ANEXA

(Anexa 3 la Ordinul Presedintelui CNAS nr. 696/30.06.2009)

SECIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREUL DE REFERIN CONFORM
DCI-urilor UTILIZATE N TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI PENTRU CARE DECONTAREA SE FACE PE BAZA PROTOCOALELOR TERAPEUTICE CU MONITORIZAREA PRESCRIERII I CONSUMULUI PRIN COMISIILE PARITARE;
MEDICAMENTELE DIN ACEAST SUBLIST SE ELIBEREAZ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZ DE PRESCRIPIE MEDICAL CU REINERE N FARMACIE ( P-RF)
DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOARE
VALABIL NCEPND CU 12 SEPTEMBRIE 2014

NR.CRT

COD ATC

DCI

Denumire Comerciala

forma farm.

concentratie

DETINATOR APP

TARA
DET. APP

AMBALAJ

Prescriptie

VAL.SUPORT
PRET
ATAT CNAS/
AMANU
UT(RON)NTUL
PRET
LEGEA NR. VAL.SUPORT
cant/ MAXIMA AMANUNTUL 95/2006 ART ATAT CNAS/
amba
L
MAXIMAL/UT 213 alin.(1) lit.
UT (RON)
laj
(RON)
(RON)
a) si f)
PT. ADULTI

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

SE MODIFICA
17
12
11
21
4
10
19
16
15
20
14
18
5
2
6
1
7
3
8
9
41
45
46
42
43
44
30
49
68
93
97
98
99

N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA03
N06DX01
N06DX01
N06DX01
N06DX01

100 N06DX01
101 N06DX01
102 N06DX01
113 N06DX01

DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
RIVASTIGMINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***

DOSPELIN 10 mg
COGITON 10 mg
DONECEPT 10 MG
XALINAT 10 mg
DAVIA 10 mg
ALZEPIL 10 mg
DOSPELIN 10 mg
DOSPELIN 10 mg
DOSPELIN 10 mg

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
DONEPEZIL TORRENT 10 mg COMPR. FILM.
DOSPELIN 10 mg
COMPR. FILM.
DOSPELIN 10 mg
COMPR. FILM.
TUADIN 10 mg
COMPR. FILM.
ZILDON 10mg
COMPR. FILM.
PRIDIA 10 mg
COMPR. FILM.
YASNAL 10 mg
COMPR. FILM.
ALZEPIL 10 mg
COMPR. FILM.
DAVIA 10 mg
COMPR. FILM.
ALZEPIL 10 mg
COMPR. FILM.
ALZEPIL 10 mg
COMPR. FILM.
YASNAL 10 mg
COMPR. ORODISPERSABILE
DONEPEZIL STADA HEMOFARM 10 mg

COMPR. ORODISPERSABILE

DONEPEZIL STADA HEMOFARM 10 mg

COMPR. ORODISPERSABILE

ARICEPT EVESS
DONEPEZIL TEVA 10 mg
DARIZOL 10 mg
DONECEPT 5 MG
DONEPEZIL TEVA 5 mg
NIMVASTID 6mg
NEMDATINE 10mg

COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE

COMPR. FILM.
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE

COMPR. FILM.

MEMANTINA TERAPIA 10 mg COMPR. FILM.

MEMANTINA TERAPIA 10 mg COMPR. FILM.

MEMANTINA ATB 10 mg
MARIXINO 10mg
COGNOMEM 10 mg
TORMORO 10 mg
MEMANTINA TEVA 10 mg

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. ORODISPERSABILE

10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10 mg
10mg
10mg
10mg
10mg
10mg
5mg
5mg
6mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg

MEDOCHEMIE LTD. CIPRU

CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM.
BMF PHARM S.R.L. ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 COMPR. FILM.
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM.
GALENICA S.A.
GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM.
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM.
EGIS PHARMACEUTICALS P.L.C.

UNGARIA

MEDOCHEMIE LTD. CIPRU

MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU

P-RF
P-RF
P-RF
P-RF
P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P-RF

CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF

CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM.

P-RF

CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM.

P-RF

TORRENT PHARMA S.R.L.

ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM.

PRF

MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
ANTIBIOTICE S.A.
SANDOZ S.R.L.

CIPRU
CIPRU

CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM.

P-RF

CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM.

P-RF

ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.

ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM.
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
KRKA D.D. NOVO MESTO SLOVENIA

EGIS PHARMACEUTICALS P.L.C.

UNGARIA
ROMANIA
UNGARIA
UNGARIA

KRKA D.D.

SLOVENIA

EGIS PHARMACEUTICALS P.L.C.

TERAPIA SA
EGIS PHARMACEUTICALS P.L.C.

P-RF
P-RF
P-RF

CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF

CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM.

P-RF

CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.

P-RF

CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM.

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF

CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL TIP "PEEL-OPEN" A CATE 28 COMPR. ORODISP.

