVIS 10mcg/ml SOL. DE INHALAT PRIN NEBULIZ. 10mcg/ml BAYER SCHERING PHARMA AG GERMANIA CUTIE X 30 FIOLE X 1 ML SOL. DE INHALAT PRIN NEBULIZ. S 30 1.947,00 64,900000 64,900000 2.160,38 72,012666 72,012666

18 B01AD02 ALTEPLASUM** ACTILYSE PULB+SOLV. PT. SOL. INJ 50mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FLACON SOLV. + CANULA DE TRANSFER S 1 1.490,89 1.490,890000 1.490,890000 1.663,22 1.663,220000 1.663,220000

19 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 9,47 1,894000 1,894000 12,80 2,560000 2,560000

20 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 2mg (100 KUI) PULB. + SOLV. PT. SOL. INJ. 100 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 5.431,43 5.431,430000 5.431,430000 5.958,41 5.958,410000 5.958,410000

21 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 5mg (250 KUI) PULB. + SOLV. PT. SOL. INJ. 250 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 13.793,54 13.793,540000 13.793,540000 15.073,11 15.073,110000 15.073,110000

22 B02BD08 EPTACOG ALFA ACTIVATUM** NOVOSEVEN 1mg (50 KUI) PULB. + SOLV. PT. SOL. INJ. 50 KIU NOVO NORDISK A/S DANEMARCA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + 1 FLAC. SOLV. PT. RECONSTITUIRE P-RF/R 1 2.730,72 2.730,720000 2.730,720000 3.014,63 3.014,630000 3.014,630000

23 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 23,29 0,776333 0,776333 31,48 1,049333 1,049333

24 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 17,25 0,862500 0,862500 23,31 1,165500 1,165500

25 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 30 105,26 3,508666 3,508666 128,50 4,283333 4,283333

26 H01BA02 DESMOPRESSINUM MINIRIN 0,2 mg COMPR. 0,2mg FERRING GMBH GERMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF 30 95,42 3,180666 3,180666 120,65 4,021666 4,021666

27 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 30 149,92 4,997333 4,997333 183,02 6,100666 6,100666

28 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 26,04 2,604000 2,604000 34,06 3,406000 3,406000

29 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 76,73 2,557666 2,557666 97,02 3,234000 3,234000

30 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

31 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

32 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

33 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 2g/0,25g PULB. PT. SOL. INJ./PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

34 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

35 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

36 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

37 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 4g/0,5g PULB. PT. SOL. INJ./PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

38 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

39 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

40 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAN ACTAVIS 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

41 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

42 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

43 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

44 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

45 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

46 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

47 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

48 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

49 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

50 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

51 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 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

52 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 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

53 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

54 J06BB04 IMUNOGLOBULINA ANTI-HEPATITICA B** ZUTECTRA SOL INJ. IN SERINGA PRE-UMPLUTA 500 UI BIOTEST PHARMA GMBH GERMANIA CUTIE CU 5 SERINGI PREUMPLUTE DIN STICLA A CATE 500 UI AMBALATE ÎN BLISTERE PRF 5 9.205,00 1.841,000000 1.841,000000 10.071,60 2.014,320000 2.014,320000

55 J06BB04 IMUNOGLOBULINA ANTI-HEPATITICA B** HEPATECT CP 50 UI/ml SOL. PERF. 50 UI/ ml BIOTEST PHARMA GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 40 ML SOL. PERF. (2000UI) PR 1 4.477,57 4.477,570000 4.477,570000 4.918,70 4.918,700000 4.918,700000

Pagina 31 din 42

Page 131: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

56 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 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

57 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 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

58 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 1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

59 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 1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

60 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 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

61 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 1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

62 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 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

63 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 1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

64 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 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

65 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

66 L04AA06 MYCOPHENOLATUM** MYCOPHENOLATE MOFETIL MEDICO UNO 500 MG COMPR. FILM. 500mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 292,89 5,857800 5,857800 357,56 7,151200 7,151200

67 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

68 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

69 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

70 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

71 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

72 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

73 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOPHENOLATE MOFETIL ACCORD 250 mg CAPS. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL CU 100 CAPS. P-RF/R 100 292,89 2,928900 2,928900 357,56 3,575600 3,575600

74 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

75 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

76 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

77 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. DIN AL-PA-PVC/AL X 50 COMPR. FILM. PR 50 302,36 6,047200 6,047200 367,72 7,354400 7,354400

78 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

79 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

80 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOFENOLAT MOFETIL ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

81 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

82 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

83 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

84 L04AD01 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

85 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 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

86 L04AD01 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

87 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

88 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 59,45 1,189000 1,189000 75,17 1,503400 1,503400

89 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

90 L04AD01 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

91 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 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

92 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

93 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

94 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

95 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

96 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

97 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

98 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

99 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

100 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

101 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

102 L04AD02 TACROLIMUSUM** TACNI 5 mg CAPS. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPS. PR 50 1.114,65 22,293000 22,293000 1.253,12 25,062400 25,062400

103 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

104 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

105 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

106 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

107 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.4: TRANSPLANT RENAL combinat RINICHI si PANCREAS

1 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 42,41 0,706833 0,706833 55,47 0,924500 0,924500

2 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

3 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

4 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

5 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 41,43 0,690500 0,690500 54,19 0,903166 0,903166

6 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 27,43 1,371500 1,371500 35,88 1,794000 1,794000

7 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 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

8 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 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

9 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 77,10 77,100000 77,100000 97,49 97,490000 97,490000

10 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 25,70 0,514000 0,514000 33,62 0,672400 0,672400

11 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 16,99 0,566333 0,566333 22,97 0,765666 0,765666

12 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 23,23 0,774333 0,774333 31,40 1,046666 1,046666

13 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 26,00 0,866666 0,866666 34,01 1,133666 1,133666

14 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 108,79 10,879000 10,879000 132,81 13,281000 13,281000

15 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 203,78 20,378000 20,378000 248,78 24,878000 24,878000

16 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 5 103,19 20,638000 20,638000 125,97 25,194000 25,194000

Pagina 32 din 42

Page 132: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

17 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 5 139,97 27,994000 27,994000 170,87 34,174000 34,174000

18 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 5 169,45 33,890000 33,890000 206,87 41,374000 41,374000

19 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 5 192,72 38,544000 38,544000 235,27 47,054000 47,054000

20 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 61,36 6,136000 6,136000 77,59 7,759000 7,759000

21 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 10 116,45 11,645000 11,645000 142,16 14,216000 14,216000

22 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 10 166,28 16,628000 16,628000 202,99 20,299000 20,299000

23 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 49,00 4,900000 4,900000 64,09 6,409000 6,409000

24 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 93,99 9,399000 9,399000 118,84 11,884000 11,884000

25 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 10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

26 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 30,69 15,345000 15,345000 40,14 20,070000 20,070000

