Você está na página 1de 88

ANEXA 2a

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

Nr crt.

cod ATC

DCI

Denumire Comerciala

forma farm.

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48

A02BC01

OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
OMEPRAZOLUM
LANSOPRAZOLUM
LANSOPRAZOLUM
LANSOPRAZOLUM
LANSOPRAZOLUM
PAPAVERINI HYDROCHLORIDUM
PAPAVERINI HYDROCHLORIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM
METOCLOPRAMIDUM

ULTOP
OMEPRAZOL 20 mg
OMEPRAZOL LPH 20 mg
OMERAN 20
OMEPRAZOL 20 mg
OMEPRAZOL TERAPIA 20 mg
OMEPRAZOL ARENA 20 mg
OMEPRAZOL FARMEX 20 mg
NOVOGAST 20 mg

CAPS. GASTROREZ.

OMEPRAZOL ROMPHARM 20 mg

CAPS. GASTROREZ.

ORTANOL 20 mg
HELICID 20
OMEZ 20mg

CAPS. GASTROREZ.

OMEPRAZOL AUROBINDO 20 mg

CAPS. GASTROREZ.

OMZATOL 20 mg
OMZATOL 20 mg
OMZATOL 20 mg
OMEPRAZOL ATB 20 mg
OMEPRAZOL ZENTIVA 20 mg
OMEPRAZOL ZENTIVA 20 mg
OMEPRAZOL ZENTIVA 20 mg
OMEPRAZOL LPH 20 mg
OMERAN 20 mg
ORTANOL 40 mg

CAPS. GASTROREZ.

OMEPRAZOL AUROBINDO 40 mg

CAPS. GASTROREZ.

A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC01
A02BC03
A02BC03
A02BC03
A02BC03
A03AD01
A03AD01

A03FA01
A03FA01
A03FA01
A03FA01
A03FA01
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
A06AD11
A06AD11

ACIDUM URSODEOXYCHOLICUM*
ACIDUM URSODEOXYCHOLICUM*
ACIDUM URSODEOXYCHOLICUM*
ACIDUM URSODEOXYCHOLICUM*
ACIDUM URSODEOXYCHOLICUM*
ACIDUM URSODEOXYCHOLICUM*

LACTULOSUM
LACTULOSUM

CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.

CAPS. GASTROREZ.
CAPS. GASTROREZ.

CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.

concentratie

20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40mg
40mg
20mg
40mg
40mg

tara det.
APP

Detinator APP

KRKA D.D.

Ambalaj

SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ.

ROMANIA
LABORMED PHARMA SA ROMANIA
EUROPHARM SA
ROMANIA
SLAVIA PHARM SRL ROMANIA
TERAPIA SA
ROMANIA
ARENA GROUP S.A. ROMANIA
FARMEX COMPANY SRL ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ROMPHARM COMPANY SRL ROMANIA
GEDEON RICHTER ROMANIA SA

Prescriptie

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 01 OCTOMBRIE 2015

P-6L

CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L

CUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L

CUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L


CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L
CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L
CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L
CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L

CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L


CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L

LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L

ZENTIVA K.S.

CEHIA
CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L
ROMANIA CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ. P6L
ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L
NEOLA PHARMA S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L
NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L
ZENTIVA K.S.
CEHIA
CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L
ZENTIVA, K.S.
REPUBLICA CEHA
P6L
ZENTIVA, K.S.
REPUBLICA CEHA
P6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ P-6L
GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L
DR. REDDY'S LABORATORIES

CUTIE CU 2 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 14 CAPSULE GASTROREZISTENTE

CUTIE CU 4 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 7 CAPSULE GASTROREZISTENTE

LEK PHARMACEUTICALS D.D. SLOVENIA


AUROBINDO PHARMA (MALTA) LIMITED

MALTA
ROMANIA
ROMANIA
CEHIA
CEHIA

CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L


CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ.

P6L

OMEDAR 20 mg
COMPR. GASTROREZ.
DAR AL DAWA PHARMA S.R.L.
CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ. P-6L
OMEZ 40 mg
PULB. PT. SOL. PERF.
DR. REDDY'S LABORATORIES
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF.
S/P-RF
OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF.
ZENTIVA K.S.
CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF
HELICID 40 INF
PULB. PT. SOL. PERF. FARA CONCENTRATIE ZENTIVA K.S.
CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. S/P-RF
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
LANZUL
CAPS. GASTROREZ. 30mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ.
P-6L
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
LANZAP 30mg
CAPS. GASTROREZ. 30mg
DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L
PAPAVERINA ARENA 100 mg COMPR.
100mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
PAPAVERINA FARMACOM 200 mg COMPR.
200 mg
FARMACOM S.A.
ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L
METOCLOPRAMID
COMPR.
10mg
SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L
METOCLOPRAMID 10 mg
COMPR.
10mg
TERAPIA SA
ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L
METOCLOPRAMID ARENA 10 mg COMPR.
10mg
ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L
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
METOCLOPRAMID 5mg/ml
SOL. INJ.
5mg/ml
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML P-RF
URSOFALK (R)
CAPS.
250mg
DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS.
P6L
URSOFALK (R)
CAPS.
250mg
DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS.
P-6L
URSOSAN
CAPS.
250mg
PRO. MED. CS PRAHA AS CEHIA
CUTIE X 5 BLIST. AL/PVC X 10 CAPS.
P-6L
URSOROM 250 mg
CAPS.
250mg
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS.
P6L
URSOFALK 500 mg
COMPR. FILM. 500mg
DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L
URSOFALK 250 mg/5 ml
SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PPP6L
DUPHALAC (R)
LICHID ORAL 66,7%
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L
LACTULOSE
SIROP
65%
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML
P-6L
Pagina 1 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

14
14
20
28
30
30
30
30
20
30
14
28
30
28
28
28
14
20
28
28
28
30
28
7
14
28
1
1
1
14
14
14
20
20
20
40
40
40
1
5
100
50
50
60
100
1
1
1

0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,541671
0,437857
0,541671
0,541671
0,331428
0,541671
0,541671
0,541671
0,541671
0,376785
0,376785
0,376785
0,541671
0,541671
1,083342
0,645714
0,535357
15,153749
15,153749
15,153749
0,270835
0,541671
0,541671
0,541671
0,217500
0,427000
0,103500
0,104000
0,104000
9,010000
2,742000
0,879550
0,879550
0,788600
0,788500
1,759100
43,977542
6,899858
10,085999

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,134043
0,144043
0,122329
0,251900
0,240995
0,237329
0,219995
0,153329
0,305829
0,196995
0,000000
0,114400
0,198995
0,000000
0,251900
0,251900
0,251900
0,305829
0,000000
0,000000
0,000000
0,122995
0,251900
0,108086
0,000000
0,000000
1,676251
1,686251
1,676251
0,215593
0,431186
0,300471
0,321829
0,012000
0,000000
0,000000
0,043250
0,000000
0,000000
0,000000
0,272850
0,333850
0,000000
0,000000
0,922600
53,512458
3,850142
0,714001

0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,487503
0,394071
0,487503
0,487503
0,298285
0,487503
0,487503
0,487503
0,487503
0,339106
0,339106
0,339106
0,487503
0,487503
0,975007
0,581142
0,481821
13,638374
13,638374
13,638374
0,243751
0,487503
0,487503
0,487503
0,195750
0,384300
0,093150
0,093600
0,093600
8,109000
2,467800
0,791595
0,791595
0,709740
0,709650
1,583190
39,579787
6,209872
9,077399

0,188211
0,198211
0,176497
0,306068
0,295163
0,291497
0,274163
0,207497
0,359997
0,251163
0,043786
0,168568
0,253163
0,033143
0,306068
0,306068
0,306068
0,359997
0,037679
0,037679
0,037679
0,177163
0,306068
0,216421
0,064572
0,053536
3,191626
3,201626
3,191626
0,242677
0,485354
0,354639
0,375997
0,033750
0,042700
0,010350
0,053650
0,010400
0,901000
0,274200
0,360805
0,421805
0,078860
0,078850
1,098510
57,910213
4,540128
1,722601

cod ATC

49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

A06AD11
A06AD11
A06AD11
A06AD11
A07AA02
A07EC01
A07EC01
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02

DCI

LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
NYSTATINUM
SULFASALAZINUM
SULFASALAZINUM
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
MESALAZINUM**
ACENOCUMAROLUM
ACENOCUMAROLUM
TICLOPIDINUM1)
TICLOPIDINUM1)
PHYTOMENADIONUM
FERROSI SULFAS
FERROSI SULFAS

Denumire Comerciala

LACTULOSE
LACTULOSE-MIP 650 mg/ml
LACTULOSE-MIP 650 mg/ml
LACTULAK 660 mg/ml
NISTATINA
SULFASALAZIN EN
SALAZIDIN GR 500 mg
PENTASA 1 g
PENTASA 500mg
SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE
SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE
SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE

MESALAZINA SOFARFARM 400 mg


MESALAZINA SOFARFARM 800 mg
MESALAZINA SOFARFARM 800 mg

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

PENTASA 1000mg
SALOFALK 1 g
SALOFALK (R) 250 mg
SALOFALK (R) 500 mg
SALOFALK 4 g/ 60 ml
TROMBOSTOP 2 mg
SINTROM 4 mg
TICLODIN
IPATON
FITOMENADION 10 mg/ml
FERROGRADUMET (R)
TARDYFERON 80 mg
MALTOFER
FER ROMPHARM 50 mg/ml

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

FERGLUROM FORTE 50 mg/ml

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

FERRUM HAUSMANN (R)


FERRUM HAUSMANN (R)
FERGLUROM 50mg/5ml
SORBIFER DURULES
ACIFOL 5 mg
DIGOXIN ZENTIVA 0,25 mg
DIGOXIN 0,5 mg/2 ml
DIGOXIN ZENTIVA 0,5 mg/2ml
CHINIDINA ARENA 200 mg
CHINIDINA ARENA 200 mg
CHINIDINA ARENA 200 mg
CHINIDINA ARENA 200 mg

A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
B01AA07
B01AA07
B01AC05
B01AC05
B02BA01
B03AA07
B03AA07

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT


B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT
B03AEN1

COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM)

B03BB01

ACIDUM FOLICUM
DIGOXINUM
DIGOXINUM
DIGOXINUM
CHINIDINI SULFAS
CHINIDINI SULFAS
CHINIDINI SULFAS
CHINIDINI SULFAS
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
AMIODARONUM
AMIODARONUM
AMIODARONUM
AMIODARONUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM

C01AA05
C01AA05
C01AA05
C01BA01
C01BA01
C01BA01
C01BA01
C01BC03
C01BC03
C01BC03
C01BC03
C01BC03
C01BC03
C01BD01
C01BD01
C01BD01

100 C01BD01
101 C01DA02
102 C01DA02
103 C01DA02
104 C01DA02
105 C01DA02

PROPAFENONA ARENA 150 mg


PROPAFENONA ARENA 150 mg

RYTMONORM (R)
PROPAFENON AL 150
PROPAFENON SANDOZ 150 mg

RYTMONORM
CORDARONE 200 mg
AMIODARONA LPH 200 mg
AMIODARONA ARENA 200 MG

CORDARONE 200 mg
NITROMINT 2,6 mg
NITROGLICERINA 0,5 mg
NITRODERM (R) TTS 5
NITROMINT
NITROMINT

forma farm.

SIROP
SIROP
650mg/ml
SIROP
650mg/ml
SOL. ORALA 660 mg/ml
COMPR. FILM. 500.000ui
COMPR. FILM. GASTROREZ. 500mg
COMPR. GASTROREZ. 500mg
COMPR. CU ELIB. PREL. 1g
COMPR. ELIB. PREL. 500mg
COMPR. GASTROREZ. 250mg
COMPR. GASTROREZ. 500mg
COMPR. GASTROREZ. 500mg
COMPR. GASTROREZISTENTE 400mg
COMPR. GASTROREZISTENTE 800mg
COMPR. GASTROREZISTENTE 800mg
SUPOZ.
1000mg
SUPOZ.
1g
SUPOZ.
250mg
SUPOZ.
500mg
SUSP. RECTALA 4g/60ml
COMPR.
2mg
COMPR.
4mg
COMPR. FILM. 250mg
COMPR. FILM. 250mg
SOL. INJ.
10mg/ml
COMPR. ELIB. PREL. 105mg
DRAJ. ELIB. PREL. 80mg
COMPR. MAST. 100mg
PIC. ORALE, SOL. 50mg/ml
PICATURI ORALE, SOL. 50mg/ml
PICATURI ORALE-SOL. 50mg/ml
SIROP
10mg/ml
SIROP
50mg/5ml
COMPR. FILM. 100mg+60mg
COMPR. FILM. 5mg
COMPR.
0,25mg
SOL. INJ.
0,5mg/2ml
SOL. INJ.
0,5mg/2ml
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
150mg
COMPR.
150mg
COMPR. FILM. 150mg
COMPR. FILM. 150mg
COMPR. FILM. 150mg
SOL. INJ.
70mg/20ml
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR. ELIB. PREL. 2,6mg
COMPR. SUBLING. 0,5mg
SIST. TERAP. TRANSDERM. 25mg
SPRAY SUBLINGUAL 0,4mg/doza
SPRAY SUBLINGUAL 0,4mg/doza

Prescriptie

Nr crt.

tara det.
concentratie
Detinator APP
APP
Ambalaj
65%
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML

P-6L

MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L
MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L
ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L
ANTIBIOTICE SA
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L
AC HELCOR PHARMA S.R.L.

ROMANIA

CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L

FERRING GMBH
FERRING GMBH

GERMANIA CUTIE CU 6 BLIST. AL/AL X 10 COMPR. CU ELIB. PREL. P6L


GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L
DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L
DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L
DR. FALK PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ.
P-6L

SOFARFARM S.R.L.
SOFARFARM S.R.L.
SOFARFARM S.R.L.
FERRING GMBH
DR. FALK PHARMA GMBH
DR. FALK PHARMA GMBH
DR. FALK PHARMA GMBH
DR. FALK PHARMA GMBH

ROMANIA
ROMANIA
ROMANIA

CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE


CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE
CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE

P6L
P6L
P6L

GERMANIA CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI P-6L
GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L
GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.
P-6L
GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.
P-6L
GERMANIA
P-6L
CUTIE X 7 BLIST. AL/PE CONTINAND FIECARE CATE 1 FLACON UNIDOZA X 60 ML SUSPENSIE RECTALA + APLICA

TERAPIA SA

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF


NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF
AC HELCOR SRL
ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM.
P-RF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P-RF
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML S/P-RF
TEOFARMA SRL
ITALIA
CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L
LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L
VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MASTIC. P-6L
ROMPHARM COMPANY SRL ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 30 ML PIC. ORALE, SOL.
P6L
BIOFARM S.A.
ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 ML PICATURI ORALE, SOLUTIEP-6L
VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON CU PICURATOR X 30 ML P-6L
VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON X 150 ML + O MASURA DOZATOARE P-6L
BIOFARM S.A.
ROMANIA
P-6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM.
P-6L
ZENTIVA S.A.
ROMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-6L
ZENTIVA S.A.
ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. S/P-RF
ZENTIVA S.A.
ROMANIA
S/P-RF
ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 20 COMPR.
P-RF
ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF
ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE GRADATA DE LA 2,5 - 20 ML

CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ROSU SI PORTOCALIU)X 2 ML SOL. INJ.

ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM.


GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM.
HEXAL AG
GERMANIA CUTIE X 5 BLIST. AL/PP X 10 COMPR. FILM.
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ.
SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ.
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
ALIUD PHARMA GMBH & CO.KG

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

ARENA GROUP SA

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF


SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. P-RF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL. P-6L
ZENTIVA SA
ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC
EGIS PHARMACEUTICALS P.L.C.
EGIS PHARMACEUTICALS P.L.C.

UNGARIA
UNGARIA

P-6L

CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L


CUTIE X 1 FLACON DIN PLASTIC X 10G (180 DOZE) SPRAY SUBLINGUALP-6L

Pagina 2 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

1
1
1
1
20
50
50
60
100
100
100
50
60
60
90
28
30
10
10
7
30
20
20
20
5
30
30
30
1
1
1
1
1
50
30
25
5
5
20
20
30
50
20
100
50
100
50
5
30
30
30
30
60
20
10
1
1

3,361999
16,809999
33,340000
6,730000
0,480000
0,584200
0,585200
1,650889
0,825444
0,412721
0,825444
0,825444
0,660354
1,320712
1,320712
5,886666
5,886666
1,471662
2,943333
20,875714
0,187749
0,350000
0,272892
0,272892
3,340000
0,282000
0,228972
0,636035
8,780000
9,120000
9,120000
9,120000
6,080000
0,307800
0,255666
0,138800
1,652000
1,652000
0,641350
0,641350
0,641350
0,639400
0,329400
0,329400
0,329400
0,329400
0,329400
7,358000
0,291916
0,291916
0,253666
0,291916
0,150882
0,088402
1,557999
12,730000
12,730000

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,228001
0,420001
0,000000
0,000000
0,000000
0,000000
0,000000
1,542444
0,557556
0,176979
0,294956
0,395756
0,150312
0,185788
0,133732
0,320476
0,000000
0,702338
0,656667
0,000000
0,038251
0,000000
1,503608
0,415108
0,000000
0,000000
0,186694
0,107298
0,000000
0,000000
4,920000
6,860000
4,310000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000650
0,045650
0,024650
0,000000
0,011100
0,000000
0,194200
0,000000
0,032400
0,000000
0,177084
0,012750
0,000000
0,177084
0,044284
0,112098
0,000001
0,000000
0,000000

3,025799
15,128999
30,006000
6,057000
0,432000
0,525780
0,526680
1,485800
0,742899
0,371448
0,742899
0,742899
0,594318
1,188640
1,188640
5,297999
5,297999
1,324495
2,648999
18,788142
0,168974
0,315000
0,245602
0,245602
3,006000
0,253800
0,206074
0,572431
7,902000
8,208000
8,208000
8,208000
5,472000
0,277020
0,230099
0,124920
1,486800
1,486800
0,577215
0,577215
0,577215
0,575460
0,296460
0,296460
0,296460
0,296460
0,296460
6,622200
0,262724
0,262724
0,228299
0,262724
0,135793
0,079561
1,402199
11,457000
11,457000

0,564201
2,101001
3,334000
0,673000
0,048000
0,058420
0,058520
1,707533
0,640101
0,218252
0,377501
0,478301
0,216348
0,317860
0,265804
0,909143
0,588667
0,849505
0,951001
2,087572
0,057026
0,035000
1,530898
0,442398
0,334000
0,028200
0,209592
0,170902
0,878000
0,912000
5,832000
7,772000
4,918000
0,030780
0,025567
0,013880
0,165200
0,165200
0,064785
0,109785
0,088785
0,063940
0,044040
0,032940
0,227140
0,032940
0,065340
0,735800
0,206276
0,041942
0,025367
0,206276
0,059373
0,120939
0,155801
1,273000
1,273000

cod ATC

DCI

155 C03DA01

ISOSORBIDI DINITRAS
ISOSORBIDI DINITRAS
ISOSORBIDI MONONITRAS
ISOSORBIDI MONONITRAS
ISOSORBIDI MONONITRAS
ISOSORBIDI MONONITRAS
ALPROSTADILUM***
ALPROSTADILUM***
METHYLDOPUM
CLONIDINUM
CLONIDINUM
CLONIDINUM
HYDROCHLOROTHIAZIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
INDAPAMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM

156 C03EB01

COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)

157 C03EB01

COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)

158 C03EB01

COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)

159 C03EB01

COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)

160 C04AD03

PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM

106 C01DA08
107 C01DA08
108 C01DA14
109 C01DA14
110 C01DA14
111 C01DA14
112 C01EA01
113 C01EA01
114 C02AB01
115 C02AC01
116 C02AC01
117 C02AC01
118 C03AA03
119 C03BA11
120 C03BA11
121 C03BA11
122 C03BA11
123 C03BA11
124 C03BA11
125 C03BA11
126 C03BA11
127 C03BA11
128 C03BA11
129 C03BA11
130 C03BA11
131 C03BA11
132 C03BA11
133 C03BA11
134 C03BA11
135 C03BA11
136 C03BA11
137 C03BA11
138 C03BA11
139 C03CA01
140 C03CA01
141 C03CA01
142 C03CA01
143 C03CA01
144 C03CA01
145 C03CA01
146 C03CA01
147 C03DA01
148 C03DA01
149 C03DA01
150 C03DA01
151 C03DA01
152 C03DA01
153 C03DA01
154 C03DA01

161 C04AD03
162 C04AD03

Denumire Comerciala

forma farm.

ISOSORBID DINITRAT 10 mg COMPR.


ISODINIT(R) RETARD
COMPR. ELIB. PREL.
MONO ROM SR 40 mg
CAPS. ELIB. PREL.
OLICARD 40 mg RETARD
CAPS. ELIB. PREL.
MONO ROM SR 60 mg
CAPS. ELIB. PREL.
MONONITRON (R) EP 60 mg COMPR. ELIB. PREL.
PRIDAX 20mcg
CONC. PT. SOL. PERF.
VASAPROSTAN 20
LIOF. PT. SOL. PERF.
DOPEGYT
COMPR.
CLONIDINA SINTOFARM 0,15 mg COMPR.
CLONIDINA ARENA 0,15 mg COMPR.
CLONIDINA ARENA 0,15 mg COMPR.
NEFRIX 25 mg
COMPR.
SERDIMID 1,5 mg
COMPR. CU ELIB. PREL.

Prescriptie

Nr crt.

cant.
UT/

Pret de

tara det.
ambal referinta / UT
(RON)
aj
concentratie
Detinator APP
APP
Ambalaj
10mg
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3, BLIST. AL/PVC X 20 COMPR. P-6L
60
0,031000
20mg
PHARMAKI GENERICS LIMITED MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. ELIB. PREL. P-6L
60
0,068333
40mg
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L
20
0,290159

40mg
60mg
60mg
20mcg
20g
250mg
0,15mg
0,15mg
0,15mg
25mg
1,5mg
INDAPAMIDA SOPHARMA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg
SERDIMID 2,5 mg
COMPR. CU ELIB. PREL. 2,5mg
INDAPAMIDA TERAPIA 1,5 mg COMPR. CU ELIB. PRELUNGITA 1,5mg
INDAPAMIDA TERAPIA 2,5mg COMPR. CU ELIB. PRELUNGITA 2,5mg
INDAPAMID SR ZENTIVA 1,5 mg COMPR. ELIB. PREL 1,5 mg
INDAPAMIDA MYLAN 1,5 mg COMPR. ELIB. PREL. 1,5 mg
TERTENSIF SR 1,5 mg
COMPR. ELIB. PREL. 1,5mg
INDAPAMID MCC 1,5 mg
COMPR. ELIB. PREL. 1,5mg
IDUREN SR 1,5 mg
COMPR. ELIB. PREL. 1,5mg
DIUREMID SR 1,5 mg
COMPR. ELIB. PREL. 1,5mg
INDAPAMIDA TEVA 1,5 mg
COMPR. ELIB. PREL. 1,5mg
INDAPAMIDA SR TORRENT 1,5 mg COMPR. ELIB. PREL. 1,5mg
INDAPAGAMMA 1,5 mg
COMPR. ELIB. PREL. 1,5mg
INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg
INDAPAMID SR 1,5 mg LAROPHARM COMPR. FILM. ELIB. PREL. 1,5 mg
INDAPAMID LPH (R) 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg
RAWEL SR 1,5 mg
COMPR. FILM. ELIB. PREL. 1,5mg
IMPAMID SR 1,5 mg
COMPR. FILM. ELIB. PREL. 1,5mg
INDAPAMIDA ACTAVIS 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg
FUROSEMID MCC 40 mg
COMPR.
40mg
FUROSEMID SLAVIA
COMPR.
40mg
FUROSEMID ZENTIVA
COMPR.
40mg
FUROSEMID LPH 40 mg
COMPR.
40mg
FUROSEMID ARENA 40 mg COMPR.
40mg
FUROSEMID BIOEEL 40 mg COMPR.
40mg
FUROSEMID LPH 40 mg
COMPR.
40mg
FUROSEMID 20 mg/2 ml
SOL. INJ.
10mg/ml
VEROSPIRON
CAPS.
100mg
SPIRONOLACTONA ARENA 25 mg CAPS.
25mg
SPIRONOLACTONA LPH 25 mg CAPS.
25mg
VEROSPIRON
CAPS.
50mg
SPIRONOLACTONA ARENA 50 mg CAPS.
50mg
SPIRONOLACTONA BIOEEL 25 mg COMPR.
25mg
SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM. 25mg
ALSPIRON 25 mg
COMPR. FILM. 25mg
ALSPIRON 50 mg
COMPR. FILM. 50mg
DIUROCARD 50 mg/20 mg
CAPS.
50mg/20 mg
DIUREX 50
CAPS.
50mg/20mg
DIOCOR 50 mg/20 mg
CAPS.
50mg/20mg
DIOCOR 50 mg/20 mg
CAPS.
50mg/20mg
PENTOXI RETARD 400 mg
COMPR. ELIB. PREL. 400mg
PENTOXI RETARD 400 mg
COMPR. ELIB. PREL. 400mg
PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg

ABBOTT LABORATORIES GMBH

GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L

ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L


ZENTIVA S.A
ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L
GEBRO PHARMA GMBH AUSTRIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF S/P-RF
UCB PHARMA GMBH GERMANIA CUTIE X 10 FIOLE X 5 ML LIOF. PT. SOL. PERF. PRF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR.
P-6L
SINTOFARM SA
ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L
ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR.
P-6L
ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L
ZENTIVA SA
ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P6L
SOPHARMA PLC
BULGARIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. CU ELIB. PREL. P6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10COMPR. CU ELIB. PREL. P-6L
ZENTIVA S.A.
ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P6L
MYLAN S.A.S.
FRANTA CUTIE CU BLIST DIN PVC/AL X 30 COMPR. ELIB. PREL. P-6L
LES LAB. SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-6L
MAGISTRA C&C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L
VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L
GLENMARK PHARMACEUTICALS SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.
P-6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL.
P-6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. ELIB. PREL. P6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L
LAROPHARM SRL
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L
ROMPHARM COMPANY S.R.L.

KRKA D.D. NOVO MESTO SLOVENIA

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

P-6L

ROMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
MAGISTRA C&C S.R.L. ROMANIA
SLAVIA PHARM SRL ROMANIA
ZENTIVA SA
ROMANIA
LABORMED PHARMA SA ROMANIA
ARENA GROUP S.A. ROMANIA
BIO EEL SRL
ROMANIA
LABORMED PHARMA SA ROMANIA
ZENTIVA SA
ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
ARENA GROUP S.A. ROMANIA
LABORMED PHARMA S.A. ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
ARENA GROUP S.A. ROMANIA
BIO EEL SRL
ROMANIA
TERAPIA SA
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
AC HELCOR PHARMA SRL ROMANIA
LABORMED PHARMA S.A. ROMANIA
TERAPIA SA
ROMANIA
SANIENCE S.R.L.
ROMANIA
SANIENCE S.R.L.
ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
ZENTIVA AS
SLOVACIA

CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. ELIB. PREL.

P-6L

GEDEON RICHTER ROMANIA SA

CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. CU ELIB. PRELUNGITA P-6L

CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 1 FLAC. DIN PEID X 20 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.

P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L


CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ.

P-RF

CUTIE X 3 BLIST. AL/PVC X 10 CAPS.


CUTIE CU 5 BLIST. PVC/AL X 10 CAPS.
CUTIE CU 6 BLIST. PVC/AL X 10 CAPS.
CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
CUTIE CU 3 BLIST. PVC/AL X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-6L
P-6L

P6L
P-6L
P-6L
P-6L

CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L


CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L

CUTIE X 2 BLIST. AL/PVC X 10 CAPS.


CUTIE CU 3 BLIST. PVC/AL X 10 CAPS.
CUTIE CU 2 BLIST. PVC/AL X 10 CAPS.

P-6L

P6L
P6L

CUTIE X 4 BLIST. X 10 COMPR. CU ELIB. PREL. P-6L


CUTIE X 2 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL.

Pagina 3 din 21

P-6L

20
20
40
5
10
50
50
50
50
25
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
20
30
30
30
30
20
20
20
20
20
20
30
5
30
50
60
30
30
20
50
20
20
30
20
30
20
40
20
20

0,290159
0,435238
0,435016
42,012500
38,580000
0,554400
0,195499
0,195499
0,195499
0,173200
0,280664
0,280664
0,467774
0,280664
0,467774
0,280664
0,268000
0,280664
0,280664
0,280664
0,280664
0,264666
0,280664
0,280664
0,467774
0,280664
0,280664
0,264666
0,280664
0,268666
0,156500
0,156500
0,156750
0,156750
0,156750
0,156750
0,156750
1,260000
0,753000
0,220833
0,220833
0,441666
0,441666
0,220833
0,220833
0,215000
0,441666
1,079083
1,079083
1,049333
1,079083
0,432283
0,432283
0,432283

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,000000
0,000000
0,302841
0,151841
0,489262
0,509484
10,297500
0,000000
0,000000
0,044501
0,060501
0,060301
0,000000
0,069002
0,041336
0,053559
0,069002
0,047226
0,069002
0,000000
0,257669
0,069002
0,069002
0,069002
0,000000
0,069002
0,069002
0,053559
0,069336
0,069002
0,000000
0,069002
0,000000
0,000000
0,000000
0,156250
0,000250
0,156250
0,114250
0,000916
0,000000
0,000000
0,112567
0,115500
0,000000
0,120334
0,001667
0,148967
0,000000
0,245334
0,009917
0,130417
0,000000
0,086417
0,149467
0,460717
0,098717

0,027900
0,061499
0,261143
0,261143
0,391714
0,391514
37,811250
34,722000
0,498960
0,175949
0,175949
0,175949
0,155880
0,252597
0,252597
0,420996
0,252597
0,420996
0,252597
0,241200
0,252597
0,252597
0,252597
0,252597
0,238199
0,252597
0,252597
0,420996
0,252597
0,252597
0,238199
0,252597
0,241799
0,140850
0,140850
0,141075
0,141075
0,141075
0,141075
0,141075
1,134000
0,677700
0,198749
0,198749
0,397499
0,397499
0,198749
0,198749
0,193500
0,397499
0,971174
0,971174
0,944399
0,971174
0,389054
0,389054
0,389054

0,003100
0,006834
0,331857
0,180857
0,532786
0,552986
14,498750
3,858000
0,055440
0,064051
0,080051
0,079851
0,017320
0,097069
0,069403
0,100337
0,097069
0,094004
0,097069
0,026800
0,285736
0,097069
0,097069
0,097069
0,026467
0,097069
0,097069
0,100337
0,097403
0,097069
0,026467
0,097069
0,026867
0,015650
0,015650
0,171925
0,015925
0,171925
0,129925
0,016591
0,126000
0,075300
0,134651
0,137584
0,044167
0,164501
0,023751
0,171051
0,021500
0,289501
0,117826
0,238326
0,104934
0,194326
0,192696
0,503946
0,141946

cod ATC

163 C04AD03
164 C04AD03
165 C04AD03
166 C04AD03
167 C04AD03
168 C04AD03
169 C04AD03
170 C07AA05
171 C07AA05
172 C07AA05
173 C07AA05
174 C07AA05
175 C07AA05
176 C07AA07
177 C07AA07
178 C07AA07
179 C07AA07
180 C07AB02
181 C07AB02
182 C07AB02
183 C07AB02
184 C07AB02
185 C07AB02
186 C07AB02
187 C07AB02
188 C07AB02
189 C07AB02
190 C07AB02
191 C07AB02
192 C07AB02
193 C07AB02
194 C07AB02
195 C07AB02
196 C07AB02
197 C07AB02
198 C07AB02
199 C07AB02
200 C07AB02
201 C07AB02
202 C07AB02
203 C07AB02
204 C07AB02
205 C07AB02
206 C07AB02
207 C07AB02
208 C07AB02
209 C07AB02
210 C07AB02
211 C07AB02
212 C07AB02
213 C07AB02
214 C07AB02
215 C07AB02
216 C07AB03
217 C07AB03
218 C07AB03
219 C07AB03

DCI

PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
PROPRANOLOLUM
SOTALOLUM
SOTALOLUM
SOTALOLUM
SOTALOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
ATENOLOLUM
ATENOLOLUM
ATENOLOLUM
ATENOLOLUM

Denumire Comerciala

forma farm.

concentratie

400mg
PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg
PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg
VASONIT RETARD 600 mg
COMPR. ELIB. PREL. 600mg
ANGIOPENT 400 mg
COMPR. FILM. ELIB. PREL. 400mg
OXIFLUX 400 mg
COMPR. FILM. ELIB. PREL. 400mg
ANGIOPENT 600 mg
COMPR. FILM. ELIB. PREL. 600mg
PROPRANOLOL EEL 10 mg COMPR.
10 mg
PROPRANOLOL 10 mg
COMPR.
10mg
PROPRANOLOL EEL 40 mg COMPR.
40mg
PROPRANOLOL 40 mg
COMPR.
40mg
PROPRANOLOL ARENA 40 mg COMPR.
40mg
HEMANGIOL 3,75 mg/ml
SOL. ORALA 3,75 mg/ml
SOTALOL AL 160
COMPR.
160mg
DAROB (R) 80 mg
COMPR.
80mg
SOTAGAMMA 80
COMPR.
80mg
SOTALOL AL 80
COMPR.
80mg
BLOXAN
COMPR.
100mg
BETAPROL 100 mg
COMPR.
100mg
EGILOK 100 mg
COMPR.
100mg
METOPROLOL LPH 100 mg COMPR.
100mg
METOPROLOL LAROPHARM 100 mg COMPR.
100mg
METOPROLOL 100 mg
COMPR.
100mg
METOPROLOL TERAPIA 100 mg COMPR.
100mg
METOPROLOL VIM SPECTRUM 100 mg COMPR.
100mg
METOPROLOL ARENA 100 MG COMPR.
100mg
METOPROLOL 100 mg
COMPR.
100mg
METOPROLOL AL 100
COMPR.
100mg
METOPROLOL ZENTIVA 100 mg COMPR.
100mg
EGILOK 25 mg
COMPR.
25mg
METOPROLOL LPH 25 mg
COMPR.
25mg
METOPROLOL 25 mg
COMPR.
25mg
METOPROLOL ARENA 25 MG COMPR.
25mg
METOPROLOL LPH 25 mg
COMPR.
25mg
METOPROLOL LAROPHARM 50 mg COMPR.
50mg
BETAPROL 50 mg
COMPR.
50mg
EGILOK 50 mg
COMPR.
50mg
METOPROLOL LPH 50 mg
COMPR.
50mg
METOPROLOL 50 mg
COMPR.
50mg
METOPROLOL TERAPIA 50 mg COMPR.
50mg
METOPROLOL VIM SPECTRUM 50 mg COMPR.
50mg
METOPROLOL ARENA 50 MG COMPR.
50mg
METOPROLOL 50 mg
COMPR.
50mg
METOPROLOL AL 50
COMPR.
50mg
METOPROLOL ZENTIVA 50 mg COMPR.
50mg
METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg
METOPROLOL TARTRAT AUROBINDO 100 mg
COMPR. FILM. 100mg
METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg
BETALOC (R) ZOK 100 mg
COMPR. FILM. ELIB. PREL. 100mg
BETALOC (R) ZOK 50 mg
COMPR. FILM. ELIB. PREL. 50mg
METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg
METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg
METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg
ATENOLOL LPH 100 mg
COMPR.
100mg
ATENOLOL LPH 100 mg
COMPR.
100mg
ATENOLOL ARENA 100 MG COMPR.
100mg
ATENOLOL LPH 50 mg
COMPR.
50mg
PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL.

Detinator APP

ZENTIVA AS
ZENTIVA AS
ZENTIVA AS
LANNACHER HEILMITTEL GES.M.B.H.

AC HELCOR PHARMA SRL


LABORMED PHARMA S.A.
AC HELCOR PHARMA SRL

BIO EEL S.R.L.


SINTOFARM SA
BIO EEL SRL
SINTOFARM SA
ARENA GROUP SA
PIERRE FABRE DERMATOLOGIE

AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
FRANTA

Ambalaj

Prescriptie

Nr crt.

tara det.
APP
SLOVACIA
SLOVACIA
SLOVACIA

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL.

P-6L

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL.

P-6L

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

P-6L

CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L


CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.

P-6L

CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L


CUTIE X 2 BLIST., AL/PVC X 10 COMPR. FILM. ELIB. PREL.

CUTIE CU 2 BLIST. PVC/AL X 25 COMPR.


CUTIE X 5 BLIST. AL/PVC X 10 COMPR.
CUTIE X 5 BLIST. AL/PVC X 10 COMPR.
CUTIE X 5 BLIST. AL/PVC X 10 COMPR.
CUTIE X 5 BLIST. AL/PVC X 10 COMPR.
CUTIE X 1 FLACON DIN STICLA BRUNA X 120ML SOLUTIE ORALA

ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR.


ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVP X 10 COMPR.

P-6L

P6L
P-6L
P-6L
P-6L
P-6L
PR/PRF

P-6L
P-6L

GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L


ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L

WORWAG PHARMA GMBH & CO. KG

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L


UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
LAROPHARM SRL
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L
ZENTIVA S.A.
ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L
MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L
LAROPHARM SRL
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L
ZENTIVA S.A.
ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L
ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
AC HELCOR PHARMA SRL

EGIS PHARMACEUTICALS P.L.C.