PRF

STADA HEMOFARM SRL ROMANIA

CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE

PRF

STADA HEMOFARM SRL ROMANIA

CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE

PRF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE

P-RF

TEVA PHARMACEUTICALS S.R.L.

CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.

P-RF

ROMASTRU TRADING S.R.L.

ROMANIA
ROMANIA

CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE

PRF

ACTAVIS GROUP PTC EHF.

ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM.

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.

P-RF

KRKA ,D.D., NOVO MESTO SLOVENIA

CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE

P-RF/R

CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE

PR

P-RF

ACTAVIS GROUP PTC EHF.

ISLANDA

TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.

ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR
ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR

CONSILIENT HEALTH LTD.

IRLANDA

CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE

ZENTIVA K.S.

REPUBLICA CEHA

CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM.

ABBOTT PRODUCTS SAS

FRANTA

CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM.

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. ORODISPERSABILE

Pagina 1 din 4

PR
PR
PR
PR

60
28
28
28
30
56
100
56
50
30
28
98
30
28
28
28
28
30
56
28
28
28
28
28
28
28
28
28
28
28
56
56
56
56
56
60
56

116.33
134.46
57.41
64.86
64.72
206.27
183.87
108.57
96.95
54.62
57.17
180.19
65.30
171.82
62.61
52.19
108.76
64.72
206.27
108.76
52.19
238.90
238.90
379.17
41.65
62.61
41.01
58.11
101.04
27.73
56.51
56.51
69.82
56.01
56.36
60.48
56.50

1.938833
4.802142
2.050357
2.316428
2.157333
3.683392
1.838700
1.938750
1.939000
1.820666
2.041785
1.838673
2.176666
6.136428
2.236071
1.863928
3.884285
2.157333
3.683392
3.884285
1.863928
8.532142
8.532142
13.541785
1.487500
2.236071
1.464642
2.075357
3.608571
0.990357
1.009107
1.009107
1.246785
1.000178
1.006428
1.008000
1.008928

1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.487500
1.785000
1.464642
1.487570
3.608571
0.990357
1.009070
1.009070
1.009070
1.000178
1.006428
1.008000
1.008928

1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.785000
1.487500
1.785000
1.464642
1.487570
3.608571
0.990357
1.009070
1.009070
1.009070
1.000178
1.006428
1.008000
1.008928

NR.CRT

DCI

COD ATC

108 N06DX01
109 N06DX01
110 N06DX01
111 N06DX01

MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***

Denumire Comerciala

forma farm.

NEMDATINE 20mg

COMPR. FILM.
MEMANTINA TERAPIA 20 mg COMPR. FILM.
MEMANTINA TERAPIA 20 mg COMPR. FILM.
MEMANTINA ATB 20 mg
COMPR. FILM.

concentratie

20mg
20mg
20mg
20mg

DETINATOR APP

TARA
DET. APP

ACTAVIS GROUP PTC EHF.

ISLANDA

TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.

ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PR

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. PR
ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PR

AMBALAJ
CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE

Prescriptie

PR

VAL.SUPORT
PRET
ATAT CNAS/
AMANU
UT(RON)NTUL
PRET
LEGEA NR. VAL.SUPORT
cant/ MAXIMA AMANUNTUL 95/2006 ART ATAT CNAS/
amba
L
MAXIMAL/UT 213 alin.(1) lit.
UT (RON)
laj
(RON)
(RON)
a) si f)
PT. ADULTI

28 55.92
28 56.51
28 56.51
30 110.25

1.997142
2.018214
2.018214
3.675000

1.997142
2.018142
2.018142
2.018142

1.997142
2.018142
2.018142
2.018142

56 153.96
56 157.92

2.749285
2.820000

2.749285
1.009070

2.749285
1.009070

SE ELIMINA
64
92

N06DA03
N06DX01

RIVASTIGMINUM***
MEMANTINUM***

RIDAXIN 6 mg
MARUXA

CAPS.
COMPR. FILM.

6mg
10mg

ROMASTRU TRADING SRL

ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS.

P-RF/R

KRKA D.D.

SLOVENIA

CUTIE CU BLISTER DIN PVC/PVDC-AL X 56 COMPRIMATE FILMATE

PR

ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLACON X 4ML PICATURI OFTALMICE, SOLUTIE

PRF

84.46

84.460000

84.460000

84.460000

P-6L

60.09

60.090000

60.090000

60.090000

21. GLAUCOM - G 26
SE ADAUGA
34

S01EE04

TRAVOPROSTUM

IZBA

PIC. OFT., SOL

30mcg/ml

SE MODIFICA
33

S01EE04

TRAVOPROSTUM

TRAVATAN 40mcg/ml

PICATURI OFT.SOL.

40mcg/ml

ALCON LABORATORIES LTD.

Pagina 2 din 4

MAREA BRITANIE

CUTIE X 1 FLACON X 2,5 ML