27 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 66,80 6,680000 6,680000 84,46 8,446000 8,446000

28 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 80,20 16,040000 16,040000 101,41 20,282000 20,282000

29 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 3.478,41 3.478,410000 3.478,410000 3.829,62 3.829,620000 3.829,620000

30 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 2.167,33 2.167,330000 2.167,330000 2.400,54 2.400,540000 2.400,540000

31 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 4.817,21 4.817,210000 4.817,210000 5.288,92 5.288,920000 5.288,920000

32 H01CB02 OCTREOTIDUM** SANDOSTATIN (R) SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 125,02 25,004000 25,004000 152,62 30,524000 30,524000

33 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

34 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

35 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

36 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 2g/0,25g PULB. PT. SOL. INJ./PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

37 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

38 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

39 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

40 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 4g/0,5g PULB. PT. SOL. INJ./PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

41 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

42 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

43 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAN ACTAVIS 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

44 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

45 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

46 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 109,84 109,840000 109,840000 134,09 134,090000 134,090000

47 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

48 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

49 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

50 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

51 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 5,08 0,508000 0,508000 6,87 0,687000 0,687000

52 J02AB02 KETOCONAZOLUM KETOCONAZOL 200 mg COMPR. 200mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 5,94 0,594000 0,594000 8,03 0,803000 0,803000

53 J02AB02 KETOCONAZOLUM NIZORAL 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. P-RF 10 15,15 1,515000 0,609600 20,48 2,048000 0,824400

54 J02AB02 KETOCONAZOLUM KETOCONAZOL ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 6,78 0,678000 0,609600 9,17 0,917000 0,824400

55 J02AB02 KETOCONAZOLUM KETOSTIN 200 mg COMPR. 200mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 9,34 0,934000 0,609600 12,62 1,262000 0,824400

56 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 23,31 3,330000 3,330000 31,51 4,501428 4,501428

57 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 6,98 3,490000 3,490000 9,43 4,715000 4,715000

58 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,996000 25,61 6,402500 5,401714

59 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 65,37 4,085625 3,996000 82,66 5,166250 5,166250

60 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 193,65 6,916071 3,996000 236,41 8,443214 5,401714

61 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,856000 9,68 9,680000 7,908000

62 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 10,02 10,020000 5,856000 13,54 13,540000 7,908000

63 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,27 9,270000 5,856000 12,53 12,530000 7,908000

64 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13,95 13,950000 5,856000 18,86 18,860000 7,908000

65 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 18,56 18,560000 5,856000 25,08 25,080000 7,908000

66 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

67 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

68 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,07 6,070000 5,856000 8,20 8,200000 7,908000

69 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 7,44 7,440000 5,856000 10,06 10,060000 7,908000

70 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,856000 14,58 14,580000 7,908000

71 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 9,57 9,570000 5,856000 12,94 12,940000 7,908000

72 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 48,24 12,060000 5,856000 63,10 15,775000 7,908000

73 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

74 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 4,88 4,880000 4,880000 6,59 6,590000 6,590000

75 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,856000 9,03 9,030000 7,908000

76 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 16,65 16,650000 5,856000 22,51 22,510000 7,908000

77 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 30,10 4,300000 4,300000 39,37 5,624285 5,624285

78 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

79 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,998857 19,58 2,797142 2,701714

80 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,998857 41,93 5,990000 2,701714

81 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 21,91 3,130000 1,998857 29,61 4,230000 2,701714

82 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 43,23 6,175714 1,998857 56,54 8,077142 2,701714

83 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 12,35 1,764285 1,764285 16,69 2,384285 2,384285

84 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 47,19 6,741428 1,998857 61,72 8,817142 2,701714

85 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 14,09 1,761250 1,761250 19,04 2,380000 2,380000

86 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

87 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

88 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,998857 19,12 2,731428 2,701714

89 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 11,66 1,665714 1,665714 15,76 2,251428 2,251428

Pagina 33 din 42

Page 133: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

90 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, PREVAZUT CU CAPAC DIN AL CU FILET + 1 LINGURITA DOZATOAR PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

91 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

92 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

93 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

94 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 50 ML SOL. PERF. S 10 182,90 18,290000 18,290000 223,28 22,328000 22,328000

95 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

96 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

97 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

98 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 25 443,47 17,738800 17,738800 521,53 20,861200 20,861200

99 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

100 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 10 761,71 76,171000 76,171000 868,42 86,842000 86,842000

101 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 10 330,71 33,071000 20,737200 398,62 39,862000 25,316400

102 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

103 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

104 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

105 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 200 ML SOL. PERF. S 10 770,66 77,066000 77,066000 878,17 87,817000 87,817000

106 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 100 ML SOL. PERF. S 20 796,39 39,819500 20,737200 906,22 45,311000 25,316400

107 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 100 ML SOL. PERF. S 10 454,59 45,459000 20,737200 533,65 53,365000 25,316400

108 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 50 ML SOL. PERF. S 20 362,55 18,127500 18,127500 433,33 21,666500 21,666500

109 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

110 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 20 631,41 31,570500 20,737200 726,39 36,319500 25,316400

111 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

112 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 25 781,76 31,270400 20,737200 890,27 35,610800 25,316400

113 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 35,03 35,030000 20,737200 45,82 45,820000 25,316400

114 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 20 360,77 18,038500 18,038500 431,39 21,569500 21,569500

115 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 10 181,93 18,193000 18,193000 222,10 22,210000 22,210000

116 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,033440

117 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

118 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF 15 60,84 4,056000 3,214399 76,92 5,128000 4,204000

119 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

120 J02AC02 ITRACONAZOLUM SPORILIN 100 mg CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

121 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

122 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

123 J02AC02 ITRACONAZOLUM ITRACONAZOL LPH 100 mg CAPS. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

124 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,55 3,503333 3,503333

125 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

126 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

127 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

128 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

129 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 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

130 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 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

131 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 15,85 0,792500 0,577200 21,42 1,071000 0,780000

132 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,577200 20,23 1,011500 0,780000

133 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 704,14 0,704140 0,577200 805,66 0,805660 0,780000

134 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,577200 21,42 1,071000 0,780000

135 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 14,41 1,441000 1,441000 19,48 1,948000 1,948000

136 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 10,22 0,511000 0,511000 13,81 0,690500 0,690500

137 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 12,75 0,637500 0,577200 17,23 0,861500 0,780000

138 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,577200 17,15 0,857500 0,780000

139 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,62 0,481000 0,481000 13,00 0,650000 0,650000

140 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 14,23 1,423000 1,423000 19,23 1,923000 1,923000

141 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 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

142 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 43,54 4,354000 4,354000 56,95 5,695000 5,695000

143 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

144 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 100 ML S 1 872,00 872,000000 872,000000 988,63 988,630000 988,630000