Pagina 4 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

50
50
100
50
20
60
20
50
50
50
50
50
1
50
20
100
50
30
30
20
30
20
30
30
20
30
20
30
30
20
20
30
30
60
20
30
20
30
30
30
20
30
20
30
30
20
30
30
30
30
30
30
30
30
20
20
20

0,426200
0,648425
0,648425
0,648425
0,318000
0,318166
0,648425
0,025273
0,025273
0,099600
0,099600
0,101092
1,137290
0,404370
0,202185
0,202185
0,202185
0,077000
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,225734
0,056433
0,056433
0,056433
0,056433
0,056433
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,112867
0,225734
0,225734
0,112867
0,225734
0,112867
0,428895
0,107223
0,214447
0,365666
0,365000
0,324500
0,204000

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,000000
0,053575
0,029875
0,027375
0,000000
0,000000
0,174575
0,042127
0,056727
0,000000
0,000000
0,002108
1.066,852710
0,154430
0,315315
0,134315
0,124815
0,000000
0,070599
0,070766
0,020266
0,070766
0,070599
0,070599
0,070766
0,016599
0,064766
0,070599
0,070599
0,042067
0,042067
0,042233
0,042233
0,041900
0,069633
0,069466
0,069633
0,051466
0,069466
0,131133
0,059633
0,069466
0,069633
0,038799
0,069466
0,070766
0,070599
0,068466
0,230266
0,267133
0,075105
0,108443
0,143886
0,000000
0,000000
0,000000
0,000000

0,383580
0,583582
0,583582
0,583582
0,286200
0,286349
0,583582
0,022745
0,022745
0,089640
0,089640
0,090982
1,023561
0,363933
0,181966
0,181966
0,181966
0,069300
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,203160
0,050789
0,050789
0,050789
0,050789
0,050789
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,101580
0,203160
0,203160
0,101580
0,203160
0,101580
0,386005
0,096500
0,193002
0,329099
0,328500
0,292050
0,183600

0,042620
0,118418
0,094718
0,092218
0,031800
0,031817
0,239418
0,044655
0,059255
0,009960
0,009960
0,012218
1.066,966439
0,194867
0,335534
0,154534
0,145034
0,007700
0,093173
0,093340
0,042840
0,093340
0,093173
0,093173
0,093340
0,039173
0,087340
0,093173
0,093173
0,047711
0,047711
0,047877
0,047877
0,047544
0,080920
0,080753
0,080920
0,062753
0,080753
0,142420
0,070920
0,080753
0,080920
0,050086
0,080753
0,093340
0,093173
0,079753
0,252840
0,278420
0,117995
0,119166
0,165331
0,036567
0,036500
0,032450
0,020400

cod ATC

220 C07AB03
221 C07AB03
222 C07AB05
223 C07AB07
224 C07AB07
225 C07AB07
226 C07AB07
227 C07AB07
228 C07AB07
229 C07AB07
230 C07AB07
231 C07AB07
232 C07AB07
233 C07AB07
234 C07AB07
235 C07AB07
236 C07AB07
237 C07AB07
238 C07AB07
239 C07AB07
240 C07AB07
241 C07AB07
242 C07AB07
243 C07AB07
244 C07AB07
245 C07AB07
246 C07AB07
247 C07AB07
248 C07AG02
249 C07AG02
250 C07AG02
251 C07AG02
252 C07AG02
253 C07AG02
254 C07AG02
255 C07AG02
256 C07AG02
257 C07AG02
258 C07AG02
259 C07AG02
260 C07AG02
261 C07AG02
262 C07AG02
263 C07AG02
264 C07AG02
265 C07AG02
266 C07AG02
267 C07AG02
268 C07AG02
269 C07AG02
270 C07AG02
271 C07AG02
272 C07AG02
273 C07AG02
274 C07AG02
275 C07AG02
276 C08CA01

DCI

ATENOLOLUM
ATENOLOLUM
BETAXOLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
AMLODIPINUM

Denumire Comerciala

ATENOLOL LPH 50 mg
ATENOLOL ARENA 50 MG
LOKREN 20 mg
BISOPROLOL LPH 10mg
BISOBLOCK 10 mg
BISOPROLOL LPH 5mg
BISOBLOCK 5 mg
BOREZ 10 mg
CONCOR 10 mg
BISOGAMMA (R) 10
BISOGAMMA (R) 10
CONCOR COR 10 mg
BISOTENS 10 mg
BISOPROLOL FUMARAT AUROBINDO 10 mg

CONCOR COR 10 mg
SOBYC 10 mg
BOREZ 2,5 mg
CONCOR COR 2,5 mg
CONCOR COR 2,5 mg
SOBYC 2,5 mg
CONCOR 5 mg
BISOGAMMA (R) 5
BISOGAMMA (R) 5
CONCOR COR 5 mg
BISOTENS 5 mg
BISOPROLOL FUMARAT AUROBINDO 5 mg

CONCOR COR 5 mg
SOBYC 5 mg

Prescriptie

Nr crt.

COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

CARVEDILOL SANDOZ 12,5 mg COMPR.

DILATREND (R) 12,5 mg


CORYOL 12,5 mg
TALLITON (R) 12,5 mg
CARVEDILOL LPH 12,5 mg
CARVEDILOL VIM SPECTRUM 12,5mg

GLADYCOR 12,5 mg
MIOCARVIL 12,5 mg
CARVEDILOL HELCOR 12,2 mg

DILATREND (R) 25 mg
CORYOL 25 mg
TALLITON (R) 25 mg
CARVEDILOL LPH 25 mg
GLADYCOR 25 mg
MIOCARVIL 25 mg
CARVEDILOL HELCOR 25 mg
CARVEDILOL SANDOZ 25 mg
DILATREND (R) 6,25 mg
CORYOL (R)
TALLITON 6,25 mg
CARVEDILOL LPH 6,25 mg
CARVEDILOL VIM SPECTRUM 6,25 mg

GLADYCOR 6,25 mg
MIOCARVIL 6,25 mg
CARVEDILOL SANDOZ 6,25 mg

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

CARVEDILOL AUROBINDO 12,5mg COMPR. FILM.


CARVEDILOL AUROBINDO 25mg COMPR. FILM.
CARVEDILOL AUROBINDO 6,25mg COMPR. FILM.

AMLODIPINA TEVA 10 mg

cant.
UT/

Pret de

tara det.
ambal referinta / UT
(RON)
aj
forma farm. concentratie
Detinator APP
APP
Ambalaj
COMPR.
50mg
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
30
0,204000
COMPR.
50mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
20
0,185000
COMPR. FILM. 20mg
SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM. P-6L
28
0,338601
COMPR.
10mg
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
30
0,338601

COMPR.

10mg
5mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5 mg
2,5mg
2,5mg
2,5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
12,5 mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
12,5mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
12,5mg
25mg
6,25mg
10 mg

ACTAVIS GROUP PTC EHF.

LABORMED PHARMA S.A.


ACTAVIS GROUP PTC EHF.

ISLANDA CUTIE X 3 BLIST. X 10 COMPR.


ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR.
ISLANDA CUTIE X 3 BLIST. X 10 COMPR.

P-6L
P-6L
P-6L

ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM.
P-6L/S
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM.
P-6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM.
P-6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM.
P-6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR.

UNGARIA
LABORMED PHARMA SA ROMANIA
VIM SPECTRUM SRL ROMANIA
ANTIBIOTICE S.A.
ROMANIA
SLAVIA PHARM S.R.L. ROMANIA
AC HELCOR PHARMA SRL ROMANIA
ROCHE ROMANIA S.R.L. ROMANIA
EGIS PHARMACEUTICALS P.L.C.

P-6L

CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.

P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-6L
P-6L
P-6L
P-6L
P-6L

CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L
EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

ANTIBIOTICE S.A.

P-6L

ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L


SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L

Pagina 5 din 21

30
30
30
30
30
100
30
30
30
30
30
30
30
30
30
30
30
30
100
30
30
30
30
30
30
28
28
30
30
20
30
30
20
28
28
30
30
30
30
20
30
28
28
30
30
20
30
30
30
28
28
28
30

0,231000
0,169300
0,122333
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,338601
0,084650
0,084650
0,084650
0,084650
0,169300
0,160333
0,168900
0,169300
0,169300
0,169300
0,169300
0,169300
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,252074
0,504149
0,355000
0,504149
0,504149
0,504149
0,504149
0,504149
0,317333
0,126037
0,126037
0,126037
0,126037
0,126037
0,126037
0,126037
0,126037
0,252074
0,285714
0,126037
0,123333

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,000000
0,000000
0,017470
0,235065
0,000000
0,083366
0,000000
0,024399
0,544399
0,162599
0,022065
0,746732
0,288065
0,134065
0,746732
0,008732
0,158683
0,289683
0,289683
0,124350
0,345700
0,000000
0,000000
0,220033
0,126700
0,103033
0,220033
0,037033
0,025259
0,582211
0,007211
0,028926
0,210259
0,083926
0,200926
0,210259
0,199926
0,422636
0,000000
0,019184
0,097851
0,098184
0,096851
0,098351
0,000000
0,263605
0,072177
0,058963
0,112296
0,101963
0,105629
0,112296
0,054296
0,005068
0,000000
0,053963
0,000000

0,183600
0,166500
0,304740
0,304740
0,207900
0,152370
0,110099
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,304740
0,076185
0,076185
0,076185
0,076185
0,152370
0,144299
0,152010
0,152370
0,152370
0,152370
0,152370
0,152370
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,226866
0,453734
0,319500
0,453734
0,453734
0,453734
0,453734
0,453734
0,285599
0,113433
0,113433
0,113433
0,113433
0,113433
0,113433
0,113433
0,113433
0,226866
0,257142
0,113433
0,110999

0,020400
0,018500
0,051331
0,268926
0,023100
0,100296
0,012234
0,058260
0,578260
0,196460
0,055926
0,780593
0,321926
0,167926
0,780593
0,042593
0,167148
0,298148
0,298148
0,132815
0,362630
0,016034
0,016890
0,236963
0,143630
0,119963
0,236963
0,053963
0,050467
0,607419
0,032419
0,054134
0,235467
0,109134
0,226134
0,235467
0,225134
0,473051
0,035500
0,069599
0,148266
0,148599
0,147266
0,148766
0,031734
0,276209
0,084781
0,071567
0,124900
0,114567
0,118233
0,124900
0,066900
0,030276
0,028572
0,066567
0,012334

cod ATC

277 C08CA01
278 C08CA01
279 C08CA01
280 C08CA01
281 C08CA01
282 C08CA01
283 C08CA01
284 C08CA01
285 C08CA01
286 C08CA01
287 C08CA01
288 C08CA01
289 C08CA01
290 C08CA01
291 C08CA01
292 C08CA01
293 C08CA01
294 C08CA01
295 C08CA01
296 C08CA01
297 C08CA01
298 C08CA01
299 C08CA01
300 C08CA01
301 C08CA01
302 C08CA01
303 C08CA01
304 C08CA01
305 C08CA01
306 C08CA02
307 C08CA02
308 C08CA02
309 C08CA02
310 C08CA02
311 C08CA02
312 C08CA02
313 C08CA02
314 C08CA02
315 C08CA02
316 C08CA02
317 C08CA05
318 C08CA05
319 C08DA01
320 C08DA01
321 C08DA01
322 C08DA01
323 C08DA01
324 C08DA01
325 C08DA01
326 C08DA01
327 C08DB01
328 C08DB01
329 C08DB01
330 C08DB01
331 C08DB01
332 C08DB01
333 C08DB01

DCI

AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
NIFEDIPINUM
NIFEDIPINUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM

Denumire Comerciala

AMLOHEXAL 10 mg
TENOX (R) 10

forma farm.

COMPR.
COMPR.
AMLODIPINE MEDOCHEMIE 10 mg COMPR.
ALMACOR 10 mg
COMPR.
AMLODIPINA LPH 10 mg
COMPR.
AMLODIPINA TERAPIA 10 mg COMPR.
AMLODIPINA TERAPIA 10 mg COMPR.
RECOTENS 10 mg
COMPR.
AMLODIPIN VIM SPECTRUM 10 mg COMPR.
AMLODIPINA ACTAVIS 10 mg COMPR.
AMLODIPINA ZENTIVA 10 mg COMPR.
NORVASC 10 mg
COMPR.
AMLODIPINA HELCOR 10 mg COMPR.
AMLODIPINA ARENA 10 mg COMPR.
AMLODIPINA TEVA 5 mg
COMPR.
AMLOHEXAL 5 mg
COMPR.
TENOX (R) 5
COMPR.
AMLODIPINE MEDOCHEMIE 5 mg COMPR.
ALMACOR 5 mg
COMPR.
AMLODIPINA LPH 5 mg
COMPR.
AMLODIPINA TERAPIA 5 mg COMPR.
AMLODIPINA TERAPIA 5 mg COMPR.
RECOTENS 5 mg
COMPR.
AMLODIPIN VIM SPECTRUM 5 mg COMPR.
AMLODIPINA ACTAVIS 5 mg COMPR.
AMLODIPINA ZENTIVA 5 mg COMPR.
NORVASC 5 mg
COMPR.
AMLODIPINA HELCOR 5 mg COMPR.
AMLODIPINA ARENA 5 mg
COMPR.
PLENDIL
COMPR. ELIB. PREL.
PLENDIL
COMPR. ELIB. PREL.
PLENDIL
COMPR. ELIB. PREL.
SISTAR 10 mg
COMPR. FILM. ELIB. MODIF.
SISTAR 2,5 mg
COMPR. FILM. ELIB. MODIF.
SISTAR 5 mg
COMPR. FILM. ELIB. MODIF.
AURONAL 10 mg
COMPR. FILM. ELIB. PREL.
FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL.
AURONAL 2,5 mg
COMPR. FILM. ELIB. PREL.
AURONAL 5 mg
COMPR. FILM. ELIB. PREL.
FELODIPIN SANDOZ 5 mg
COMPR. FILM. ELIB. PREL.
ADALAT CR 30
COMPR. ELIB. MODIF.

concentratie

10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
10mg
2,5mg
5mg
10mg
2,5mg
5mg
10mg
10mg
2,5mg
5mg
5mg
30mg
NIFEDIPIN RETARD TERAPIA 20 mg COMPR. ELIB. PREL. 20mg
VERAPAMIL ARENA 40 mg
CAPS.
40mg
VERAPAMIL ARENA 80 mg CAPS.
80mg
ISOPTIN RR
COMPR. ELIB. PREL. 240mg
CORDAMIL 40 mg
COMPR. FILM. 40mg
CORDAMIL 80 mg
COMPR. FILM. 80mg
ISOPTIN (R) 80 mg
COMPR. FILM. 80mg
VERAPAMIL 40 mg
DRAJ.
40mg
VERAPAMIL 80 mg
DRAJ.
80mg
DILTIAZEM SR ROMPHARM 180 mg CAPS. ELIB. PREL. 180mg
DILTIAZEM SR ROMPHARM 90 mg CAPS. ELIB. PREL. 90mg
DILTIAZEM EIPICO 60 mg
COMPR.
60mg
DILTIAZEM LPH 60 mg
COMPR.
60mg
DILTIAZEM ARENA 60 mg
COMPR.
60mg
DILTIAZEM BIOEEL 60 mg
COMPR.
60mg
DILTIAZEM LPH 60 mg
COMPR.
60mg

Detinator APP

HEXAL AG
KRKA D.D.
MEDOCHEMIE LTD.
ANTIBIOTICE S.A.

Ambalaj

Prescriptie

Nr crt.

tara det.
APP

GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L


SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
CIPRU
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L

ROMANIA
ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
ICN POLFA RZESZOW S.A. POLONIA
VIM SPECTRUM SRL ROMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
ZENTIVA K.S.
REPUBLICA CEHA
LABORMED PHARMA S.A.

CUTIE X 3 BLIST. PVC/AL X 10 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L
P-6L

CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L


CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L

CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L


CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L
KRKA D.D.
SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

MEDOCHEMIE LTD.
ANTIBIOTICE S.A.

CIPRU
ROMANIA
LABORMED PHARMA S.A. ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
ICN POLFA RZESZOW S.A. POLONIA
VIM SPECTRUM SRL ROMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
ZENTIVA K.S.
REPUBLICA CEHA

CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L

CUTIE X 3 BLIST. PVC/AL X 10 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L
P-6L

CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L


CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L

CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L


CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

ASTRAZENECA AB
ASTRAZENECA AB
ASTRAZENECA AB

EGIS PHARMACEUTICALS P.L.C.

SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL.


SUEDIA CUTIE 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL.
SUEDIA CUTIE X 1 FLAC. DIN PE X, 30 COMPR. ELIB. PREL.
ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF.
ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF.
ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF.
UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL.

HEXAL AG

GERMANIA

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.

P-6L

EGIS PHARMACEUTICALS P.L.C.

UNGARIA
UNGARIA

CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL.

P-6L

CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL.

P-6L

GEDEON RICHTER ROMANIA SA


GEDEON RICHTER ROMANIA SA
GEDEON RICHTER ROMANIA SA

EGIS PHARMACEUTICALS P.L.C.

HEXAL AG
BAYER PHARMA AG
TERAPIA SA
ARENA GROUP S.A.
ARENA GROUP S.A.

P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L


GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L

ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.


ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS.
ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS.

P-6L

P6L
P6L

ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L

AC HELCOR SRL
AC HELCOR SRL

ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM.


ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM.

P-6L
P-6L

ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L

ROMANIA
ROMANIA
ROMPHARM COMPANY S.R.L. ROMANIA
ROMPHARM COMPANY S.R.L. ROMANIA
E.I.P.I.CO. MED S.R.L. ROMANIA
LABORMED PHARMA SA ROMANIA
ARENA GROUP SA ROMANIA
BIO EEL SRL
ROMANIA
LABORMED PHARMA SA ROMANIA
SANOFI-AVENTIS ROMANIA S.R.L.
SANOFI-AVENTIS ROMANIA S.R.L.

CUTIE X 2 BLIST. AL/PVC X 25 DRAJ.


CUTIE X 2 BLIST. AL/PVC X 25 DRAJ.

P-6L

CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 10 CAPS. ELIB. PREL.

P6L
P6L

CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 7 CAPS. ELIB. PREL.

CUTIE X 2, BLIST. AL/PVC X 10 COMPR.


CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-6L

P-6L
P-6L

CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L


CUTIE X 2 BLIST. DIN AL/ PVC X 10 COMPR. P-6L
CUTIE X 6 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L

Pagina 6 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

30
30
30
30
30
30
30
30
20
20
30
30
20
30
30
30
30
30
30
30
30
30
30
20
20
30
30
20
30
30
30
30
30
30
30
30
30
30
30
30
28
50
30
30
20
30
30
50
50
50
30
21
20
20
50
20
60

0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,192500
0,264299
0,264299
0,264299
0,264299
0,125333
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,121500
0,132149
0,132149
0,132149
0,132149
0,264299
0,066074
0,132149
0,264299
0,066074
0,132149
0,264299
0,264299
0,066074
0,132149
0,132149
0,132149
0,088099
0,099832
0,199666
0,598999
0,099832
0,197666
0,199666
0,099832
0,197600
0,781541
0,227619
0,260513
0,260513
0,260513
0,260513
0,260513

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,029367
0,029367
0,029367
0,029367
0,029367
0,029367
0,029367
0,029367
0,029201
0,000000
0,009034
0,187701
0,029201
0,029367
0,000000
0,238184
0,097517
0,096851
0,238184
0,238184
0,238184
0,238184
0,131184
0,237851
0,000000
0,003851
0,437517
0,237851
0,140517
1,030367
0,703926
0,712184
0,605367
0,434259
0,416851
0,605367
0,546034
0,434592
0,416851
0,251517
0,409993
0,135901
0,015168
0,000667
0,229001
0,011168
0,000000
0,104134
0,145368
0,000000
0,411459
0,000000
0,008987
0,018987
0,017087
0,008987
0,019153

0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,173250
0,237869
0,237869
0,237869
0,237869
0,112799
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,118934
0,109350
0,118934
0,118934
0,118934
0,118934
0,237869
0,059466
0,118934
0,237869
0,059466
0,118934
0,237869
0,237869
0,059466
0,118934
0,118934
0,118934
0,079289
0,089848
0,179699
0,539099
0,089848
0,177899
0,179699
0,089848
0,177840
0,703386
0,204857
0,234461
0,234461
0,234461
0,234461
0,234461

0,055797
0,055797
0,055797
0,055797
0,055797
0,055797
0,055797
0,055797
0,055631
0,019250
0,035464
0,214131
0,055631
0,055797
0,012534
0,251399
0,110732
0,110066
0,251399
0,251399
0,251399
0,251399
0,144399
0,251066
0,012150
0,017066
0,450732
0,251066
0,153732
1,056797
0,710534
0,725399
0,631797
0,440867
0,430066
0,631797
0,572464
0,441200
0,430066
0,264732
0,423208
0,144711
0,025152
0,020634
0,288901
0,021152
0,019767
0,124101
0,155352
0,019760
0,489614
0,022762
0,035039
0,045039
0,043139
0,035039
0,045205

cod ATC

334 C08DB01
335 C09AA01
336 C09AA01
337 C09AA01
338 C09AA01
339 C09AA01
340 C09AA01
341 C09AA01
342 C09AA01
343 C09AA01
344 C09AA01
345 C09AA01
346 C09AA01
347 C09AA01
348 C09AA01
349 C09AA02
350 C09AA02
351 C09AA02
352 C09AA02
353 C09AA02
354 C09AA02
355 C09AA02
356 C09AA02
357 C09AA02
358 C09AA02
359 C09AA02
360 C09AA02
361 C09AA02
362 C09AA02
363 C09AA02
364 C09AA02
365 C09AA02
366 C09AA02
367 C09AA02
368 C09AA02
369 C09AA02
370 C09AA02
371 C09AA02
372 C09AA02
373 C09AA02
374 C09AA02
375 C09AA02
376 C09AA02
377 C09AA02
378 C09AA02
379 C09AA03
380 C09AA03
381 C09AA03
382 C09AA03
383 C09AA03
384 C09AA03
385 C09AA03
386 C09AA03
387 C09AA03
388 C09AA03
389 C09AA03
390 C09AA03

DCI

DILTIAZEMUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM

Denumire Comerciala

DILZEM 90 mg RETARD
CAPTOPRIL MCC 12,5 mg
CAPTOPRIL 25 mg
CAPTOPRIL 25 EEL
CAPTOPRIL - AC 25 mg
CAPTOPRIL MCC 25 mg
CAPTOPRIL LPH 25 mg
CAPTOPRIL SINTOFARM 25 mg

CAPTOPRIL ARENA 25 mg
CAPTOPRIL ARENA 50 mg
CAPTOPRIL 50 mg
CAPTOPRIL 50 EEL
CAPTOPRIL - AC 50 mg
CAPTOPRIL MCC 50 mg
CAPTOPRIL LPH 50 mg
ENALAPRIL 10 mg
ENALAPRIL LPH 10 mg
ENALAPRIL LPH 10 mg
ENAP 10 mg
ENALAPRIL SLAVIA 10 mg
RENITEC 10 mg
ENALAPRIL TERAPIA 10 mg
ENALAPRIL ARENA 10mg
ENALAPRIL ARENA 10mg
ENALAPRIL ARENA 10mg
ENALAPRIL VIM SPECTRUM 10 mg

ENALAPRIL LAROPHARM 10 mg

ENALAPRIL 20 mg
ENALAPRIL LPH 20 mg
ENAP 20 mg
RENITEC 20 mg
ENALAPRIL TERAPIA 20 mg
ENALAPRIL ARENA 20 mg
ENALAPRIL ARENA 20 mg
ENALAPRIL SLAVIA 20 mg
ENALAPRIL LAROPHARM 20 mg

ENALAPRIL 5 mg
ENAP 5 mg
RENITEC 5 mg
ENALAPRIL LPH (R) 5 mg
ENALAPRIL TERAPIA 5 mg
ENALAPRIL ARENA 5 mg
ENALAPRIL SLAVIA 5 mg
ENALAPRIL LAROPHARM 5 mg

ENAP 1,25 mg/ml


RANOLIP
LISIREN 10 mg
LISINOPRIL SANDOZ 10 mg
LISIGAMMA 10 mg
LISINOPRIL 10 MEDO
LISINOPRIL ACTAVIS 10 mg
LISINOPRIL ATB 10 MG
TONOLYSIN 10 mg
TONOLYSIN 2,5 mg
RANOLIP
LISIREN 20 mg
LISINOPRIL SANDOZ 20 mg

forma farm.

concentratie

90mg
COMPR.
12,5mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
25mg
COMPR.
50 mg
COMPR.
50mg
COMPR.
50mg
COMPR.
50mg
COMPR.
50mg
COMPR.
50mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
SOL. INJ./PERF. 1,25mg/ml
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
10mg
COMPR.
2,5mg
COMPR.
20mg
COMPR.
20mg
COMPR.
20mg

COMPR. ELIB. PREL.

Detinator APP
PFIZER EUROPE MA EEIG

MAREA BRITANIE

MAGISTRA C & C
TERAPIA SA
BIO EEL SRL

ROMANIA
ROMANIA
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
MAGISTRA C & C
ROMANIA
LABORMED PHARMA SA ROMANIA
SINTOFARM SA
ROMANIA
ARENA GROUP SA ROMANIA
ARENA GROUP SA ROMANIA
TERAPIA SA
ROMANIA
BIO EEL SRL
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
MAGISTRA C & C
ROMANIA
LABORMED PHARMA SA ROMANIA
MAGISTRA C & C
ROMANIA
LABORMED PHARMA SA ROMANIA
LABORMED PHARMA SA ROMANIA

Ambalaj

Prescriptie

Nr crt.

tara det.
APP

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L

CUTIE X 3 BLIST. AL/PVC, X 10 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.
CUTIE X 3 BLIST. AL/AL X 10 COMPR.
CUTIE X 2 BLIST. AL/AL X 10 COMPR.

P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L

SLAVIA PHARM SRL ROMANIA


ROMANIA
TERAPIA SA
ROMANIA
ARENA GROUP SA ROMANIA
ARENA GROUP SA ROMANIA
ARENA GROUP SA ROMANIA
VIM SPECTRUM SRL ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA
LABORMED PHARMA SA ROMANIA

MERCK SHARP & DOHME

CUTIE X 2 BLIST. PVC/ AL X 10 COMPR.


CUTIE X 2 BLIST. AL/AL X 14 COMPR.

P-6L
P-6L

CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L

CUTIE X 3 BLIST. AL/PVC, X 10 COMPR.


CUTIE X 5 BLIST. AL/PVC, X 10 COMPR.
CUTIE X 10 BLIST. AL/PVC, X 10 COMPR.

P-6L
P-6L
P-6L

CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.


CUTIE X 2 BLIST. X 10 COMPR.
CUTIE X 2 BLIST. AL/AL X 10 COMPR.

P6L
P-6L
P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L
MERCK SHARP & DOHME

CUTIE X 2 BLIST. AL/AL X 14 COMPR.

TERAPIA SA
ARENA GROUP SA
ARENA GROUP SA

CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L

ROMANIA
ROMANIA
ROMANIA
ROMANIA
SLAVIA PHARM S.R.L. ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA

CUTIE X 3 BLIST. PVC/AL X 10 COMPR.


CUTIE X 5 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.

P-6L
P-6L
P-6L

P6L
P6L
P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L
MERCK SHARP & DOHME

ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.

P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR.


P-6L
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L

ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
LAROPHARM SRL
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR.

P-6L

P6L
P6L

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.

PR/PRF

RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR.

P-6L

AC HELCOR SRL
HEXAL AG

ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE CU BLIST. PVC/AL X 30 COMPR.
ANTIBIOTICE SA
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
GEDEON RICHTER ROMANIA SA
CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
GEDEON RICHTER ROMANIA SA
CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR.
AC HELCOR SRL
ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
MEDOCHEMIE ROMANIA SRL

ACTAVIS GROUP PTC EHF.

ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA

Pagina 7 din 21

P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

30
30
30
20
20
30
30
30
20
20
30
20
20
30
30
20
30
20
20
20
28
20
30
50
100
20
20
20
20
20
28
20
30
50
20
20
20
20
28
20
20
30
20
20
5
30
20
30
30
30
30
30
28
28
30
20
30

0,350333
0,037241
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,138000
0,148965
0,148965
0,138000
0,148965
0,136000
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
0,074482
3,204000
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,037241
0,297931
0,297931
0,297931

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,000000
0,080425
0,067184
0,076518
0,044018
0,043518
0,043518
0,080184
0,044018
0,000000
0,081701
0,044535
0,000000
0,006701
0,000000
0,050535
0,050368
0,050035
0,050535
0,041535
0,157463
0,050535
0,050368
0,050435
0,050235
0,050535
0,050035
0,032569
0,032569
0,032569
0,210997
0,032569
0,032735
0,032669
0,032569
0,032569
0,018518
0,019518
0,069803
0,018518
0,018518
0,018851
0,015518
0,015518
0,000000
0,369368
0,388035
0,121035
0,149035
0,105368
0,121035
0,264368
0,237463
0,273830
0,501402
0,484569
0,081069

0,315299
0,033516
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,124200
0,134068
0,134068
0,124200
0,134068
0,122400
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
0,067033
2,883600
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,033516
0,268137
0,268137
0,268137

0,035034
0,084150
0,074633
0,083967
0,051467
0,050967
0,050967
0,087633
0,051467
0,013800
0,096598
0,059432
0,013800
0,021598
0,013600
0,065432
0,065265
0,064932
0,065432
0,056432
0,172360
0,065432
0,065265
0,065332
0,065132
0,065432
0,064932
0,062363
0,062363
0,062363
0,240791
0,062363
0,062529
0,062463
0,062363
0,062363
0,025967
0,026967
0,077252
0,025967
0,025967
0,026300
0,022967
0,022967
0,320400
0,384265
0,402932
0,135932
0,163932
0,120265
0,135932
0,279265
0,252360
0,277555
0,531196
0,514363
0,110863

cod ATC

391 C09AA03
392 C09AA03
393 C09AA03
394 C09AA03
395 C09AA03
396 C09AA03
397 C09AA03
398 C09AA03
399 C09AA03
400 C09AA03
401 C09AA03
402 C09AA05
403 C09AA05
404 C09AA05
405 C09AA05
406 C09AA05
407 C09AA05
408 C09AA05
409 C09AA05
410 C09AA05
411 C09AA05
412 C09AA05
413 C09AA05
414 C09AA05
415 C09AA05
416 C09AA05
417 C09AA05
418 C09AA05
419 C09AA05
420 C09AA05
421 C09AA05
422 C09AA05
423 C09AA05
424 C09AA05
425 C09AA05
426 C09AA05
427 C09AA05
428 C09AA05
429 C09AA05
430 C09AA05
431 C09AA05
432 C09AA05
433 C09AA06
434 C09AA06
435 C09AA06
436 C09AA09
437 C09AA09
438 C09AA09
439 C09AA09
440 C09AA09
441 C09AA09
442 C09AA09
443 C09AA09
444 C09BA02
445 C09BA02
446 C09BA02
447 C09BA02

DCI

LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
QUINAPRILUM
QUINAPRILUM
QUINAPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM

Denumire Comerciala

LISIGAMMA 20 mg
LISINOPRIL ACTAVIS 20 mg
LISINOPRIL ATB 20 MG
TONOLYSIN 20 mg
LISINOPRIL 20 MEDO
LISINOPRIL ATB 40 MG
RANOLIP
LISIGAMMA 5 mg
LISINOPRIL 5 MEDO
LISINOPRIL ACTAVIS 5 mg
TONOLYSIN 5 mg
VIVACE 10 mg
PIRAMIL 10 mg
RAMIPRIL-AC 10 mg
AMPRIL 10 mg
ZENRA 10
TRITACE 10
RAMIPRIL AUROBINDO 10 mg
AMPRIGEN 10 mg
RAMIPRIL TEVA 10 mg
RAMIRAN 10 mg
RAMIRAN 10 mg
VIVACE 2,5 mg
PIRAMIL 2,5 mg
RAMIPRIL-AC 2,5 mg
AMPRIL 2,5 mg
ZENRA 2,5
TRITACE(R) 2,5
AMPRIGEN 2,5 mg
RAMIRAN 2,5 mg
RAMIRAN 2,5 mg
VIVACE 5 mg
PIRAMIL 5 mg
RAMIPRIL-AC 5 mg
AMPRIL 5 mg
ZENRA 5
TRITACE 5
RAMIPRIL AUROBINDO 5 mg
AMPRIGEN 5 mg
RAMIPRIL TEVA 5 mg
RAMIRAN 5 mg
RAMIRAN 5 mg
ACCUPRO 10 mg
ACCUPRO (R) 20
ACCUPRO (R) 5
MONOPRIL 10 mg
FOSYPRIL 10 mg

forma farm.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

concentratie

20mg
20mg
20mg
20mg
20mg
40mg
5mg
5mg
5mg
5mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5 mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
COMPR. FILM. 10mg
COMPR. FILM. 20mg
COMPR. FILM. 5mg
COMPR.
10mg
COMPR.
10mg
FOSINOPRIL AUROBINDO 10 mg COMPR.
10mg
MONOPRIL 10 mg
COMPR.
10mg
MONOPRIL 20 mg
COMPR.
20mg
FOSYPRIL 20 mg
COMPR.
20mg
FOSINOPRIL AUROBINDO 20 mg COMPR.
20mg
MONOPRIL 20 mg
COMPR.
20mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)ENAP HL
COMPR.
10mg+12,5mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)ENAP H
COMPR.
10mg+25mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)VIMAPRIL H
COMPR.
10mg/25mg
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)ENAP (R) HL 20 mg/12,5 mg
COMPR.
20 mg/12,5mg

Detinator APP

Ambalaj

Prescriptie

Nr crt.

tara det.
APP

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

ACTAVIS GROUP PTC EHF.

ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

ANTIBIOTICE SA
GEDEON RICHTER ROMANIA SA

MEDOCHEMIE ROMANIA SRL

ANTIBIOTICE SA

CUTIE CU BLIST. PVC/AL X 30 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
CUTIE X 2 BLIST. PVDC/AL X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. X 10 COMPR.

P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE CU BLIST. PVC/AL X 30 COMPR.
CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
CUTIE X 4 BLIST. AL/AL X 7 COMPR.

P-6L

P-6L
P-6L
P-6L
P-6L

RANBAXY U.K. LIMITED MAREA BRITANIE


P-6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

ROMANIA
ISLANDA
GEDEON RICHTER ROMANIA SA ROMANIA
ACTAVIS GROUP HF ISLANDA
SANDOZ SRL
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
MEDOCHEMIE ROMANIA SRL

ACTAVIS GROUP PTC EHF.

P-6L
P-6L
P-6L

CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

ZENTIVA S.A.

ROMANIA CUTIE X 2 BLIST. X 14 COMPR.


P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR.
P-6L
SANDOZ SRL
ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
SANOFI - AVENTIS ROMANIA S.R.L.

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

ZENTIVA S.A.
SANOFI - AVENTIS ROMANIA S.R.L.

ROMANIA CUTIE X 2 BLIST. X 14 COMPR.


ROMANIA CUTIE X 2 BLIST. X 14 COMPR.

P-6L
P-6L

ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L


TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L

TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR.
P-6L
SANDOZ SRL
ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

ZENTIVA S.A.

ROMANIA CUTIE X 2 BLIST. X 14 COMPR.


P-6L
ROMANIA CUTIE X 2 BLIST. X 14 COMPR.
P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L
SANOFI - AVENTIS ROMANIA S.R.L.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM.P-6L

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L

UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L


TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
BRISTOL MYERS SQUIBB KFT

PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA

CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L

BRISTOL-MYERS SQUIBB UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L

TERAPIA SA
AUROBINDO PHARMA (MALTA) LIMITED

ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR. P-6L


MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L

PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA

CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L

VIM SPECTRUM SRL ROMANIA

CUTIE X 3 BLIST.OPA-AL-PVC/AL A CATE 10 CAPS. P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

Pagina 8 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

30
30
30
28
20
30
30
30
30
30
28
28
28
30
30
28
28
28
30
30
30
30
28
28
30
30
28
28
30
30
30
28
28
30
30
28
28
28
30
30
30
30
30
30
30
28
30
30
28
28
30
30
28
20
20
30
20

0,297931
0,297931
0,297931
0,297931
0,297931
0,595863
0,074482
0,074482
0,074482
0,074482
0,074482
0,238214
0,302142
0,302000
0,302000
0,302142
0,464285
0,302142
0,302000
0,302000
0,302000
0,302000
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,172142
0,248214
0,248000
0,248000
0,239285
0,297931
0,248214
0,248000
0,239333
0,248000
0,248000
0,099310
0,198620
0,049655
0,099310
0,099310
0,099310
0,099310
0,198620
0,198620
0,198620
0,198620
0,374175
0,374175
0,374175
0,374175

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,149402
0,081069
0,514069
0,350997
0,130569
0,763470
0,190184
0,150518
0,118184
0,118518
0,188732
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000677
0,023177
0,019368
0,023035
0,017106
0,115677
0,023035
0,023035
0,023035
0,000000
0,000000
0,000000
0,000000
0,000000
0,083854
0,000000
0,000000
0,000000
0,000000
0,000000
0,302356
0,378046
0,142345
0,486047
0,281356
0,281356
0,486047
0,650308
0,353380
0,353380
0,650308
0,052825
0,092825
0,019825
0,037825

0,268137
0,268137
0,268137
0,268137
0,268137
0,536276
0,067033
0,067033
0,067033
0,067033
0,067033
0,214392
0,271927
0,271800
0,271800
0,271927
0,417856
0,271927
0,271800
0,271800
0,271800
0,271800
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,134068
0,154927
0,223392
0,223200
0,223200
0,215356
0,268137
0,223392
0,223200
0,215399
0,223200
0,223200
0,089379
0,178758
0,044689
0,089379
0,089379
0,089379
0,089379
0,178758
0,178758
0,178758
0,178758
0,336757
0,336757
0,336757
0,336757

0,179196
0,110863
0,543863
0,380791
0,160363
0,823057
0,197633
0,157967
0,125633
0,125967
0,196181
0,023822
0,030215
0,030200
0,030200
0,030215
0,046429
0,030215
0,030200
0,030200
0,030200
0,030200
0,015574
0,038074
0,034265
0,037932
0,032003
0,130574
0,037932
0,037932
0,037932
0,017215
0,024822
0,024800
0,024800
0,023929
0,113648
0,024822
0,024800
0,023934
0,024800
0,024800
0,312287
0,397908
0,147311
0,495978
0,291287
0,291287
0,495978
0,670170
0,373242
0,373242
0,670170
0,090243
0,130243
0,057243
0,075243

cod ATC

DCI

448 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM)

449 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM)

450 C09BA05

COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM)

451 C09CA01

LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
LOSARTANUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
LOVASTATINUM
LOVASTATINUM
PRAVASTATINUM
PRAVASTATINUM

452 C09CA01
453 C09CA01
454 C09CA01
455 C09CA01
456 C09CA01
457 C09CA01
458 C09CA01
459 C09CA01
460 C09CA01
461 C09CA01
462 C09CA01
463 C09CA01
464 C10AA01
465 C10AA01
466 C10AA01
467 C10AA01
468 C10AA01
469 C10AA01
470 C10AA01
471 C10AA01
472 C10AA01
473 C10AA01
474 C10AA01
475 C10AA01
476 C10AA01
477 C10AA01
478 C10AA01
479 C10AA01
480 C10AA01
481 C10AA01
482 C10AA01
483 C10AA01
484 C10AA01
485 C10AA01
486 C10AA01
487 C10AA01
488 C10AA01
489 C10AA01
490 C10AA01
491 C10AA01
492 C10AA01
493 C10AA01
494 C10AA01
495 C10AA01
496 C10AA01
497 C10AA01
498 C10AA01
499 C10AA01
500 C10AA01
501 C10AA02
502 C10AA02
503 C10AA03
504 C10AA03

Denumire Comerciala

TRITACE 2,5 PLUS


HARTIL HCT 5 mg/25mg
TRITACE 5 PLUS
LODIAL 100mg
TALOSAN 100 mg
TALOSAN 100 mg
LOZAP 100
LORISTA 100 mg
LOSARTAN ZENTIVA 100 mg
LODIAL 50mg
TALOSAN 50 mg
TALOSAN 50 mg
LOZAP 50
COZAAR 50 mg
LORISTA 50 mg
LOSARTAN ZENTIVA 50 mg
SIMVASTATINA ARENA 10 mg
SIMVAHEXAL (R) 10 mg
ZEPLAN (R) 10 mg
SINTENAL 10 mg
VASILIP 10 mg
SIMVASTATIN LPH 10 mg
SIMVASTATINA SUN 10 mg
SIMVACARD 10 mg
SIMVASTATIN AUROBINDO 10 mg

SIMVASTATIN ACTAVIS 10 mg
SIMVASTATIN TERAPIA 10 mg
SIMVASTATINA ARENA 20 mg
SIMVAHEXAL (R) 20 mg
ZEPLAN (R) 20 mg
ZOCOR 20 mg
SINTENAL 20 mg
VASILIP 20 mg
SIMCOR 20 mg
SIMVASTATIN LPH 20 mg
SIMVASTATINA SUN 20 mg
SIMVACARD 20 mg
SIMVASTATIN AUROBINDO 20 mg

SIMVASTATIN ACTAVIS 20 mg
SIMVASTATIN TERAPIA 20 mg
SIMVAHEXAL (R) 30 mg
SIMVASTATINA ARENA 40 mg
VASILIP (R) 40 mg
ZEPLAN (R) 40 mg
SINTENAL 40 mg
SIMVAHEXAL (R) 40 mg
SIMCOR 40 mg
SIMVASTATIN LPH 40 mg
SIMVASTATINA SUN 40 mg
SIMVACARD 40 mg
SIMVASTATIN AUROBINDO 40 mg

SIMVASTATIN ACTAVIS 40 mg
SIMVASTATIN TERAPIA 40 mg
MEDOSTATIN
LOVASTATINA ARENA 20 mg
PRAVATOR 20 mg
PRAVATOR 40 mg

forma farm.

COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

COMPR.
COMPR.
COMPR.
COMPR.

concentratie
2,5mg/12,5mg

5mg/25mg
5mg/25mg
100 mg
100mg
100mg
100mg
100mg
100mg
50 mg
50mg
50mg
50mg
50mg
50mg
50mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
30mg
40 mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
20mg
20mg
20mg
40mg

Detinator APP
SANOFI - AVENTIS ROMANIA S.R.L.

EGIS PHARMACEUTICALS P.L.C.


SANOFI - AVENTIS ROMANIA S.R.L.

ALKALOID-INT D.O.O.
TERAPIA SA
TERAPIA SA
ZENTIVA A.S.
KRKA, D.D., NOVO MESTO

ZENTIVA A.S.
ALKALOID-INT D.O.O.
TERAPIA SA
TERAPIA SA
ZENTIVA A.S.
MERCK SHARP & DOHME
KRKA, D.D., NOVO MESTO

Ambalaj

CUTIE X 2 BLIST. AL/PVC X 14 COMPR.

Prescriptie

Nr crt.

tara det.
APP
ROMANIA
UNGARIA
ROMANIA
SLOVENIA
ROMANIA
ROMANIA
SLOVACIA
SLOVENIA
SLOVACIA
SLOVENIA
ROMANIA
ROMANIA
SLOVACIA
ROMANIA
SLOVENIA
SLOVACIA
ROMANIA

P-6L

CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L

CUTIE X 2 BLIST. AL/PVC X 14 COMPR.

P-6L

CUTIE CU 2 BLIST. DIN PVC/AL X 15 COMPR. FILM.

P6L

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

P-6L

CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM.

P-6L

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

P-6L

CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L


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

P-6L

CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPR. FILM.

P6L

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

P-6L

CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM.

P-6L

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

P-6L

CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L


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

P6L

ZENTIVA A.S.
CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
ARENA GROUP S.A.
CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L
CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L
ZENTIVA K.S.
CEHIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L
AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.

P6L

ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L


TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L
ANTIBIOTICE SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L
ZENTIVA K.S.
CEHIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L
ACTAVIS GROUP PTC EHF.

P6L

AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.

ACTAVIS GROUP PTC EHF.

ISLANDA
ROMANIA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L

MAREA BRITANIE

CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.

TERAPIA SA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 7 COMPR. FILM P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L
ZENTIVA K.S.
CEHIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L
AUROBINDO PHARMA LIMITED

P6L

ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L


TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
MEDOCHEMIE LTD. CIPRU
CUTIE X 1 BLIST. X 10 COMPR.
P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

ACTAVIS GROUP PTC EHF.

RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L


RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR.P-6L

Pagina 9 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

28
28
28
30
30
30
30
28
30
30
30
30
30
28
28
30
28
30
28
30
28
30
28
28
30
30
30
28
30
28
28
30
28
30
30
28
28
30
30
30
30
28
28
28
30
30
30
30
28
28
30
30
30
10
30
28
28

0,314285
0,374175
0,374175
0,705631
0,705631
0,705631
0,445333
0,517857
0,445333
0,334333
0,334333
0,334333
0,268000
0,352815
0,334642
0,268000
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,125095
0,250191
0,250191
0,250191
0,250191
0,250191
0,250191
0,250191
0,250191
0,235000
0,245357
0,246000
0,118666
0,250191
0,375287
0,500383
0,500383
0,500383
0,500383
0,500383
0,500383
0,500383
0,323571
0,337857
0,338000
0,237333
0,500383
0,166794
0,166794
0,250191
0,500383

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,000000
0,000110
0,201539
0,519035
0,412369
0,412369
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,161827
0,000000
0,000000
0,199190
0,022238
0,198476
0,186571
0,198476
0,198905
0,017047
0,023476
0,022905
0,022238
0,179571
0,183023
0,090475
0,183023
0,416237
0,182809
0,183023
0,182809
0,182809
0,000000
0,000000
0,000000
0,000000
0,182809
0,108046
0,606759
0,451045
0,606402
0,565950
0,126283
0,605950
0,605950
0,000000
0,000000
0,000000
0,000000
0,391617
0,358206
0,727872
0,581951
0,815688

0,282856
0,336757
0,336757
0,635067
0,635067
0,635067
0,400799
0,466071
0,400799
0,300899
0,300899
0,300899
0,241200
0,317533
0,301177
0,241200
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,112585
0,225171
0,225171
0,225171
0,225171
0,225171
0,225171
0,225171
0,225171
0,211500
0,220821
0,221400
0,106799
0,225171
0,337758
0,450344
0,450344
0,450344
0,450344
0,450344
0,450344
0,450344
0,291213
0,304071
0,304200
0,213599
0,450344
0,150114
0,150114
0,225171
0,450344

0,031429
0,037528
0,238957
0,589599
0,482933
0,482933
0,044534
0,051786
0,044534
0,033434
0,033434
0,033434
0,026800
0,197109
0,033465
0,026800
0,211700
0,034748
0,210986
0,199081
0,210986
0,211415
0,029557
0,035986
0,035415
0,034748
0,192081
0,208043
0,115495
0,208043
0,441257
0,207829
0,208043
0,207829
0,207829
0,023500
0,024536
0,024600
0,011867
0,207829
0,145575
0,656798
0,501084
0,656441
0,615989
0,176322
0,655989
0,655989
0,032358
0,033786
0,033800
0,023734
0,441656
0,374886
0,744552
0,606971
0,865727

cod ATC

505 C10AB05
506 C10AB05
507 C10AB05
508 C10AB05
509 D01AC02
510 D07AA02
511 D07AC01
512 D07AC01
513 D07AC01
514 G01AF04
515 G01AF04
516 G02AB03
517 G03BA03
518 G03BA03
519 G03BA03
520 G03BA03
521 G03CA03
522 G03CA03
523 G04CAN1
524 G04CAN1
525 G04CAN1
526 G04CAN1
527 G04CAN1
528 G04CAN1
529 G04CAN1
530 G04CAN1
531 H02AB04
532 H02AB04
533 H02AB04
534 H02AB07
535 H02AB07
536 H02AB07
537 H02AB07
538 H02AB09
539 H02AB09
540 H02AB09
541 H02AB09
542 H02AB09
543 J01AA02
544 J01AA02
545 J01AA02
546 J01CA04
547 J01CA04
548 J01CA04
549 J01CA04
550 J01CA04
551 J01CA04
552 J01CA04
553 J01CA04
554 J01CA04
555 J01CA04
556 J01CA04
557 J01CA04
558 J01CA04
559 J01CA04
560 J01CA04
561 J01CA04

DCI

FENOFIBRATUM
FENOFIBRATUM
FENOFIBRATUM
FENOFIBRATUM
MICONAZOLUM
HYDROCORTISONUM
BETAMETHASONUM
BETAMETHASONUM
BETAMETHASONUM
MICONAZOLUM
MICONAZOLUM
ERGOMETRINUM
TESTOSTERONUM*
TESTOSTERONUM*
TESTOSTERONUM*
TESTOSTERONUM*
ESTRADIOLUM*
ESTRADIOLUM*
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
METHYLPREDNISOLONUM*
METHYLPREDNISOLONUM*
METHYLPREDNISOLONUM*
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
DOXYCYCLINUM
DOXYCYCLINUM
DOXYCYCLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM

Denumire Comerciala

LIPOFIB 160 mg
LIPIVIM
LIPANTHYL SUPRA 160 mg
LIPANTIL NANO 145 mg
MICONAZOL NITRAT 2%
HIDROCORTIZON 1%
EKARZIN 0,5MG/G
BETADERM 1 mg/g
BETADERM 1mg/g
GYNOZOL 200
GYNOZOL 400

forma farm.

CAPS.
CAPS. PULB. MICRONIZATA

COMPR. FILM. 145mg

LAB. FOURNIER SA

P-6L
P-6L

FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. CU ELIB. MOD. P-6L


FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CREMA
2%
SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G
P-RF
UNGUENT
1%
ANTIBIOTICE SA
ROMANIA CUTIE X 1 TUB X 20 G
P-RF
CREMA
0,5mg/g
ANTIBIOTICE S.A.
ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA
P-RF
CREMA
1mg/g
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G
P-RF
UNGUENT
1mg/g
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G
P-RF
CAPS. VAG. 200mg
PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI
P-RF
CAPS. VAG. 400mg
PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI
P-RF
MALEAT DE ERGOMETRINA ZENTIVA 0,2 mg/ml SOL. INJ.
0,2mg/ml
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE P-RF
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
ANDROGEL 50 mg
GEL
50mg
LAB. BESINS INTERNATIONAL FRANTA CUTIE X 30 PLICURI DIN FOLIE PET/AL/PE X 5 G GEL P-RF
TESTIM 50 mg
GEL TRANSDERMIC 50mg
FERRING GMBH
GERMANIA CUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMICPR/PRF
NEBIDO 1000 mg/4 ml
SOL. INJ.
1000mg/4ml BAYER PHARMA AG GERMANIA CUTIE CU 1 FIOLA DIN STICLA BRUNA, CU CAPACITATEA DE 5 ML A 4 ML SOL. INJ.S/P-RF
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
CLIMARA
PLASTURE TRANSDERM. 50g/24ore
BAYER PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L
KAMIREN (vezi G04CAN1)
COMPR.
1mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
KAMIREN (vezi G04CAN1)
COMPR.
1mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
KAMIREN (vezi G04CAN1)
COMPR.
2mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
KAMIREN (vezi G04CAN1)
COMPR.
2mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
KAMIREN (vezi G04CAN1)
COMPR.
4mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L
KAMIREN (vezi G04CAN1)
COMPR.
4mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L
CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L
CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL. P-6L
SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE
P-RF
LEMOD SOLU 125 mg
125mg
STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF
LEMOD SOLU 500 mg
500mg
STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF
PREDNISON MCC 5 mg
COMPR.
5mg
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
PREDNISON ARENA 5 mg
COMPR.
5mg
ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF
PREDNISON 5 mg
COMPR.
5mg
SINTOFARM SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF
PREDNISON - RICHTER 5 mg COMPR.
5mg
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF
HYDROCORTISONE ROUSSEL COMPR.
10mg
CN UNIFARM
ROMANIA CUTIE X 1 FLAC. 25 COMPR.
PRF
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
HIDROCORTIZON HF 500 mg
500mg
STADA HEMOFARM S.R.L. ROMANIA
PR/PRF
HIDROCORTIZON HF 100 mg
100mg
STADA HEMOFARM S.R.L. ROMANIA
PR/PRF
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
DOXICICLINA ATB 100 mg
CAPS.
100 mg
ANTIBIOTICE S.A.
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF
DOXICICLINA ARENA
CAPS.
100mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
P-RF
DOXICICLINA SANDOZ 100 mg CAPS.
100mg
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
P-RF
AMOXICILINA ARENA 250 mg CAPS.
250mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
P-RF
AMOXICILINA ANTIBIOTICE 250 mg CAPS.
250mg
ANTIBIOTICE SA
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
P-RF
OSPAMOX 250 mg
CAPS.
250mg
SANDOZ GMBH
AUSTRIA CUTIE X 2 BLIST. AL-PVC/PVDC X 6 CAPS. P-RF/S
AMOXICILINA SANDOZ 250 mg CAPS.
250mg
SANDOZ SRL
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
P-RF
AMOXICILINA ANTIBIOTICE 500 mg CAPS.
500mg
ANTIBIOTICE SA
ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
P-RF
AMOXICILINA FORTE 500 mg CAPS.
500mg
FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS.
P-RF
AMOXICILINA FORTE 500 mg CAPS.
500mg
FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS.
P-RF
AMOXICILINA ARENA 500 mg CAPS.
500mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS.
P-RF
AMOXICILINA SANDOZ 500 mg CAPS.
500mg
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
P-RF
OSPAMOX 1000 mg
COMPR. FILM. 1000mg
SANDOZ GMBH
AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.P-RF
OSPAMOX 500 mg
COMPR. FILM. 500mg
SANDOZ GMBH
AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF
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
DUOMOX 1000 mg
COMPR. PT. DISPERSIE ORALA 1000mg
ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR.
P-RF
DUOMOX 250 mg
COMPR. PT. DISPERSIE ORALA 250mg
ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR.
P-RF
DUOMOX 500 mg
COMPR. PT. DISPERSIE ORALA 500mg
ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR.
P-RF
DUOMOX 750 mg
COMPR. PT. DISPERSIE ORALA 750mg
ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR.
P-RF
COMPR. ELIB. MODIF.

160mg

Prescriptie

Nr crt.

tara det.
concentratie
Detinator APP
APP
Ambalaj
160mg
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
200mg
VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
LABORATOIRES FOURNIER S.A.S.

CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV

PULB+SOLV. PT. SOL. INJ./PERF.


PULB+SOLV. PT. SOL. INJ./PERF.

PULB. + SOLV. PT. SOL. INJ./PERF.

CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV.

PULB. SI SOLV. PT. SOL. INJ./PERF.

CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV.

Pagina 10 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

30
0,754650
30
0,881000
30
0,754650
30
0,683901
1
4,633333
1
7,670000
1
7,670000
1
3,512400
1
3,512400
6
1,031666
3
1,976666
5
1,480000
60
0,818333
30
4,574333
30
4,832083
1 435,370000
1
6,415578
4
7,755000
30
0,148687
30
0,148687
30
0,297374
30
0,297374
30
0,594749
30
0,594749
28
0,594749
28
0,594749
1 16,565000
1
8,282500
1 31,020000
20
0,090333
30
0,090333
30
0,090333
20
0,090333
25
0,506800
1
3,527999
1 11,910000
1
3,527999
5
0,881999
10
0,376250
20
0,363000
10
0,361000
20
0,308000
20
0,314775
12
0,314775
20
0,314775
10
0,483636
10
0,483636
20
0,440500
10
0,483636
10
0,483636
12
0,910000
12
0,483636
21
0,959047
20
0,967273
20
0,314775
20
0,483636
20
0,725455

0,034350
0,000000
0,420016
0,486765
2,376667
0,000000
0,000000
2,247600
2,247600
0,000000
0,000000
0,000000
0,000000
0,000000
0,773250
0,000000
7,404422
0,000000
0,203646
0,203646
0,293292
0,293292
0,044251
0,044251
0,388465
0,388465
3,915000
0,527500
0,000000
0,046667
0,000000
0,033333
0,043167
0,000000
0,382001
0,000000
3,562001
3,544001
0,039750
0,000000
0,000000
0,000000
0,045225
0,055225
0,004225
0,123364
0,108364
0,000000
0,106364
0,009364
0,000000
0,008030
0,000000
0,008227
0,115225
0,115864
0,035545

0,679185
0,792900
0,679185
0,615510
4,169999
6,903000
6,903000
3,161160
3,161160
0,928499
1,778999
1,332000
0,736499
4,116899
4,348874
391,833000
5,774020
6,979500
0,133818
0,133818
0,267636
0,267636
0,535274
0,535274
0,535274
0,535274
14,908500
7,454250
27,918000
0,081299
0,081299
0,081299
0,081299
0,456120
3,175199
10,719000
3,175199
0,793799
0,338625
0,326700
0,324900
0,277200
0,283297
0,283297
0,283297
0,435272
0,435272
0,396450
0,435272
0,435272
0,819000
0,435272
0,863142
0,870545
0,283297
0,435272
0,652909

0,109815
0,088100
0,495481
0,555156
2,840001
0,767000
0,767000
2,598840
2,598840
0,103167
0,197667
0,148000
0,081834
0,457434
1,256459
43,537000
8,045980
0,775500
0,218515
0,218515
0,323030
0,323030
0,103726
0,103726
0,447940
0,447940
5,571500
1,355750
3,102000
0,055701
0,009034
0,042367
0,052201
0,050680
0,734801
1,191000
3,914801
3,632201
0,077375
0,036300
0,036100
0,030800
0,076703
0,086703
0,035703
0,171728
0,156728
0,044050
0,154728
0,057728
0,091000
0,056394
0,095905
0,104955
0,146703
0,164228
0,108091

cod ATC

562 J01CA04
563 J01CA04
564 J01CA04
565 J01CE02
566 J01CE02
567 J01CE02
568 J01CE02
569 J01CE08
570 J01CE08
571 J01CF04
572 J01CF04
573 J01CF04
574 J01CF04
575 J01CF04
576 J01CF04
577 J01CF04
578 J01CF04
579 J01CF04
580 J01CF04
581 J01CF04
582 J01CF04
583 J01CF04
584 J01CF04
585 J01CF04
586 J01CR02
587 J01CR02
588 J01CR02
589 J01CR02

DCI

Denumire Comerciala

AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
PHENOXYMETHYLPENICILLINUM
PHENOXYMETHYLPENICILLINUM
PHENOXYMETHYLPENICILLINUM
PHENOXYMETHYLPENICILLINUM

AMOXICILINA SANDOZ 125 mg/5 ml

forma farm.

concentratie

Detinator APP

SANDOZ S.R.L.
AMOXICILINA SANDOZ 250 mg/ 5 ml
SANDOZ S.R.L.
OSPAMOX 250 mg/5 ml
SANDOZ GMBH
AUSTRIA
OSPEN (R) 1000
SANDOZ GMBH
AUSTRIA
OSPEN 1500
SANDOZ GMBH
AUSTRIA
OSPEN (R) 500
SANDOZ GMBH
AUSTRIA
OSPEN 400.000 U.I./5 ml
SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH
AUSTRIA
BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ. 1200000UI
ANTIBIOTICE S.A.
ROMANIA
BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ. 1200000UI
ANTIBIOTICE S.A.
ROMANIA
OXACILLINUM
OXACILINA ARENA 250 mg CAPS.
250mg
ARENA GROUP SA ROMANIA
OXACILLINUM
OXACILINA 250 mg
CAPS.
250mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA SANDOZ 250 mg CAPS.
250mg
SANDOZ SRL
ROMANIA
OXACILLINUM
OXACILINA 500 mg
CAPS.
500mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ARENA 500 mg CAPS.
500mg
ARENA GROUP SA ROMANIA
OXACILLINUM
OXACILINA FORTE 500 mg CAPS.
500mg
FARMEX COMPANY SRL ROMANIA
OXACILLINUM
OXACILINA SANDOZ 500 mg CAPS.
500mg
SANDOZ SRL
ROMANIA
OXACILLINUM
OXACILINA ATB 1000 mg
PULB. PT. SOL. INJ./PERF. 1000mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ATB 1000 mg
PULB. PT. SOL. INJ./PERF. 1000mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ATB 500 mg
PULB. PT. SOL. INJ./PERF. 500mg
ANTIBIOTICE S.A.
ROMANIA
OXACILLINUM
OXACILINA ATB 500 mg
PULB. PT. SOL. INJ./PERF. 500mg
ANTIBIOTICE S.A.
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 500 mg
500mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 500 mg
500mg
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 1 g
1g
ANTIBIOTICE SA
ROMANIA
OXACILLINUM
OXACILINA ANTIBIOTICE 1 g
1g
ANTIBIOTICE SA
ROMANIA
AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg
COMPR. FILM. 1000mg
LEK PHARMACEUTICALS D.D. SLOVENIA
AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 500 mg/125mg
COMPR. FILM. 500 mg/125 mg RANBAXY UK LIMITED MAREA BRITANIE
AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500/125 mg
COMPR. FILM. 500/125mg ANTIBIOTICE S.A.
ROMANIA
AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA BRITANIE

590 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM


591 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM
592 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM
593 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM
594 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM

599 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM

AMOKSIKLAV 156,25mg/5ml
AMOKSIKLAV 2x
AMOKSIKLAV 2x

600 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM

AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml

598 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM

P-RF
P-RF

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 20 G PULB. PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE PE CU GRADATII PT. 1,25 ML, 2,5 ML, 5 ML

CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE

P-RF

CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF


CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM.

P-RF

CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF


CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE

P-RF

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M.

P-RF

CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M.
S/P-RF

CUTIE X 2 BLIST. AL/PVC X 10 CAPS.


CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE X 1 BLIST. X 10 CAPS.
CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE X 1 BLIST. AL/PVC X 10 CAPS.

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

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF
CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF.

PRF

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF
CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF.

PRF

CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S

PULB. PT. SOL. INJ./PERF. I.M./I.V.

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V.

PULB. PT. SOL. INJ./PERF.I.M./I.V.

CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S

PULB. PT. SOL. INJ./PERF.I.M./I.V.

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V.

P-RF

CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM.


CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM.

P-RF

CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM.

P-RF

COMPR. FILM.
AMOKSIKLAV 2 x 625 mg
COMPR. FILM.
AMOXIPLUS 875 mg/125 mg COMPR. FILM.
AUGMENTIN 875 mg/125 mg COMPR. FILM.
AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM.

596 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg

Ambalaj
CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE

PULB. PT. SOL. INJ./PERF. I.M./I.V.

AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg

595 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg


597 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM

125mg/5ml
PULB. PT. SUSP. ORALA 250mg/5ml
PULB. PT. SUSP. ORALA 250mg/5ml
COMPR. FILM. 1000000ui
COMPR. FILM. 1500000ui
COMPR. FILM. 500000ui
PULB. PT. SUSP. ORALA

Prescriptie

Nr crt.

tara det.
APP
ROMANIA
ROMANIA

500mg/125mg

AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT

P-RF

P-RF

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF

625mg

PULB. PT. SUSP. ORALA

LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 14 COMPR. FILM. P-RF
875mg/125mg ANTIBIOTICE S.A.
ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF
875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE
P-RF
875mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF
1000mg
BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF
625mg
BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF
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
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
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

COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE

COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE

PULB. PT. SUSP. ORALA


PULB. PT. SUSP. ORALA

CUTIE X 2 BLISTERE PVC-PVDC/AL X 7 COMPRIMATE FILMATE, FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTOARE DIN AL LAMINAT, CONTINAND UN DESICANT

MALTA

PRF

PULB. PT. SUSP. ORALA

400mg/57mg/5ml

601 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml

PULB. PT. SUSP. ORALA

400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALA

P-RF

602 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml

PULB. PT. SUSP. ORALA

400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE

P-RF

603 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml

PULB. PT. SUSP. ORALA

400mg/57mg/5ml SMITHKLINE BEECHAM LTD. MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE

P-RF

SMITHKLINE BEECHAM LTD. MAREA BRITANIE

CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE

P-RF

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

604 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM


605 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM
606 J01DB01
607 J01DB01
608 J01DB01
609 J01DB01
610 J01DB01
611 J01DB01
612 J01DB01
613 J01DB01
614 J01DB01
615 J01DB01
616 J01DB01
617 J01DB01
618 J01DB01

CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM

AUGMENTIN (R) ES
PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml
AMOKSIKLAV 312,5mg/5ml
PULB. PT.SUSP. ORALA 312,5mg/5ml
CEFALEXINA ARENA 250 mg CAPS.
250mg
CEFALEXINA ATB 250 mg
CAPS.
250mg
OSPEXIN (R) 250 mg
CAPS.
250mg
CEFALEXIN SANDOZ 250 mg CAPSULE CAPS.
250mg
CEFALEXINA ATB 500 mg
CAPS.
500mg
CEFALEXINA ARENA 500 mg CAPS.
500mg
CEFALEXIN SANDOZ
CAPS.
500mg
OSPEXIN 1000 mg
COMPR. FILM. 1000mg
OSPEXIN 500 mg
COMPR. FILM. 500mg
KEFLEX (R) 125 mg/5 ml
GRAN. PT. SUSP. ORALA 125mg/5ml
OSPEXIN (R) 125 mg/5 ml
GRAN. PT. SUSP. ORALA 125mg/5ml
GRAN. PT. SUSP. ORALA 125mg/5ml
KEFLEX (R) 250 mg/5 ml
GRAN. PT. SUSP. ORALA 250mg/5ml

CEFALEXIN SANDOZ 125 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA

AUROBINDO PHARMA (MALTA) LIMITED

ARENA GROUP SA
ANTIBIOTICE SA
SANDOZ GMBH
SANDOZ SRL
ANTIBIOTICE SA
ARENA GROUP SA
SANDOZ S.R.L.
SANDOZ GMBH
SANDOZ GMBH
ACTAVIS GROUP HF
SANDOZ GMBH
SANDOZ SRL
ACTAVIS GROUP HF

ROMANIA
ROMANIA
AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
AUSTRIA
AUSTRIA
ISLANDA
AUSTRIA
ROMANIA
ISLANDA

CUTIE CU 1 FLAC. PEID CARE CONTINE PULB. PT. SUSP. ORALA PT. OBTINEREA A 35 ML SUSP. RECONSTITUITA + 1 SERINGA DE POLISTIREN CU GRADATII LA INTERVALE DE 0,5 ML

CUTIE X 2 BLIST. AL/PVC X 10 CAPS.


CUTIE X 2 BLIST. X 10 CAPS.

P-RF

CUTIE X 1 BLIST. PVC-PVDC/AL X 12 CAPS.


CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS.

P-RF

CUTIE X 1 BLIST. X 10 CAPS.


CUTIE X 1 BLIST. PVC/AL X 10 CAPS.

P-RF

CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS.

P-RF

P-RF

P-RF

P-RF

CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF


CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF
CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE

P-RF

CUTIE X 1 FLAC. X 33 G GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA PP

P-RF
P-RF

CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE

CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE

Pagina 11 din 21

P-RF

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

1
1
1
12
12
12
1
1
100
20
20
20
10
10
20
10
1
100
1
100
100
1
100
1
14
28
14
14
14
14
14
14
14
14
14
1
1
1
1
1
1
1
1
1
20
20
12
10
10
10
10
12
12
1
1
1
1

1,888650
3,777300
3,777300
0,299166
0,457031
0,152343
0,203124
4,970048
4,662700
0,307220
0,307220
0,307220
0,614440
0,614440
0,558500
0,614440
5,303075
4,622300
2,651537
2,651537
2,651537
2,651537
4,622300
5,303075
0,962142
0,570254
0,570254
0,570254
0,570254
0,570254
0,962142
0,997945
0,962142
0,997945
0,570254
5,986607
6,700000
13,410000
6,700000
6,705000
6,705000
13,410000
28,735714
11,973214
0,467549
0,467549
0,467549
0,467549
0,935099
0,934000
0,935099
1,365000
0,935099
5,307500
5,307500
5,307500
10,615000

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

4,061350
1,232700
1,212700
0,000000
0,070469
0,073490
8,716876
0,619952
0,000000
0,061280
0,084280
0,092780
0,163560
0,028560
0,000000
0,115560
0,226925
0,000000
2,448463
1,668063
1,668063
2,448463
0,000000
0,226925
0,000000
0,020817
0,020460
0,339031
0,020460
0,020460
0,000000
0,481340
0,000000
0,859912
0,654746
4,833393
0,000000
0,000000
0,000000
3,615000
3,615000
7,220000
6,844286
7,026786
0,150451
0,155951
0,149951
0,153451
0,155901
0,000000
0,103901
0,000000
0,092401
1,122500
1,842500
1,842500
0,265000

1,699785
3,399570
3,399570
0,269249
0,411327
0,137108
0,182811
4,473043
4,196430
0,276498
0,276498
0,276498
0,552996
0,552996
0,502650
0,552996
4,772767
4,160070
2,386383
2,386383
2,386383
2,386383
4,160070
4,772767
0,865927
0,513228
0,513228
0,513228
0,513228
0,513228
0,865927
0,898150
0,865927
0,898150
0,513228
5,387946
6,030000
12,069000
6,030000
6,034500
6,034500
12,069000
25,862142
10,775892
0,420794
0,420794
0,420794
0,420794
0,841589
0,840600
0,841589
1,228500
0,841589
4,776750
4,776750
4,776750
9,553500

4,250215
1,610430
1,590430
0,029917
0,116173
0,088725
8,737189
1,116957
0,466270
0,092002
0,115002
0,123502
0,225004
0,090004
0,055850
0,177004
0,757233
0,462230
2,713617
1,933217
1,933217
2,713617
0,462230
0,757233
0,096215
0,077843
0,077486
0,396057
0,077486
0,077486
0,096215
0,581135
0,096215
0,959707
0,711772
5,432054
0,670000
1,341000
0,670000
4,285500
4,285500
8,561000
9,717858
8,224108
0,197206
0,202706
0,196706
0,200206
0,249411
0,093400
0,197411
0,136500
0,185911
1,653250
2,373250
2,373250
1,326500

cod ATC

619 J01DB01
620 J01DB01
621 J01DB05
622 J01DB05
623 J01DB05
624 J01DB05
625 J01DB05
626 J01DB05
627 J01DC02
628 J01DC02
629 J01DC02
630 J01DC02
631 J01DC02
632 J01DC02
633 J01DC02
634 J01DC02
635 J01DC02
636 J01DC02
637 J01DC04
638 J01DC04
639 J01DC04
640 J01DC04
641 J01DC04
642 J01DC04
643 J01DC04
644 J01DC04
645 J01DC04
646 J01DC04
647 J01DC04
648 J01DC04
649 J01DC04
650 J01DC04
651 J01DC04
652 J01DC04
653 J01DC04
654 J01DC04
655 J01DC04
656 J01DC04
657 J01DC04
658 J01DC04
659 J01DD08
660 J01DD08
661 J01DD08
662 J01DD08

DCI

CEFALEXINUM
CEFALEXINUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFADROXILUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFUROXIMUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM

663 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM


664 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM
665 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM
666 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM
667 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM
668 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM
669 J01FA01
670 J01FA01
671 J01FA01
672 J01FA01
673 J01FA09
674 J01FA09
675 J01FA09

ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM

Denumire Comerciala
CEFALEXIN SANDOZ 250 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA

OSPEXIN (R) 250 mg/5 ml


CEXYL 250 mg
CEXYL 500 mg
CEFORAN 500 mg
CEXYL 1000 mg
CEXYL 125 mg/5 ml
CEXYL 250 mg/5 ml

forma farm.
GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA

CAPS.
CAPS.
CAPS.
COMPR. FILM.
GRAN. PT. SUSP. ORALA

GRAN. SUSP. ORALA

COMPR.
CEFUROXIMA ANTIBIOTICE 250 mg COMPR.
CEFUROXIMA AUROBINDO 250 mg COMPR.
CEFUROXIMA ANTIBIOTICE 500 mg COMPR.
CEFUROXIMA ANTIBIOTICE 500 mg COMPR.
CEFUROXIMA AUROBINDO 500 mg COMPR.
ZINNAT (R) 125 mg
COMPR. FILM.
ZINNAT (R) 250 mg
COMPR. FILM.
ZINNAT (R) 500 mg
COMPR. FILM.
ZINNAT
GRAN. PT. SUSP. ORALA
CEFACLOR ARENA 250 mg CAPS.
CLORACEF (R) 250
CAPS.
CEFACLOR TERAPIA 250 mg CAPS.
CLORACEF (R) FORTE 500 CAPS.
CEFACLOR ARENA 500 mg CAPS.
CEFACLOR TERAPIA 500 mg CAPS.
CECLOR MR 500 mg
COMPR. CU ELIB. PREL.
CECLOR MR 750 mg
COMPR. CU ELIB. PREL.
CEFACLOR TERAPIA MR 375 COMPR. ELIB. PREL.
CEFACLOR TERAPIA MR 750 COMPR. ELIB. PREL.
CECLODYNE (R) MR 375 mg COMPR. FILM. ELIB. MODIF.
CECLODYNE (R) MR 500 mg COMPR. FILM. ELIB. MODIF.
CECLODYNE (R) MR 750 mg COMPR. FILM. ELIB. MODIF.
CECLOR (R) 125 mg/5 ml
GRAN. PT. SUSP. ORALA
CEFUROXIMA ANTIBIOTICE 250 mg

CEFACLOR TERAPIA 125mg/5ml


CEFACLOR TERAPIA 250mg/5ml
CEFACLOR TERAPIA 250mg/5ml

CECLOR (R) 250 mg/5 ml


CLORACEF (R) 125
CEFAKLOR 125 mg/5 ml
CLORACEF (R) 250
CEFAKLOR 250 mg/5 ml
EFICEF 100 mg
EFICEF (R) 200 mg
XIFIA 400mg
XIFIA 400mg
TAGREMIN
SUMETROLIM
CO - TRIM ELL
BITRIM 400mg/80mg
EPITRIM
SUMETROLIM
ERITROMAGIS 200 mg
ERITROMICINA 200 mg

GRAN. PT. SUSP. ORALA


GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA

CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.

COMPR.
COMPR.
COMPR.
COMPR.

concentratie

250mg/5ml
250mg/5ml
250mg
500mg
500mg
1000mg
125mg/5ml
250mg/5ml
250mg
250mg
250mg
500mg
500mg
500mg
125mg
250mg
500mg
125mg/5ml
250mg
250mg
250mg
500mg
500mg
500mg
500mg
750mg
375mg
750mg
375mg
500mg
750mg
125mg/5ml
125mg/5ml
250 mg/5 ml
250 mg/5 ml
250mg/5ml
125mg/5ml
125mg/5ml
250mg/5ml
250mg/5ml
100mg
200mg
400mg
400mg
400mg/80mg
400mg/80mg
400mg/80mg
400mg/80mg

Detinator APP

SANDOZ SRL
SANDOZ GMBH
SANDOZ S.R.L.
SANDOZ S.R.L.
ANTIBIOTICE S.A.
SANDOZ S.R.L.
SANDOZ S.R.L.
SANDOZ S.R.L.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.

Prescriptie

Nr crt.

tara det.
APP
ROMANIA

Ambalaj

P-RF

CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE

AUROBINDO PHARMA ROMANIA S.R.L.

AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

GLAXOWELLCOME UK LTD.

MAREA BRITANIE

GLAXOWELLCOME UK LTD.

MAREA BRITANIE

GLAXOWELLCOME UK LTD.

MAREA BRITANIE

CUTIE X 1 BLIST. X 10 COMPR. FILM.


CUTIE X 1 BLIST. X, 10 COMPR.FILM
CUTIE X 1 BLIST. X 10 COMPR.FILM

GLAXO WELLCOME UK LTD.

MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA BRUNA CONTINAND GRANULE PT. 50 ML SUSP. ORALA + 1 MASURA DOZATOARE

ARENA GROUP SA

ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ISLANDA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

CUTIE X 1 BLIST. AL/PVC X 10 CAPS.


CUTIE X 2 BLIST. X 8 CAPS.

P-RF

CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS.

P-RF

CUTIE X 2 BLIST. X 8 CAPS.


CUTIE CU 1 BLIST. AL/PVC X 10 CAPS.

P-RF

CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS.

P-RF

AUROBINDO PHARMA ROMANIA S.R.L.

ANTIBIOTICE S.A.
ANTIBIOTICE S.A.

DAR AL DAWA PHARMA S.R.L.

TERAPIA SA
DAR AL DAWA PHARMA S.R.L.

ARENA GROUP S.A.


TERAPIA SA
ACTAVIS GROUP HF
ACTAVIS GROUP HF
TERAPIA SA
TERAPIA SA
SANDOZ SRL
SANDOZ SRL
SANDOZ SRL
ACTAVIS GROUP HF
TERAPIA SA
TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF
DAR AL DAWA PHARMA S.R.L.

STADA HEMOFARM S.R.L.


DAR AL DAWA PHARMA S.R.L.

STADA HEMOFARM S.R.L.

ANTIBIOTICE S.A.
ANTIBIOTICE SA
INN-FARM D.O.O.
INN-FARM D.O.O.
ZENTIVA S.A.

SLOVENIA
SLOVENIA

ROMANIA
EGIS PHARMACEUTICALS P.L.C. UNGARIA
BIO EEL SRL
ROMANIA
ARENA GROUP S.A. ROMANIA
SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA
SUSP. ORALA 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA
COMPR.
200mg
ARENA GROUP SA ROMANIA
COMPR.
200mg
ANTIBIOTICE SA
ROMANIA
ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR.
200mg
SANDOZ S.R.L.
ROMANIA
ERITROMICINA ATB 200 mg COMPR.
200mg
ANTIBIOTICE SA
ROMANIA
CLAXIRIT 500 mg
COMPR. CU ELIB. PREL. 500mg
ACTAVIS GROUP PTC EHF. ISLANDA
KLACID SR
COMPR. ELIB. PREL. 500mg
ABBOTT LABORATORIES LTD. MAREA BRITANIE
CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg
TEVA PHARMACEUTICALS S.R.L. ROMANIA

CUTIE X 1 FLAC. X 33G GRANULE PT. 60ML SUSP.+ LINGURITA DOZATOARE X 5MLP-RF

CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS.


CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS.

P-RF

CUTIE CU 1 BLIST. PVC/AL X 10 CAPS.

P-RF

P-RF

CUTIE X 1 BLIST. PVC/PVDC X 10. COMPR. FILM. P-RF


CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE

P-RF

CUTIE X 1 FLAC. CU GRAN. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE

P-RF

CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR.


CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR.
CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR.
CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR.
CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR.
CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR.