145 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** HUMAGLOBIN PULB.+SOLV. PT. SOL. PERF. 5% HUMAN BIOPLAZMA MANUFACTURING AND TRADING LTD. UNGARIA CUTIE X 1 CUTIE X 1 FLAC. CU PULB. + 1 CUTIE X 1 FLAC. SOLV. X 50 ML S 1 451,00 451,000000 451,000000 529,74 529,740000 529,740000

146 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 6.114,44 6.114,440000 6.114,440000 6.702,89 6.702,890000 6.702,890000

147 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 3.072,10 3.072,100000 3.072,100000 3.386,74 3.386,740000 3.386,740000

148 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 1.550,55 1.550,550000 1.550,550000 1.728,25 1.728,250000 1.728,250000

149 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP) LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 663,61 663,610000 663,610000 761,48 761,480000 761,480000

150 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL. PERF.(10G/100ML) S 1 1.749,51 1.749,510000 1.749,510000 1.945,12 1.945,120000 1.945,120000

151 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL. PERF.(5G/50ML) S 1 889,76 889,760000 889,760000 1.007,99 1.007,990000 1.007,990000

152 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL. PERF.(20G/200ML) S 1 3.469,04 3.469,040000 3.469,040000 3.819,40 3.819,400000 3.819,400000

153 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 100 ML SOL. PERF. S 1 1.751,89 1.751,890000 1.751,890000 1.947,71 1.947,710000 1.947,710000

154 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 50 ML SOL. PERF. S 1 890,95 890,950000 890,950000 1.009,28 1.009,280000 1.009,280000

155 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL. PERF.(30G/300ML) S 1 7.459,41 7.459,410000 7.459,410000 8.168,91 8.168,910000 8.168,910000

156 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 25ML SOL. PERF.(2,5G/25ML) S 1 459,88 459,880000 459,880000 539,42 539,420000 539,420000

157 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 25 ML SOL. PERF. S 1 460,47 460,470000 460,470000 540,07 540,070000 540,070000

158 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL. PERF.(1G/10ML) S 1 188,56 188,560000 188,560000 230,20 230,200000 230,200000

159 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** PRIVIGEN 100mg/ml SOL. PERF. 100mg/ml CSL BEHRING GMBH GERMANIA CUTIE X 1 FLAC.X 200 ML SOL. PERF. S 1 3.473,78 3.473,780000 3.473,780000 3.824,57 3.824,570000 3.824,570000

160 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 2.050,80 2.050,800000 2.050,800000 2.273,52 2.273,520000 2.273,520000

161 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 222,29 222,290000 222,290000 271,37 271,370000 271,370000

162 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 535,20 535,200000 535,200000 621,52 621,520000 621,520000

Pagina 34 din 42

Page 134: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

163 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL.PERF. S 1 99,02 99,020000 99,020000 125,20 125,200000 125,200000

164 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL.PERF. S 1 472,05 472,050000 472,050000 552,68 552,680000 552,680000

165 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL.PERF. S 1 1.798,20 1.798,200000 1.798,200000 1.998,19 1.998,190000 1.998,190000

166 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMA 5% SOL. PERF. 5% INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL.PERF. S 1 914,10 914,100000 914,100000 1.034,52 1.034,520000 1.034,520000

167 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 200 ML S 1 2.261,30 2.261,300000 2.261,300000 2.502,97 2.502,970000 2.502,970000

168 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 50 ML S 1 640,45 640,450000 640,450000 736,24 736,240000 736,240000

169 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 100 ML S 1 1.166,70 1.166,700000 1.166,700000 1.309,85 1.309,850000 1.309,850000

170 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.040,40 1.040,400000 1.040,400000 1.172,19 1.172,190000 1.172,190000

171 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 19,33 0,386600 0,386600 26,13 0,522600 0,522600

172 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 11,76 11,760000 11,760000 15,89 15,890000 15,890000

173 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 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

174 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 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

175 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 1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

176 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 1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

177 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 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

178 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 1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

179 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 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

180 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 1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

181 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 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

182 L04AA04 IMUNOGLOBULINA ANTI-LIMFOCITE** ATG-FRESENIUS CONC. PT. SOL. PERF. 20mg/ml FRESENIUS BIOTECH GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 1.158,60 1.158,600000 1.158,600000 1.301,02 1.301,020000 1.301,020000

183 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

184 L04AA06 MYCOPHENOLATUM** MYCOPHENOLATE MOFETIL MEDICO UNO 500 MG COMPR. FILM. 500mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 292,89 5,857800 5,857800 357,56 7,151200 7,151200

185 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

186 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

187 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

188 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

189 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

190 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

191 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOPHENOLATE MOFETIL ACCORD 250 mg CAPS. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL CU 100 CAPS. P-RF/R 100 292,89 2,928900 2,928900 357,56 3,575600 3,575600

192 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

193 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

194 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

195 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. DIN AL-PA-PVC/AL X 50 COMPR. FILM. PR 50 302,36 6,047200 6,047200 367,72 7,354400 7,354400

196 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

197 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

198 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOFENOLAT MOFETIL ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

199 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

200 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

201 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

202 L04AC02 BASILIXIMABUM** SIMULECT 20 mg LIOF. + SOLV. PT. SOL. INJ./PERF. 20mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU LIOF.+ 1 FIOLA SOLV. APA PT. PREP. INJ. S 1 4.267,46 4.267,460000 4.267,460000 4.689,69 4.689,690000 4.689,690000

203 L04AD01 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

204 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 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

205 L04AD01 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

206 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

207 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 59,45 1,189000 1,189000 75,17 1,503400 1,503400

208 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

209 L04AD01 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

210 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 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

211 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

212 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

213 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

214 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

215 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

216 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

217 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

218 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

219 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

220 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

221 L04AD02 TACROLIMUSUM** TACNI 5 mg CAPS. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPS. PR 50 1.114,65 22,293000 22,293000 1.253,12 25,062400 25,062400

222 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

223 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

224 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

225 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

226 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

227 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

228 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 62,39 0,623900 0,623900 78,89 0,788900 0,788900

229 M05BA04 ACIDUM ALENDRONICUM ACID ALENDRONIC ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L 28 36,90 1,317857 1,317857 48,27 1,723928 1,723928

230 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 36,90 9,225000 5,694000 48,27 12,067500 7,692000

231 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 36,44 9,110000 5,694000 47,66 11,915000 7,692000

232 M05BA04 ACIDUM ALENDRONICUM FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. AL/AL X 2 COMPR. P-6L 2 28,39 14,195000 5,694000 37,13 18,565000 7,692000

233 M05BA04 ACIDUM ALENDRONICUM ACID ALENDRONIC ACCORD 70 mg COMPR. 70mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA -AL-PVC/AL X 4 COMPR. P-6L 4 36,90 9,225000 5,694000 48,27 12,067500 7,692000