P-RF

P-RF

P-RF

PRF
P-RF
P-RF

PRF
P-RF
P-RF
P-RF

P-RF

P-RF

CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF


CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF

CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. ELIB. PREL.

P-RF

CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL.

P-RF

CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF.

P-RF

CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF.

P-RF

CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF.

P-RF

CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE

P-RF

CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA

P-RF

CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA

P-RF

CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 100 ML SUSP. ORALA P-RF
CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE

P-RF

CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE

P-RF

CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE

P-RF

CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE

P-RF

CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE

P-RF

CUTIE CU 1 BLIST. PVC/AL X 10 CAPS.


CUTIE X 1 BLIST. AL/PVC X 10 CAPS.

P-RF

CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE

PRF

PRF

CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE

PRF

CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-RF

CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML

P-RF

CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE

P-RF

CUTIE X 2 BLIST. X 10 COMPR.


CUTIE X 2 BLIST. X 10 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.
CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.

P-RF

CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL.

PRF

P-RF
P-RF
P-RF

P-RF
P-RF

PRF

CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. ELIB. PREL. P-RF


CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF

Pagina 12 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

1
1
10
10
10
10
1
1
10
10
10
10
10
10
10
10
10
1
10
16
15
16
10
15
10
10
10
10
10
10
10
1
1
1
1
1
1
1
1
1
10
10
5
10
20
20
20
20
1
1
20
20
20
20
7
5
6

9,820000
9,820000
0,467549
0,935099
0,935099
1,870199
5,307500
10,615000
0,982800
0,982800
0,982800
1,863000
1,863000
1,863000
1,076700
0,982800
1,965600
10,767000
0,491400
0,491400
0,491400
0,982800
0,982800
0,982800
0,982800
1,474200
0,737100
1,474200
0,737100
0,982800
1,474200
8,075250
8,075250
16,150500
17,950000
16,150500
8,075250
6,460200
16,150500
12,920400
1,915987
3,609000
7,663950
7,663950
0,360750
0,348000
0,360750
0,360750
4,710000
4,205531
0,367500
0,382692
0,382692
0,382692
1,913463
1,913463
1,913463

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,000000
0,000000
1,456451
0,460901
0,415901
0,842801
7,192500
0,955000
0,109200
0,109200
0,109200
0,000000
0,000000
0,000000
0,054300
0,698200
0,900400
9,373000
1,081600
0,896100
0,463933
0,782200
1,911200
0,783200
1,733200
2,238800
2,557900
1,020800
2,811900
0,783200
1,020800
5,854750
0,984750
1,799500
0,000000
11,459500
0,984750
2,599800
1,789500
3,609600
0,321013
0,000000
2,356050
1,852050
0,039750
0,000000
0,004250
0,039750
0,000000
5,654469
0,000000
0,114808
0,039308
0,114808
0,520822
1,834537
0,521537

8,838000
8,838000
0,420794
0,841589
0,841589
1,683179
4,776750
9,553500
0,884520
0,884520
0,884520
1,676700
1,676700
1,676700
0,969030
0,884520
1,769040
9,690300
0,442260
0,442260
0,442260
0,884520
0,884520
0,884520
0,884520
1,326780
0,663390
1,326780
0,663390
0,884520
1,326780
7,267725
7,267725
14,535450
16,155000
14,535450
7,267725
5,814180
14,535450
11,628360
1,724388
3,248100
6,897555
6,897555
0,324675
0,313200
0,324675
0,324675
4,239000
3,784977
0,330750
0,344422
0,344422
0,344422
1,722116
1,722116
1,722116

0,982000
0,982000
1,503206
0,554411
0,509411
1,029821
7,723250
2,016500
0,207480
0,207480
0,207480
0,186300
0,186300
0,186300
0,161970
0,796480
1,096960
10,449700
1,130740
0,945240
0,513073
0,880480
2,009480
0,881480
1,831480
2,386220
2,631610
1,168220
2,885610
0,881480
1,168220
6,662275
1,792275
3,414550
1,795000
13,074550
1,792275
3,245820
3,404550
4,901640
0,512612
0,360900
3,122445
2,618445
0,075825
0,034800
0,040325
0,075825
0,471000
6,075023
0,036750
0,153078
0,077578
0,153078
0,712169
2,025884
0,712884

cod ATC

676 J01FA09
677 J01FA09
678 J01FA09
679 J01FA09
680 J01FA09
681 J01FA09
682 J01FA09
683 J01FA09
684 J01FA09
685 J01FA09
686 J01FA09
687 J01FA09
688 J01FA09
689 J01FA09
690 J01FA09
691 J01FA09
692 J01FA09
693 J01FA09
694 J01FA09
695 J01FA09
696 J01FA09
697 J01FA09
698 J01FA09
699 J01FA09
700 J01MA01
701 J01MA01
702 J01MA02
703 J01MA02
704 J01MA02
705 J01MA02
706 J01MA02
707 J01MA02
708 J01MA02
709 J01MA02
710 J01MA02
711 J01MA02
712 J01MA02
713 J01MA02
714 J01MA02
715 J01MA02
716 J01MA02
717 J01MA02
718 J01MA02
719 J01MA02
720 J01MA02
721 J01MA02
722 J01MA02
723 J01MA03
724 J01MA06
725 J01MA06
726 J01MA06
727 J01MB02
728 J01XD01
729 J01XD01
730 J01XD01
731 J01XD01
732 J01XD01

DCI

CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
CLARITHROMYCINUM
OFLOXACINUM
OFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
PEFLOXACINUM
NORFLOXACINUM
NORFLOXACINUM
NORFLOXACINUM
ACIDUM NALIDIXICUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM

Denumire Comerciala

forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CLARITROMICINA TEVA 250 mg COMPR. FILM.
LEKOKLAR 250 mg
COMPR. FILM.
CLARITROMICINA AUROBINDO 250 mg COMPR. FILM.
KLERIMED (R) 500
COMPR. FILM.
KLABAX 500 mg
COMPR. FILM.
FROMILID 500
COMPR. FILM.
ROCLARIN 500 mg
COMPR. FILM.
CLAR 500
COMPR. FILM.
CLARITROMICINA TEVA 500 mg COMPR. FILM.
LEKOKLAR 500 mg
COMPR. FILM.
CLARITROMICINA AUROBINDO 500 mg COMPR. FILM.

KLACID (R)
KLERIMED (R) 250
KLABAX 250 mg
FROMILID 250

FROMILID (R) UNO


KLACID (R)
KLACID (R)
LEKOKLAR 125 mg/5 ml
KLABAX 125 mg/5 ml
KLABAX 250 mg/5 ml
KLABAX 250 mg/5 ml
LEKOKLAR 250 mg/5 ml
KLACID I.V.
ZANOCIN
OFLOXIN 200

COMPR. FILM. ELIB. PREL.

GRAN. PT. SUSP. ORALA


GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA
GRAN. PT. SUSP. ORALA

PULB. PT. SOL. PERF.

COMPR. FILM.
COMPR. FILM.
CIPROFLOXACINA ARENA 100 mg COMPR. FILM.
CIPROFLOXACINA ARENA 100 mg COMPR. FILM.
CIPROCIN 250 mg
COMPR. FILM.
CIPRINOL 250 mg
COMPR. FILM.
CIPROLEN (R) 250 mg
COMPR. FILM.
CUMINOL 250 mg
COMPR. FILM.
CIFRAN
COMPR. FILM.
CIPROFLOXACINA ARENA 250 mg COMPR. FILM.
CIPROFLOXACINA ARENA 250 mg COMPR. FILM.
CIPRINOL 500 mg
COMPR. FILM.
CIPROCIN 500 mg
COMPR. FILM.
CIPROLEN (R) 500 mg
COMPR. FILM.
CUMINOL 500 mg
COMPR. FILM.
CIFRAN
COMPR. FILM.
CIPRO QUIN (R)
COMPR. FILM.
CIPROFLOXACINA ARENA 500 mg COMPR. FILM.
CIPROFLOXACINA ARENA 500 mg COMPR. FILM.
CIPRINOL 750 mg
COMPR. FILM.
CIPROFLOXACINA ARENA 750 mg COMPR. FILM.

CIPROBAY XR 1000 mg
COMPR. FILM. ELIB. PREL.
CIPROBAY XR 500 mg
COMPR. FILM. ELIB. PREL.
PEFLOXACIN LAROPHARM COMPR. FILM.
NORFLOXACINA LPH 400 mg COMPR. FILM.
NOLICIN 400 mg
COMPR. FILM.
NORFLOXACIN HELCOR 400 mg COMPR. FILM.

NALIXID 500 mg
METRONIDAZOL ARENA 250 mg (J01XD01)
METRONIDAZOL ARENA 250 mg (J01XD01)

FLAGYL ( vezi J01XD01)


FLAGYL ( vezi J01XD01)
METRONIDAZOL A 5 g/l

CAPS.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.

SOL. PERF.

concentratie

250mg
250mg
250mg
250mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
125mg/5ml
125mg/5ml
125mg/5ml
125mg/5ml
250mg/5ml
250mg/5ml
250mg/5ml
500mg
200mg
200mg
100mg
100mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
750mg
750mg
1000 mg
500 mg
400mg
400mg
400mg
400mg
500mg
250mg
250mg
250mg
250mg
5g/l

Detinator APP

ABBOTT S.R.L.
MEDOCHEMIE LTD.
TERAPIA SA

Ambalaj

ITALIA
CUTIE X 1 BLIST. X 14 COMPR. FILM.
CIPRU
CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.
ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.

Prescriptie

Nr crt.

tara det.
APP

P-RF
P-RF
P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF

ROMANIA
SANDOZ S.R.L.
ROMANIA
AUROBINDO PHARMA (MALTA) LIMITED MALTA
MEDOCHEMIE LTD. CIPRU
TERAPIA SA
ROMANIA

PRF

TEVA PHARMACEUTICALS S.R.L.

CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)

CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF


CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF
CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.

P-RF

CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF

ANTIBIOTICE S.A.

ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF


GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)
PRF
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF
KRKA D.D.
SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF
ABBOTT S.R.L.
ITALIA
P-RF
ABBOTT S.R.L.
ITALIA
P-RF
SANDOZ SRL
ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PPP-RF
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF
SANDOZ S.R.L.
ROMANIA
PRF
ABBOTT LABORATORIES LTD. FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. PERF. S/P-RF
RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
ZENTIVA K.S.
CEHIA
CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF
CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF

AC HELCOR SRL
GEDEON RICHTER ROMANIA SA

ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.


ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

RANBAXY UK LIMITED

MAREA BRITANIE

P-RF
P-RF

CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF

ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.


ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF
P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF

E.I.P.I.CO. MED S.R.L. ROMANIA


ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
RANBAXY UK LIMITED MAREA BRITANIE
ANTIBIOTICE SA
ROMANIA
ARENA GROUP S.A. ROMANIA
ARENA GROUP S.A. ROMANIA
KRKA D.D. NOVO MESTO SLOVENIA
ARENA GROUP S.A. ROMANIA

AC HELCOR SRL

CUTIE X 1 BLIST. X 10 COMPR. FILM.

P-RF

CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.


CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF
P-RF

CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF

CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.


CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF
P-RF
P-RF

CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF

CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF

BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL.
BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL.
LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

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

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

ROMANIA
ROMANIA
ROMANIA
ROMANIA
LABORATOIRE AVENTIS FRANTA
LABORATOIRE AVENTIS FRANTA
INFOMED FLUIDS SRL ROMANIA

A.C. HELCOR PHARMA S.R.L.

CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

ZENTIVA SA
ARENA GROUP SA
ARENA GROUP SA

CUTIE X 3 BLIST. AL/PVC X 10 CAPS.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-RF
P-RF
P-RF

CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF


CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

CUTIE X 12 FLACOANE X 200 ML

Pagina 13 din 21

S/P-RF

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

14
14
14
14
14
14
14
14
14
14
20
20
14
14
14
7
1
1
1
1
1
1
1
1
10
10
10
20
10
10
10
10
10
10
20
10
10
10
10
10
10
10
20
10
10
7
3
10
20
20
20
30
30
30
20
20
12

0,956731
0,956731
0,956731
0,956731
0,840714
0,842142
0,756428
1,911428
1,913463
1,913463
1,913463
1,913463
1,825000
1,911428
1,642142
1,913463
23,854500
14,312700
12,820000
12,820000
47,709000
28,625400
28,625400
39,540000
1,179000
1,216800
0,243360
0,243360
0,608400
0,608400
0,608400
0,608400
0,608400
0,608400
0,608400
1,183000
0,920000
1,216800
1,216800
0,911000
1,216800
0,957000
0,852000
1,031000
1,825200
2,433600
1,216800
1,216800
0,804000
0,792000
0,804000
1,013000
0,238666
0,238666
0,301762
0,301762
8,667500

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,990411
0,215411
0,130411
0,278983
0,000000
0,000000
0,000000
0,000000
0,125822
0,007965
0,335037
0,442537
0,000000
0,000000
0,000000
0,520822
6,125500
5,407300
0,000000
0,000000
5,301000
4,244600
1,234600
0,000000
0,000000
0,860200
3,627640
3,160640
0,074600
0,098600
0,074600
0,100600
0,111600
0,072600
0,029600
0,000000
0,000000
0,105200
0,154200
0,000000
0,154200
0,000000
0,000000
0,000000
2,045800
10,120685
8,336533
1,674200
0,012000
0,000000
0,076000
0,000000
0,000000
0,000000
0,065738
0,065738
0,000000

0,861057
0,861057
0,861057
0,861057
0,756642
0,757927
0,680785
1,720285
1,722116
1,722116
1,722116
1,722116
1,642500
1,720285
1,477927
1,722116
21,469050
12,881430
11,538000
11,538000
42,938100
25,762860
25,762860
35,586000
1,061100
1,095120
0,219024
0,219024
0,547560
0,547560
0,547560
0,547560
0,547560
0,547560
0,547560
1,064700
0,828000
1,095120
1,095120
0,819900
1,095120
0,861300
0,766800
0,927900
1,642680
2,190240
1,095120
1,095120
0,723600
0,712800
0,723600
0,911700
0,214799
0,214799
0,271585
0,271585
7,800750

1,086085
0,311085
0,226085
0,374657
0,084072
0,084215
0,075643
0,191143
0,317169
0,199312
0,526384
0,633884
0,182500
0,191143
0,164215
0,712169
8,510950
6,838570
1,282000
1,282000
10,071900
7,107140
4,097140
3,954000
0,117900
0,981880
3,651976
3,184976
0,135440
0,159440
0,135440
0,161440
0,172440
0,133440
0,090440
0,118300
0,092000
0,226880
0,275880
0,091100
0,275880
0,095700
0,085200
0,103100
2,228320
10,364045
8,458213
1,795880
0,092400
0,079200
0,156400
0,101300
0,023867
0,023867
0,095915
0,095915
0,866750

cod ATC

733 J01XD01
734 J01XD01
735 J01XD01
736 J01XD01
737 J01XD01
738 J01XD01
739 J02AC01
740 J02AC01
741 J02AC01
742 J02AC01
743 J02AC01
744 J02AC01
745 J02AC01
746 J02AC01
747 J02AC01
748 J02AC01
749 J02AC01
750 J02AC01
751 J02AC01
752 J02AC01
753 J02AC01
754 J02AC01
755 J02AC01
756 J02AC01
757 J02AC01
758 J02AC01
759 J02AC01
760 J02AC01
761 J02AC01
762 J02AC01
763 J02AC01
764 J02AC01
765 J02AC01
766 J02AC01
767 J02AC01
768 J02AC01
769 J02AC01
770 J05AB01
771 J05AB01
772 J05AB01
773 J05AB01
774 J05AB01
775 J05AB01
776 J05AB01
777 J05AB01
778 J05AB01
779 J05AB01
780 J05AB01
781 M01AB01
782 M01AB01
783 M01AB01
784 M01AB01
785 M01AB01
786 M01AB01
787 M01AB05
788 M01AB05
789 M01AB05

DCI

METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
FLUCONAZOLUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM

Denumire Comerciala

forma farm.

METRONIDAZOL A 5 g/l
METRONIDAZOL B 5 g/l
METRONIDAZOL B 5 g/l

SOL. PERF.
SOL. PERF.
SOL. PERF.
METRONIDAZOL BRAUN 5mg/ml SOL. PERF.
METRONIDAZOL BRAUN 5mg/ml SOL. PERF.
METRONIDAZOL BRAUN 5mg/ml SOL. PERF.
FLUCOVIM 100
CAPS.
FUNGOLON 100 mg
CAPS.
FLUCONAZOLE TEVA 100 mg CAPS.
FLUCONAZOL AUROBINDO 100 mg CAPS.
FLUCOVIM 150
CAPS.
DIFLUCAN 150 mg
CAPS.
FLUCORIC 150 mg
CAPS.
FLUCONAZOL SANDOZ (R) 150 CAPS.
FLUCONAZOLE TEVA 150 mg CAPS.
FLUCONAZOL 150 mg
CAPS.
FLUCONAZOL MEDOCHEMIE 150 mg CAPS.
FLUCONAZOL BIOGALENICA 150 mg CAPS.
FLUCONAZOL ARENA 150 MG CAPS.
FLUCONAZOL ACTAVIS 150 mg CAPS.
FLUCONAZOL LPH 150 mg
CAPS.
FLUCONAZOL ROMPHARM 150 mg CAPS.
FLUCONAZOL AUROBINDO 150 mg CAPS.
FLUCONAZOL ZENTIVA 150 mg CAPS.
FLUCONAZOLE TEVA 200 mg CAPS.
FLUCOVIM 50
CAPS.
DIFLUCAN 50 mg
CAPS.
FLUCORIC 50 mg
CAPS.
FLUCONAZOL SANDOZ (R) 50 CAPS.
FLUCONAZOLE TEVA 50 mg CAPS.
FLUCONAZOL 50 mg
CAPS.
FLUCONAZOL MEDOCHEMIE 50 mg CAPS.
FLUCONAZOL ARENA 50 MG CAPS.
FLUCONAZOL LPH 50 mg
CAPS.
FLUCONAZOL AUROBINDO 50 mg CAPS.
DIFLUCAN 10 mg/ml
PULB. PT. SUSP. ORALA
DIFLAZON 2mg/ml
SOL. PERF.
ACICLOVIR 200 mg
CAPS.
ACICLOVIR ARENA 200 mg CAPS.
ACICLOVIR FARMEX 200 mg CAPS.
ACICLOVIR ARENA 400 mg CAPS.
ACICLOVIR TERAPIA 200 mg COMPR.
ACICLOVIR 200 mg
COMPR.
ACICLOVIR 200 mg
COMPR.
ACICLOVIR LAROPHARM 200 mg COMPR.
ACICLOVIR-RICHTER 200 mg COMPR.
ACICLOVIR 400 mg
COMPR.
VIROLEX
PULB. PT. SOL. INJ./PERF.
INDOMETACIN LAROPHARM 25 mg CAPS.
INDOMETACIN ARENA 25 MG CAPS.
INDOMETACIN ARENA 50 MG CAPS.
INDOMETACIN 50 mg
SUPOZ.
INDOMETACIN 50 mg
SUPOZ.
INDOMETACIN 50 mg
SUPOZ.
DICLOREUM 150 mg
CAPS. ELIB. PREL.
DICLOFENAC DUO PHARMASWISS 75 mg

CAPS. ELIB. PREL.

DICLOTARD 100 mg

COMPR. CU ELIB. PREL.

5mg/ml
5mg/ml
5mg/ml
100mg
100mg
100mg
100mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
200mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
10mg/ml
2mg/ml
200mg
200mg
200mg
400mg
200mg
200mg
200mg
200mg
200mg
400mg
250mg
25mg
25mg
50mg
50mg
50mg
50mg
150mg
75mg
100mg

Prescriptie

Nr crt.

tara det.
concentratie
Detinator APP
APP
Ambalaj
5g/l
INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML
5g/l
INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML
5g/l
INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML

S/P-RF
S/P-RF
S/P-RF

B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF.

S/P-RF

B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL. PERF.

S/P-RF

B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL. PERF.

S/P-RF

VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS.


P-RF
BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS.
P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS.PRF
VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS.
P-RF
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF
SANDOZ SRL
GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF
SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
LABORATOARELE PROF.DR.MORAIT S.R.L.
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF
ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF
LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS.
PRF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS.
PRF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS.
PRF
ZENTIVA K.S.
REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS.
P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF
VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS.
P-RF
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS.
P-RF
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS.
P-RF
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF
SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS.
P-RF
MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS.
P-RF
ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS.
P-RF
LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS.
PRF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS.PRF
PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 1 FLACON PEID DE CAPACITATE 60 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 LINGURITA DOZATOARE A 5ML, CU PULB. PENTRU 35 ML SUSP. ORALA

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML

PRF
S/PR-F

SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.


P-RF
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
P-RF
FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS.
P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
P-RF
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF
LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
PRF
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF.

LAROPHARM SRL
ARENA GROUP SA
ARENA GROUP SA
ANTIBIOTICE SA
SINTOFARM SA
MAGISTRA C & C

ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ALFA WASSERMANN SPA ITALIA
PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA
TERAPIA SA
ROMANIA

CUTIE X 2 BLIST., PVC/AL, X 10 CAPS.


CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.

S/P-RF

P-6L
P-6L
P-6L

CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ. P-6L

CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.

P-6L

CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ.

P-6L

CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L


CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL.

P-6L

CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL

P-6L

Pagina 14 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

1
12
1
10
10
20
4
16
7
7
1
1
1
1
1
1
1
1
1
1
1
1
1
1
7
7
7
7
7
7
7
7
7
7
7
1
1
20
20
20
10
20
20
20
20
20
10
5
20
30
20
6
10
10
20
30
20

8,953750
8,499166
8,953750
4,476875
4,476875
4,476875
3,027150
2,178750
3,027150
3,027150
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
4,540725
5,834285
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
1,513575
10,595025
22,050000
0,804149
0,804149
0,804149
1,608299
0,804149
0,804149
0,716500
0,804149
0,804149
1,608299
47,124000
0,063112
0,063112
0,126225
0,326250
0,326250
0,326250
0,378675
0,189337
0,252450

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,496250
0,000000
0,286250
0,530125
0,530125
0,278625
3,375350
0,000000
1,644278
0,392850
2,619275
6,489275
2,619275
2,619275
1,779275
2,619275
2,619275
2,039275
2,619275
2,619275
2,619275
2,619275
1,699275
2,619275
0,000000
1,266425
2,763567
1,266425
0,013567
0,452139
1,264996
0,879282
1,266425
1,266425
0,196425
18,974975
25,400000
0,244351
0,306851
0,266851
0,411701
0,085851
0,089351
0,000000
0,089351
0,089351
1,149701
0,000000
0,020888
0,010888
0,057275
0,387083
0,360750
0,357750
2,095825
0,391663
0,102050

8,058375
7,649249
8,058375
4,029187
4,029187
4,029187
2,724435
1,960875
2,724435
2,724435
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
4,086652
5,250856
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
1,362217
9,535522
19,845000
0,723734
0,723734
0,723734
1,447469
0,723734
0,723734
0,644850
0,723734
0,723734
1,447469
42,411600
0,056800
0,056800
0,113602
0,293625
0,293625
0,293625
0,340807
0,170403
0,227205

1,391625
0,849917
1,181625
0,977813
0,977813
0,726313
3,678065
0,217875
1,946993
0,695565
3,073348
6,943348
3,073348
3,073348
2,233348
3,073348
3,073348
2,493348
3,073348
3,073348
3,073348
3,073348
2,153348
3,073348
0,583429
1,417783
2,914925
1,417783
0,164925
0,603497
1,416354
1,030640
1,417783
1,417783
0,347783
20,034478
27,605000
0,324766
0,387266
0,347266
0,572531
0,166266
0,169766
0,071650
0,169766
0,169766
1,310531
4,712400
0,027200
0,017200
0,069898
0,419708
0,393375
0,390375
2,133693
0,410597
0,127295

cod ATC

790 M01AB05
791 M01AB05
792 M01AB05
793 M01AB05
794 M01AB05
795 M01AB05
796 M01AB05
797 M01AB05
798 M01AB05
799 M01AB05
800 M01AB05
801 M01AB05
802 M01AB05
803 M01AB05
804 M01AB05
805 M01AB05
806 M01AB05
807 M01AB05
808 M01AB05
809 M01AB05
810 M01AB05
811 M01AB15
812 M01AB15
813 M01AB15
814 M01AB15
815 M01AB16
816 M01AB16
817 M01AC02
818 M01AC02
819 M01AC02
820 M01AC06
821 M01AC06
822 M01AC06
823 M01AC06
824 M01AC06
825 M01AC06
826 M01AC06
827 M01AC06
828 M01AC06
829 M01AC06
830 M01AC06
831 M01AC06
832 M01AC06
833 M01AC06
834 M01AC06
835 M01AC06
836 M01AC06
837 M01AC06
838 M01AC06
839 M01AC06
840 M01AE03
841 M01AE03
842 M01AE03
843 M01AE03
844 M01AE03
845 M01AE03
846 M01AE03

DCI

Denumire Comerciala

forma farm.

DICLOFENACUM
DICLAC (R) 75 ID
COMPR. ELIB. MODIF.
DICLOFENACUM
VOLTAREN (R) RETARD
COMPR. FILM. ELIB. PREL.
DICLOFENACUM
REFEN (R) RETARD
COMPR. FILM. ELIB. PREL.
DICLOFENACUM
VOLTAREN (R) 50
COMPR. FILM. GASTROREZ.
DICLOFENACUM
DICLOFENAC 50 mg
COMPR. FILM. GASTROREZ.
DICLOFENACUM
DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ.
DICLOFENACUM
VOLTAREN RAPID (R)
DRAJ.
DICLOFENACUM
DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ.
DICLOFENACUM
DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ.
DICLOFENACUM
DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ.
DICLOFENACUM
VOLTAREN (R)
SOL. INJ.
DICLOFENACUM
TRATUL (R)
SOL. INJ.
DICLOFENACUM
DICLOFENAC 75 mg
SOL. INJ.
DICLOFENACUM
REFEN 75 mg
SOL. INJ./PERF.
DICLOFENACUM
CLAFEN 100 mg
SUPOZ.
DICLOFENACUM
VOLTAREN (R)
SUPOZ.
DICLOFENACUM
DICLOFENAC 100 mg
SUPOZ.
DICLOFENACUM
DICLOFENAC SODIC 100 mg SUPOZ.
DICLOFENACUM
DICLOFENAC SINTOFARM 12,5 mg SUPOZ.
DICLOFENACUM
DICLOFENAC SINTOFARM 12,5 mg SUPOZ.
DICLOFENACUM
VOLTAREN (R)
SUPOZ.
KETOROLACUM TROMETHAMIN KETOROL
COMPR. FILM.
KETOROLACUM TROMETHAMIN KETANOV 10 mg
COMPR. FILM.
KETOROLACUM TROMETHAMIN KETANOV
SOL. INJ.
KETOROLACUM TROMETHAMIN KETOROL
SOL. INJ.
ACECLOFENACUM
AFLAMIL 100mg
COMPR. FILM.
ACECLOFENACUM
ACE-TAB 100 mg
COMPR. FILM.
TENOXICAMUM
TENOXICAM ARENA 20 mg COMPR.
TENOXICAMUM
NEO - ENDUSIX (R)
COMPR. FILM.
TENOXICAMUM
NEO - ENDUSIX (R)
LIOF. + SOLV. PT. SOL. INJ.
MELOXICAMUM
MOVALIS (R) 15 mg
COMPR.
MELOXICAMUM
MOVALIS (R) 15 mg
COMPR.
MELOXICAMUM
MELOXICAM LPH 15 mg
COMPR.
MELOXICAMUM
MELOXICAM SANDOZ 15 mg COMPR.
MELOXICAMUM
MELOXICAM MCC 15 mg
COMPR.
MELOXICAMUM
MELOXICAM VIM SPECTRUM 15 mg COMPR.
MELOXICAMUM
Meloxicam Zentiva 15 mg comprimate COMPR.
MELOXICAMUM
MELOXICAM LPH 15 mg
COMPR.
MELOXICAMUM
MOVALIS (R) 7,5 mg
COMPR.
MELOXICAMUM
MOVALIS (R) 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM LPH 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM SANDOZ 7,5 mg COMPR.
MELOXICAMUM
MELOXICAM MCC 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM VIM SPECTRUM 7,5 mg COMPR.
MELOXICAMUM
MELOXICAM LPH 7,5 mg
COMPR.
MELOXICAMUM
MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ.
MELOXICAMUM
MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ.
MELOXICAMUM
MELOX 15 mg/1,5 ml
SOL. INJ.
MELOXICAMUM
MOVALIS 15mg/1,5ml
SOL. INJ.
MELOXICAMUM
MELOXICAM 15 mg
SUPOZ.
KETOPROFENUM
KETOPROFEN SR TERAPIA 100 MG CAPS. ELIB. PREL.
KETOPROFENUM
KETONAL (R) DUO 150 mg
CAPS. ELIB. PREL.
KETOPROFENUM
KETOPROFEN SR TERAPIA 200 MG CAPS. ELIB. PREL.
KETOPROFENUM
KETONAL RETARD
COMPR. ELIB. PREL.
KETOPROFENUM
PROFENID (R) 100 mg
COMPR. FILM.
KETOPROFENUM
KETONAL FORTE 100 mg
COMPR. FILM.
KETOPROFENUM
KETOPROXIN 100 mg
COMPR. FILM.

concentratie

75mg
100mg
100mg
50mg
50mg
50mg
50mg
25mg
50mg
50mg
25mg/ml
30mg/ml
75mg/3ml
25mg/ml
100mg
100mg
100mg
100mg
12,5 mg
12,5 mg
50mg
10mg
10mg
30mg/ml
30mg/ml
100mg
100mg
20mg
20mg
20mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
7,5mg
7,5mg
7,5mg
7,5mg
7,5mg
7,5mg
7,5mg
15mg/1,5ml
15mg/1,5ml
10mg/ml
15mg/1,5ml
15mg
100mg
150mg
200mg
150mg
100mg
100mg
100mg

Detinator APP

Ambalaj

Prescriptie

Nr crt.

tara det.
APP

HEXAL AG

GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L


NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L
STADA HEMOFARM S.R.L.

ROMANIA

CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL.

P-6L

NOVARTIS PHARMA GMBH GERMANIA

CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ.

P-6L

TERAPIA SA

CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L

A.C. HELCOR PHARMA S.R.L.

ROMANIA
ROMANIA

CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L

ARENA GROUP SA
ARENA GROUP SA
ARENA GROUP SA

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L


ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L
ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML

P-RF

AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML P-RF
STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF. P-RF
ANTIBIOTICE SA
ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L
SINTOFARM SA
ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.
P-6L
MAGISTRA C & C
ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L
SINTOFARM S.A.
ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 3 SUPOZITOARE P6L
SINTOFARM S.A.
ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 5 SUPOZITOARE P6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ.
P-6L
DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
TERAPIA SA
ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L
TERAPIA SA
ROMANIA CUTIE X 10 FIOLE X 1 ML
P-RF
DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR.
P-6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA
CUTIE X 1 BLIST. X 10 COMPR. FILM.
P-6L
ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA
CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF
GEROT PHARMAZEUTIKA GES.M.B.H.

BOEHRINGER INGELHEIM INTERNATIONAL GMBH


BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L


GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.


P-6L
GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

HEXAL AG

MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L


VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ZENTIVA AS
CEHIA
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L
BOEHRINGER INGELHEIM INTERNATIONAL GMBH
BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L


GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.


P-6L
GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

HEXAL AG

MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIAT. AL/PVC X 10 COMPR.


VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.
ROMPHARM COMPANY S.R.L. ROMANIA
ROMPHARM COMPANY S.R.L. ROMANIA
MEDOCHEMIE LTD. CIPRU

PRF
PRF

CUTIE CU 1 BLIST. DIN PVC A 5 FIOLE TRANSPARENTE DIN STICLA CU CAPACITATEA DE 2 ML, CONTINAND 1,5 ML

PRF

CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1,5 ML SIL. INJ.

P-RF

MAGISTRA C & C
TERAPIA SA
SANDOZ S.R.L.
TERAPIA SA

ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ.


ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL.
ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL.
ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL.

P-6L
P-6L
P-6L
P-6L

CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L

FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM.


P-6L
CUTIE X 1 FLAC. X, 20 COMPR. FILM.
P-6L
ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L

LEK PHARMACEUTICALS D.D. SLOVENIA

AC HELCOR PHARMA SRL

P6L

CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ.

GERMANIA

LAB. AVENTIS

P-6L

CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ.

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

LEK PHARMACEUTICALS D.D. SLOVENIA

P-6L

Pagina 15 din 21

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

10
10
20
20
20
20
10
30
20
30
5
5
5
5
6
5
10
10
6
10
10
20
20
10
10
20
20
20
10
1
20
10
20
20
20
20
20
30
10
20
20
20
20
20
30
3
5
5
5
6
10
20
10
20
30
20
20

0,163000
0,252450
0,252450
0,126225
0,117000
0,117000
0,126225
0,063112
0,117000
0,117000
0,902550
1,083060
0,902550
0,842000
0,570000
0,652500
0,570000
0,572000
0,081562
0,081562
0,326250
0,084149
0,084149
1,203400
1,203400
0,126225
0,126225
0,324000
0,324000
1,768500
0,324000
0,324000
0,324000
0,324000
0,324000
0,324000
0,324000
0,324000
0,162000
0,162000
0,162000
0,162000
0,162000
0,162000
0,162000
1,768500
1,768500
1,768500
1,768500
0,759249
0,297000
0,712800
0,644000
0,712800
0,431333
0,475199
0,280500

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,000000
0,292550
0,102050
0,054275
0,000000
0,000000
0,116775
0,134554
0,000000
0,000000
0,779450
0,010940
0,191450
0,000000
0,000000
0,225500
0,000000
0,000000
0,525104
0,519438
0,633750
0,265851
0,441851
1,363600
0,830600
0,609275
0,352275
0,408000
0,334000
3,871500
0,230000
0,231000
0,036000
0,036000
0,036000
0,036000
0,026500
0,036000
0,285000
0,285000
0,128500
0,128500
0,128500
0,128500
0,128333
0,194833
0,195500
0,197500
1,255500
0,877417
0,000000
0,133700
0,000000
0,066700
0,000000
0,091301
0,000000

0,146700
0,227205
0,227205
0,113602
0,105300
0,105300
0,113602
0,056800
0,105300
0,105300
0,812295
0,974754
0,812295
0,757800
0,513000
0,587250
0,513000
0,514800
0,073405
0,073405
0,293625
0,075734
0,075734
1,083060
1,083060
0,113602
0,113602
0,291600
0,291600
1,591650
0,291600
0,291600
0,291600
0,291600
0,291600
0,291600
0,291600
0,291600
0,145800
0,145800
0,145800
0,145800
0,145800
0,145800
0,145800
1,591650
1,591650
1,591650
1,591650
0,683324
0,267300
0,641520
0,579600
0,641520
0,388199
0,427679
0,252450

0,016300
0,317795
0,127295
0,066898
0,011700
0,011700
0,129398
0,140866
0,011700
0,011700
0,869705
0,119246
0,281705
0,084200
0,057000
0,290750
0,057000
0,057200
0,533261
0,527595
0,666375
0,274266
0,450266
1,483940
0,950940
0,621898
0,364898
0,440400
0,366400
4,048350
0,262400
0,263400
0,068400
0,068400
0,068400
0,068400
0,058900
0,068400
0,301200
0,301200
0,144700
0,144700
0,144700
0,144700
0,144533
0,371683
0,372350
0,374350
1,432350
0,953342
0,029700
0,204980
0,064400
0,137980
0,043134
0,138821
0,028050

cod ATC

847 M01AE03
848 M01AE03
849 M01AE03
850 M01AE03
851 M01AE03
852 M01AE03
853 M04AA01
854 M04AA01
855 M04AC01
856 N02AX02
857 N02AX02
858 N02AX02
859 N02AX02
860 N02AX02
861 N02AX02
862 N02AX02
863 N02AX02
864 N02AX02
865 N02AX02
866 N02AX02
867 N02AX02
868 N02AX02
869 N02AX02
870 N02AX02
871 N02AX02
872 N02AX02
873 N02AX02
874 N02AX02
875 N02AX02
876 N02AX02
877 N02AX02
878 N02AX02
879 N02AX02
880 N02AX02
881 N02AX02
882 N02AX02
883 N02AX02
884 N02AX02
885 N02AX02
886 N02AX02
887 N02AX02
888 N02AX02
889 N02AX02
890 N02CC01
891 N02CC01
892 N02CC01
893 N02CC01
894 N02CC01
895 N02CC01
896 N03AF01
897 N03AF01
898 N03AF01
899 N03AF01
900 N03AF01
901 N03AF01
902 N03AF01
903 N03AF01

DCI

KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
ALLOPURINOLUM*
ALLOPURINOLUM*
COLCHICINUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
SUMATRIPTANUM*
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM

MABRON RETARD 100 mg


MABRON RETARD 100 mg
MABRON RETARD 100 mg
MABRON RETARD 100 mg
TRADOLAN RETARD 150 mg
TRAMADOL SR ZENTIVA 150 mg

MABRON RETARD 150 mg


MABRON RETARD 150 mg
MABRON RETARD 150 mg
MABRON RETARD 150 mg
TRADOLAN RETARD 200 mg
MABRON RETARD 200 mg
MABRON RETARD 200 mg
MABRON RETARD 200 mg
MABRON RETARD 200 mg
TRADOLAN 50 mg
TRAMADOL RETARD 150 mg
TRAMADOL RETARD 200 mg
TRAMADOL ZENTIVA 50 mg
TRAMADOL ZENTIVA 50 mg
MABRON
MABRON
TRAMADOL
TRAMADOL
TRAMADOL
IMIGRAN DR 100 mg
IMIGRAN DR 50 mg
XIBIMER 100 mg
SUMACTA 100 mg
XIBIMER 50 mg
SUMACTA 50 mg
TEGRETOL (R) 200
CARBAMAZEPINA LPH (R) 200 mg

CARBAMAZEPINA LPH 200 mg

CARBAVIM
CARBEPSIL 200mg
CARBAMAZEPIN
CARBAMAZEPIN EEL
CARBAMAZEPINA ARENA 200 mg

100mg
100mg
COMPR. ELIB. PREL. 100mg
COMPR. ELIB. PREL. 100mg
COMPR. ELIB. PREL. 150mg
COMPR. ELIB. PREL. 150mg
COMPR. ELIB. PREL. 150mg
COMPR. ELIB. PREL. 150mg
COMPR. ELIB. PREL. 150mg
COMPR. ELIB. PREL. 150mg
COMPR. ELIB. PREL. 200mg
COMPR. ELIB. PREL. 200mg
COMPR. ELIB. PREL. 200mg
COMPR. ELIB. PREL. 200mg
COMPR. ELIB. PREL. 200mg
COMPR. FILM. 50mg
COMPR. FILM. ELIB. PREL. 150mg
COMPR. FILM. ELIB. PREL. 200mg
COMPR. ORODISPERSABILE 50mg
COMPR. ORODISPERSABILE 50mg
SOL. INJ.
100mg
SOL. INJ.
100mg
SOL. INJ.
50mg/ml
SOL. INJ.
50mg/ml
SUPOZ.
100mg
COMPR. DISP. 100mg
COMPR. DISP. 50mg
COMPR. FILM. 100mg
COMPR. FILM. 100mg
COMPR. FILM. 50mg
COMPR. FILM. 50mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.

Prescriptie

Nr crt.

tara det.
Denumire Comerciala
forma farm. concentratie
Detinator APP
APP
KETOPROXIN 50 mg
COMPR. FILM. 50mg
AC HELCOR PHARMA SRL ROMANIA
KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ.
100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA
KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ.
100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA
KETONAL 100 mg/ 2 ml
SOL. INJ.
100mg/2ml LEK PHARMACEUTICALS D.D. SLOVENIA
KETOPROFEN TERAPIA 100MG/2ML SOL. INJ./CONC. SOL. PERF. 100mg/2ml
TERAPIA SA
ROMANIA
KETOMAG
SUPOZ.
100mg
MAGISTRA C & C
ROMANIA
MILURIT 100 mg
COMPR.
100mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA
MILURIT 300 mg
COMPR.
300mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA
COLCHICINA
COMPR.
1mg
BIOFARM SA
ROMANIA
TRAMADOL
CAPS.
50mg
KRKA D.D.
SLOVENIA
K-ALMA (R)
CAPS.
50mg
ANTIBIOTICE SA
ROMANIA
TRAMADOL ARENA
CAPS.
50mg
ARENA GROUP S.A. ROMANIA
TRAMACALM
CAPS.
50mg
A.C. HELCOR PHARMA S.R.L. ROMANIA
TRAMADOL ZENTIVA 50 mg CAPS.
50mg
ZENTIVA A.S.
SLOVACIA
TRAMAG 50
COMPR.
50mg
MAGISTRA C & C
ROMANIA
TRAMADOL EEL
COMPR.
50mg
BIO EEL SRL
ROMANIA
TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg
KRKA, D.D., NOVO MESTO SLOVENIA
TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg
ZENTIVA AS
SLOVACIA

Ambalaj
CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L
CUTIE CU 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ

PRF

CUTIE CU 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ

PRF

CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF. P-RF

CUTIE X 5 FIOLE X 2 ML

P-RF

CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L

CUTIE X 1 FLAC. X 50 COMPR.


CUTIE X 1 FLAC. X 30 COMPR.
CUTIE X 2 BLIST. AL/PVC X 20 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE CU 1 BLIST. PVC/AL X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-6L

CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL.

PRF

P-6L
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF

CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF

MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.

CIPRU
CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
CIPRU
CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
CIPRU
CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
CIPRU
CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
ZENTIVA AS
SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF
MEDOCHEMIE LTD. CIPRU
CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.
PRF
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.

P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL.

P-RF

ZENTIVA, A.S.
ZENTIVA, A.S.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
KRKA D.D.
KRKA D.D.
KRKA D.D.

PRF

REPUBLICA SLOVACA

CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE

REPUBLICA SLOVACA

CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE

PRF

CIPRU
CIPRU

CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF

CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF

SLOVENIA CUTIE X 5 FIOLE X 1 ML


SLOVENIA CUTIE X 5 FIOLE X 2 ML
SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ.

GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP.
GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP.

DR. REDDY'S LABORATORIES

ACTAVIS GROUP PTC EHF.


DR. REDDY'S LABORATORIES

ACTAVIS GROUP PTC EHF.

ROMANIA
ISLANDA
ROMANIA
ISLANDA

CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.

S/P-RF
S/P-RF

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

CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF


CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.

P-RF

CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE P-6L/S


LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L

VIM SPECTRUM SRL ROMANIA


ROMANIA
SLAVIA PHARM SRL ROMANIA
BIO EEL SRL
ROMANIA
ARENA GROUP SA ROMANIA

AC HELCOR PHARMA SRL

CUTIE X 5 BLIST. AL/PVC X 10 COMPR.


CUTIE X 5 BLIST. X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

Pagina 16 din 21

P-6L
P-6L
P-6L
P-6L
P-6L

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

20
5
10
10
5
10
50
30
40
20
20
20
10
20
20
20
30
30
10
30
10
30
30
30
10
30
10
30
30
10
30
10
30
30
30
30
10
10
5
100
5
5
5
2
2
6
6
6
6
50
60
50
50
50
20
20
20

0,237599
1,138000
1,136000
0,971000
1,138000
0,678000
0,151450
0,435000
0,149500
0,263832
0,263832
0,263832
0,263832
0,263832
0,263832
0,263832
0,527666
0,527666
0,527000
0,527666
0,527000
0,527666
0,791500
0,791500
0,791500
0,791333
0,791500
0,791333
1,055333
1,055000
1,055333
1,055000
1,055333
0,263832
0,791500
1,055333
0,263832
0,263832
1,580422
1,396100
0,790208
1,580422
1,158000
8,246250
4,123125
8,246250
7,645000
4,123125
1,315000
0,141833
0,141833
0,141800
0,141800
0,141800
0,140000
0,141833
0,141833

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,119901
0,002000
0,000000
0,000000
0,858000
0,000000
0,019350
0,000000
0,000000
0,035668
0,134668
0,203168
0,121168
0,020668
0,134668
0,119668
0,126000
0,102667
0,000000
0,000334
0,000000
0,000334
0,326500
0,112833
0,000500
0,000000
0,000500
0,000000
0,115333
0,000000
0,000000
0,000000
0,000000
0,066501
0,493833
0,640667
0,134168
0,134168
0,295578
0,000000
0,233792
1,137578
0,000000
8,653750
4,391875
1,803750
0,000000
1,408541
0,000000
0,076367
0,000000
0,000000
0,000000
0,000000
0,000000
0,000167
0,000167

0,213839
1,024200
1,022400
0,873900
1,024200
0,610200
0,136305
0,391500
0,134550
0,237448
0,237448
0,237448
0,237448
0,237448
0,237448
0,237448
0,474899
0,474899
0,474300
0,474899
0,474300
0,474899
0,712350
0,712350
0,712350
0,712199
0,712350
0,712199
0,949799
0,949500
0,949799
0,949500
0,949799
0,237448
0,712350
0,949799
0,237448
0,237448
1,422379
1,256490
0,711187
1,422379
1,042200
7,421625
3,710812
7,421625
6,880500
3,710812
1,183500
0,127649
0,127649
0,127620
0,127620
0,127620
0,126000
0,127649
0,127649

0,143661
0,115800
0,113600
0,097100
0,971800
0,067800
0,034495
0,043500
0,014950
0,062052
0,161052
0,229552
0,147552
0,047052
0,161052
0,146052
0,178767
0,155434
0,052700
0,053101
0,052700
0,053101
0,405650
0,191983
0,079650
0,079134
0,079650
0,079134
0,220867
0,105500
0,105534
0,105500
0,105534
0,092885
0,572983
0,746201
0,160552
0,160552
0,453621
0,139610
0,312813
1,295621
0,115800
9,478375
4,804188
2,628375
0,764500
1,820854
0,131500
0,090551
0,014184
0,014180
0,014180
0,014180
0,014000
0,014351
0,014351

cod ATC

904 N03AF01
905 N03AF01
906 N03AF01
907 N03AF01
908 N03AF01
909 N03AF01
910 N03AF01
911 N03AF01
912 N03AF01
913 N03AF01
914 N03AX12
915 N03AX12
916 N03AX12
917 N03AX12
918 N03AX12
919 N03AX12
920 N03AX12
921 N03AX12
922 N03AX12
923 N03AX12
924 N03AX12
925 N03AX12
926 N03AX12
927 N03AX12
928 N03AX12
929 N03AX12
930 N03AX12
931 N03AX12
932 N03AX12
933 N03AX12
934 N03AX12
935 N03AX12
936 N03AX12
937 N03AX12
938 N03AX12
939 N05AD01
940 N05AD01
941 N05AD01
942 N05AD01
943 N05AD01
944 N05AD01
945 N05AD01
946 N05AD01
947 N05BA01
948 N05BA01
949 N05BA01
950 N05BA01
951 N05BA01
952 N05BA01
953 N05BA01
954 N05BA03
955 N05BA03
956 N05BA03
957 N05BA03
958 N05BA03
959 N05BA06
960 N05BA08

DCI

CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
GABAPENTINUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
DIAZEPAMUM
MEDAZEPAMUM*
MEDAZEPAMUM*
MEDAZEPAMUM*
MEDAZEPAMUM*
MEDAZEPAMUM*
LORAZEPAMUM*
BROMAZEPAMUM*

Denumire Comerciala

forma farm.

CARBEPSIL 400mg

COMPR.
CARBAMAZEPINA ARENA 400 mg COMPR.
TIMONIL RETARD 150 mg
COMPR. CU ELIB. PRELUNGITA 150mg
TIMONIL RETARD 300 mg
300mg
TIMONIL RETARD 600 mg
600mg
NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg
NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg
TEGRETOL CR 200
COMPR. FILM. ELIB. PREL. 200mg
TEGRETOL CR 400
COMPR. FILM. ELIB. PREL. 400mg
TIMONIL SIROP
SUSP. ORALA 100mg/5ml
GABAPENTIN AUROBINDO 100 mg CAPS.
100 mg
GABAGAMMA 100 mg
CAPS.
100mg
GRIMODIN 100 mg
CAPS.
100mg
GABAPENTINA PFIZER 100 mg CAPS.
100mg
GABAPENTINA PFIZER 100 mg CAPS.
100mg
GABAPENTIN ARENA 100 mg CAPS.
100mg
GABAPENTIN AUROBINDO 300 mg CAPS.
300 mg
GABAGAMMA 300 mg
CAPS.
300mg
GABARAN 300 mg
CAPS.
300mg
GABALEPT 300 mg
CAPS.
300mg
GRIMODIN 300 mg
CAPS.
300mg
GABAPENTINA PFIZER 300 mg CAPS.
300mg
GABAPENTINA PFIZER 300 mg CAPS.
300mg
GABAPENTIN ARENA 300 mg CAPS.
300mg
GABAPENTIN AUROBINDO 400 mg CAPS.
400 mg
GABAGAMMA 400 mg
CAPS.
400mg
GABARAN 400 mg
CAPS.
400mg
GABALEPT 400 mg
CAPS.
400mg
GRIMODIN 400 mg
CAPS.
400mg
GABAPENTINA PFIZER 400 mg CAPS.
400mg
GABAPENTINA PFIZER 400 mg CAPS.
400mg
GABAPENTIN ARENA 400 mg CAPS.
400mg
GABARAN 600 mg
COMPR. FILM. 600mg
GRIMODIN 600 mg
COMPR. FILM. 600mg
GABARAN 800 mg
COMPR. FILM. 800mg
HALOPERIDOL LAROPHARM 0,5 mg COMPR.
0,5mg
HALOPERIDOL ARENA 1 mg COMPR.
1mg
HALOPERIDOL ARENA 2 mg COMPR.
2mg
HALDOL
COMPR.
5mg
HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml
HALOPERIDOL 2 mg/ml
PIC. ORALE-SOL. 2mg/ml
HALOPERIDOL DECANOAT SOL. INJ.
50mg/ml
HALOPERIDOL RICHTER 5 mg/ml SOL. INJ.
5mg/ml
DIAZEPAM RICHTER 10 mg COMPR.
10mg
DIAZEPAM
COMPR.
10mg
DIAZEPAM LAROPHARM 10 mg COMPR.
10mg
DIAZEPAM 10 mg
SOL. INJ.
10mg/2ml
DIAZEPAM 5 mg/ml
SOL. INJ.
10mg/2ml
DIAZEPAM DESITIN (R) SOLUTIE RECTALA 10 mg SOL. RECTALA 10mg/2,5ml
DIAZEPAM DESITIN (R) SOLUTIE RECTALA 5 mg SOL. RECTALA 5mg/2,5ml
MEDAZEPAM ARENA 10mg COMPR.
10 mg
MEDAZEPAM ARENA 10mg COMPR.
10 mg
MEDAZEPAM 10 mg
COMPR.
10mg
MEDAZEPAM LPH 10 mg
COMPR.
10mg
MEDAZEPAM LPH 10 mg
COMPR.
10mg
ANXIAR (R) 1 mg
COMPR.
1 mg
BROMAZEPAM LPH 1,5 mg COMPR.
1,5mg

DESITIN ARZNEIMITTEL GMBH

COMPR. CU ELIBERARE PRELUNGITA

DESITIN ARZNEIMITTEL GMBH

COMPR. CU ELIBERARE PRELUNGITA

DESITIN ARZNEIMITTEL GMBH


GEROT PHARMAZEUTIKA GMBH
GEROT PHARMAZEUTIKA GMBH

Prescriptie

Nr crt.

tara det.
concentratie
Detinator APP
APP
Ambalaj
400mg
AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR.
400mg
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.

P-6L
P-6L

P6L
P6L
P6L

GERMANIA
GERMANIA
GERMANIA

CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA

AUSTRIA
AUSTRIA

CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L

CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA


CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA

CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL.

P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L
DESITIN ARZNEIMITTEL GMBH

GERMANIA

CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L

AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS.

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS.

P6L
P-6L

UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L


CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L
ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L
AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS.
P6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS.
P-6L
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS.
P-6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L
ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L
AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS.
P6L
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS.
P-6L
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS.
P-6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L
ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATEPRF
JANSSEN PHARMACEUTICA N.V. BELGIA
CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL.
PRF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML
P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-RF
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF
LAROPHARM SRL
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE X 2 ML
S/P-RF
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE X 2 ML
S/P-RF
EGIS PHARMACEUTICALS P.L.C.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

DESITIN ARZNEIMITTEL GMBH

GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF


GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF
ROMANIA CUTIE X 2 BLISTERE PVC/AL X 10 COMPRIMATEP-RF
ROMANIA CUTIE X 5 BLISTERE PVC/AL X 10 COMPRIMATEP-RF

DESITIN ARZNEIMITTEL GMBH

ARENA GROUP SA
ARENA GROUP SA
LAROPHARM SRL

ROMANIA CUTIE X 1 BLIST. X 20 COMPR.

P-RF

LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.

P-RF/S

ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR.

P-RF

LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-RF

GEDEON RICHTER ROMANIA SA

Pagina 17 din 21

P-RF

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

50
20
50
50
50
50
50
50
30
1
50
100
60
50
100
60
50
100
50
100
60
50
100
60
50
100
50
100
60
50
100
60
30
60
30
20
30
30
25
1
1
5
5
20
30
20
5
5
5
5
20
50
20
20
30
50
20

0,283666
0,283666
0,106374
0,212749
0,425498
0,212749
0,425498
0,141833
0,283666
23,360000
0,149200
0,173669
0,173669
0,173669
0,173669
0,173669
0,447800
0,521011
0,521011
0,521011
0,521011
0,447400
0,433000
0,521011
0,597600
0,694684
0,694684
0,694684
0,694684
0,596200
0,577100
0,694684
1,042026
1,042026
1,389368
0,093037
0,186074
0,372149
0,299600
3,721497
3,721497
8,452000
1,066859
0,103000
0,138666
0,108000
2,392000
2,392000
5,178000
4,530000
0,127000
0,116400
0,132000
0,128000
0,128000
0,105600
0,039600

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,108534
0,108334
0,197426
0,199851
0,306102
0,143251
0,260502
0,205567
0,320334
0,000000
0,000000
0,020431
0,402831
0,294131
0,279031
0,233664
0,000000
0,235089
0,825589
0,835289
0,054489
0,000000
0,000000
0,376322
0,000000
0,498416
0,814316
1,060416
0,334649
0,000000
0,000000
0,426982
1,137974
0,825807
2,215632
0,074963
0,080926
0,001184
0,000000
1,668503
3,178503
0,000000
1,139141
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,026000
0,000000
0,000000
0,033400
0,071400

0,255299
0,255299
0,095736
0,191474
0,382948
0,191474
0,382948
0,127649
0,255299
21,024000
0,134280
0,156302
0,156302
0,156302
0,156302
0,156302
0,403020
0,468909
0,468909
0,468909
0,468909
0,402660
0,389700
0,468909
0,537840
0,625215
0,625215
0,625215
0,625215
0,536580
0,519390
0,625215
0,937823
0,937823
1,250431
0,083733
0,167466
0,334934
0,269640
3,349347
3,349347
7,606800
0,960173
0,092700
0,124799
0,097200
2,152800
2,152800
4,660200
4,077000
0,114300
0,104760
0,118800
0,115200
0,115200
0,095040
0,035640

0,136901
0,136701
0,208064
0,221126
0,348652
0,164526
0,303052
0,219751
0,348701
2,336000
0,014920
0,037798
0,420198
0,311498
0,296398
0,251031
0,044780
0,287191
0,877691
0,887391
0,106591
0,044740
0,043300
0,428424
0,059760
0,567885
0,883785
1,129885
0,404118
0,059620
0,057710
0,496451
1,242177
0,930010
2,354569
0,084267
0,099534
0,038399
0,029960
2,040653
3,550653
0,845200
1,245827
0,010300
0,013867
0,010800
0,239200
0,239200
0,517800
0,453000
0,012700
0,011640
0,039200
0,012800
0,012800
0,043960
0,075360

cod ATC

961 N05BA08
962 N05BA08
963 N05BA08
964 N05BA08
965 N05BA08
966 N05BA08
967 N05BA12
968 N05BA12
969 N05BA12
970 N05BA12
971 N05BA12
972 N05BA12
973 N05BA12
974 N05BA12
975 N05BA12
976 N05BA12
977 N05BA12
978 N05BA12
979 N05BA12
980 N05BA12
981 N05BA12
982 N05BA12
983 N05BA12
984 N05BA12
985 N05BA12
986 N05BA12
987 N05BA12
988 N05CD02
989 N05CD02
990 N05CD02
991 N05CD02
992 N05CD02
993 N05CD02
994 N05CF01
995 N05CF02
996 N05CF02
997 N05CF02
998 N05CF02
999 N05CF02
1000

N05CF02

1001

N05CF02

1002

N06AA04

1003

N06AA04

1004

N06AA09

1005

N06AA12

1006

N06AB03

1007

N06AB03

1008

N06AB03

1009

N06AB03

1010

N06AB03

1011

N06AB04

1012

N06AB04

1013

N06AB05

1014

N06AB05

1015

N06AB05

1016

N06AB05

1017

N06AB05

DCI

BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
BROMAZEPAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
NITRAZEPAMUM
ZOPICLONUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
ZOLPIDEMUM*
CLOMIPRAMINUM*
CLOMIPRAMINUM*
AMITRIPTYLINUM*
DOXEPINUM*
FLUOXETINUM*
FLUOXETINUM*
FLUOXETINUM*
FLUOXETINUM*
FLUOXETINUM*
CITALOPRAMUM**
CITALOPRAMUM**
PAROXETINUM*
PAROXETINUM*
PAROXETINUM*
PAROXETINUM*
PAROXETINUM*

Denumire Comerciala

BROMAZEPAM LPH 1,5 mg


LEXOTAN
BROMAZEPAM LPH 3 mg
BROMAZEPAM SLAVIA 3 mg
BROMAZEPAM ARENA 3 mg
BROMAZEPAM LPH 3 mg
XANAX 0,25 mg
ALPRAZOLAM LPH (R) 0,25 mg

PRAZOLEX (R) 0,25 mg


FRONTIN 0,25 mg
ALPRAZOLAM ATB 0,25 mg
ALPRAZOLAM ATB 0,25 mg
ALPRAZOLAM ATB 0,25 mg
XANAX 0,5 mg
ALPRAZOLAM LPH (R) 0,5 mg
FRONTIN 0,5 mg
PRAZOLEX (R) 0,5 mg
ALPRAZOLAM ATB 0,5 mg
ALPRAZOLAM ATB 0,5 mg
ALPRAZOLAM ATB 0,5 mg
XANAX 1 mg
ALPRAZOLAM LPH (R) 1 mg
PRAZOLEX (R) 1 mg
FRONTIN 1mg
ALPRAZOLAM ATB 1 mg
ALPRAZOLAM ATB 1 mg
ALPRAZOLAM ATB 1 mg
NITRAZEPAM LPH (R) 2,5 mg
NITRAZEPAM LPH 2,5 mg
NITRAZEPAM LPH (R) 5 mg
NITRAZEPAM 5 mg
NITRAZEPAM - RICHTER 5 mg

NITRAZEPAM LPH 5 mg
IMOVANE 7,5 mg
SANVAL (R) 10 mg
SANVAL (R) 10 mg
ZOLPIDEM ATB 10 MG
STILNOX 10 mg
STILNOX 10 mg
ZOLPIDEM AUROBINDO 10 mg

STILNOX 10 mg
ANAFRANIL (R) 10 mg
ANAFRANIL (R) 25 mg
AMITRIPTILINA ARENA 25 mg
DOXEPIN 25 mg
FLUOXIN 20 mg
FLUOXIN 20 mg
MAGRILAN 20 mg
ROFLUXIN 20 mg
PROZAC 20 mg
LINISAN 10 mg
LINISAN 20 mg
ARKETIS
PAROXETINA ATB 20 mg
SEROXAT 20 mg
PAXETIN 20 mg
PALUXETIL 40 mg

forma farm.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

0,25mg
0,25mg
0,25mg
0,25mg
0,25mg
0,25mg
0,25mg
0,5mg
0,5mg
0,5mg
0,5mg
0,5mg
0,5mg
0,5mg
1mg
1mg
1mg
1mg
1mg
1mg
1mg
2,5mg
2.5mg
5mg
5mg
5mg
5mg
COMPR. FILM. 7,5mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
DRAJ.
10mg
DRAJ.
25mg
COMPR. FILM. 25mg
DRAJ.
25mg
CAPS.
20mg
CAPS.
20mg
CAPS.
20mg
CAPS.
20mg
COMPR. DISP. 20mg
COMPR. FILM. 10mg
COMPR. FILM. 20mg
COMPR.
20mg
COMPR. FILM. 20 mg
COMPR. FILM. 20mg
COMPR. FILM. 20mg
COMPR. FILM. 40mg

PFIZER EUROPE MA EEIG

MAREA BRITANIE

LABORMED PHARMA SA ROMANIA

ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.

ROMANIA
UNGARIA
ROMANIA
ROMANIA
ROMANIA

PFIZER EUROPE MA EEIG

MAREA BRITANIE

GEDEON RICHTER ROMANIA SA


EGIS PHARMACEUTICALS P.L.C.

LABORMED PHARMA SA ROMANIA

ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.

UNGARIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

PFIZER EUROPE MA EEIG

MAREA BRITANIE

EGIS PHARMACEUTICALS P.L.C.


GEDEON RICHTER ROMANIA SA

LABORMED PHARMA SA ROMANIA

Ambalaj

CUTIE CU BLIST. PVC/AL X 30 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 1 BLIST. AL/PVC X 10 COMPR.
CUTIE CU 1 BLIST. PVC/AL X 10 COMPR.
CUTIE CU BLIST. PVC/AL X 30 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
CUTIE X 1 FLAC. X 30 COMPR.
CUTIE CU 1 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.
CUTIE X 1 FLAC. X 30 COMPR.
CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
CUTIE CU 1 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
CUTIE X 1 FLAC. X 30 COMPR.
CUTIE CU 1 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

Prescriptie

Nr crt.

tara det.
concentratie
Detinator APP
APP
1,5mg
LABORMED PHARMA S.A. ROMANIA
3mg
ROCHE ROMANIA S.R.L. ROMANIA
3mg
LABORMED PHARMA SA ROMANIA
3mg
SLAVIA PHARM SRL ROMANIA
3mg
ARENA GROUP S.A. ROMANIA
3mg
LABORMED PHARMA S.A. ROMANIA

PRF
P-RF
P-RF
P-RF
P-RF

PRF
P-RF
P-RF
P-RF
P-RF

PRF
PRF
PRF
P-RF
P-RF
P-RF
P-RF

PRF
PRF
PRF
P-RF
P-RF

ROMANIA
EGIS PHARMACEUTICALS P.L.C. UNGARIA
ANTIBIOTICE S.A.
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
LABORMED PHARMA SA ROMANIA
LABORMED PHARMA SA ROMANIA
LABORMED PHARMA SA ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
LABORMED PHARMA SA ROMANIA
SANOFI AVENTIS
FRANTA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. FILM.
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. X 10 COMPR. FILM.
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM.
ANTIBIOTICE S.A.
ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM.
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM.
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/AL X 20 COMPR. FILM.
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ.
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ.
ARENA GROUP S.A. ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM.
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ.
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 CAPS.
VIM SPECTRUM SRL ROMANIA CUTIE X 4 BLIST. PVC/AL X 7 CAPS.
MEDOCHEMIE LTD. CIPRU
CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
ANTIBIOTICE S.A.
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
ELI LILLY SA
SPANIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 14 COMPR. DISP.
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
MEDOCHEMIE LTD. CIPRU
CUTIE X 3 BLIST. AL/PVC, X 10 COMPR.
ANTIBIOTICE SA
ROMANIA CUTIE CU 3 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. FILM.

P-RF

SMITHKLINE BEECHAM MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.


ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM.

P-RF

SANDOZ S.R.L.

P-RF

GEDEON RICHTER ROMANIA SA

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

Pagina 18 din 21

P-RF

PRF
PRF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF

PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF

PRF
P-RF

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

30
30
20
10
10
30
30
20
30
30
10
20
30
30
20
30
30
10
20
30
30
20
30
30
10
20
30
20
30
20
20
20
30
20
10
20
10
10
20
10
20
30
30
50
30
14
28
30
20
28
30
30
30
30
30
30
30

0,039600
0,079200
0,079200
0,079200
0,079200
0,079200
0,066000
0,066000
0,066000
0,066000
0,066000
0,066000
0,066000
0,132000
0,132000
0,132000
0,132000
0,132000
0,132000
0,132000
0,264000
0,263500
0,264000
0,264000
0,263000
0,264000
0,264000
0,051374
0,051374
0,081500
0,102749
0,102749
0,081666
0,363000
0,225000
0,224000
0,225000
0,225000
0,225000
0,225000
0,225000
0,145412
0,363532
0,311600
0,363532
0,585803
0,585803
0,422333
0,585803
0,585803
0,246000
0,585803
0,519666
0,585803
0,585803
0,519666
1,171606

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,071400
0,159466
0,028800
0,020800
0,028800
0,028800
0,126666
0,059000
0,059333
0,059333
0,059000
0,059500
0,059333
0,174666
0,067000
0,067333
0,067333
0,068000
0,068500
0,067333
0,141666
0,000000
0,000000
0,000000
0,000000
0,000500
0,000000
0,019626
0,019959
0,000000
0,022251
0,022251
0,000000
0,000000
0,000000
0,000000
0,000000
0,120000
0,120000
0,000000
0,120000
0,099588
0,097134
0,000000
0,396134
0,219911
0,202054
0,000000
0,198697
0,729197
0,000000
0,782197
0,000000
0,031197
0,362863
0,000000
0,054060

0,035640
0,071280
0,071280
0,071280
0,071280
0,071280
0,059400
0,059400
0,059400
0,059400
0,059400
0,059400
0,059400
0,118800
0,118800
0,118800
0,118800
0,118800
0,118800
0,118800
0,237600
0,237150
0,237600
0,237600
0,236700
0,237600
0,237600
0,046236
0,046236
0,073350
0,092474
0,092474
0,073499
0,326700
0,202500
0,201600
0,202500
0,202500
0,202500
0,202500
0,202500
0,130870
0,327178
0,280440
0,327178
0,527222
0,527222
0,380099
0,527222
0,527222
0,221400
0,527222
0,467699
0,527222
0,527222
0,467699
1,054445

0,075360
0,167386
0,036720
0,028720
0,036720
0,036720
0,133266
0,065600
0,065933
0,065933
0,065600
0,066100
0,065933
0,187866
0,080200
0,080533
0,080533
0,081200
0,081700
0,080533
0,168066
0,026350
0,026400
0,026400
0,026300
0,026900
0,026400
0,024764
0,025097
0,008150
0,032526
0,032526
0,008167
0,036300
0,022500
0,022400
0,022500
0,142500
0,142500
0,022500
0,142500
0,114130
0,133488
0,031160
0,432488
0,278492
0,260635
0,042234
0,257278
0,787778
0,024600
0,840778
0,051967
0,089778
0,421444
0,051967
0,171221

cod ATC

1018

N06AB06

1019

N06AB06

1020

N06AB06

1021

N06AB06

1022

N06AB06

1023

N06AB06

1024

N06AB06

1025

N06AB06

1026

N06AB06

1027

N06AB06

1028

N06AB06

1029

N06AB06

1030

N06AB06

1031

N06AB06

1032

N06AB06

1033

N06AB08

1034

N06AB08

1035

N06AX11

1036

N06AX11

1037

N06AX11

1038

N06AX11

1039

N06AX11

1040

N06AX11

1041

N06AX11

1042

N06AX11

1043

N06AX11

1044

N06AX11

1045

N06AX11

1046

N06AX16

1047

N06AX16

1048

N06AX16

1049

N06AX16

1050

N06AX16

1051

N06AX16

1052

N06AX16

1053

N06AX16

1054

N06AX16

1055

N06AX16

1056

N06AX16

1057

N06AX16

1058

N06AX16

1059

N06AX16

1060

N06AX16

1061

N06AX16

1062

N06AX16

1063

N06AX16

1064

N06AX16

1065

N06AX16

1066

N06AX16

1067

N06AX16

1068

N06AX16

1069

N06AX16

1070

N06AX16

1071

N06AX16

1072

N06AX16

1073

N07AA01

1074

P01AB02

DCI

SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
SERTRALINUM*
FLUVOXAMINUM*
FLUVOXAMINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
MIRTAZAPINUM*
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
NEOSTIGMINI BROMIDUM
TINIDAZOLUM

Denumire Comerciala

SERLIFT 100 mg
ASENTRA (R)
SETALOFT 100 mg
ZOLOFT 100 mg
ADJUVIN 100 mg
STIMULOTON 100 mg
SERTRALINA ARENA 100 mg
SERLIFT 50 mg
ASENTRA (R)
SETALOFT 50 mg
ZOLOFT 50 mg
ADJUVIN 50 mg
STIMULOTON 50 mg
SERTRALINA ARENA 50 mg
ZOLOFT 20 mg/ml
FEVARIN (R) 100
FEVARIN (R) 50
REMERON SOLTAB 30 mg
MIRTAZAPIN ARENA 15 mg
MIRZATEN (R) 30 mg
PHARMATAZ 30 mg
ESPRITAL (R) 30
MIRTAZAPIN ARENA 45 mg

forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

concentratie

100mg
100mg
100mg
100mg
100mg
100mg
100mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
CONC. PT. SOL. ORALA 20mg/ml
COMPR. FILM. 100mg
COMPR. FILM. 50mg
COMPR. DISP. 30mg
COMPR. FILM. 15mg
COMPR. FILM. 30mg
COMPR. FILM. 30mg
COMPR. FILM. 30mg
COMPR. FILM. 45mg
MIRTAZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE 15mg
MIRZATEN Q-TAB 30 mg
COMPR. ORODISPERSABILE 30mg
MIRTAZAPINA AUROBINDO 30 mg COMPR. ORODISPERSABILE 30mg
ZULIN 30 mg
COMPR. ORODISPERSABILE 30mg
MIRTAZAPINA AUROBINDO 45 mg COMPR. ORODISPERSABILE 45mg
EFECTIN EP 150 mg
CAPS. ELIB. PREL. 150 mg
ELIFY EP 150 mg
CAPS. ELIB. PREL. 150 mg
IVRYX 150mg
CAPS. ELIB. PREL. 150 mg
VELAXIN 150 mg
CAPS. ELIB. PREL. 150mg
ALVENTA 150mg
CAPS. ELIB. PREL. 150mg
VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg
VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg
VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg
VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg
FOBILESS 37,5 mg
CAPS. ELIB. PREL. 37,5mg
VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL. 37,5mg
EFECTIN EP 75 mg
CAPS. ELIB. PREL. 75 mg
ELIFY EP 75 mg
CAPS. ELIB. PREL. 75 mg
IVRYX 75mg
CAPS. ELIB. PREL. 75 mg
IVRYX 75mg
CAPS. ELIB. PREL. 75 mg
VELAXIN 75 mg
CAPS. ELIB. PREL. 75mg
ALVENTA 75 mg
CAPS. ELIB. PREL. 75mg
FOBILESS 75 mg
CAPS. ELIB. PREL. 75mg
VENLAFAXINA ACTAVIS 75 mg CAPS. ELIB. PREL. 75mg
VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg
VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg
VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL. 75mg
VENLAFAXINA ARENA 37,5 mg COMPR.
37,5mg
VENLAFAXINA ARENA 50 mg COMPR.
50mg
VENLAFAXINA ARENA 75 mg COMPR.
75mg
ARGOFAN 150 SR
COMPR. ELIB. PREL. 150mg
ARGOFAN 75 SR
COMPR. ELIB. PREL. 75mg
NEOSTIGMINA LPH 15 mg
COMPR.
15mg
TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg

Detinator APP

TERAPIA SA
KRKA D.D.
ACTAVIS GROUP PTC EHF.

ISLANDA

PFIZER EUROPE MA EEIG

MAREA BRITANIE CUTIE X BLISTERE DIN AL/PVC X 28 COMPRIMATE FILMATE

CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM.

Prescriptie

Nr crt.

tara det.
APP
Ambalaj
ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM.
SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM.

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

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


EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-RF
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. X 7 COMPR. FILM.
P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM.
P-RF
LANNACHER HEILMITTEL GES.M.B.H.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

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

ARENA GROUP SA

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


UNGARIA CUTIE X 3 BLIST. X 10 COMPR. FILM.
P-RF
ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

LANNACHER HEILMITTEL GES.M.B.H.

EGIS PHARMACEUTICALS P.L.C.

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA + 1 PIPETA GRADATA

P-RF

OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF


ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM. P-RF
NV ORGANON
OLANDA
P-RF
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.PRF
KRKA D.D.
SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL, X 10 COMPR. FILM. P-RF
ZENTIVA KS
CEHIA
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.PRF
ABBOTT HEALTHCARE PRODUCTS B.V.

CUTIE X 5 BLIST. AL/PVC-PA-POLIESTER PERFORAT PT. ELIB. UNEI UNIT. DOZATE X 6 COMPR. DISP.

AUROBINDO PHARMA LIMITED

MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE

KRKA D.D. NOVO MESTO SLOVENIA

P-RF

CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 30 COMPR. ORODISPERSABILE P-RF

P-RF

AUROBINDO PHARMA LIMITED

MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE

ANTIBIOTICE S.A.

ROMANIA

AUROBINDO PHARMA LIMITED

MAREA BRITANIE CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF

MEDOCHEMIE LTD.

CIPRU

CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF

NEOLA PHARMA S.R.L. ROMANIA


EGIS PHARMACEUTICALS P.L.C.

UNGARIA

CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE P-RF

CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL.

P-RF

P-RF

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF

ISLANDA
ARENA GROUP S.A. ROMANIA
TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
ARENA GROUP S.A. ROMANIA

CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL.

PFIZER EUROPE MA EEIG

CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF

ACTAVIS GROUP PTC EHF.

MEDOCHEMIE LTD.

MAREA BRITANIE

CIPRU
NEOLA PHARMA S.R.L. ROMANIA
NEOLA PHARMA S.R.L. ROMANIA
EGIS PHARMACEUTICALS P.L.C. UNGARIA

P-RF

CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF

CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF


CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL.

PRF

CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF


CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF

CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL.

PRF

CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL.

P-RF

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF


CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL

P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF
LANNACHER HEILMITTEL GES.M.B.H.

ACTAVIS GROUP PTC EHF.

AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF


ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF
ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF
ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF
ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF
ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF
ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF

ARENA GROUP S.A.


TERAPIA S.A.
TERAPIA S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
ZENTIVA A.S.
SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL.
ZENTIVA A.S.
SLOVACIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL.
LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR.
ZENTIVA S.A.
ROMANIA CUTIE X 1 BLIST. X 4 COMPR. FILM.
Pagina 19 din 21

P-RF
P-RF

P-6L
P-RF

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

28
28
28
28
30
28
30
28
28
28
28
30
30
30
1
30
30
30
30
30
30
30
30
30
30
30
30
30
28
30
28
28
30
28
30
30
30
30
30
28
30
28
28
28
30
30
28
30
30
30
30
30
30
30
30
20
4

1,171606
1,076428
0,719642
1,171606
1,171606
1,171606
1,171606
0,585803
0,438571
0,355000
0,585803
0,585803
0,533666
0,585803
14,059283
0,585803
0,292901
0,656333
0,328166
0,481666
0,656333
0,481333
0,984499
0,328166
0,495000
0,656333
0,656333
0,984499
1,153452
0,998333
0,860714
1,153452
0,554666
0,856428
1,153452
1,153452
1,153452
0,288363
0,288363
0,576726
0,576726
0,576726
0,576726
0,576726
0,326000
0,576726
0,576726
0,576726
0,576726
0,576726
0,288363
0,384484
0,576726
0,665000
0,391000
0,712000
0,603524

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

0,110894
0,000000
0,000000
0,801608
0,091394
0,110894
0,110727
0,138482
0,000000
0,000000
0,607054
0,108197
0,000000
0,115197
37,530717
0,530863
0,265432
1,529000
0,523500
0,000000
0,161333
0,000000
1,139167
0,522500
0,000000
0,219333
0,654333
0,273501
0,859405
0,000000
0,000000
0,155119
0,000000
0,000000
0,155214
0,155214
0,155214
0,307970
0,543303
0,741488
0,172607
0,086488
0,086488
0,308274
0,000000
0,085940
0,079702
0,302607
0,308607
0,308607
0,543303
0,462849
0,302607
0,000000
0,000000
0,000000
0,356476

1,054445
0,968785
0,647677
1,054445
1,054445
1,054445
1,054445
0,527222
0,394713
0,319500
0,527222
0,527222
0,480299
0,527222
12,653354
0,527222
0,263610
0,590699
0,295349
0,433499
0,590699
0,433199
0,886049
0,295349
0,445500
0,590699
0,590699
0,886049
1,038106
0,898499
0,774642
1,038106
0,499199
0,770785
1,038106
1,038106
1,038106
0,259526
0,259526
0,519053
0,519053
0,519053
0,519053
0,519053
0,293400
0,519053
0,519053
0,519053
0,519053
0,519053
0,259526
0,346035
0,519053
0,598500
0,351900
0,640800
0,543171

0,228055
0,107643
0,071965
0,918769
0,208555
0,228055
0,227888
0,197063
0,043858
0,035500
0,665635
0,166778
0,053367
0,173778
38,936646
0,589444
0,294723
1,594634
0,556317
0,048167
0,226967
0,048134
1,237617
0,555317
0,049500
0,284967
0,719967
0,371951
0,974751
0,099834
0,086072
0,270465
0,055467
0,085643
0,270560
0,270560
0,270560
0,336807
0,572140
0,799161
0,230280
0,144161
0,144161
0,365947
0,032600
0,143613
0,137375
0,360280
0,366280
0,366280
0,572140
0,501298
0,360280
0,066500
0,039100
0,071200
0,416829

cod ATC

1075

P01AB02

1076

P01AB02

1077

P01AB02

1078

P02CA03

1079

P02CA03

1080

P02CA03

1081

P02CA03

1082

P02CA03

1083

P02CA03

1084

P02CE01

1085

P02CE01

1086

P02CE01

1087

P02CE01

1088

R01AD01

1089

R03AC02

1090

R03AC02

1091

R03AC02

1092

R03BA01

1093

R03BA02

1094

R03BA02

1095

R03BA02

1096

R03BA02

1097

R03BA02

1098

R03BA02

1099

R03BB01

1100

R03CC02

1101

R03CC02

1102

R03DA04

1103

R03DA04

1104

R05DA04

1105

R05DA04

1106

R05DA04

1107

R05DA04

1108

R05DA04

1109

R05DA04

1110

R06AB04

1111

R06AE07

1112

R06AE07

1113

R06AE07

1114

R06AX17

1115

R06AX17

1116

R06AX17

1117

R06AX17

1118

R06AX17

1119

R06AX17

1120

S01BC03

1121

S01BC03

1122

S01BC03

TINIDAZOLUM
TINIDAZOLUM
TINIDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
LEVAMISOLUM
LEVAMISOLUM
LEVAMISOLUM
LEVAMISOLUM
BECLOMETASONUM
SALBUTAMOLUM
SALBUTAMOLUM
SALBUTAMOLUM
BECLOMETASONUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
IPRATROPII BROMIDUM*
SALBUTAMOLUM
SALBUTAMOLUM
THEOPHYLLINUM
THEOPHYLLINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CHLORPHENAMINUM
CETIRIZINUM
CETIRIZINUM
CETIRIZINUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM

1123

S01CA05

COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM)

1124

S01CA05

COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM)

ESKAZOLE
DUADOR 200 mg
ALBENDAZOL LPH 200 mg
ZENTEL 0,4 g/10 ml

COMPR.