234 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 36,67 9,167500 5,694000 47,97 11,992500 7,692000

235 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 12 108,06 9,005000 5,694000 131,92 10,993333 7,692000

Pagina 35 din 42

Page 135: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

236 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 9,49 4,745000 4,745000 12,82 6,410000 6,410000

237 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 18,33 9,165000 5,694000 24,78 12,390000 7,692000

238 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 6,92 1,384000 1,384000 9,35 1,870000 1,870000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.5: TRANSPLANT CELULE PANCREATICE

1 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 66,80 6,680000 6,680000 84,46 8,446000 8,446000

2 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 80,20 16,040000 16,040000 101,41 20,282000 20,282000

3 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

4 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

5 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

6 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

7 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

8 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

9 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

10 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

11 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.6: TRANSPLANT PULMONAR

1 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 49,00 4,900000 4,900000 64,09 6,409000 6,409000

2 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 93,99 9,399000 9,399000 118,84 11,884000 11,884000

3 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 10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

4 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 30,69 15,345000 15,345000 40,14 20,070000 20,070000

5 B01AB08 REVIPARINUM CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 66,80 6,680000 6,680000 84,46 8,446000 8,446000

6 B01AB08 REVIPARINUM CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 80,20 16,040000 16,040000 101,41 20,282000 20,282000

7 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 9,47 1,894000 1,894000 12,80 2,560000 2,560000

8 C01CA24 EPINEPHRINUM ADRENALINA 1 mg SOL. INJ. 1mg/ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE X 1 ML S 100 137,50 1,375000 1,375000 167,86 1,678600 1,678600

9 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

10 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

11 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

12 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 2g/0,25g PULB. PT. SOL. INJ./PERF. 2g/0,25g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

13 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

14 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

15 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

16 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLINUM/TAZOBACTAMUM KABI 4g/0,5g PULB. PT. SOL. INJ./PERF. 4g/0,5g S.C. FRESENIUS KABI S.R.L. ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA (CAPACITATE 50 ML) CONTINAND PULB. PT. SOL. INJ/PERF S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

17 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

18 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

19 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAN ACTAVIS 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 12 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

20 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

21 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

22 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

23 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

24 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

25 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA 10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

26 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 23,31 3,330000 3,330000 31,51 4,501428 4,501428

27 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 6,98 3,490000 3,490000 9,43 4,715000 4,715000

28 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,996000 25,61 6,402500 5,401714

29 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 65,37 4,085625 3,996000 82,66 5,166250 5,166250

30 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 193,65 6,916071 3,996000 236,41 8,443214 5,401714

31 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,856000 9,68 9,680000 7,908000

32 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 10,02 10,020000 5,856000 13,54 13,540000 7,908000

33 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,27 9,270000 5,856000 12,53 12,530000 7,908000

34 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13,95 13,950000 5,856000 18,86 18,860000 7,908000

35 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 18,56 18,560000 5,856000 25,08 25,080000 7,908000

36 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

37 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

38 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,07 6,070000 5,856000 8,20 8,200000 7,908000

39 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 7,44 7,440000 5,856000 10,06 10,060000 7,908000

40 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,856000 14,58 14,580000 7,908000

41 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 9,57 9,570000 5,856000 12,94 12,940000 7,908000

42 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 48,24 12,060000 5,856000 63,10 15,775000 7,908000

43 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

44 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 4,88 4,880000 4,880000 6,59 6,590000 6,590000

45 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,856000 9,03 9,030000 7,908000

46 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 16,65 16,650000 5,856000 22,51 22,510000 7,908000

47 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 30,10 4,300000 4,300000 39,37 5,624285 5,624285

48 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

49 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,998857 19,58 2,797142 2,701714

Pagina 36 din 42

Page 136: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

50 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,998857 41,93 5,990000 2,701714

51 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 21,91 3,130000 1,998857 29,61 4,230000 2,701714

52 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 43,23 6,175714 1,998857 56,54 8,077142 2,701714

53 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 12,35 1,764285 1,764285 16,69 2,384285 2,384285

54 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 47,19 6,741428 1,998857 61,72 8,817142 2,701714

55 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 14,09 1,761250 1,761250 19,04 2,380000 2,380000

56 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

57 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

58 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,998857 19,12 2,731428 2,701714

59 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 11,66 1,665714 1,665714 15,76 2,251428 2,251428

60 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, PREVAZUT CU CAPAC DIN AL CU FILET + 1 LINGURITA DOZATOAR PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

61 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

62 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

63 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

64 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 50 ML SOL. PERF. S 10 182,90 18,290000 18,290000 223,28 22,328000 22,328000

65 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

66 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

67 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

68 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 25 443,47 17,738800 17,738800 521,53 20,861200 20,861200

69 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

70 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 10 761,71 76,171000 76,171000 868,42 86,842000 86,842000

71 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 10 330,71 33,071000 20,737200 398,62 39,862000 25,316400

72 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

73 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

74 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

75 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 200 ML SOL. PERF. S 10 770,66 77,066000 77,066000 878,17 87,817000 87,817000

76 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 100 ML SOL. PERF. S 20 796,39 39,819500 20,737200 906,22 45,311000 25,316400

77 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 100 ML SOL. PERF. S 10 454,59 45,459000 20,737200 533,65 53,365000 25,316400

78 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 50 ML SOL. PERF. S 20 362,55 18,127500 18,127500 433,33 21,666500 21,666500

79 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

80 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 20 631,41 31,570500 20,737200 726,39 36,319500 25,316400

81 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

82 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 25 781,76 31,270400 20,737200 890,27 35,610800 25,316400

83 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 35,03 35,030000 20,737200 45,82 45,820000 25,316400

84 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 20 360,77 18,038500 18,038500 431,39 21,569500 21,569500

85 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 10 181,93 18,193000 18,193000 222,10 22,210000 22,210000

86 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,033440

87 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

88 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

89 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

90 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

91 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

92 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 15,85 0,792500 0,577200 21,42 1,071000 0,780000

93 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,577200 20,23 1,011500 0,780000

94 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 704,14 0,704140 0,577200 805,66 0,805660 0,780000

95 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,577200 21,42 1,071000 0,780000

96 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 14,41 1,441000 1,441000 19,48 1,948000 1,948000

97 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 10,22 0,511000 0,511000 13,81 0,690500 0,690500

98 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 12,75 0,637500 0,577200 17,23 0,861500 0,780000

99 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,577200 17,15 0,857500 0,780000

100 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,62 0,481000 0,481000 13,00 0,650000 0,650000

101 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 14,23 1,423000 1,423000 19,23 1,923000 1,923000

102 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 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

103 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

104 L04AA04 IMUNOGLOBULINA ANTI-LIMFOCITE** ATG-FRESENIUS CONC. PT. SOL. PERF. 20mg/ml FRESENIUS BIOTECH GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 1.158,60 1.158,600000 1.158,600000 1.301,02 1.301,020000 1.301,020000