400mg

COMPR. FILM. 200mg

COMPR.FILM 200 mg
SUSP. ORALA 0,4g/10ml
VERMIGAL NOVO 400 mg/10 ml SUSP. ORALA 400mg/10ml
DECARIS 150 mg
COMPR.
150mg
LEVAMISOL ARENA 150 mg COMPR.
150mg
DECARIS 50 mg
COMPR.
50mg
LEVAMISOL ARENA 50 mg
COMPR.
50mg
RINOCLENIL 100
SPRAY NAZ.,SUSP. 100mcg/doza
VENTOLIN (R)
SOL. INHAL. 5mg/ml
VENTOLIN 100 INHALER CFC-FREE SUSP. INHAL. PRESURIZATA 100mcg/doza
ASTHALIN INHALER
SUSP. INHAL. PRESURIZATA 100mcg/doza
CLENIL (R) JET 250 mcg
SOL. INHALAT PRESURIZATA
250mcg/doza
FRENOLYN 200
PULB. INHAL. 200 mcg/doza
FRENOLYN 200
PULB. INHAL. 200 mcg/doza
PULMICORT TURBUHALER 200 mcg/doza PULB. INHAL. 200mcg/doza
FRENOLYN 400
PULB. INHAL. 400 mcg/doza
BUDIAIR 200 mcg
200 mcg/doza
BUDIAIR 200 mcg JET
200mcg/doza
IPRAVENT INHALER 20mcg/doza SUSP. INHAL. PRESURIZATA 20mcg/doza
SALBUTAMOL EIPICO 2mg/5ml SIROP
2mg/5ml
VENTOLIN (R)
SOL. INJ.
0,5mg/ml
TEOTARD (R) 200 mg
CAPS. ELIB. PREL. 200mg
TEOTARD (R) 350 mg
CAPS. ELIB. PREL. 350mg
FOSFAT DE CODEINA 15 mg COMPR.
15mg
CODEINA FOSFORICA
COMPR.
15mg
FARMACOD
COMPR.
15mg
CODEINA FOSFAT
COMPR.
15mg
CODEINA FOSFAT LPH 15 mg COMPR.
15mg
CODEINA FOSFAT MCC 15 mg COMPR.
15mg
CLORFENIRAMIN
COMPR.
4mg
CELERG
COMPR. FILM. 10 mg
LETIZEN (R) 10 mg
COMPR. FILM. 10mg
ZYRTEC 10 mg/ml
PICATURI ORALE, SOL. 10mg/ml
H - KETOTIFEN
COMPR.
1mg
KETOTIFEN
COMPR.
1mg
KETOTIFEN LAROPHARM 1 mg COMPR.
1mg
KETOTIFEN LPH 1 mg
COMPR.
1mg
KETOTIFEN LPH 1 mg
COMPR.
1mg
KETOF 1 mg/5 ml
SIROP
1mg/5ml
DICLOFENAC ROMPHARM PIC. OFT.-SOL. 1mg/ml
UNICLOPHEN (R) 0,1%
PICATURI OFT.-SOL. 0,1%
VOLTAREN OPHTHA CD
PICATURI OFT.-SOL. 0,1%
BETABIOPTAL
PICATURI OFT.SUSP. 0,2g+0,5g/100ml
BETABIOPTAL
UNG. OFT.
0,2g+0,5g/100g

Prescriptie

DCI

Nr crt.

tara det.
Denumire Comerciala
forma farm. concentratie
Detinator APP
APP
TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg
AC HELCOR SRL
ROMANIA
TINIZOL (R) 500 mg (J01XD02) COMPR. FILM. 500mg
ZENTIVA S.A.
ROMANIA
TIPROGYN 500 (vezi J01XD02) COMPR. FILM. 500mg
AC HELCOR SRL
ROMANIA
ALBENDAZOL VIM SPECTRUM 200 mg COMPR.
200mg
VIM SPECTRUM SRL ROMANIA

Ambalaj

CUTIE X 1 BLIST. X 4 COMPR.FILM.


CUTIE X 1 BLIST. X 4 COMPR. FILM.
CUTIE X 1 BLIST. X 4 COMPR.FILM.
CUTIE X 1 BLIST. AL/PVC X 2 COMPR.

P6L
P-RF

P6L
P-RF

CUTIE X 12 BLIST. PVC-PVDC/AL X 1 COMPR.

P-RF

ROMANIA CUTIE X 1 BLIST. X 2 COMPR. FILM.


LABORMED PHARMA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 2 COMPR. FILM.

P-RF

GLAXOSMITHKLINE EXPORT LTD. MAREA BRITANIE CUTIE X 1 FLACON UNIDOZA DIN PVC X 10 ML SUSP. ORALA

P-RF

GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE

GEDEON RICHTER ROMANIA SA

BIOFARM S.A.

ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
ARENA GROUP S.A. ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
ARENA GROUP S.A. ROMANIA
CHIESI FARMACEUTICI SPA ITALIA

P-RF

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA

PRF

CUTIE X 1 BLIST. AL/PVC X 1 COMPR.


CUTIE CU 1 BLIST. PVC/AL X 1 COMPR.
CUTIE X 1 BLIST. AL/PVC X 2 COMPR.
CUTIE CU 1 BLIST. PVC/AL X 2 COMPR.

P-RF

CUTIE X 1 FLACON DIN PET X 30 ML SPRAY NAZ.,SUSP., PREVAZUT CU POMPA DOZATOARE

P-RF

P-RF
P-RF
P-RF

GLAXOWELLCOME UK LTD.

MAREA BRITANIE CUTIE X 1 FALC. DIN STICLA BRUNA X 10 ML SOL. DE INHAL.

P-6L

GLAXOWELLCOME UK LTD.

MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE X 200 DOZE + DISPOZITIV DE ADMINISTRA

P-RF

CIPLA (UK) LIMITED

MAREA BRITANIE

CUTIE X 1 FLAC. AL + VALVA DOZATOARE + DISP. ADM. X 200 DOZE SUSP. INHAL. PRESURIZATA

P-6L

SOL. DE INHALAT PRESURIZATA

CHIESI FARMACEUTICI SPA

SOL. DE INHALAT PRESURIZATA

CHIESI FARMACEUTICI SPA

ITALIA
P-RF
ROMANIA CUTIE X 1 PUNGA, X 1 INHALATOR X 100 DOZE P-RF
ROMANIA
P-RF
SUEDIA CUTIE X 1 FLACON MULTIDOZA DIN PEID X 100 DOZE PULB. INHAL. P-RF
ROMANIA
P-RF
ITALIA
P-RF
ITALIA
P-RF

CIPLA (UK) LIMITED

MAREA BRITANIE CUTIE X 1 FLACON AL PRESURIZAT X 200 DOZE SUSP.DE INHALAT PRESURIZATAP-6L

CHIESI FARMACEUTICI SPA


MEDOCHEMIE ROMANIA SRL
MEDOCHEMIE ROMANIA SRL

ASTRAZENECA AB
MEDOCHEMIE ROMANIA SRL

CUTIE X 1 FLACON PRESURIZAT DIN AL X 200 DOZE, PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM., "SPASER JET" CU CAPAC

CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 200 DOZE

CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 100 DOZE
CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA + VALVA DOZATOARE + DISPOZITIV DE ADMINISTRA

CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA = VALVA DOZATOARE + DISPOZITIV JET DE ACTION

E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 125 ML SIROP P-6L

CUTIE X 5 FIOLE DIN STICLA X 1 ML

GLAXO WELLCOME UK LTD.

MAREA BRITANIE

KRKA D.D.
KRKA D.D.
SINTOFARM SA
BIO EEL SRL
FARMACOM SA
SLAVIA PHARM SRL

SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.


SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.

P-6L
P-RF
P-RF

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF


ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF
ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-RF
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-RF
MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L
KRKA D.D.
SLOVENIA CUTIE X 2 BLIST. X 10 COMPR. FILM.
P-6L
UCB PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA + PICURATOR DIN PEJD X 20 ML PIC. ORALE, SOL. P6L
AC HELCOR SRL
ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
LAROPHARM SRL
ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. PVC X 10 COMPR
P6L
LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR P6L
HEXAL AG
GERMANIA CUTIE X 1 FLACON X 100 ML SIROP + MASURA DOZATOARE P-6L
ROMPHARM COMPANY SRL ROMANIA FLACON PICURATOR DIN PEJD X 5 ML PIC. OFT., SOL. P-6L
UNIMED PHARMA LTD. SLOVACIA
LABORATOIRES THEA FRANTA

THEA FARMA S.P.A. ITALIA


THEA FARMA S.P.A. ITALIA

CUTIE X 1 FLACON DIN PE X 10 ML PIC. OFTALMICE, SOL., PREVAZUT CU PICURATOR

P-6L
P-6L

CUTIE X 1 FLAC. PEJD X 5 ML PICATURI OFT.-SOL. + PICURATOR PEJD + CAPAC CU INEL DE SIGURANTA

CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.,SUSP. + APLICATOR PT. PICURARE P-RF

CUTIE X 1 TUB AL X 5 G

P-RF

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

4
0,603524
4
0,603524
4
0,603524
2
3,107291
12
6,198333
2
3,107291
2
3,107291
1
3,951000
1
3,870000
1
3,540000
1
3,540000
2
1,179988
2
1,179988
1 42,718000
1
1,616400
1
8,082000
1
7,070000
1 101,960000
1 26,670000
1 66,167500
1 33,083750
1 66,167500
1 63,460000
1 66,167500
1 13,080000
1
3,050000
5
0,740000
40
0,243500
40
0,362500
30
0,167500
25
0,167500
20
0,151000
20
0,167500
20
0,165500
20
0,167500
20
0,120000
20
0,504900
20
0,504900
1 10,098000
20
0,175250
20
0,175250
20
0,175250
20
0,172000
30
0,172000
1 11,860000
1
8,678750
1 11,650000
1
8,678750
1 13,940000
1 14,459999

0,316476
0,356476
0,316476
0,002709
0,000000
0,207709
0,212709
1,999000
0,000000
0,000000
0,000000
0,385012
0,385012
5,802000
6,183600
2,808000
0,000000
0,000000
0,000000
11,652500
6,626250
21,192500
0,000000
8,122500
0,000000
0,000000
0,000000
0,000000
0,000000
0,032833
0,037700
0,000000
0,006000
0,000000
0,022000
0,000000
0,593100
0,045100
3,062000
0,007250
0,003250
0,003250
0,000000
0,000000
0,000000
0,951250
0,000000
6,141250
0,000000
1,560001

0,543171
0,543171
0,543171
2,796561
5,578499
2,796561
2,796561
3,555900
3,483000
3,186000
3,186000
1,061989
1,061989
38,446200
1,454760
7,273800
6,363000
91,764000
24,003000
59,550750
29,775375
59,550750
57,114000
59,550750
11,772000
2,745000
0,666000
0,219150
0,326250
0,150750
0,150750
0,135900
0,150750
0,148950
0,150750
0,108000
0,454410
0,454410
9,088200
0,157725
0,157725
0,157725
0,154800
0,154800
10,674000
7,810875
10,485000
7,810875
12,546000
13,013999

0,376829
0,416829
0,376829
0,313439
0,619834
0,518439
0,523439
2,394100
0,387000
0,354000
0,354000
0,503011
0,503011
10,073800
6,345240
3,616200
0,707000
10,196000
2,667000
18,269250
9,934625
27,809250
6,346000
14,739250
1,308000
0,305000
0,074000
0,024350
0,036250
0,049583
0,054450
0,015100
0,022750
0,016550
0,038750
0,012000
0,643590
0,095590
4,071800
0,024775
0,020775
0,020775
0,017200
0,017200
1,186000
1,819125
1,165000
7,009125
1,394000
3,006001

NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu(*) se iniiaza de medicul de specialitate in limita competenei i poate fi prescris n continuare de medicul de familie pe baza scrisorii medicale emise
de medicul de specialitate;
Pagina 20 din 21

cod ATC

DCI

Denumire Comerciala

forma farm.

concentratie

Detinator APP

Ambalaj

Prescriptie

Nr crt.

tara det.
APP

cant.
Pret de
UT/
ambal referinta / UT
(RON)
aj

- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Snt
ii;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Snt
ii i cu aprobarea comisiilor de la
nivelul Caselor Judeene de Asigurri de Sntate;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu(1) se efectueaza pentru pacienii cu intoleran la acidum acetylsalicylicum.

Pagina 21 din 21

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)

ANEXA 2b

SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM

Nr. crt

cod ATC

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60

A02BC02

DCI

PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC02 PANTOPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A02BC05 ESOMEPRAZOLUM
A03AB06 OTILONIUM BROMIDUM
A06AD15 MACROGOLUM*2)
A06AD15 MACROGOLUM*2)
A07AA11 RIFAXIMINUM
A07AA11 RIFAXIMINUM
A07AA11 RIFAXIMINUM
A07EA06 BUDESONIDUM**#
A07EA06 BUDESONIDUM**#
A07XA04 RACECADOTRILUM
A07XA04 RACECADOTRILUM
A07XA04 RACECADOTRILUM
A08AB01 ORLISTATUM****
A08AB01 ORLISTATUM****
A11CC03 ALFACALCIDOLUM
A11CC03 ALFACALCIDOLUM
A11CC03 ALFACALCIDOLUM
A11CC03 ALFACALCIDOLUM
A02BC02
A02BC02

Denumire Comerciala

CONTROLOC 20 mg
CONTROLOC 40mg
SELTRAZ 40 mg
ZENCOPAN 20 mg
PANTEXEL 20 mg
NOLPAZA 20 mg
AZATOL 20 mg
PANTOPRAZOL TERAPIA 20 mg
PANTOPRAZOL TORRENT 20 mg
PANTOPRAZOL AUROBINDO 20 mg
CONTROLOC 20 mg
ZENCOPAN 40 mg
PANTEXEL 40 mg
NOLPAZA 40mg
PANTOPRAZOL TERAPIA 40 mg
PANTOPRAZOL TERAPIA 40 mg
PANTOPRAZOL ATB 40 mg
AZATOL 40 mg
PANTOPRAZOL TORRENT 40 mg
PANTOPRAZOL AUROBINDO 40 mg
CONTROLOC 40mg
GESOFLUX 20 mg
GESOFLUX 40 mg
NOLPAZA 40 mg
CONTROLOC 40mg
CONTROLOC 40mg
EMANERA 20 mg
HELIDES 20 mg
EMANERA 40 mg
HELIDES 40 mg
NEXIUM 20 mg
ESOMEPRAZOL SANDOZ 20 mg
ESOMEPRAZOL TEVA 20 mg
PRAGASTROL 20 mg
NEXIUM 40 mg
ESOMEPRAZOL SANDOZ 40 mg
ESOMEPRAZOL TEVA 40 mg
PRAGASTROL 40 mg
ESOMEPRAZOL TERAPIA 20mg
ESOMEPRAZOL TERAPIA 40mg
NEXIUM 10 mg
ESOMEPRAZOL SANDOZ 40 mg
ESOMEPRAZOL POLPHARMA 40 mg
SPASMOMEN (R)
OLOPEG
OLOPEG
NORMIX 200 mg
NORMIX 200 mg
NORMIX 200mg/10ml
BUDENOFALK
BUDENOFALK 2 mg/doza
HIDRASEC 100 mg
HIDRASEC 10 mg
HIDRASEC 30 mg
XENICAL 120mg
XENICAL 120mg
ALPHA D3 0,25 mcg
ALFACALCIDOL SANDOZ 0,25 mcg
ALPHA D3 0,50 mcg
ALFACALCIDOL SANDOZ 0,5 mcg

forma farm.

concentratie

20mg
40mg
40mg
COMPR. GASTROREZ. 20 mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 40 mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
20mg
40mg
PULB. PT. SOL. INJ. 40mg
PULB. PT. SOL. INJ. 40mg
PULB. PT. SOL. INJ. 40mg
CAPS. GASTROREZ. 20mg
CAPS. GASTROREZ. 20mg
CAPS. GASTROREZ. 40mg
CAPS. GASTROREZ. 40mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 20mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
COMPR. GASTROREZ. 40mg
20mg
40mg
10mg
PULB. PT. SOL. INJ./PERF. 40mg
PULB. PT. SOL. PERF./INJ. 40mg
COMPR. FILM. 40mg

Detinator APP

Tara det.
APP

Prescriptie

DENUMIRILOR 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 2015

Ambalaj

NYCOMED GMBH
NYCOMED GMBH

GERMANIA

CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ.

P-6L

COMPR. FILM. GASTROREZ.

GERMANIA

CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ.

P-6L

COMPR. FILM. GASTROREZ.

DR. REDDY'S LABORATORIES

ROMANIA

CUTIE X 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. FILM. GASTROREZISTENTE

P-6L

ZENTIVA K.S.

REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ.

COMPR. FILM. GASTROREZ.

COMPR. GASTROREZISTENTE
COMPR. GASTROREZISTENTE

COMPR. GASTROREZISTENTE
COMPR. GASTROREZISTENTE

GRAN. GASTROREZ. PT. SUSP.ORALA

CONC. PT. SOL. ORALA

FARA CONCENTRATIE

CONC. PT. SOL. ORALA

FARA CONCENTRATIE

COMPR. FILM. 200mg


COMPR. FILM. 200mg
GRAN. PT. SUSP. ORALA

CAPS. GASTROREZ.

SPUMA RECTALA

CAPS.
PULB. PT. SOL. ORALA
PULB. PT. SOL. ORALA

CAPS.
CAPS.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI

ROMANIA
KRKA D.D., NOVO MESTO SLOVENIA
NEOLA PHARMA SRL ROMANIA
TERAPIA S.A.
ROMANIA
TORRENT PHARMA S.R.L. ROMANIA

GEDEON RICHTER ROMANIA SA

P6L
P-6L

CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ

CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L

P6L
P6L
P6L

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

CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ.


CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ.

AUROBINDO PHARMA (MALTA) LIMITED

MALTA

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L

TAKEDA GMBH
ZENTIVA K.S.

GERMANIA

CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ.

REPUBLICA CEHA CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ.

ROMANIA
KRKA D.D., NOVO MESTO SLOVENIA
TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
ANTIBIOTICE SA
ROMANIA
NEOLA PHARMA SRL ROMANIA
TORRENT PHARMA S.R.L. ROMANIA

GEDEON RICHTER ROMANIA SA

CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ

P6L
P6L
P-6L

CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR. P-6L


CUTIE X 1 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L
CUTIE X 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ. P-6L

P6L
P6L
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ. P6L
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ. P6L
CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ.

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

MALTA
TAKEDA GMBH
GERMANIA
P6L
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE P6L

AUROBINDO PHARMA (MALTA) LIMITED

CUTIE DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ.

KRKA D.D., NOVO MESTO SLOVENIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ.

NYCOMED GMBH
TAKEDA GMBH

CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. S/P-RF

GERMANIA
GERMANIA

KRKA, D.D., NOVO MESTO SLOVENIA

ZENTIVA K.S.

CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, CU CAPSA DIN AL SI DOP DIN CAUCIUC A 40 MG CU PULB. PT. SOL. INJ.

PRF

CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ.

P-6L

REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ.

KRKA, D.D., NOVO MESTO SLOVENIA

P-RF

P-6L

CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ.

P-6L

ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ.
ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. X 7 COMPR. FILM. GASTROREZ.
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ.

P-6L

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

ALVOGEN IPCO S.A.R.L

LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ.

ASTRAZENECA AB SUEDIA
SANDOZ SRL
ROMANIA

CUTIE CU BLIST. AL/AL X 14 COMPR. GASTROREZ.

CUTIE X 2 BLIST. AL/PVC X 7 COMPR. FILM. GASTROREZ.

ROMANIA

ALVOGEN IPCO S.A.R.L

LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ.

TERAPIA S.A.
TERAPIA S.A.
ASTRAZENECA AB
SANDOZ S.R.L.

ROMANIA
ROMANIA

SUEDIA

PHARMACEUTICAL WORKS POLPHARMA SA

A. MENARINI IND. FARM. RIUNITE SRL

ITALIA

CNP PHARMA GMBH GERMANIA


CNP PHARMA GMBH GERMANIA
ALFA WASSERMANN SPA
ALFA WASSERMANN SPA

ITALIA
ITALIA
ITALIA

P-6L

P6L
P6L
P-6L

CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ. P-6L

TEVA PHARMACEUTICALS S.R.L.

ROMANIA
POLONIA

P-6L

CUTIE CU BLIST. AL/AL X 14 COMPR. GASTROREZ.

P6L
P6L

CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE

P-6L

CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE

P-6L

CUTIE X 28 PLICURI DIN PET/AL/PEJD CONTINAND GRANULE GASTROREZ. PT. SUSP. ORALA

P-6L

CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF.

PRF

CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CONTINAND PULB. PT. SOL. INJ./PERF.

P6L

CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L


CUTIE CU 1 FLAC. DIN PET X 500 ML CONC. PT. SOL. ORALA, INSOTIT DE UN RECIPIENT DOZATOR GRADAT

PRF

CUTIE CU 1 FLAC. DIN PET X 200 ML CONC. PT. SOL. ORALA, INSOTIT DE UN RECIPIENT DOZATOR GRADAT

PRF

CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM. P-RF


CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF

200mg/10ml ALFA WASSERMANN SPA


P-RF
3mg
DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ.
P-RF
2mg/doza
DR. FALK PHARMA GMBH GERMANIA
P-RF
100mg
LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS.
P-RF
10mg
LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 16 PLICURI X 1 G
P-RF
30mg
LAB. FOURNIER SA FRANTA CUTIE X 16 PLICURI X 3 G
P-RF
120mg
ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 21 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF
120mg
ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC) P-RF
0,25mcg
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF
0,25g
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF
0,50mcg
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI
P-RF
0,5g
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF
CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML

CUTIE X 1 FLAC. DIN AL X 14 DOZE X 1,2G SPUMA RECTALA, 14 APLICATOARE LUBREFIANTE PVC SI 14 PUNGI PL

Pagina 1 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
0,508333
30
0,935666
28
0,608214
28
0,236785
28
0,330714
30
0,273666
28
0,330714
30
0,330666
30
0,330666
30
0,212666
30
0,508333
28
0,430714
28
0,608214
30
0,576666
10
0,609000
30
0,608000
30
0,608000
28
0,608214
30
0,608000
30
0,387666
30
0,935666
30
0,177333
30
0,246000
1
8,810000
1 13,560000
1 13,560000
28
0,644285
28
0,480000
28
1,038571
28
0,878928
14
0,722227
14
0,555000
14
0,472142
30
0,720000
14
1,444456
14
1,057857
14
0,735000
30
1,156000
14
0,722227
14
1,384285
28
2,539642
10 20,061000
10 20,060000
30
1,103333
1 33,340000
1 13,949499
12
2,519583
36
2,413333
1 15,117513
100
3,516900
1 303,800000
20
2,076500
16
2,307000
16
2,307000
21
2,029672
84
1,677500
50
0,543166
30
0,543166
30
1,086333
30
1,086333

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,795630
0,000000
0,000000
0,000000
0,686258
0,000000
0,000000
0,000000
0,215630
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
1,840501
0,106250
0,000000
4,692487
0,000000
0,000000
0,000000
0,353000
0,230500
1,056518
0,000000
0,045834
0,222500
0,000000
0,047333

0,254166
0,467833
0,304107
0,118392
0,165357
0,136833
0,165357
0,165333
0,165333
0,106333
0,254166
0,215357
0,304107
0,288333
0,304500
0,304000
0,304000
0,304107
0,304000
0,193833
0,467833
0,088666
0,123000
4,405000
6,780000
6,780000
0,322142
0,240000
0,519285
0,439464
0,361113
0,277500
0,236071
0,360000
0,722228
0,528928
0,367500
0,578000
0,361113
0,692142
1,269821
10,030500
10,030000
0,551666
16,670000
6,974749
1,259791
1,206666
7,558756
1,758450
151,900000
1,038250
1,153500
1,153500
1,014836
0,838750
0,271583
0,271583
0,543166
0,543166

0,254167
0,467833
0,304107
0,118393
0,165357
0,136833
0,165357
0,165333
0,165333
0,106333
0,254167
0,215357
0,304107
0,288333
0,304500
0,304000
0,304000
0,304107
0,304000
0,193833
0,467833
0,088667
0,123000
4,405000
6,780000
6,780000
0,322143
0,240000
0,519286
0,439464
1,156744
0,277500
0,236071
0,360000
1,408486
0,528929
0,367500
0,578000
0,576744
0,692143
1,269821
10,030500
10,030000
0,551667
16,670000
8,815251
1,366042
1,206667
12,251244
1,758450
151,900000
1,038250
1,506500
1,384000
2,071354
0,838750
0,317417
0,494083
0,543167
0,590500

0,457499
0,842099
0,547392
0,213106
0,297642
0,246299
0,297642
0,297599
0,297599
0,191399
0,457499
0,387642
0,547392
0,518999
0,548100
0,547200
0,547200
0,547392
0,547200
0,348899
0,842099
0,159599
0,221400
7,929000
12,204000
12,204000
0,579856
0,432000
0,934713
0,791035
0,650004
0,499500
0,424927
0,648000
1,300010
0,952071
0,661500
1,040400
0,650004
1,245856
2,285677
18,054900
18,054000
0,992999
30,006000
12,554549
2,267624
2,171999
13,605761
3,165210
273,420000
1,868850
2,076300
2,076300
1,826704
1,509750
0,488849
0,488849
0,977699
0,977699

0,050834
0,093567
0,060822
0,023679
0,033072
0,027367
0,033072
0,033067
0,033067
0,021267
0,050834
0,043072
0,060822
0,057667
0,060900
0,060800
0,060800
0,060822
0,060800
0,038767
0,093567
0,017734
0,024600
0,881000
1,356000
1,356000
0,064429
0,048000
0,103858
0,087893
0,867853
0,055500
0,047215
0,072000
0,830704
0,105786
0,073500
0,115600
0,287853
0,138429
0,253965
2,006100
2,006000
0,110334
3,334000
3,235451
0,358209
0,241334
6,204239
0,351690
30,380000
0,207650
0,583700
0,461200
1,259486
0,167750
0,100151
0,276817
0,108634
0,155967

61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

cod ATC

DCI

A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#


A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#
B01AB04
B01AB04
B01AB04
B01AB04
B01AB04
B01AB04
B01AB04
B01AB05
B01AB05
B01AB05
B01AB05
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB06
B01AB10
B01AB10
B01AB10
B01AB10
B01AB10
B01AB10
B01AB10
B01AB11
B01AB11
B01AB11
B01AB11
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04

100 B01AC04
101 B01AC04
102 B01AC04
103 B01AC04
104 B01AC04
105 B01AC04
106 B01AC04
107 B01AC04
108 B01AC04
109 B01AC04
110 B01AC04
111 B01AC04
112 B01AC18
113 B01AC18
114 B01AC30
115 B01AF01
116 B01AF01
117 B01AX05
118 B01AX05
119 B01AX05
120 B01AX05
121 B03AC02
122 C01EB17
123 C01EB17
124 C02AC05
125 C02AC05
126 C02AC05

DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
DALTEPARINUM**#
ENOXAPARINUM**#
ENOXAPARINUM**#
ENOXAPARINUM**#
ENOXAPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
NADROPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
TINZAPARINUM**#
SULODEXIDUM**
SULODEXIDUM**
SULODEXIDUM**
SULODEXIDUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
CLOPIDOGRELUM**
TRIFLUSALUM
TRIFLUSALUM

Denumire Comerciala

THIOSSEN 600 (vezi N07XN03)


THIOCTACID 600T (vezi N07XN03)
FRAGMIN 10000 UI/0,4 ml
FRAGMIN 12500 UI/0,5 ml
FRAGMIN15000 UI/0,6 ml
FRAGMIN 18000 UI/0,72 ml
FRAGMIN 2500 UI/0,2 ml
FRAGMIN 5000 UI/0,2 ml
FRAGMIN 7500 UI/0,3 ml
CLEXANE 2000ui anti-Xa/0,2ml
CLEXANE 4000ui anti-Xa/0,4ml
CLEXANE 6000ui anti-Xa/0,6ml
CLEXANE 8000ui anti-Xa/0,8ml
FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml
FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml
FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml
FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml
FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml
FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml
FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml
FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml

INNOHEP 10000 UI ANTI-XA/ml


INNOHEP 20000 UI ANTI-Xa/ml
INNOHEP 10000 UI ANTI-XA/ml
INNOHEP 10000 UI ANTI-XA/ml
INNOHEP 20000 UI ANTI-Xa/ml
INNOHEP 20000 UI ANTI-Xa/ml
INNOHEP 20000 UI ANTI-Xa/ml
VESSEL DUE F
COREFLUX 250 ULS
COREFLUX 600 ULS/2 ml
VESSEL DUE F
PLAVIX 300mg
PLAVIX 300mg
ZYLLT
PLAVIX 75mg
CLOPIDOGREL MYLAN 75mg
TROGRAN 75 mg
CLOPIGAMMA 75 mg
CLOPIGAMMA 75 mg
PLAVOCORIN 75 mg
CLOPIDOGREL ACTAVIS 75 mg
DEFROZYP 75 mg
TESSYRON 75 mg
CLOPIDOGREL DR. REDDY'S 75 mg
CLOPIDOGREL TERAPIA 75 mg
DEPLATT 75 mg
TROMBEX 75 mg
TROMBEX 75 mg
CLOPIDOGREL AUROBINDO 75 mg
PLAVIX 75mg
PLATROX 300 mg
AFLEN (R)
COMBINATII (ACID ACETYLSALICYLICUM+DIPYRIDAMOLUM)** AGGRENOX 200mg/25mg
RIVAROXABANUM**
XARELTO 10mg
RIVAROXABANUM**
XARELTO 10mg
FONDAPARINUX SODIUM**#
ARIXTRA 2,5mg/0,5ml
FONDAPARINUX SODIUM**#
ARIXTRA 2,5mg/0,5ml
FONDAPARINUX SODIUM**#
ARIXTRA 7,5mg/0,6ml
FONDAPARINUX SODIUM**#
ARIXTRA 7,5mg/0,6ml
COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R)
IVABRADINUM**
CORLENTOR 5mg
IVABRADINUM**
CORLENTOR 7,5mg
MOXONIDINUM
MOXOGAMMA 0,2 mg
MOXONIDINUM
PHYSIOTENS 0,2
MOXONIDINUM
MOXONIDINA MYLAN 0,2 mg

Tara det.
forma farm. concentratie
APP
Detinator APP
COMPR. FILM. 600mg
AAA - PHARMA GMBH GERMANIA

SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.

25mg/ml

10000UI/0,4ml PFIZER EUROPE MA EEIG


12500 UI/0,5ml PFIZER EUROPE MA EEIG
15000ui/0,6ml PFIZER EUROPE MA EEIG

S/P-RF
S/P-RF

MAREA BRITANIE

CUTIE CU 5 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,6 ML SOLUTIE INJECTABILA

S/P-RF

MAREA BRITANIE

CUTIE CU 5 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,72 ML SOLUTIE INJECTABILA

S/P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE CU 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP X 0,2 ML SOLUTIE INJECTABILA

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE CU 10 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA

S/P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE CU 10 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,3 ML SOLUTIE INJECTABILA

S/P-RF
PR/PRF

CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML SOL. INJ.

PR/PRF

CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ.

PR/PRF

8000UI anti-Xa/0,8ml

LABORATOIRE AVENTIS

FRANTA
FRANTA
FRANTA
FRANTA

CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ.

6000ui anti-Xa/0,6ml

LAB. AVENTIS
LAB. AVENTIS
LAB. AVENTIS

CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,8 ML SOL INJ.

PR/PRF

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.

18000 UI/0,72ml PFIZER EUROPE MA EEIG

2500ui/0,2ml
5000ui/0,2ml
7500ui/0,3ml
2000ui anti-Xa/0,2ml
4000ui anti-Xa/0,4ml

2850 ui AFXa/0,3ml ASPEN PHARMA TRADING LIMITED IRLANDA


3800 ui AFXa/0,4ml

5700 ui AFXa/0,6ml

7600 ui AFXa/0,8ml

10000UI anti-XA/ml

SOL. INJ. IN SERINGI PREUMPLUTE

20000UI anti-Xa/ml

SOL. INJ. IN SERINGI PREUMPLUTE

20000UI anti-Xa/ml

SOL. INJ. IN SERINGI PREUMPLUTE

20000UI anti-Xa/ml

SOL. INJ. IN SERINGA PREUMPLUTA

SOL. INJ. IN SERINGA PREUMPLUTA

SOL. INJ./PERF.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE

250ULS
250ULS
600ULS/2ml
600ULS/2ml
300mg
300mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
300 mg
300mg
25mg/200mg
10mg
10mg
2,5mg/0,5ml
2,5mg/0,5ml
7,5mg/0,6ml
7,5mg/0,6ml
20mg/ml
5mg
7,5mg
0,2mg
0,2mg
0,2mg

S/P-RF

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ.

S/P-RF
S/P-RF

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ.

S/P-RF

MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ.

S/P-RF

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ.

S/P-RF

MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ.

S/P-RF

7600 ui AFXa/0,8ml ASPEN PHARMA TRADING LIMITED IRLANDA

SOL. INJ. IN SERINGI PREUMPLUTE

SOL. INJ. IN SERINGA PREUMPLUTA

GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE

S/P-RF

MAREA BRITANIE CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ.

5700 ui AFXa/0,6ml ASPEN PHARMA TRADING LIMITED IRLANDA

10000UI anti-XA/ml

SOL. INJ. IN SERINGA PREUMPLUTA

GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE

3800 ui AFXa/0,4ml ASPEN PHARMA TRADING LIMITED IRLANDA

SOL. INJ. IN SERINGI PREUMPLUTE

COMPR. FILM.
COMPR. FILM.

S/P-RF

CUTIE CU 5 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,5 ML SOLUTIE INJECTABILA

20000 UI anti-Xa/ml

CAPS. ELIB. MODIF.

CUTIE X 5 FIOLE X 24 ML SOL.INJ.


CUTIE CU 5 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,4 ML SOLUTIE INJECTABILA

SOL. INJ. IN FLACOANE

CAPS.
CAPS.

Ambalaj

CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM. P-6L

MAREA BRITANIE

10000UI anti-XA/ml

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

GERMANIA
MAREA BRITANIE

SOL. INJ. IN FLACOANE

CAPS. MOI
CAPS. MOI
SOL INJ.
SOL. INJ.

MEDA PHARMA GMBH & CO KG

Prescriptie

Nr. crt

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ.

S/P-RF

LEO PHARMA A/S


LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S
LEO PHARMA A/S

DANEMARCA

ALFA WASSERMANN SPA

ITALIA

SANIENCE S.R.L.
SANIENCE S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. MOI


ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ.

ALFA WASSERMANN SPA

CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA)

P-RF

SANOFI CLIR SNC

ITALIA
FRANTA
FRANTA

CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA)

P-RF

KRKA D.D. NOVO MESTO

SLOVENIA

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

FRANTA
FRANTA

CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-RF

SANOFI PHARMA - BRISTOL MYERS SQUIBB

SANOFI PHARMA - BRISTOL MYERS SQUIBB

MYLAN S.A.S.

DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT IN AURIU SI CAPSA DE SIGURANTA DIN PP DE CULOARE PORTOCALIE

CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT CU LAC DE CULOARE VERDE SI CAPSA DE SIGURANTA DIN PP DE CULOARE VERDE INCHIS

PR/PRF
PR/PRF

CUTIE CU 10 SERINGI PREUMPLUTE X 0.35 ML (3500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC VERDE

PR/PRF

CUTIE CU 10 SERINGI PREUMPLUTE X 0.45 ML (4500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU

PR/PRF

CUTIE CU 2 SERINGI PREUMPLUTE X 0,50 ML (10000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ROSU

PR/PRF

CUTIE CU 2 SERINGI PREUMPLUTE X 0,70 ML (14000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC GALBEN

PR/PRF

CUTIE CU 2 SERINGI PREUMPLUTE X 0,90 ML (18000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU

PR/PRF

CUTIE X 2 BLIST. PVDC-PVC/AL-PVDC X 25 CAPS. MOI P-RF

PRF
PRF

CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML P-RF

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

P-RF

P-RF

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

WORWAG PHARMA GMBH & CO. KG

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

WORWAG PHARMA GMBH & CO. KG

GERMANIA

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

SANDOZ S.R.L.

ROMANIA

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

P-RF

ACTAVIS GROUP PTC EHF.

ISLANDA

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

P-RF

P-RF

LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF

ROMANIA
ROMANIA
ROMANIA
TORRENT PHARMA S.R.L. ROMANIA

GEDEON RICHTER ROMANIA SA

CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM.

P-RF

DR. REDDY'S LABORATORIES

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-RF

TERAPIA S.A.

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

PRF

ZENTIVA K.S.
ZENTIVA K.S.
AUROBINDO PHARMA (MALTA) LIMITED

SANOFI CLIR SNC

CEHIA
CEHIA
MALTA
FRANTA

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

PRF

CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 30 COMPRIMATE FILMATE

P-RF

CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 90 COMPRIMATE FILMATE

P-RF

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


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

P-RF

CUTIE CU 5 BLIST. AL-PVC/PVDC X 10 CAPS. PRF

GALENICA S.A.

GRECIA CUTIE X 5 BLIST. X 10 CAPS.

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA

CUTIE X 1 FLAC. DIN PP X 60 CAPS. CU ELIB.MODIF. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII +DESICAN

BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 10 COMPR. FILM.


BAYER PHARMA AG GERMANIA CUTIE X BLIST PP/AL X 30 COMPR. FILM.
GLAXO GROUP LTD. MAREA BRITANIE
ASPEN PHARMA TRADING LIMITED IRLANDA
GLAXO GROUP LTD. MAREA BRITANIE
ASPEN PHARMA TRADING LIMITED IRLANDA
VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML
LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR)
LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR)

P-RF

P-6L
P-RF
P-RF

CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA X 0,5ML SOLUTIE INJECTABILA PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA DE CULOARE ALBASTRA

P-RF

CUTIE X 10 SERINGI PREUMPLUTE X 0,5 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE ALBASTRA

P-RF

CUTIE X 10 SERINGI PREUMPLUTE DIN STICLA X 0,6ML SOLUTIE INJECTABILA PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA DE CULOARE PURPURIE

P-RF

CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE

P-RF
S/P-RF

P-6L
P-6L

WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L

GENERICS (UK) LTD

MAREA BRITANIE

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

Pagina 2 din 16

P6L

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
5
5
5
5
5
10
10
10
10
10
10
6
10
10
10
10
10
10
10
10
10
10
10
10
2
2
2
50
50
10
10
30
30
28
28
28
28
28
28
28
28
28
30
30
30
30
30
90
28
28
50
50
60
10
30
10
10
10
10
5
56
56
30
28
28

1,592000
24,924000
18,430000
23,398000
27,346000
33,530000
5,280730
10,561460
13,673000
5,280730
10,561460
14,988000
19,778333
5,280730
5,280730
7,040971
7,040971
10,561460
10,561460
14,081943
14,081943
30,175597
60,351199
5,280730
6,789508
7,543897
21,122920
27,158040
1,540449
1,365800
5,413000
6,037000
4,366281
4,366281
0,460714
1,091570
0,545714
1,091570
0,637142
0,637142
0,618928
0,422142
1,091570
0,688666
1,091570
1,091570
0,919333
0,581000
0,562000
0,593928
1,091570
0,545785
0,545785
0,880833
11,170250
11,020000
19,409000
19,409000
58,227000
48,522499
31,080000
2,633544
3,856071
0,483666
0,781998
0,383571

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,918270
0,889540
0,000000
1,146270
1,098540
0,000000
0,000000
1,164270
1,164270
1,456029
1,456029
2,623540
2,623540
1,936057
1,936057
22,635403
52,533801
7,047270
9,064492
29,446103
29,297080
32,616960
0,523951
0,000000
0,000000
1,872000
4,976052
4,976052
0,000000
0,556287
0,000000
0,015215
0,000000
0,000000
0,000000
0,000000
0,015215
0,000000
0,014763
0,014763
0,000000
0,000000
0,000000
0,000000
0,556287
0,151815
0,527215
0,000000
0,450750
0,000000
0,000000
0,000000
0,293000
9,997501
0,000000
1,358956
0,000000
0,000000
0,297644
0,000000

0,796000
12,462000
9,215000
11,699000
13,673000
16,765000
2,640365
5,280730
6,836500
2,640365
5,280730
7,494000
9,889166
2,640365
2,640365
3,520485
3,520485
5,280730
5,280730
7,040971
7,040971
15,087798
30,175599
2,640365
3,394754
3,771948
10,561460
13,579020
0,770224
0,682900
2,706500
3,018500
2,183140
2,183140
0,230357
0,545785
0,272857
0,545785
0,318571
0,318571
0,309464
0,211071
0,545785
0,344333
0,545785
0,545785
0,459666
0,290500
0,281000
0,296964
0,545785
0,272892
0,272892
0,440416
5,585125
5,510000
9,704500
9,704500
29,113500
24,261249
15,540000
1,316772
1,928035
0,241833
0,390999
0,191785

0,796000
12,462000
9,215000
11,699000
13,673000
16,765000
3,558635
6,170270
6,836500
3,786635
6,379270
7,494000
9,889167
3,804635
3,804635
4,976515
4,976515
7,904270
7,904270
8,977029
8,977029
37,723202
82,709401
9,687635
12,459246
33,218052
39,858540
46,195980
1,294176
0,682900
2,706500
4,890500
7,159193
7,159193
0,230357
1,102072
0,272857
0,561000
0,318571
0,318571
0,309464
0,211071
0,561000
0,344333
0,560548
0,560548
0,459667
0,290500
0,281000
0,296964
1,102072
0,424708
0,800108
0,440417
6,035875
5,510000
9,704500
9,704500
29,406500
34,258751
15,540000
2,675728
1,928036
0,241833
0,688643
0,191786

1,432800
22,431600
16,587000
21,058200
24,611400
30,177000
4,752657
9,505314
12,305700
4,752657
9,505314
13,489200
17,800499
4,752657
4,752657
6,336873
6,336873
9,505314
9,505314
12,673748
12,673748
27,158037
54,316079
4,752657
6,110557
6,789507
19,010628
24,442236
1,386404
1,229220
4,871700
5,433300
3,929652
3,929652
0,414642
0,982413
0,491142
0,982413
0,573427
0,573427
0,557035
0,379927
0,982413
0,619799
0,982413
0,982413
0,827399
0,522900
0,505800
0,534535
0,982413
0,491206
0,491206
0,792749
10,053225
9,918000
17,468100
17,468100
52,404300
43,670249
27,972000
2,370189
3,470463
0,435299
0,703798
0,345213

0,159200
2,492400
1,843000
2,339800
2,734600
3,353000
1,446343
1,945686
1,367300
1,674343
2,154686
1,498800
1,977834
1,692343
1,692343
2,160127
2,160127
3,679686
3,679686
3,344252
3,344252
25,652963
58,568921
7,575343
9,743443
30,200493
31,409372
35,332764
0,677996
0,136580
0,541300
2,475700
5,412681
5,412681
0,046072
0,665444
0,054572
0,124372
0,063715
0,063715
0,061893
0,042215
0,124372
0,068867
0,123920
0,123920
0,091934
0,058100
0,056200
0,059393
0,665444
0,206394
0,581794
0,088084
1,567775
1,102000
1,940900
1,940900
6,115700
14,849751
3,108000
1,622311
0,385608
0,048367
0,375844
0,038358

DCI

MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
RILMENIDINUM
RILMENIDINUM
EPLERENONUM*#
EPLERENONUM*#
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM

128 C02AC05
129 C02AC05
130 C02AC05
131 C02AC05
132 C02AC06
133 C02AC06
134 C03DA04
135 C03DA04
136 C07AB12
137 C07AB12
138 C07AB12
139 C07AB12
140 C07AB12
141 C07AB12
142 C07AB12
143 C07AB12
144 C07AB12
145 C07AB12
146 C07BB07
147 C07BB07
148 C07BB07
149 C07BB07
150 C08CA09
151 C08CA13
152 C08CA13
153 C08CA13
154 C08CA13
155 C08CA13
156 C08CA13
157 C08CA13
158 C08CA13
159 C08CA13
160 C08CA13
161 C08CA13
162 C08CA13
163 C09AA04
164 C09AA04
165 C09AA04
166 C09AA04
167 C09AA04
168 C09AA04
169 C09AA04
170 C09AA04
171 C09AA04
172 C09AA04
173 C09AA04
174 C09AA04
175 C09AA04
176 C09AA04
177 C09AA04
178 C09AA04
179 C09AA04
180 C09AA04
181 C09AA04
182 C09AA07
183 C09AA07
184 C09AA10
185 C09AA10
186 C09AA10
187 C09AA15
188 C09AA15
189 C09BA04
190 C09BA04
191 C09BA04
192 C09BA04

Denumire Comerciala

MOXOGAMMA 0,3 mg
MOXONIDINA MYLAN 0,3 mg
MOXOGAMMA 0,4 mg
PHYSIOTENS 0,4
MOXONIDINA MYLAN 0,4 mg
TENAXUM
RILMENIDINA TEVA 1 mg
INSPRA 25 mg
INSPRA 50 mg
NEBILET (R)
NEBIVOLOL ACTAVIS 5 mg
X-PRESSOL 5 mg
NOLET 5 mg
NEBIVOLOL TEVA 5 mg
NEBIVOLOL TEVA 5 mg
NEBINORM 5 mg
NEBIVOLOL SANDOZ 5 mg
NEBIVOLOL TERAPIA 5mg
NEBIVOLOL TORRENT 5 mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 2,5mg/6,25mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM) LODOZ 5mg/6,25mg
LACIDIPINUM
LACIPIL 4 mg
LERCANIDIPINUM
LERCANIDIPINA TEVA 10 mg
LERCANIDIPINUM
LERCANIDIPINA TEVA 10 mg
LERCANIDIPINUM
LERCANIDIPIN ACTAVIS 10 mg
LERCANIDIPINUM
LERIDIP
LERCANIDIPINUM
KAPIDIN10 mg
LERCANIDIPINUM
LERCANIDIPIN ACTAVIS 10 mg
LERCANIDIPINUM
LERCANIDIPINA ZENTIVA 10 mg
LERCANIDIPINUM
LERCANIDIPINA TEVA 20 mg
LERCANIDIPINUM
LERCANIDIPINA TEVA 20 mg
LERCANIDIPINUM
LERCANIDIPIN ACTAVIS 20 mg
LERCANIDIPINUM
LERIDIP 20
LERCANIDIPINUM
LERCANIDIPIN ACTAVIS 20 mg
PERINDOPRILUM
PRENESSA 2 mg
PERINDOPRILUM
PERINDOPRIL TEVA 4 mg
PERINDOPRILUM
VIDOTIN 4 mg
PERINDOPRILUM
STOPRESS 4 mg
PERINDOPRILUM
TREZEN 4 mg
PERINDOPRILUM
TREZEN 4 mg
PERINDOPRILUM
PRENESSA 4 mg
PERINDOPRILUM
PRINDEX 4 mg
PERINDOPRILUM
PERINDOPRIL TEVA 8 mg
PERINDOPRILUM
VIDOTIN 8 mg
PERINDOPRILUM
STOPRESS 8 mg
PERINDOPRILUM
TREZEN 8 mg
PERINDOPRILUM
TREZEN 8 mg
PERINDOPRILUM
PRINDEX 8 mg
PERINDOPRILUM
PRENESSA 8 mg
PERINDOPRILUM
PRESTARIUM 10 mg
PERINDOPRILUM
PERINDOPRIL TOSILAT TEVA 10 mg
PERINDOPRILUM
PRESTARIUM 5 mg
PERINDOPRILUM
PERINDOPRIL TOSILAT TEVA 5 mg
BENAZEPRILUM
CIBACEN (R) 20 mg
BENAZEPRILUM
CIBACEN (R) 5 mg
TRANDOLAPRILUM
GOPTEN (R) 0,5 mg
TRANDOLAPRILUM
GOPTEN (R) 2 mg
TRANDOLAPRILUM
GOPTEN (R) 4 mg
ZOFENOPRILUM
ZOMEN (R) 30 mg
ZOFENOPRILUM
ZOMEN (R) 7,5 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 2 mg/0,625 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX PLUS 2 mg/0,625 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 2mg/0,625 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) COTREZEN 4 mg/1,25 mg

forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

concentratie

0,3mg
0,3mg
0,4mg
0,4mg
0,4mg
COMPR.
1mg
COMPR.
1mg
COMPR. FILM. 25mg
COMPR. FILM. 50mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.

COMPR.
COMPR.
COMPR.
COMPR.

Detinator APP

Tara det.
APP

Ambalaj

Prescriptie

cod ATC

127 C02AC05

Nr. crt

WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L

GENERICS (UK) LTD

MAREA BRITANIE

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

P6L

WORWAG PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM. P-6L

GENERICS (UK) LTD

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

P6L

LES LABORATOIRES SERVIER

FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.

P-6L

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

PFIZER EUROPE MA EEIG

MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM.

P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM.

P-RF

BERLIN CHEMIE AG MENARINI GROUP

GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L

MAREA BRITANIE

ACTAVIS S.R.L.

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

ROMANIA
LABORMED PHARMA S.A. ROMANIA
ANTIBIOTICE S.A. ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L


CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L

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

P-6L

CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P-6L


CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L

SANDOZ S.R.L.
TERAPIA S.A.

ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L


ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L
TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L

2,5mg/6,25mg MERCK KGAA


2,5mg/6,25mg MERCK KGAA

GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM.

5mg/6,25mg
5mg/6,25mg
4mg
10 mg
10 mg
10mg
10mg
10mg
10mg
10mg
20 mg
20 mg
20mg
20mg
20mg
2mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
10 mg
10mg
5mg
5mg
20mg
5mg
0,5mg
2mg
4mg
30mg
7,5mg

GERMANIA CUTIE X 3 BLIST. PP/AL X 10 COMPR. FILM.

MERCK KGAA
MERCK KGAA

P-6L

GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L


P-6L

GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-6L

GLAXO OPERATIONS UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-6L

ROMANIA
ROMANIA

CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. FILM. P-6L

TEVA PHARMACEUTICALS S.R.L.

ACTAVIS GROUP PTC EHF.

ISLANDA

CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L

BERLIN CHEMIE AG MENARINI GROUP

GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR.FILM.

ZENTIVA K.S.

REPUBLICA CEHA

TEVA PHARMACEUTICALS S.R.L.

CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L

P-6L

CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L

ACTAVIS GROUP PTC EHF.

ISLANDA

ZENTIVA K.S.

REPUBLICA CEHA

CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L


CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. FILM. P-6L

TEVA PHARMACEUTICALS S.R.L.

ROMANIA
ROMANIA

ACTAVIS GROUP PTC EHF.

ISLANDA

CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L

BERLIN CHEMIE AG MENARINI GROUP

GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. P-6L

ACTAVIS GROUP PTC EHF.

ISLANDA

TEVA PHARMACEUTICALS S.R.L.

CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L

CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-6L

CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM. P-6L

POLONIA CUTIE CU 1 BLIST. DIN PVC-PE-PVDC/AL X 30 COMPR. P-6L


TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST. PVC/VMCH-AL X 30 COMPR.
P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L
PHARMACEUTICAL WORKS POLPHARMA SA
POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L
TERAPIA S.A.
ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
TERAPIA S.A.
ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L
KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 PUNGA DIN AL X 1 BLIST PVC/VMCH-AL X 30 COMPR. P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR. P-6L
PHARMACEUTICAL WORKS POLPHARMA SA
POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L
TERAPIA S.A.
ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
TERAPIA S.A.
ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L
KRKA POLSKA SP Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
KRKA POLSKA SP. Z.O.O.

LES LABORATOIRES SERVIER

FRANTA

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L

LES LABORATOIRES SERVIER

FRANTA

CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM.


CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM.

P-6L

P-6L

ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L


CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 10 CAPS.
P-6L
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS.
P-6L
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. X 14 CAPS.
P-6L

TEVA PHARMACEUTICALS S.R.L.

NOVARTIS PHARMA GMBH GERMANIA

MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A.

LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L

MENARINI INTERNATIONAL OPERATIONS LUXEMBURG S.A.

LUXEMBURG CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L

TERAPIA S.A.

ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR. P6L


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
2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
4 mg/1,25 mg TERAPIA S.A.
ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR. P6L
2 mg/0,625 mg

Pagina 3 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
28
30
28
28
30
30
30
30
28
30
30
30
28
30
30
28
28
30
30
30
30
30
14
60
30
30
60
30
30
30
60
30
30
60
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
28
28
20
28
28
28
28
30
30
30
30

0,697000
0,575000
0,772000
1,563998
0,928928
1,003000
0,651666
3,016791
4,889000
0,647142
0,363000
0,420666
0,420666
0,420357
0,229000
0,229000
0,420357
0,420357
0,420666
0,722000
0,722000
0,722000
0,722000
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,264299
0,528598
0,528598
0,528598
0,528598
0,528598
0,148965
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,595863
0,595863
0,595863
0,595863
0,595863
0,595863
0,595863
0,744828
0,744828
0,372414
0,372414
0,794483
0,198620
0,074482
0,297931
0,595863
0,297931
0,074482
0,543333
0,559333
0,372333
0,748350

0,000000
0,000000
0,000000
0,038859
0,000000
0,000000
0,000000
1,716875
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,397129
0,165034
0,165034
0,165034
0,374867
0,165034
0,165034
0,165034
0,150068
0,173068
0,113402
0,515402
0,113402
0,224035
0,342069
0,079735
0,216735
0,596735
0,596735
0,190069
0,097069
0,221137
0,094470
0,314803
1,103137
1,103137
0,028803
0,214137
0,950172
0,120172
0,617252
0,271252
1,324088
0,584594
0,310018
0,314926
0,581279
1,250640
0,655160
0,000000
0,000000
0,000000
0,088983

0,348500
0,287500
0,386000
0,781999
0,464464
0,501500
0,325833
1,508395
2,444500
0,323571
0,181500
0,210333
0,210333
0,210178
0,114500
0,114500
0,210178
0,210178
0,210333
0,361000
0,361000
0,361000
0,361000
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,132149
0,264299
0,264299
0,264299
0,264299
0,264299
0,074482
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,148965
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,297931
0,372414
0,372414
0,186207
0,186207
0,397241
0,099310
0,037241
0,148965
0,297931
0,148965
0,037241
0,271666
0,279666
0,186166
0,374175

0,348500
0,287500
0,386000
0,820858
0,464464
0,501500
0,325833
3,225271
2,444500
0,323571
0,181500
0,210333
0,210333
0,210179
0,114500
0,114500
0,210179
0,210179
0,210333
0,361000
0,361000
0,361000
0,361000
0,529279
0,297184
0,297184
0,297184
0,507017
0,297184
0,297184
0,297184
0,414367
0,437367
0,377701
0,779701
0,377701
0,298518
0,491035
0,228701
0,365701
0,745701
0,745701
0,339035
0,246035
0,519069
0,392402
0,612735
1,401069
1,401069
0,326735
0,512069
1,322586
0,492586
0,803459
0,457459
1,721330
0,683904
0,347259
0,463892
0,879211
1,399606
0,692401
0,271667
0,279667
0,186167
0,463158

0,627300
0,517500
0,694800
1,407598
0,836035
0,902700
0,586499
2,715111
4,400100
0,582427
0,326700
0,378599
0,378599
0,378321
0,206100
0,206100
0,378321
0,378321
0,378599
0,649800
0,649800
0,649800
0,649800
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,237869
0,475738
0,475738
0,475738
0,475738
0,475738
0,134068
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,268137
0,536276
0,536276
0,536276
0,536276
0,536276
0,536276
0,536276
0,670345
0,670345
0,335172
0,335172
0,715034
0,178758
0,067033
0,268137
0,536276
0,268137
0,067033
0,488999
0,503399
0,335099
0,673515

0,069700
0,057500
0,077200
0,195259
0,092893
0,100300
0,065167
2,018555
0,488900
0,064715
0,036300
0,042067
0,042067
0,042036
0,022900
0,022900
0,042036
0,042036
0,042067
0,072200
0,072200
0,072200
0,072200
0,423559
0,191464
0,191464
0,191464
0,401297
0,191464
0,191464
0,191464
0,202928
0,225928
0,166262
0,568262
0,166262
0,238932
0,371863
0,109529
0,246529
0,626529
0,626529
0,219863
0,126863
0,280724
0,154057
0,374390
1,162724
1,162724
0,088390
0,273724
1,024655
0,194655
0,654494
0,308494
1,403537
0,604456
0,317467
0,344720
0,640866
1,280434
0,662609
0,054334
0,055934
0,037234
0,163818

cod ATC

DCI

Denumire Comerciala

193 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PRINDEX


194 C09BA04
195 C09BA04
196 C09BA04
197 C09BA04
198 C09BA04

PLUS 4 mg/1,25mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PANINDORIL 4 mg/1,25 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 4mg/1,25 mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) CO-PRENESSA 8 mg/2,5mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLITERAX 10 mg/2,5mg
COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL ARG 2,5mg/0,625mg

199 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM)PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 2,5 mg/0,625 mg


200 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) NOLIPREL

ARG FORTE 5mg/1,25mg

201 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM)PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 5 mg/1,25 mg

ACCUZIDE
ACCUZIDE FORTE
ENEAS
COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/10 mg
COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 4 mg/5 mg
COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/10 mg
COMBINATII (PERINDOPRILUM+AMLODIPINUM) AMLESSA 8 mg/5 mg
COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/2 mg
COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA 240 mg/4 mg
COMBINATII (VERAPAMILUM+TRANDOLAPRILUM) TARKA
VALSARTANUM
VALSARTAN TEVA 160 mg
VALSARTANUM
VALSARTAN TEVA 80 mg
VALSARTANUM
WENZELL 160 mg
VALSARTANUM
WENZELL 160 mg
VALSARTANUM
VALSARGAMMA 160 mg
VALSARTANUM
DIOVAN 160 mg
VALSARTANUM
VALSACOR 160 mg
VALSARTANUM
AVASSAN 160 mg
VALSARTANUM
VALSARTAN ZENTIVA 160 mg
VALSARTANUM
VAPRESS 160 mg
VALSARTANUM
VAPRESS 160 mg
VALSARTANUM
DIOVAN 40 mg
VALSARTANUM
AVASSAN 40 mg
VALSARTANUM
VAPRESS 40 mg
VALSARTANUM
VAPRESS 40 mg
VALSARTANUM
WENZELL 80 mg
VALSARTANUM
WENZELL 80 mg
VALSARTANUM
VALSARGAMMA 80 mg
VALSARTANUM
DIOVAN 80 mg
VALSARTANUM
VALSACOR 80 mg
VALSARTANUM
AVASSAN 80 mg
VALSARTANUM
VALSARTAN ZENTIVA 80 mg
VALSARTANUM
VAPRESS 80 mg
VALSARTANUM
VAPRESS 80 mg
VALSARTANUM
DIOVAN 3 mg/ml
IRBESARTANUM
IRBESARTAN AUROBINDO 150 mg
IRBESARTANUM
IRBESARTAN AUROBINDO 300 mg
IRBESARTANUM
IRBESARTAN GALENICA 150 mg
IRBESARTANUM
APROVEL 150mg
IRBESARTANUM
IRBESARTAN TERAPIA 150 mg
IRBESARTANUM
IRBESARTAN SANDOZ 150 mg
IRBESARTANUM
IRPRESTAN 150 mg
IRBESARTANUM
IFIRMASTA 150 mg
IRBESARTANUM
IRBESARTAN TEVA 150 mg
IRBESARTANUM
ATOKKEN 150 mg
IRBESARTANUM
IRBESARTAN ZENTIVA 150mg
IRBESARTANUM
IRBESARTAN HF 150 mg
IRBESARTANUM
APROVEL 150mg
IRBESARTANUM
ATOKKEN 150 mg
IRBESARTANUM
IRBESARTAN TEVA 300 mg
IRBESARTANUM
IRBESARTAN GALENICA 300 mg
IRBESARTANUM
APROVEL 300mg
IRBESARTANUM
IRBESARTAN TERAPIA 300 mg
IRBESARTANUM
IRBESARTAN SANDOZ 300 mg
IRBESARTANUM
IFIRMASTA 300mg
IRBESARTANUM
ATOKKEN 300 mg
IRBESARTANUM
IRBESARTAN ZENTIVA 300mg

202 C09BA06

COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM)

203 C09BA06

COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM)

204 C09BB02 COMBINATII (NITRENDIPINUM+ENALAPRILUM)


205 C09BB04
206 C09BB04
207 C09BB04
208 C09BB04
209 C09BB10
210 C09BB10
211 C09BB10
212 C09CA03
213 C09CA03
214 C09CA03
215 C09CA03
216 C09CA03
217 C09CA03
218 C09CA03
219 C09CA03
220 C09CA03
221 C09CA03
222 C09CA03
223 C09CA03
224 C09CA03
225 C09CA03
226 C09CA03
227 C09CA03
228 C09CA03
229 C09CA03
230 C09CA03
231 C09CA03
232 C09CA03
233 C09CA03
234 C09CA03
235 C09CA03
236 C09CA03
237 C09CA04
238 C09CA04
239 C09CA04
240 C09CA04
241 C09CA04
242 C09CA04
243 C09CA04
244 C09CA04
245 C09CA04
246 C09CA04
247 C09CA04
248 C09CA04
249 C09CA04
250 C09CA04
251 C09CA04
252 C09CA04
253 C09CA04
254 C09CA04
255 C09CA04
256 C09CA04
257 C09CA04
258 C09CA04

forma farm.

concentratie

Detinator APP

COMPR.
COMPR.
COMPR.
COMPR.

4 mg/1,25mg GLENMARK PHARMACEUTICALS S.R.O.


4mg/1, 25mg SANDOZ S.R.L.
4mg/1,25mg KRKA POLSKA SP ZO.O.
8mg/2,5mg KRKA-POLSKA SP. Z O.O.
COMPR. FILM. 10mg/2,5mg LES LAB. SERVIER

Prescriptie

Nr. crt

Tara det.
APP

Ambalaj
P6L
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L
POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L

REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

2,5mg/0,625mg

LES LABORATOIRES SERVIER

FRANTA
FRANTA

2,5mg/0,625mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L

5mg/1,25mg
5mg/1,25mg

LES LABORATOIRES SERVIER

FRANTA

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

20mg+10mg
4mg/10mg
4mg/5mg
8mg/10mg
8mg/5mg
240mg/2mg
240mg/4mg
180mg/2mg
160mg
80mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
3mg/ml
150mg
300mg
150 mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
300 mg
300 mg
300mg
300mg
300mg
300mg
300mg
300mg

COMPR. CU ELIB. MODIF.


COMPR. CU ELIB. MODIF.
COMPR.FILM.ELIB.MODIF.

CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

SOL. ORALA
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

10mg/12,5mg PFIZER EUROPE MA EEIG


20mg/12,5mg PFIZER EUROPE MA EEIG

GALENICA S.A.

CUTIE X 1 FLAC. DIN PP CU CAPAC PEJD CU SILICAGEL X 30 COMPR. FILM. P-6L

CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM.

CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM.

P-6L

P-6L

MAREA BRITANIE

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

P-6L

MAREA BRITANIE

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

P-6L

GRECIA

CUTIE X 3 BLIST. PA-PVC-AL/AL X 10 COMPR. P-6L

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

P6L

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

P6L
P6L
P6L

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.


KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

ABBOTT GMBH & CO.KG GERMANIA

CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF.

ABBOTT GMBH & CO.KG GERMANIA

CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF.

P6L
P6L

ABBOTT GMBH&CO.KG GERMANIA

CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. FILM. CU ELIB. PREL.

P-6L

ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS.


ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS.
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM.
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM.

TEVA PHARMACEUTICALS S.R.L.


TEVA PHARMACEUTICALS S.R.L.

WORWAG PHARMA GMBH & CO. KG

GERMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L
P-6L
P-6L
P-6L

P6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L

KRKA D.D. NOVO MESTO

SLOVENIA

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

P6L

TERAPIA S.A.
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.
P-6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM. P6L

TERAPIA S.A.
ROMANIA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU

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

P6L

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

P6L

ROMANIA
ROMANIA

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

P-6L

ROMASTRU TRADING S.R.L.

CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM.

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM.

P6L
P6L
P6L

ROMASTRU TRADING S.R.L.

KRKA D.D. NOVO MESTO

SLOVENIA

CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L

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

TERAPIA S.A.
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.
P-6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM. P6L
NOVARTIS PHARMA GMBH GERMANIA

CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML )

P-6L

SANOFI PHARMA - BRISTOL MYERS SQUIBB

MALTA
MALTA
GRECIA
FRANTA

TERAPIA S.A.
SANDOZ S.R.L.

ROMANIA
ROMANIA

CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L

ACTAVIS GROUP PTC EHF.

ISLANDA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L

AUROBINDO PHARMA (MALTA) LIMITED


AUROBINDO PHARMA (MALTA) LIMITED

GALENICA S.A.

CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L


CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L
CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM.

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

KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM.

TEVA PHARMA B.V. OLANDA


FRANTA

P-6L

P-6L

CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L

ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.


SANOFI-AVENTIS GROUPE

P6L

CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L

P6L

CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L

STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L

SANOFI CLIR SNC

FRANTA

NEOLA PHARMA S.R.L. ROMANIA

TEVA PHARMA B.V. OLANDA


GALENICA S.A.
GRECIA
SANOFI PHARMA - BRISTOL MYERS SQUIBB
FRANTA
TERAPIA S.A.
ROMANIA
SANDOZ S.R.L.
ROMANIA

CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L


CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.

P6L

CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.P-6L


CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM.

P6L

CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L


CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.

P-6L

KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM.

P-6L

ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.

P6L

SANOFI-AVENTIS GROUPE

FRANTA

CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L

Pagina 4 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
28
28
28
28
28
28
30
30
28
28
28
28
28
28
28
28
28
28
28
30
30
28
28
28
28
28
28
1
28
28
28
28
28
28
30
28
28
28
28
30
28
28
28
28
28
28
28
28
28
28

0,748350
0,703000
0,694000
0,748350
0,748350
0,748350
0,339333
0,748350
0,679666
0,536666
0,748350
2,927000
0,732000
0,505253
1,010506
0,729810
1,829285
1,829285
1,829285
0,459642
0,409285
1,070357
1,070333
0,761333
1,411263
0,534285
1,070357
0,561785
0,772142
0,772142
0,352815
0,352815
0,352815
0,352815
0,705631
0,705631
0,611666
0,705631
0,437857
0,705631
0,522857
0,385714
0,385714
4,233791
0,368571
0,516071
0,368571
0,705631
0,705631
0,616785
0,299333
0,537500
0,597500
0,705631
0,567500
0,705631
0,705631
0,705631
0,812142
0,576785
1,411263
1,075357
0,802500
0,863571
1,075357
0,887142

0,009650
0,000000
0,000000
0,249983
1,026983
0,580650
0,000000
0,419650
0,000000
0,000000
0,234650
0,000000
0,000000
0,159747
0,172827
0,389190
0,225357
0,864286
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,182665
0,000000
0,000000
0,000000
0,000000
0,000000
2,215399
1,226827
0,060399
0,060399
0,097226
0,097035
0,000000
0,489369
0,000000
0,097226
0,000000
0,000000
0,000000
37,186209
0,000000
0,000000
0,000000
0,500083
0,077940
0,000000
0,000000
0,000000
0,000000
0,077940
0,000000
0,054369
0,500083
0,077940
0,000000
0,000000
0,189451
0,000000
0,000000
0,000000
0,000000
0,000000

0,374175
0,351500
0,347000
0,374175
0,374175
0,374175
0,169666
0,374175
0,339833
0,268333
0,374175
1,463500
0,366000
0,252626
0,505253
0,364905
0,914642
0,914642
0,914642
0,229821
0,204642
0,535178
0,535166
0,380666
0,705631
0,267142
0,535178
0,280892
0,386071
0,386071
0,176407
0,176407
0,176407
0,176407
0,352815
0,352815
0,305833
0,352815
0,218928
0,352815
0,261428
0,192857
0,192857
2,116895
0,184285
0,258035
0,184285
0,352815
0,352815
0,308392
0,149666
0,268750
0,298750
0,352815
0,283750
0,352815
0,352815
0,352815
0,406071
0,288392
0,705631
0,537678
0,401250
0,431785
0,537678
0,443571

0,383825
0,351500
0,347000
0,624158
1,401158
0,954825
0,169667
0,793825
0,339833
0,268333
0,608825
1,463500
0,366000
0,412374
0,678080
0,754095
1,140000
1,778929
0,914643
0,229821
0,204643
0,535179
0,535167
0,380667
0,888297
0,267143
0,535179
0,280893
0,386071
0,386071
2,391807
1,403235
0,236807
0,236807
0,450042
0,449851
0,305833
0,842185
0,218929
0,450042
0,261429
0,192857
0,192857
39,303105
0,184286
0,258036
0,184286
0,852899
0,430756
0,308393
0,149667
0,268750
0,298750
0,430756
0,283750
0,407185
0,852899
0,430756
0,406071
0,288393
0,895083
0,537679
0,401250
0,431786
0,537679
0,443571

0,673515
0,632700
0,624600
0,673515
0,673515
0,673515
0,305399
0,673515
0,611699
0,482999
0,673515
2,634300
0,658800
0,454727
0,909455
0,656829
1,646356
1,646356
1,646356
0,413677
0,368356
0,963321
0,963299
0,685199
1,270136
0,480856
0,963321
0,505606
0,694927
0,694927
0,317533
0,317533
0,317533
0,317533
0,635067
0,635067
0,550499
0,635067
0,394071
0,635067
0,470571
0,347142
0,347142
3,810411
0,331713
0,464463
0,331713
0,635067
0,635067
0,555106
0,269399
0,483750
0,537750
0,635067
0,510750
0,635067
0,635067
0,635067
0,730927
0,519106
1,270136
0,967821
0,722250
0,777213
0,967821
0,798427

0,084485
0,070300
0,069400
0,324818
1,101818
0,655485
0,033934
0,494485
0,067967
0,053667
0,309485
0,292700
0,073200
0,210273
0,273878
0,462171
0,408286
1,047215
0,182929
0,045965
0,040929
0,107036
0,107034
0,076134
0,323792
0,053429
0,107036
0,056179
0,077215
0,077215
2,250681
1,262109
0,095681
0,095681
0,167790
0,167599
0,061167
0,559933
0,043786
0,167790
0,052286
0,038572
0,038572
37,609589
0,036858
0,051608
0,036858
0,570647
0,148504
0,061679
0,029934
0,053750
0,059750
0,148504
0,056750
0,124933
0,570647
0,148504
0,081215
0,057679
0,330578
0,107536
0,080250
0,086358
0,107536
0,088715

cod ATC

DCI

Denumire Comerciala

312 C09DA01
313 C09DA03

COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)VALSARTAN HIDROCLOROTIAZIDA TORRENT 160 mg/12,5 mg

314 C09DA03

COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)VALSARTAN HIDROCLOROTIAZIDA TORRENT 80 mg/12,5 mg

260 C09CA04
261 C09CA04
262 C09CA04
263 C09CA06
264 C09CA06
265 C09CA06
266 C09CA06
267 C09CA06
268 C09CA06
269 C09CA06
270 C09CA06
271 C09CA06
272 C09CA06
273 C09CA06
274 C09CA06
275 C09CA06
276 C09CA06
277 C09CA06
278 C09CA06
279 C09CA06
280 C09CA06
281 C09CA06
282 C09CA06
283 C09CA06
284 C09CA06
285 C09CA06
286 C09CA06
287 C09CA06
288 C09CA06
289 C09CA06
290 C09CA06
291 C09CA06
292 C09CA07
293 C09CA07
294 C09CA07
295 C09CA07
296 C09CA07
297 C09CA07
298 C09CA07
299 C09CA07
300 C09CA07
301 C09CA07
302 C09CA07
303 C09CA07
304 C09CA07
305 C09CA07
306 C09CA07
307 C09CA07
308 C09CA07
309 C09CA07
310 C09CA07
311 C09DA01

315 C09DA04
316 C09DA04
317 C09DA04
318 C09DA04
319 C09DA04
320 C09DA04
321 C09DA04
322 C09DA04
323 C09DA04
324 C09DA04

IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
CANDESARTANUM CILEXETIL
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM

forma farm.

IRBESARTAN HF 300 mg
COMPR. FILM.
APROVEL 300mg
COMPR. FILM.
ATOKKEN 300 mg
COMPR. FILM.
ATOKKEN 75 mg
COMPR. FILM.
ATACAND
COMPR.
TANDESAR 16 mg
COMPR.
CANDESARTAN SANDOZ 16 mg
COMPR.
KARBIS 16 mg
COMPR.
CANDESARTAN TORRENT 16 mg
COMPR.
ATACAND 16mg
COMPR.
CANZENO 16mg
COMPR.
CANDESARTAN LABORMED 16 mg
COMPR.
CANDESARTAN AUROBINDO 16 mg
COMPR.
CADEXYL 16 mg
COMPR.
CANDESARTAN CILEXETIL MCC 16 mg COMPR.
ATACAND 32 mg
COMPR.
KARBIS 32 mg
COMPR.
CANDESARTAN TORRENT 32 mg
COMPR.
ATACAND 32 mg
COMPR.
CANZENO 32mg
COMPR.
CADEXYL 32 mg
COMPR.
CANDESARTAN CILEXETIL MCC 32 mg COMPR.
ATACAND
COMPR.
TANDESAR 8 mg
COMPR.
CANDESARTAN SANDOZ 8 mg
COMPR.
KARBIS 8 mg
COMPR.
CANDESARTAN TORRENT 8 mg
COMPR.
ATACAND 8mg
COMPR.
CANZENO 8mg
COMPR.
CANDESARTAN LABORMED 8 mg
COMPR.
CANDESARTAN AUROBINDO 8 mg
COMPR.
CADEXYL 8 mg
COMPR.
CANDESARTAN CILEXETIL MCC 8 mg COMPR.
TELMISARTAN ACTAVIS 40mg
COMPR.
TOLURA 40 mg
COMPR.
TEZEO 40 mg
COMPR.
TELMISARTAN TEVA 40 mg
COMPR.
TELMISARTAN RANBAXY 40 mg
COMPR.
TELMISARTAN ACTAVIS 80mg
COMPR.
MICARDIS 80 mg
COMPR.
TOLURA 80 mg
COMPR.
TEZEO 80 mg
COMPR.
TELMISARTAN TEVA 80 mg
COMPR.
TELMISARTAN RANBAXY 80 mg
COMPR.
TELMARK 40 mg
COMPR. FILM.
TANYDON 40 mg
COMPR. FILM.
TELMISARTAN EGIS 40 mg
COMPR. FILM.
TELMOTENS 40mg
COMPR. FILM.
TELMARK 80 mg
COMPR. FILM.
TANYDON 80 mg
COMPR. FILM.
TELMISARTAN EGIS 80 mg
COMPR. FILM.
TELMOTENS 80mg
COMPR. FILM.
COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA HL 100 mg/12,5 mg
COMPR.FILM
COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM) LORISTA H
COMPR.FILM

259 C09CA04

concentratie

300mg
300mg
300mg
75mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
32mg
32mg
32mg
32mg
32mg
32mg
32mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
40 mg
40mg
40mg
40mg
40mg
80 mg
80mg
80mg
80mg
80mg
80mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg

Detinator APP

Tara det.
APP

Ambalaj

Prescriptie

Nr. crt

STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L

SANOFI CLIR SNC

FRANTA

NEOLA PHARMA S.R.L. ROMANIA


NEOLA PHARMA S.R.L. ROMANIA

CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L


CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.
CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.