105 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

106 L04AA06 MYCOPHENOLATUM** MYCOPHENOLATE MOFETIL MEDICO UNO 500 MG COMPR. FILM. 500mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 292,89 5,857800 5,857800 357,56 7,151200 7,151200

107 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

108 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

109 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

110 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

111 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

112 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

113 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOPHENOLATE MOFETIL ACCORD 250 mg CAPS. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL CU 100 CAPS. P-RF/R 100 292,89 2,928900 2,928900 357,56 3,575600 3,575600

114 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

115 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

116 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

117 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. DIN AL-PA-PVC/AL X 50 COMPR. FILM. PR 50 302,36 6,047200 6,047200 367,72 7,354400 7,354400

118 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

119 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

120 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOFENOLAT MOFETIL ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

121 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

122 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

Pagina 37 din 42

Page 137: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

123 L04AC02 BASILIXIMABUM** SIMULECT 20 mg LIOF. + SOLV. PT. SOL. INJ./PERF. 20mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 1 FLAC. CU LIOF.+ 1 FIOLA SOLV. APA PT. PREP. INJ. S 1 4.267,46 4.267,460000 4.267,460000 4.689,69 4.689,690000 4.689,690000

124 L04AD01 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

125 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 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

126 L04AD01 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

127 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

128 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 59,45 1,189000 1,189000 75,17 1,503400 1,503400

129 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

130 L04AD01 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

131 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 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

132 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

133 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 62,39 0,623900 0,623900 78,89 0,788900 0,788900

134 N02AX02 TRAMADOLUM URGENDOL CAPS. 50mg MEDICAROM GROUP SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 2,83 0,283000 0,258600 3,82 0,382000 0,349200

135 N02AX02 TRAMADOLUM TRALGIT 50 CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,31 0,215500 0,215500 5,82 0,291000 0,291000

136 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,31 0,215500 0,215500 5,82 0,291000 0,291000

137 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,66 0,333000 0,258600 9,00 0,450000 0,349200

138 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 2,85 0,285000 0,258600 3,85 0,385000 0,349200

139 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 2,85 0,285000 0,258600 3,85 0,385000 0,349200

140 N02AX02 TRAMADOLUM TRAMADOL LPH 50 mg CAPS. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

141 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

142 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

143 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,258600 7,67 0,383500 0,349200

144 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 4,66 0,466000 0,466000 6,30 0,630000 0,630000

145 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 13,98 0,466000 0,466000 18,89 0,629666 0,629666

146 N02AX02 TRAMADOLUM TRAMADOL (R) RETARD COMPR. ELIB. PREL. 100mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. X 10 COMPR. ELIB. PREL. P-RF 30 13,99 0,466333 0,466333 18,91 0,630333 0,630333

147 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 20,38 0,679333 0,679333 27,55 0,918333 0,918333

148 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 24,72 0,824000 0,815200 33,41 1,113666 1,102000

149 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 26,22 0,874000 0,874000 34,30 1,143333 1,143333

150 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 7,88 0,262666 0,258600 10,65 0,355000 0,349200

151 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 7,17 0,717000 0,559200 9,69 0,969000 0,755599

152 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 31,78 1,059333 0,815200 41,57 1,385666 1,102000

153 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 16,30 1,630000 0,815200 22,03 2,203000 1,102000

154 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 40,67 1,355666 1,048800 53,20 1,773333 1,372000

155 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 20,85 2,085000 1,048800 28,18 2,818000 1,372000

156 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 2,84 0,284000 0,258600 3,84 0,384000 0,349200

157 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 110,22 1,102200 1,102200 134,56 1,345600 1,345600

158 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 7,27 1,454000 1,322640 9,83 1,966000 1,614720

159 N02AX02 TRAMADOLUM TRALGIT 100 SOL. INJ. 100mg/2ml ZENTIVA A.S. SLOVACIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S/P-RF 5 9,09 1,818000 1,322640 12,28 2,456000 1,614720

160 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 9,69 1,938000 1,322640 13,10 2,620000 1,614720

161 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 3,65 0,730000 0,730000 4,93 0,986000 0,986000

162 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 5,67 1,134000 1,134000 7,67 1,534000 1,534000

163 N02AX02 TRAMADOLUM URGENDOL SOL. INJ. 50mg/ml MEDICAROM GROUP SRL ROMANIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 3,63 0,726000 0,726000 4,90 0,980000 0,980000

164 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 5 SUPOZ. P-RF 5 4,13 0,826000 0,826000 5,58 1,116000 1,116000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.7: TRATAMENTUL STARII POSTTRANSPLANT IN AMBULATORIU A PACIENTILOR TRANSPLANTATI

1 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 42,41 0,706833 0,706833 55,47 0,924500 0,924500

2 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

3 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

4 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

5 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 41,43 0,690500 0,690500 54,19 0,903166 0,903166

6 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 27,43 1,371500 1,371500 35,88 1,794000 1,794000

7 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 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

8 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 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

9 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 77,10 77,100000 77,100000 97,49 97,490000 97,490000

10 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 24,13 0,482600 0,482600 32,62 0,652400 0,652400

11 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 21,94 1,097000 1,097000 29,65 1,482500 1,482500

12 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 6,52 6,520000 6,520000 8,81 8,810000 8,810000

13 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 22,95 22,950000 22,950000 31,02 31,020000 31,020000

14 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 15,15 15,150000 15,150000 20,48 20,480000 20,480000

15 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,94 0,064666 0,053316 2,62 0,087333 0,069744

16 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. P-RF/S 1000 44,43 0,044430 0,044430 58,12 0,058120 0,058120

17 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,74 0,091333 0,053316 3,71 0,123666 0,069744

18 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 1,90 0,095000 0,053316 2,57 0,128500 0,069744

19 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 1,96 0,098000 0,053316 2,65 0,132500 0,069744

20 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 5,21 0,260500 0,260500 7,04 0,352000 0,352000

21 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 5,47 0,273500 0,273500 7,40 0,370000 0,370000

22 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 5,71 0,285500 0,285500 7,72 0,386000 0,386000

23 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,71 0,285500 0,285500 7,72 0,386000 0,386000

24 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SIROP 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 6,07 6,070000 6,070000 8,20 8,200000 8,200000

25 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 3,52 3,520000 3,520000 4,76 4,760000 4,760000

26 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 23,31 3,330000 3,330000 31,51 4,501428 4,501428

Pagina 38 din 42

Page 138: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

27 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 6,98 3,490000 3,490000 9,43 4,715000 4,715000

28 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,996000 25,61 6,402500 5,401714

29 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 65,37 4,085625 3,996000 82,66 5,166250 5,166250

30 J02AC01 FLUCONAZOLUM DIFLAZON 100 mg CAPS. 100mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. X 7 CAPS. P-RF 28 193,65 6,916071 3,996000 236,41 8,443214 5,401714

31 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,856000 9,68 9,680000 7,908000

32 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 10,02 10,020000 5,856000 13,54 13,540000 7,908000

33 J02AC01 FLUCONAZOLUM MYCOMAX 150 CAPS. 150mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,27 9,270000 5,856000 12,53 12,530000 7,908000

34 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 13,95 13,950000 5,856000 18,86 18,860000 7,908000

35 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 18,56 18,560000 5,856000 25,08 25,080000 7,908000

36 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

37 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,856000 9,94 9,940000 7,908000

38 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,07 6,070000 5,856000 8,20 8,200000 7,908000

39 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 7,44 7,440000 5,856000 10,06 10,060000 7,908000

40 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,856000 14,58 14,580000 7,908000

41 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 9,57 9,570000 5,856000 12,94 12,940000 7,908000

42 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 48,24 12,060000 5,856000 63,10 15,775000 7,908000

43 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

44 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 4,88 4,880000 4,880000 6,59 6,590000 6,590000

45 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,856000 9,03 9,030000 7,908000

46 J02AC01 FLUCONAZOLUM DIFLAZON 150 mg CAPS. 150mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 1 CAPS. P-RF 1 16,65 16,650000 5,856000 22,51 22,510000 7,908000

47 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 30,10 4,300000 4,300000 39,37 5,624285 5,624285

48 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

49 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,998857 19,58 2,797142 2,701714

50 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,998857 41,93 5,990000 2,701714

51 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 21,91 3,130000 1,998857 29,61 4,230000 2,701714

52 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 43,23 6,175714 1,998857 56,54 8,077142 2,701714

53 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 12,35 1,764285 1,764285 16,69 2,384285 2,384285

54 J02AC01 FLUCONAZOLUM DIFLAZON 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 47,19 6,741428 1,998857 61,72 8,817142 2,701714

55 J02AC01 FLUCONAZOLUM FUNGOLON 50 mg CAPS. 50mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. PVC/AL X 8 CAPS. P-RF 8 14,09 1,761250 1,761250 19,04 2,380000 2,380000

56 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,998857 22,56 3,222857 2,701714

57 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

58 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,998857 19,12 2,731428 2,701714

59 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 11,66 1,665714 1,665714 15,76 2,251428 2,251428

60 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, PREVAZUT CU CAPAC DIN AL CU FILET + 1 LINGURITA DOZATOAR PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

61 J02AC01 FLUCONAZOLUM DIFLUCAN (R) 50 mg/5 ml PULB. PT. SUSP. ORALA 50mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. PEID PULB. PT. 35 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 5 ML P-RF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

62 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

63 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

64 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 50 ML SOL. PERF. S 10 182,90 18,290000 18,290000 223,28 22,328000 22,328000

65 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

66 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

67 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PE PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

68 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 25 443,47 17,738800 17,738800 521,53 20,861200 20,861200

69 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

70 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 10 761,71 76,171000 76,171000 868,42 86,842000 86,842000

71 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 10 330,71 33,071000 20,737200 398,62 39,862000 25,316400

72 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

73 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

74 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

75 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 200 ML SOL. PERF. S 10 770,66 77,066000 77,066000 878,17 87,817000 87,817000

76 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 100 ML SOL. PERF. S 20 796,39 39,819500 20,737200 906,22 45,311000 25,316400

77 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. PEJD X 100 ML SOL. PERF. S 10 454,59 45,459000 20,737200 533,65 53,365000 25,316400

78 J02AC01 FLUCONAZOLUM FLUCONAZOL B. BRAUN 2mg/ml SOL. PERF. 2mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. PEJD X 50 ML SOL. PERF. S 20 362,55 18,127500 18,127500 433,33 21,666500 21,666500

79 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

80 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 20 631,41 31,570500 20,737200 726,39 36,319500 25,316400

81 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200 ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

82 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 25 FLAC. PEJD (KABIPAC) X 100 ML SOL. PERF. S 25 781,76 31,270400 20,737200 890,27 35,610800 25,316400

83 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 35,03 35,030000 20,737200 45,82 45,820000 25,316400

84 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 20 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 20 360,77 18,038500 18,038500 431,39 21,569500 21,569500

85 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 10 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 10 181,93 18,193000 18,193000 222,10 22,210000 22,210000

86 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,033440

87 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

88 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

89 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

90 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

91 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 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

92 J02AC04 POSACONAZOLUM** NOXAFIL SP 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA P-RF/R 1 2.488,19 2.488,190000 2.488,190000 2.750,28 2.750,280000 2.750,280000

93 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 15,85 0,792500 0,577200 21,42 1,071000 0,780000

94 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,577200 20,23 1,011500 0,780000

95 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. P-RF/S 1000 704,14 0,704140 0,577200 805,66 0,805660 0,780000

96 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,577200 21,42 1,071000 0,780000

97 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 14,41 1,441000 1,441000 19,48 1,948000 1,948000

98 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 10,22 0,511000 0,511000 13,81 0,690500 0,690500

99 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 12,75 0,637500 0,577200 17,23 0,861500 0,780000

Pagina 39 din 42

Page 139: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

100 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,577200 17,15 0,857500 0,780000

101 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,62 0,481000 0,481000 13,00 0,650000 0,650000

102 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 14,23 1,423000 1,423000 19,23 1,923000 1,923000

103 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 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

104 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 81,051500 5.338,93 88,982166 88,982166

105 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 30 159,00 5,300000 5,300000 194,11 6,470333 6,470333

106 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 28 228,32 8,154285 6,360000 278,73 9,954642 7,764400

107 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM. P-RF/R 60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

108 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM. P-RF/R 60 476,54 7,942333 6,385399 557,58 9,293000 7,723200

109 J05AF05 LAMIVUDINUM LAMIVUDINA AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PVC-ACLAR/AL X 60 COMPR. FILM. PR 60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

110 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 319,27 10,642333 10,642333 386,16 12,872000 12,872000

111 J05AF05 LAMIVUDINUM EPIVIR 10mg/ml SOL. ORALA 10mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLACON PEID X 240ML SOL. ORALA + 1 SERINGA DOZATOARE + 1 ADAPTOR P-RF/R 1 131,82 131,820000 131,820000 160,92 160,920000 160,920000

112 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS. P-RF/R 100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

113 L04AA06 MYCOPHENOLATUM** MYCOPHENOLATE MOFETIL MEDICO UNO 500 MG COMPR. FILM. 500mg MEDICO UNO PHARMA KFT. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 292,89 5,857800 5,857800 357,56 7,151200 7,151200

114 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM. P-RF/R 50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

115 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

116 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ. S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

117 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

118 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

119 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

120 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOPHENOLATE MOFETIL ACCORD 250 mg CAPS. 250mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL CU 100 CAPS. P-RF/R 100 292,89 2,928900 2,928900 357,56 3,575600 3,575600

121 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS. P-RF/R 100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

122 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM. P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

123 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

124 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL TERAPIA 500 mg COMPR. FILM. 500 mg TERAPIA S.A. ROMANIA CUTIE CU 1 BLIST. DIN AL-PA-PVC/AL X 50 COMPR. FILM. PR 50 302,36 6,047200 6,047200 367,72 7,354400 7,354400

125 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

126 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

127 L04AA06 MYCOPHENOLATUM MOFETILUM** MYCOFENOLAT MOFETIL ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-RF/R 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

128 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM. P-RF/R 50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

129 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10 COMPR. FILM. PRF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

130 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR) P-RF/R 30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

131 L04AD01 CICLOSPORINUM EQUORAL (R) 100 mg CAPS. MOI 100mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

132 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 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

133 L04AD01 CICLOSPORINUM EQUORAL (R) 25 mg CAPS. MOI 25mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

134 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

135 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 59,45 1,189000 1,189000 75,17 1,503400 1,503400

136 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

137 L04AD01 CICLOSPORINUM EQUORAL (R) 50 mg CAPS. MOI 50mg IVAX - PHARMACEUTICALS S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

138 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 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

139 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

140 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

141 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

142 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

143 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

144 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

145 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

146 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

147 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS. S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

148 L04AD02 TACROLIMUSUM** TACROLIMUSUM ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. AL/AL X 50 CAPS. PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

149 L04AD02 TACROLIMUSUM** TACNI 5 mg CAPS. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPS. PR 50 1.114,65 22,293000 22,293000 1.253,12 25,062400 25,062400

150 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X 5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANT S/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

151 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

152 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

153 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. GERMANIA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-PVDC/AL) P-RF/R 50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

154 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

155 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

156 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 62,39 0,623900 0,623900 78,89 0,788900 0,788900

P10: PROGRAM NATIONAL DE SUPLEERE A FUNCTIEI RENALE LA BOLNAVII CU INSUFICIENTA RENALA CRONICA

1 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 25,70 0,514000 0,514000 33,62 0,672400 0,672400

2 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 16,99 0,566333 0,566333 22,97 0,765666 0,765666

3 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 23,23 0,774333 0,774333 31,40 1,046666 1,046666

4 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 26,00 0,866666 0,866666 34,01 1,133666 1,133666

5 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 108,79 10,879000 10,879000 132,81 13,281000 13,281000

6 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 203,78 20,378000 20,378000 248,78 24,878000 24,878000

7 A11CC04 CALCITRIOLUM** ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 CAPS. MOI P-RF 100 60,88 0,608800 0,608800 76,98 0,769800 0,769800

8 A11CC07 PARICALCITOLUM** ZEMPLAR 1mcg CAPS. MOI 1mcg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI P-RF 28 394,36 14,084285 14,084285 468,00 16,714285 16,714285

Pentru următoarele DCI-uri: VORICONAZOLUM si VALGANCICLOVIRUM prescrierea şi eliberarea medicamentelor se fac numai cu aprobarea Agenţiei Naţionale de Transplant

Pagina 40 din 42

Page 140: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

9 A11CC07 PARICALCITOLUM** ZEMPLAR 2mcg CAPS. MOI 2mcg ABBOTT LABORATORIES LTD. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. P-RF 28 819,29 29,260357 29,260357 931,18 33,256428 33,256428

10 B01AB01 HEPARINUM** HEPARIN NATRIUM 25000 RATIOPHARM SOL INJ. 25000UI/5ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU 5 FIOLE A 5 ML X 25000 UI PRF 5 68,32 13,664000 13,664000 86,38 17,276000 17,276000

11 B01AB01 HEPARINUM** HEPARIN NATRIUM 25000 RATIOPHARM SOL. INJ. 5000 UI/ml HK&ZY BEST PHARMA DISTRIBUTION ROMANIA CUTIE CU 5 FLACOANE X 25000 UI P-RF 5 72,53 14,506000 14,506000 91,71 18,342000 18,342000

12 B01AB01 HEPARINUM** HEPARINE SODIQUE PANPHARMA SOL. INJ. 5000ui/ml LAB. PANPHARMA FRANTA CUTIE X 10 FLACOANE DIN STICLA INCOLORA X 5 ML SOL. INJ. S 10 104,96 10,496000 10,496000 128,14 12,814000 12,814000

13 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 49,00 4,900000 4,900000 64,09 6,409000 6,409000

14 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 93,99 9,399000 9,399000 118,84 11,884000 11,884000

15 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 10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

16 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 30,69 15,345000 15,345000 40,14 20,070000 20,070000

17 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 59,65 5,965000 5,965000 75,42 7,542000 7,542000

18 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 81,83 8,183000 8,183000 103,46 10,346000 10,346000

19 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 10 108,50 10,850000 10,850000 132,46 13,246000 13,246000

20 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 10 155,43 15,543000 15,543000 189,75 18,975000 18,975000

21 B01AB06 NADROPARINUM** FRAXIPARINE 9500 UI anti-factor Xa/1 ml multidoza SOL. INJ. 9500 UI AFXa/1 ml GLAXO GROUP LIMITED MAREA BRITANIE CUTIE CU 10 FLAC. DIN STICLA INCOLORA, MULTIDOZA X 5 ML SOL. INJ. S 10 759,56 75,956000 75,956000 866,07 86,607000 86,607000

22 B01AB08 REVIPARINUM** CLIVARIN (R) 1432UI/0,25 ml SOL. INJ. 1432ui/0,25ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 5 SERINGI PREUMPLUTE UNIDOZA X 0,25ML S/P-RF 10 66,80 6,680000 6,680000 84,46 8,446000 8,446000

23 B01AB08 REVIPARINUM** CLIVARIN (R) 3436 UI/0,6 ml SOL. INJ. 3436ui/0,6ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 1 BLIST X 5 SERINGI PREUMPLUTE UNIDOZA X 0,60 ML S/P-RF 5 80,20 16,040000 16,040000 101,41 20,282000 20,282000

24 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 10000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 10 SERINGI PREUMPLUTE X 0.45 ML SOL. INJ. (4500 U-AXA) S/P-RF 10 127,04 12,704000 12,704000 155,09 15,509000 15,509000

25 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 10000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 10 SERINGI PREUMPLUTE X 0.35 ML SOL. INJ. (3500 U-AXA) S/P-RF 10 105,75 10,575000 10,575000 129,10 12,910000 12,910000

26 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 10000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 2 ML SOL. INJ. (10000 U-AXA/ML) S/P-RF 10 456,77 45,677000 45,677000 536,03 53,603000 53,603000

27 B01AB10 TINZAPARINUM** INNOHEP SOL. INJ. 20000 U-AXa/ml LEO PHARMA A/S DANEMARCA CUTIE X 2 SERINGI PREUMPLUTE X 0,50 ML SOL. IN. (10000 U-AXA) S/P-RF 2 58,25 29,125000 29,125000 73,65 36,825000 36,825000

28 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 10 965,50 96,550000 96,550000 1.090,55 109,055000 109,055000

29 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 2 95,03 47,515000 47,515000 120,16 60,080000 60,080000

30 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 2 77,76 38,880000 38,880000 98,32 49,160000 49,160000

31 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 5 122,68 24,536000 24,536000 149,77 29,954000 29,954000

32 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 1.550,81 258,468333 258,468333 1.728,54 288,090000 288,090000

33 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 6 178,92 29,820000 29,820000 218,42 36,403333 36,403333

34 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 6 355,67 59,278333 59,278333 425,83 70,971666 70,971666

35 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 1 688,15 688,150000 688,150000 788,23 788,230000 788,230000

36 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 6 518,88 86,480000 86,480000 603,73 100,621666 100,621666

37 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 1.206,71 1.206,710000 1.052,784000 1.353,47 1.353,470000 1.193,316000

38 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 1 877,32 877,320000 877,320000 994,43 994,430000 994,430000

39 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 6 682,04 113,673333 113,673333 781,57 130,261666 130,261666

40 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 6 845,15 140,858333 140,858333 959,37 159,895000 159,895000

41 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 2.117,84 352,973333 352,973333 2.346,60 391,100000 391,100000

42 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 6 447,82 74,636666 74,636666 526,27 87,711666 87,711666

43 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 1.042,55 1.042,550000 1.042,550000 1.174,53 1.174,530000 1.174,530000

44 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 6 865,04 144,173333 144,173333 981,05 163,508333 163,508333

45 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 1.073,53 178,921666 178,921666 1.208,30 201,383333 201,383333

46 B03XA01 EPOETINUM BETA** NEORECORMON 500UI/0,3ml SOL. INJ. IN SERINGA PREUMPLUTA 500UI/0,3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ. + 6 ACE S/P-RF/R 6 117,90 19,650000 19,650000 143,93 23,988333 23,988333

47 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 2.876,01 719,002500 719,002500 3.173,01 793,252500 793,252500

48 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 4 324,23 81,057500 81,057500 391,56 97,890000 97,890000

49 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 4.284,58 1.071,145000 1.071,145000 4.708,35 1.177,087500 1.177,087500

50 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 4 609,62 152,405000 152,405000 702,64 175,660000 175,660000

51 B03XA02 DARBEPOETINUM ALFA** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1.991,25 1.991,250000 1.991,250000 2.208,61 2.208,610000 2.208,610000

52 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 4 891,12 222,780000 222,780000 1.009,47 252,367500 252,367500

53 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 1.175,04 293,760000 293,760000 1.318,95 329,737500 329,737500

54 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 3.298,77 3.298,770000 3.298,770000 3.633,81 3.633,810000 3.633,810000

55 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 1.457,44 364,360000 364,360000 1.626,76 406,690000 406,690000

56 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 1.742,22 435,555000 435,555000 1.937,17 484,292500 484,292500

57 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 2.309,91 577,477500 577,477500 2.555,95 638,987500 638,987500

58 H05BX01 CINACALCETUM**** MIMPARA 30 mg COMPR. FILM. 30mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM. P-RF 28 754,12 26,932857 26,932857 860,14 30,719285 30,719285

59 H05BX01 CINACALCETUM**** MIMPARA 60 mg COMPR. FILM. 60mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM. P-RF 28 1.383,17 49,398928 49,398928 1.545,81 55,207500 55,207500

60 H05BX01 CINACALCETUM**** MIMPARA 90 mg COMPR. FILM. 90mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM. P-RF 28 1.967,81 70,278928 70,278928 2.183,07 77,966785 77,966785

61 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES S.A. SPANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ. S 5 792,54 158,508000 158,508000 902,02 180,404000 180,404000

62 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES S.A. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 400,62 80,124000 80,124000 474,83 94,966000 94,966000

63 V03AE02 SEVELAMER** RENAGEL 800mg COMPR. FILM. 800mg GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC.PEID. X 180 COMPR. FILM. P-RF 180 625,88 3,477111 3,477111 720,36 4,002000 4,002000

P11: PROGRAM NATIONAL DE SANATATE MINTALA

SUBPROGRAMUL TRATAMENTUL TOXICODEPENDENTELOR

1 N07BB04 NALTREXONUM REVIA COMPR. FILM. 50mg TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 4 BLIST. PVC-PE-ACLAR/AL X 7 COMPR. FILM. P-RF 28 249,53 8,911785 8,911785 304,63 10,879642 10,879642

2 N07BB04 NALTREXONUM REVIA COMPR. FILM. 50mg TORREX CHIESI PHARMA GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 7 COMPR. FILM. P-RF 14 167,39 11,956428 10,694142 204,35 14,596428 13,055570

3 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 18,06 0,361200 0,361200 24,41 0,488200 0,488200

4 N07BC02 METHADONUM METADON BIOEEL 20 mg COMPR. 20mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 50 46,54 0,930800 0,930800 60,88 1,217600 1,217600

5 N07BC02 METHADONUM METADON BIOEEL 20 mg COMPR. 20mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 20 18,61 0,930500 0,930500 25,16 1,258000 1,258000

6 N07BC02 METHADONUM METADON BIOEEL 5 mg COMPR. 5mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS 20 4,65 0,232500 0,232500 6,29 0,314500 0,314500

7 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 11,63 0,232600 0,232600 15,72 0,314400 0,314400

8 N07BC51 COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 2mg/0,5mg COMPR. SUBLING. 2mg/0,5mg RECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC) P-TS; S 7 18,31 2,615714 2,615714 24,75 3,535714 3,535714

9 N07BC51 COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 8mg/2mg COMPR. SUBLING. 8mg/2mg RECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD. MAREA BRITANIE CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC) P-TS; S 7 55,36 7,908571 7,908571 70,00 10,000000 10,000000

NOTA:

Pagina 41 din 42

Page 141: ANEXA 1 - Casa N nr. 702 din 30 09 2013 cu privire la lista...P-6L 20 16,66 0,833000 0,662699 0,596429 52 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE

Medicamentul corespunzator DCI-ului notat cu (3)

se livreaza impreuna cu solvent;

Medicamentele corespunzatoare DCI-urilor notate cu (4) se importa cu avizul Ministerului Sanatatii;

Medicamentele din această sublistă se eliberează atât prin farmacii cu circuit închis cât și prin farmacii cu circuit deschis pe bază de prescripție medicală cu reținere în farmacie (P-RF).

- 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 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;

Pagina 42 din 42