P6L
P6L

ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L


TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L
KRKA D.D. NOVO MESTO

SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

P6L

ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L


ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR.
AUROBINDO PHARMA (MALTA) LIMITED

MALTA

P6L

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L

NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L


MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L

ASTRAZENECA AB SUEDIA

CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. P-6L

SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L


TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L
KRKA D.D. NOVO MESTO

ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L


ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L
MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L

ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L


TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L
KRKA D.D. NOVO MESTO

SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L


P6L

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L


ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR.
AUROBINDO PHARMA (MALTA) LIMITED

MALTA

P6L

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L

NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L


MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L
KRKA D.D. NOVO MESTO

SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR.

P-6L

ZENTIVA, K.S.
REPUBLICA CEHA
TEVA PHARMA B.V. OLANDA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

P-6L

CUTIE CU BLIST. AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE 30X1

P6L

RANBAXY (U.K.) LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. P6L

ACTAVIS GROUP PTC EHF.

ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)

P-6L

KRKA D.D. NOVO MESTO

SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR.

P-6L

ZENTIVA, K.S.
REPUBLICA CEHA
TEVA PHARMA B.V. OLANDA

CUTIE CU BLIST. AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE 30X1

RANBAXY (U.K.) LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR.

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

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

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

P-6L

EGIS PHARMACEUTICALS P.L.C.

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


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

P6L
P6L
P6L
P6L
P6L

ALVOGEN IPCO S.AR.L.

LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM.

P6L

GEDEON RICHTER ROMANIA SA

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

GEDEON RICHTER ROMANIA SA


EGIS PHARMACEUTICALS P.L.C.

ALVOGEN IPCO S.AR.L.

100mg/12,5mg KRKA D.D. NOVO MESTO


50mg+ 12,50mg KRKA D.D. NOVO MESTO

COMPR. FILM. 160mg/12,5mg TORRENT PHARMA S.R.L.


COMPR. FILM. 80mg/12,5mg TORRENT PHARMA S.R.L.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg
COMPR.
150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg
COMPR.
300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg COMPR. FILM 150mg/12,5mg SANOFI-AVENTIS GROUPE
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg COMPR. FILM 300mg/12,5mg SANOFI-AVENTIS GROUPE
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg TEVA PHARMA B.V.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 150mg/12,5mg
COMPR. FILM. 150mg/12,5mg KRKA D.D. NOVO MESTO
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg COMPR. FILM. 150mg/12,5mg RANBAXY (U.K.) LIMITED
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 150mg/12,5mg
COMPR. FILM. 150mg/12,5mg SANOFI CLIR SNC
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 150 mg/12,5 mg
COMPR. FILM. 150mg/12,5mg MEDOCHEMIE LTD

CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L

ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L


UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L
LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM. P6L
SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L
SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L

FRANTA
FRANTA
FRANTA
FRANTA
OLANDA

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L

SLOVENIA

CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM.

MAREA BRITANIE

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

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L


CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L
CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM. P-6L

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

P-6L

MAREA BRITANIE

P6L
P6L
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L

FRANTA
CIPRU

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

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L

Pagina 5 din 16

P6L

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
28
28
28
28
28
28
30
30
28
30
28
30
28
30
28
30
30
28
30
28
30
28
28
28
30
30
28
30
28
30
28
30
28
28
30
30
28
28
28
28
30
30
28
28
30
28
30
28
30
28
30
28
28
28
28
28
28
28
28
28
30
28
28
28
28

1,036000
1,411263
1,075357
0,352815
1,411263
1,062500
0,998928
1,062000
0,700000
1,411263
0,866000
1,062142
1,012333
1,062500
1,062000
2,229285
1,449000
0,603000
2,229285
0,963000
1,357857
1,449000
0,705631
0,531071
0,531071
0,531000
0,531000
0,705631
0,531000
0,531071
0,531000
0,531071
0,531000
0,546428
0,593214
0,594666
0,705631
0,705631
0,914642
1,411263
0,861785
0,788000
0,976333
0,976785
0,593214
0,705631
0,547500
0,705631
0,914642
0,976333
0,892500
0,976333
0,618571
0,455000
0,684031
0,684031
0,684031
0,684031
0,610714
0,684031
0,659642
0,370666
0,684031
0,684031
0,684031
0,684031

0,000000
0,189451
0,000000
0,503613
0,170522
0,000000
0,000000
0,000000
0,000000
0,170522
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,111511
0,000000
0,000000
0,000000
0,000000
0,111511
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,097035
0,756154
0,000000
0,042665
0,000000
0,000000
0,000000
0,000000
0,000000
0,386702
0,000000
0,703369
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,375969
1,953469
0,502397
0,765969
0,000000
0,289897
0,000000
0,000000
0,087040
0,087040
0,502397
0,087040

0,518000
0,705631
0,537678
0,176407
0,705631
0,531250
0,499464
0,531000
0,350000
0,705631
0,433000
0,531071
0,506166
0,531250
0,531000
1,114642
0,724500
0,301500
1,114642
0,481500
0,678928
0,724500
0,352815
0,265535
0,265535
0,265500
0,265500
0,352815
0,265500
0,265535
0,265500
0,265535
0,265500
0,273214
0,296607
0,297333
0,352815
0,352815
0,457321
0,705631
0,430892
0,394000
0,488166
0,488392
0,296607
0,352815
0,273750
0,352815
0,457321
0,488166
0,446250
0,488166
0,309285
0,227500
0,342015
0,342015
0,342015
0,342015
0,305357
0,342015
0,329821
0,185333
0,342015
0,342015
0,342015
0,342015

0,518000
0,895083
0,537679
0,680021
0,876154
0,531250
0,499464
0,531000
0,350000
0,876154
0,433000
0,531071
0,506167
0,531250
0,531000
1,114643
0,724500
0,301500
1,114643
0,481500
0,678929
0,724500
0,464327
0,265536
0,265536
0,265500
0,265500
0,464327
0,265500
0,265536
0,265500
0,265536
0,265500
0,273214
0,296607
0,297333
0,449851
1,108970
0,457321
0,748297
0,430893
0,394000
0,488167
0,488393
0,296607
0,739518
0,273750
1,056185
0,457321
0,488167
0,446250
0,488167
0,309286
0,227500
2,717985
2,295485
0,844413
1,107985
0,305357
0,631913
0,329821
0,185333
0,429056
0,429056
0,844413
0,429056

0,932400
1,270136
0,967821
0,317533
1,270136
0,956250
0,899035
0,955800
0,630000
1,270136
0,779400
0,955927
0,911099
0,956250
0,955800
2,006356
1,304100
0,542700
2,006356
0,866700
1,222071
1,304100
0,635067
0,477963
0,477963
0,477900
0,477900
0,635067
0,477900
0,477963
0,477900
0,477963
0,477900
0,491785
0,533892
0,535199
0,635067
0,635067
0,823177
1,270136
0,775606
0,709200
0,878699
0,879106
0,533892
0,635067
0,492750
0,635067
0,823177
0,878699
0,803250
0,878699
0,556713
0,409500
0,615627
0,615627
0,615627
0,615627
0,549642
0,615627
0,593677
0,333599
0,615627
0,615627
0,615627
0,615627

0,103600
0,330578
0,107536
0,538895
0,311649
0,106250
0,099893
0,106200
0,070000
0,311649
0,086600
0,106215
0,101234
0,106250
0,106200
0,222929
0,144900
0,060300
0,222929
0,096300
0,135786
0,144900
0,182075
0,053108
0,053108
0,053100
0,053100
0,182075
0,053100
0,053108
0,053100
0,053108
0,053100
0,054643
0,059322
0,059467
0,167599
0,826718
0,091465
0,183792
0,086179
0,078800
0,097634
0,097679
0,059322
0,457266
0,054750
0,773933
0,091465
0,097634
0,089250
0,097634
0,061858
0,045500
2,444373
2,021873
0,570801
0,834373
0,061072
0,358301
0,065965
0,037067
0,155444
0,155444
0,570801
0,155444

cod ATC

325 C09DA04
326 C09DA04
327 C09DA04
328 C09DA04
329 C09DA04
330 C09DA04
331 C09DA04
332 C09DA04
333 C09DA04
334 C09DA04
335 C09DA04
336 C09DA04
337 C09DA04
338 C09DA04
339 C09DA04

forma farm.
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 300 mg/12,5 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/12,5mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/12,5 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/12,5mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/12,5 mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IFIRMACOMBI 300mg/25mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) COAPROVEL 300mg/25mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM) CONVERIDE 300 mg/25 mg
COMPR. FILM.
DCI

COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)

Denumire Comerciala

concentratie

CONVERIDE 150 mg/12,5 mg

150mg/12,5mg

340 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT)

CANDESARTAN HIDROCLOROTIAZIDA TORRENT 16 mg/12,5 mg

341 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT)

345 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

346 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

347 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

348 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

349 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

350 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

351 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

CANZENO HCT 16mg/12,5mg


KARBICOMBI 8 mg/12,5 mg
KARBICOMBI 8 mg/12,5 mg
CANZENO HCT 8mg/12,5mg
ACTELSAR HCT 80 mg/12,5 mg
TOLUCOMBI 80 mg/12,5mg
TOLUCOMBI 80 mg/25mg
ACTELSAR HCT 80 mg/25mg
MICARDISPLUS 80/12,5mg
MICARDISPLUS 80/25mg
TANYDON HCT 80 mg/12,5 mg

352 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg

353 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

354 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

355 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg

356 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg

357 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

358 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

359 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)

360 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg

361 C09DA07

COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM) TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg

342 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT)


343 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT)
344 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT)

362 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM)


363 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM)
364 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM)
365 C09DB02

COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA)

366 C09DB02

COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA)

367 C09DB02

COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA)

368 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT)


369 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT)
370 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT)
371 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT)
372 C10AA04
373 C10AA04
374 C10AA04
375 C10AA05
376 C10AA05
377 C10AA05
378 C10AA05
379 C10AA05
380 C10AA05
381 C10AA05
382 C10AA05
383 C10AA05
384 C10AA05
385 C10AA05
386 C10AA05
387 C10AA05
388 C10AA05
389 C10AA05
390 C10AA05

FLUVASTATINUM
FLUVASTATINUM
FLUVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM

TEZEO HCT 80 mg/12,5 mg


TELMARK PLUS 80mg/12,5mg

TANYDON HCT 80 mg/25 mg


TEZEO HCT 80 mg/25 mg
TELMARK PLUS 80mg/25mg

EXFORGE 10mg/160mg
EXFORGE 5mg/160mg
EXFORGE 5mg/80mg
SEVIKAR 20 mg/5 mg
SEVIKAR 40 mg/10 mg
SEVIKAR 40 mg/5 mg
EXFORGE HCT
EXFORGE HCT
EXFORGE HCT
EXFORGE HCT
LESCOL 20 mg
LESCOL 40 mg
LESCOL XL 80 mg
TORVALIPIN 10 mg
SORTIS 10 mg
TORVACARD 10 mg
ATORIS 10 mg
GLETOR 10 mg
ASCORD 10 mg
ATORGAMMA 10 mg
TORVAZIN 10 mg
XAMARA 10 mg
VOREDANIN 10 mg
ATORVASTATIN RANBAXY 10 mg
ATORVASTATINA TEVA 10 mg
STAVRA 10 mg
ATORVASTATINA TORRENT 10 mg
ATORVASTATINA AUROBINDO 10 mg
TORVALIPIN 20 mg

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

CAPS.
CAPS.
COMPR. ELIB. PREL.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

300 mg/12,5mg

Detinator APP

Tara det.
APP

MEDOCHEMIE LTD CIPRU


TEVA PHARMA B.V. OLANDA

300mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA


300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE
300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE
300mg/12,5mg SANOFI CLIR SNC FRANTA
300mg/12,5mg MEDOCHEMIE LTD CIPRU
300mg/12,5mg MEDOCHEMIE LTD CIPRU

300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
16mg/12,5mg
16mg/12,5mg
8mg/12,5mg
8mg/12,5mg
8mg/12,5mg

Ambalaj

Prescriptie

Nr. crt

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

P6L

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

P-6L

P6L
P6L
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L

CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM.

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

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L


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

P6L
P6L

FRANTA

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L

KRKA D.D. NOVO MESTO

SLOVENIA

CUTIE CU BLIST. DIN OPA/AL/PVC/AL X 30 COMPR. FILM.

RANBAXY (U.K.) LIMITED

MAREA BRITANIE

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

RANBAXY (U.K.) LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. P6L

SANOFI PHARMA - BRISTOL MYERS SQUIBB

P6L
P6L

SANOFI CLIR SNC FRANTA


MEDOCHEMIE LTD CIPRU
MEDOCHEMIE LTD CIPRU

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

TORRENT PHARMA S.R.L. ROMANIA

CUTIE CU BLIST. AL/AL X 28 COMPR. P6L

ZENTIVA K.S.

CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L

REPUBLICA CEHA

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L

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

P6L
P6L

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIT. PVC-PVDC/AL X 30 COMPR.

P6L

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.

P6L

ZENTIVA K.S.

REPUBLICA CEHA

CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L

80 mg/12,5 mg ACTAVIS GROUP PTC EHF.

ISLANDA

CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE PRF

80 mg/12,5mg KRKA D.D.

SLOVENIA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE

80 mg/25mg KRKA D.D.


SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE
80 mg/25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE
80/12,5mg
GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC)
80/25mg
GERMANIA CUTIE X 28 COMPR. (BLIST. PA/AL/PVC/AL SAU PA/PA/AL/PVC/AL)
BOEHRINGER INGELHEIM INTERNATIONAL GMBH
BOEHRINGER INGELHEIM INTERNATIONAL GMBH

80mg/12,5mg GEDEON RICHTER ROMANIA SA


80mg/12,5mg EGIS PHARMACEUTICALS P.L.C.
80mg/12,5mg ZENTIVA, K.S.
80mg/12,5mg GLENMARK PHARMACEUTICALS S.R.O.
80mg/12,5mg TERAPIA S.A.
80mg/12,5mg TERAPIA S.A.

80mg/25mg
80mg/25mg
80mg/25mg
80mg/25mg
80mg/25mg
10mg/160mg
5mg/160mg
5mg/80mg
20mg/5mg
40mg/10mg
40mg/5mg

GEDEON RICHTER ROMANIA SA

ZENTIVA, K.S.

PRF
PRF
PRF
P-6L
P-6L

ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L


UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
REPUBLICA CEHA

CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE

P-6L

ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L


ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P6L
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE

P-6L

TERAPIA S.A.
TERAPIA S.A.

ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L


ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR. P6L

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC )

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC )

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC ) P-6L

TERAPIA S.A.
TERAPIA S.A.
TERAPIA S.A.

ROMANIA
ROMANIA
ROMANIA

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

P-6L
P-6L

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

P6L
P6L

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

P6L

10mg/160mg/12,5 mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM.

PRF

10mg/160mg/25 mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF

5mg/160mg/25 mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF

5mg/160mg/12,5 mg

20mg
40mg
80mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg

NOVARTIS PHARMA GMBH GERMANIA


NOVARTIS PHARMA GMBH GERMANIA

CUTIE X 4 BLIST. AL/AL X 7 CAPS.


CUTIE X 4 BLIST. AL/AL X 7 CAPS.

P-6L
P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 (4X7) COMPR. ELIB. PREL. P-6L
ACTAVIS GROUP PTC EHF.

ISLANDA

CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM.

P-6L

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 3 BLIST. X 10 COMPR. FILM.

P-6L

ZENTIVA K.S.

CEHIA

CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L

KRKA D.D. NOVO MESTO

SLOVENIA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM.

P-6L

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

TERAPIA SA

ROMANIA

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

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

UNGARIA
DR. REDDY'S LABORATORIES ROMANIA
LABORMED PHARMA S.A. ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

EGIS PHARMACEUTICALS P.L.C.

P6L
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L
RANBAXY (U.K.) LIMITED

MAREA BRITANIE

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

ISLANDA

CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM.

TEVA PHARMACEUTICALS S.R.L.

ACTAVIS GROUP PTC EHF.

Pagina 6 din 16

P-6L

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

28
28
30
28
28
28
28
28
28
30
28
28
28
28
28
28
30
30
30
30
28
30
30
28
28
28
30
28
30
30
28
28
30
30
30
28
28
56
56
56
28
28
28
28
28
28
28
28
28
28
30
30
30
30
30
30
30
30
30
30
30
28
30
30
30
30

0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,661428
0,684031
0,441333
0,441333
0,441333
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
0,684031
3,194642
3,003750
1,669285
1,669285
3,338570
3,004713
3,125344
3,339410
3,039719
3,167500
0,250191
0,500383
0,967500
0,129333
0,375287
0,277000
0,365666
0,375287
0,375287
0,215666
0,375287
0,375287
0,375287
0,222333
0,183928
0,375287
0,375287
0,236333
0,227000

0,087040
0,289897
0,004302
0,289897
0,289897
0,765969
0,289897
0,289897
0,768111
0,064969
0,291683
0,291683
0,768111
0,290969
0,290969
0,000000
0,050969
0,000000
0,000000
0,000000
0,410611
0,324302
0,324302
0,413826
0,950969
0,950969
0,324302
0,405611
0,006302
0,412635
0,414183
0,414183
0,324302
0,412969
0,414635
0,414183
0,414183
0,000000
0,000000
1,524643
1,770357
0,431787
0,434929
0,243584
0,029518
0,127781
0,000000
0,341951
0,470331
0,000000
0,000000
0,712046
0,000000
0,000000
0,131046
0,331379
0,000000
0,274046
0,331379
0,296379
0,000000
0,000000
0,331379
0,331379
0,000000
0,000000

0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,330714
0,342015
0,220666
0,220666
0,220666
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
0,342015
1,597321
1,501875
0,834642
0,834642
1,669285
1,502356
1,562672
1,669705
1,519859
1,583750
0,125095
0,250191
0,483750
0,064666
0,187643
0,138500
0,182833
0,187643
0,187643
0,107833
0,187643
0,187643
0,187643
0,111166
0,091964
0,187643
0,187643
0,118166
0,113500

0,429056
0,631913
0,346318
0,631913
0,631913
1,107985
0,631913
0,631913
1,110127
0,406985
0,633699
0,633699
1,110127
0,632985
0,632985
0,330714
0,392985
0,220667
0,220667
0,220667
0,752627
0,666318
0,666318
0,755842
1,292985
1,292985
0,666318
0,747627
0,348318
0,754651
0,756199
0,756199
0,666318
0,754985
0,756651
0,756199
0,756199
1,597321
1,501875
2,359286
2,605000
2,101072
1,937286
1,806256
1,699223
1,647641
1,583750
0,467047
0,720523
0,483750
0,064667
0,899690
0,138500
0,182833
0,318690
0,519023
0,107833
0,461690
0,519023
0,484023
0,111167
0,091964
0,519023
0,519023
0,118167
0,113500

0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,595285
0,615627
0,397199
0,397199
0,397199
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
0,615627
2,875177
2,703375
1,502356
1,502356
3,004713
2,704241
2,812809
3,005469
2,735747
2,850750
0,225171
0,450344
0,870750
0,116399
0,337758
0,249300
0,329099
0,337758
0,337758
0,194099
0,337758
0,337758
0,337758
0,200099
0,165535
0,337758
0,337758
0,212699
0,204300

0,155444
0,358301
0,072706
0,358301
0,358301
0,834373
0,358301
0,358301
0,836515
0,133373
0,360087
0,360087
0,836515
0,359373
0,359373
0,066143
0,119373
0,044134
0,044134
0,044134
0,479015
0,392706
0,392706
0,482230
1,019373
1,019373
0,392706
0,474015
0,074706
0,481039
0,482587
0,482587
0,392706
0,481373
0,483039
0,482587
0,482587
0,319465
0,300375
1,691572
1,937286
0,765644
0,735401
0,556119
0,363459
0,431753
0,316750
0,366971
0,520370
0,096750
0,012934
0,749575
0,027700
0,036567
0,168575
0,368908
0,021567
0,311575
0,368908
0,333908
0,022234
0,018393
0,368908
0,368908
0,023634
0,022700

cod ATC

391 C10AA05
392 C10AA05
393 C10AA05
394 C10AA05
395 C10AA05
396 C10AA05
397 C10AA05
398 C10AA05
399 C10AA05
400 C10AA05
401 C10AA05
402 C10AA05
403 C10AA05
404 C10AA05
405 C10AA05
406 C10AA05
407 C10AA05
408 C10AA05
409 C10AA05
410 C10AA05
411 C10AA05
412 C10AA05
413 C10AA05
414 C10AA05
415 C10AA05
416 C10AA05
417 C10AA05
418 C10AA05
419 C10AA05
420 C10AA05
421 C10AA05
422 C10AA05
423 C10AA05
424 C10AA05
425 C10AA05
426 C10AA05
427 C10AA05
428 C10AA07
429 C10AA07
430 C10AA07
431 C10AA07
432 C10AA07
433 C10AA07
434 C10AA07
435 C10AA07
436 C10AA07
437 C10AA07
438 C10AA07
439 C10AA07
440 C10AA07
441 C10AA07
442 C10AA07
443 C10AA07
444 C10AA07
445 C10AA07
446 C10AA07
447 C10AA07
448 C10AA07
449 C10AA07
450 C10AA07
451 C10AA07
452 C10AA07
453 C10AA07
454 C10AA07
455 C10AA07
456 C10AA07

DCI

ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM

Denumire Comerciala

forma farm.

SORTIS 20 mg
COMPR. FILM.
TORVACARD 20 mg
COMPR. FILM.
ATORIS 20 mg
COMPR. FILM.
GLETOR 20 mg
COMPR. FILM.
ASCORD 20 mg
COMPR. FILM.
ATORGAMMA 20 mg
COMPR. FILM.
TORVAZIN 20 mg
COMPR. FILM.
XAMARA 20 mg
COMPR. FILM.
VOREDANIN 20 mg
COMPR. FILM.
ATORVASTATIN RANBAXY 20 mg
COMPR. FILM.
ATORVASTATINA TEVA 20 mg
COMPR. FILM.
STAVRA 20 mg
COMPR. FILM.
ATORVASTATINA TORRENT 20 mg
COMPR. FILM.
ATORVASTATINA AUROBINDO 20 mg COMPR. FILM.
TORVALIPIN 40 mg
COMPR. FILM.
SORTIS 40 mg
COMPR. FILM.
TORVACARD 40 mg
COMPR. FILM.
ATORIS 40 mg
COMPR. FILM.
ATORIS 40 mg
COMPR. FILM.
GLETOR 40 mg
COMPR. FILM.
ASCORD 40 mg
COMPR. FILM.
ATORGAMMA 40 mg
COMPR. FILM.
TORVAZIN 40 mg
COMPR. FILM.
VOREDANIN 40 mg
COMPR. FILM.
ATORVASTATIN RANBAXY 40 mg
COMPR. FILM.
ATORVASTATINA TEVA 40 mg
COMPR. FILM.
STAVRA 40 mg
COMPR. FILM.
ATORVASTATINA TORRENT 40 mg
COMPR. FILM.
ATORVASTATINA AUROBINDO 40 mg COMPR. FILM.
SORTIS 80 mg
COMPR. FILM.
ASCORD 80 mg
COMPR. FILM.
TORVACARD 80 mg
COMPR. FILM.
ATORVASTATIN RANBAXY 80 mg
COMPR. FILM.
ATORVASTATINA TEVA 80 mg
COMPR. FILM.
STAVRA 80 mg
COMPR. FILM.
ATORVASTATINA TORRENT 80 mg
COMPR. FILM.
ATORVASTATINA AUROBINDO 80 mg COMPR. FILM.
ROSUVASTATINA RATIOPHARM 10 mg COMPR. FILM.
CRESTOR 10 mg
COMPR. FILM.
ROSUCARD 10 mg
COMPR. FILM.
ROSUVASTATINA TEVA 10 mg
COMPR. FILM.
ROXARDIO 10 mg
COMPR. FILM.
ROSWERA 10 mg
COMPR. FILM.
ROSTAT 10 mg
COMPR. FILM.
TINTAROS 10 mg
COMPR. FILM.
ROSUVASTATINA TERAPIA 10 mg
COMPR. FILM.
ROSUVASTATINA TERAPIA 10 mg
COMPR. FILM.
ROSUVASTATINA AUROBINDO 10 mg COMPR. FILM.
ROVASTAMED 10mg
COMPR. FILM.
STARCREST 10 mg
COMPR. FILM.
ROZUCOR 10 mg
COMPR. FILM.
ROSUVASTATINA ATB 10 mg
COMPR. FILM.
ROSUVASTATINA RATIOPHARM 20 mg COMPR. FILM.
CRESTOR 20 mg
COMPR. FILM.
ROSUCARD 20 mg
COMPR. FILM.
ROSUVASTATINA TEVA 20 mg
COMPR. FILM.
ROXARDIO 20 mg
COMPR. FILM.
ROSWERA 20 mg
COMPR. FILM.
ROSTAT 20 mg
COMPR. FILM.
TINTAROS 20 mg
COMPR. FILM.
ROSUVASTATINA LABORMED 20 mg COMPR. FILM.
ROSUVASTATINA TERAPIA 20 mg
COMPR. FILM.
ROSUVASTATINA TERAPIA 20 mg
COMPR. FILM.
ROSUVASTATINA AUROBINDO 20 mg COMPR. FILM.
ROVASTAMED 20mg
COMPR. FILM.
STARCREST 20 mg
COMPR. FILM.

concentratie

20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40 mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg

Prescriptie

Nr. crt

Detinator APP

Tara det.
APP

PFIZER EUROPE MA EEIG

MAREA BRITANIE

Ambalaj
CUTIE X 3 BLIST. X 10 COMPR. FILM.

ZENTIVA K.S.

CEHIA

CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L

KRKA D.D. NOVO MESTO

SLOVENIA

P-6L

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM.

P-6L

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

TERAPIA SA

ROMANIA

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

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

UNGARIA
DR. REDDY'S LABORATORIES ROMANIA
LABORMED PHARMA S.A. ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

EGIS PHARMACEUTICALS P.L.C.

P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L
RANBAXY (U.K.) LIMITED

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

MAREA BRITANIE

TEVA PHARMACEUTICALS S.R.L.

ACTAVIS GROUP PTC EHF.

ISLANDA

CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM.

P-6L

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 2 BLIST. X 7 COMPR. FILM.

P-6L

ZENTIVA K.S.

CEHIA

CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L

KRKA D.D. NOVO MESTO

SLOVENIA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 14 COMPR.FILM.

P-6L

KRKA D.D. NOVO MESTO

SLOVENIA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM.

P-6L

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

TERAPIA SA

ROMANIA

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

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

UNGARIA
LABORMED PHARMA S.A. ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

EGIS PHARMACEUTICALS P.L.C.

P6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L
RANBAXY (U.K.) LIMITED

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

MAREA BRITANIE

TEVA PHARMACEUTICALS S.R.L.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 2 BLIST. X 7 COMPR. FILM.

P-6L

TERAPIA SA
ZENTIVA, K.S.

ROMANIA

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

P-6L

REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

P6L
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P-6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. P6L
RATIOPHARM GMBH GERMANIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L
ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
RANBAXY (U.K.) LIMITED

MAREA BRITANIE

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

REPUBLICA CEHA

TEVA PHARMACEUTICALS S.R.L.

ZENTIVA K.S.

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

TEVA PHARMACEUTICALS S.R.L.

CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.

P-6L

SANDOZ S.R.L.

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

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

P6L
P6L
P6L

ROMANIA
ROMANIA
KRKA D.D. NOVO MESTO SLOVENIA
GEDEON RICHTER ROMANIA SA ROMANIA
ACTAVIS GROUP PTC EHF.

ISLANDA

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

TERAPIA SA
TERAPIA SA

ROMANIA
ROMANIA

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

MALTA
MEDOCHEMIE LTD. CIPRU

AUROBINDO PHARMA (MALTA) LIMITED

CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM.

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF


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

P6L

LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L


TORRENT PHARMA SRL ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

ANTIBIOTICE S.A.

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

P6L
P6L

RATIOPHARM GMBH GERMANIA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

ASTRAZENECA UK LTD.

MAREA BRITANIE

CUTIE X 2 BLIST. X 14 COMPR. FILM.

P-6L

ZENTIVA K.S.

REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.

P-6L

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

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

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

P6L

ROMANIA

ROMANIA
SANDOZ S.R.L.
ROMANIA
KRKA D.D. NOVO MESTO SLOVENIA
GEDEON RICHTER ROMANIA SA ROMANIA
TEVA PHARMACEUTICALS S.R.L.

ACTAVIS GROUP PTC EHF.

ISLANDA

LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L

TERAPIA SA
TERAPIA SA

ROMANIA
ROMANIA

MALTA
MEDOCHEMIE LTD. CIPRU

AUROBINDO PHARMA (MALTA) LIMITED

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


CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM.

P6L
P6L

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF


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

P6L

LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L

Pagina 7 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
30
30
30
30
30
30
30
30
30
28
30
30
30
30
14
30
14
30
30
30
30
30
30
30
28
30
30
30
14
30
30
30
28
30
30
30
30
28
30
30
28
30
30
28
28
28
30
28
28
30
30
30
28
30
30
28
30
30
28
28
28
28
30
28
28

0,750575
0,408666
0,501333
0,404333
0,750575
0,431333
0,334000
0,750575
0,750575
0,267000
0,211428
0,750575
0,750575
0,278333
0,531000
1,501151
0,871666
1,102857
0,647000
0,514666
1,102666
0,863000
1,102666
1,102333
1,053000
0,674285
1,102666
1,102666
0,478666
1,677142
1,090333
1,090333
1,090333
1,090000
1,090333
1,090333
0,768000
0,711000
0,750575
0,750575
0,577666
0,311071
0,629333
0,750575
0,680714
0,750575
0,750575
0,750575
0,711071
0,688928
0,750575
0,750575
1,094000
1,501151
0,907666
0,907666
0,621428
0,930666
1,109333
0,907500
0,664642
1,501151
1,501151
1,501151
1,093928
0,689642

0,615758
0,000000
0,000000
0,000000
0,167091
0,000000
0,000000
0,167091
0,166758
0,000000
0,000000
0,167091
0,167091
0,000000
0,000000
0,194563
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,575853
0,082425
0,000000
0,000000
0,000000
0,003425
0,000000
0,491210
0,491210
0,455091
0,000000
0,000000
0,815091
0,796758
0,000000
3,363849
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,283491
0,283491
0,283849
0,000000
0,000000

0,375287
0,204333
0,250666
0,202166
0,375287
0,215666
0,167000
0,375287
0,375287
0,133500
0,105714
0,375287
0,375287
0,139166
0,265500
0,750575
0,435833
0,551428
0,323500
0,257333
0,551333
0,431500
0,551333
0,551166
0,526500
0,337142
0,551333
0,551333
0,239333
0,838571
0,545166
0,545166
0,545166
0,545000
0,545166
0,545166
0,384000
0,355500
0,375287
0,375287
0,288833
0,155535
0,314666
0,375287
0,340357
0,375287
0,375287
0,375287
0,355535
0,344464
0,375287
0,375287
0,547000
0,750575
0,453833
0,453833
0,310714
0,465333
0,554666
0,453750
0,332321
0,750575
0,750575
0,750575
0,546964
0,344821

0,991046
0,204333
0,250667
0,202167
0,542379
0,215667
0,167000
0,542379
0,542046
0,133500
0,105714
0,542379
0,542379
0,139167
0,265500
0,945139
0,435833
0,551429
0,323500
0,257333
0,551333
0,431500
0,551333
0,551167
0,526500
0,337143
0,551333
0,551333
0,239333
0,838571
0,545167
0,545167
0,545167
0,545000
0,545167
0,545167
0,384000
0,355500
2,951141
0,457713
0,288833
0,155536
0,314667
0,378713
0,340357
0,866498
0,866498
0,830379
0,355536
0,344464
1,190379
1,172046
0,547000
4,114425
0,453833
0,453833
0,310714
0,465333
0,554667
0,453750
0,332321
1,034067
1,034067
1,034425
0,546964
0,344821

0,675517
0,367799
0,451199
0,363899
0,675517
0,388199
0,300600
0,675517
0,675517
0,240300
0,190285
0,675517
0,675517
0,250499
0,477900
1,351035
0,784499
0,992571
0,582300
0,463199
0,992399
0,776700
0,992399
0,992099
0,947700
0,606856
0,992399
0,992399
0,430799
1,509427
0,981299
0,981299
0,981299
0,981000
0,981299
0,981299
0,691200
0,639900
0,675517
0,675517
0,519899
0,279963
0,566399
0,675517
0,612642
0,675517
0,675517
0,675517
0,639963
0,620035
0,675517
0,675517
0,984600
1,351035
0,816899
0,816899
0,559285
0,837599
0,998399
0,816750
0,598177
1,351035
1,351035
1,351035
0,984535
0,620677

0,690816
0,040867
0,050134
0,040434
0,242149
0,043134
0,033400
0,242149
0,241816
0,026700
0,021143
0,242149
0,242149
0,027834
0,053100
0,344679
0,087167
0,110286
0,064700
0,051467
0,110267
0,086300
0,110267
0,110234
0,105300
0,067429
0,110267
0,110267
0,047867
0,167715
0,109034
0,109034
0,109034
0,109000
0,109034
0,109034
0,076800
0,071100
2,650911
0,157483
0,057767
0,031108
0,062934
0,078483
0,068072
0,566268
0,566268
0,530149
0,071108
0,068893
0,890149
0,871816
0,109400
3,513965
0,090767
0,090767
0,062143
0,093067
0,110934
0,090750
0,066465
0,433607
0,433607
0,433965
0,109393
0,068965

cod ATC

457 C10AA07
458 C10AA07
459 C10AA07
460 C10AA07
461 C10AA07
462 C10AA07
463 C10AA07
464 C10AA07
465 C10AA07
466 C10AA07
467 C10AA07
468 C10AA07
469 C10AA07
470 C10AA07
471 C10AA07
472 C10AA07
473 C10AA07
474 C10AA07
475 C10AA07
476 C10AA07
477 C10AA07
478 C10AA07
479 C10AA07
480 C10AA07
481 C10AA07
482 C10AA07
483 C10AB02
484 C10AB02
485 C10AB02
486 C10AX09
487 C10AX09

DCI

ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
ROSUVASTATINUM
BEZAFIBRATUM
BEZAFIBRATUM
BEZAFIBRATUM
EZETIMIBUM
EZETIMIBUM

488 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)


489 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
490 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
491 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
492 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
493 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
494 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
495 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
496 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)
497 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)

504 D01BA02

TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM

505 D05AX52

COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM)*

506 D05AX52

COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM)*

507 D05BB02

ACITRETINUM**
ACIDUM FUSIDICUM
ACIDUM FUSIDICUM
SULFADIAZINUM
PODOPHYLLOTOXINUM*
PODOPHYLLOTOXINUM*
IMIQUIMODUM*

498 D01BA02
499 D01BA02
500 D01BA02
501 D01BA02
502 D01BA02
503 D01BA02

508 D06AX01
509 D06AX01
510 D06BA01
511 D06BB04
512 D06BB04
513 D06BB10
514 D07AB02
515 D07AB02
516 D07AB02
517 D07AB02
518 D07AC13
519 D07AC13
520 D07AC13
521 D07AC13

HYDROCORTISONUM BUTYRATUM
HYDROCORTISONUM BUTYRATUM
HYDROCORTISONUM BUTYRATUM
HYDROCORTISONUM BUTYRATUM

MOMETASONUM
MOMETASONUM
MOMETASONUM
MOMETASONUM

522 D07AC14 METHYLPREDNISOLONUM ACEPONAT

Denumire Comerciala

ROZUCOR 20 mg
ROSUVASTATINA ATB 20 mg
ROSUCARD 40 mg
ROSUVASTATINA TEVA 40 mg
ROSWERA 40 mg
ROSTAT 40 mg
TINTAROS 40 mg
ROSUVASTATINA TERAPIA 40 mg
ROSUVASTATINA TERAPIA 40 mg
ROSUVASTATINA AUROBINDO 40 mg
ROVASTAMED 40mg
STARCREST 40 mg
ROZUCOR 40 mg
ROSUVASTATINA ATB 40 mg
CRESTOR 5 mg
ROXARDIO 5 mg
ROSWERA 5 mg
ROSTAT 5 mg
TINTAROS 5 mg
ROSUVASTATINA TERAPIA 5 mg
ROSUVASTATINA TERAPIA 5 mg
ROSUVASTATINA AUROBINDO 5 mg
ROVASTAMED 5mg
STARCREST 5 mg
ROZUCOR 5 mg
ROSUVASTATINA ATB 5 mg
BEZAFIBRAT SLAVIA 200 mg
BEZAFIBRAT ARENA 200 mg
BEZAFIBRAT FARMEX 200 mg
EZETROL (R)
COLTOWAN 10 mg
CADUET 10mg/10mg
DUPLECOR 10 mg/10 mg
ATORDAPIN 10 mg/10 mg
TORVALIPIN PLUS 10 mg/10 mg
CADUET 10mg/5mg
DUPLECOR 10 mg/5 mg
TORVALIPIN PLUS 5mg/10mg
ATORDAPIN 10mg/5mg
DUPLECOR 20 mg/10 mg
DUPLECOR 20 mg/5 mg
LAMISIL (R)
TERBINARAN
TERBINARAN
TERBINAFINE 250 mg
TERBINAFINA SLAVIA 250mg
TERBISIL 250 mg
TERBINAFINA ARENA 250 mg
DAIVOBET 50 micrograme/0,5 mg/g
DAIVOBET 50 micrograme/0,5mg/g
NEOTIGASON 10 mg
FUCIDIN 20 mg/g
FUCIDIN 20 mg/g
FLAMMAZINE
WARTEC 1,5 mg/g
CONDYLINE
ALDARA 5%
LOCOID (R) crema 0,1%
LOCOID (R) LIPOCREAM 0,1%
LOCOID CRELO (R) 0,1%
LOCOID (R)
ELOCOM
MOMETAZONA ATB 1 mg/g
ELOCOM
MOMETAZONA ATB 1 mg/g
ADVANTAN 1mg/g crema

forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
GEL
UNGUENT
CAPS.
CREMA
UNGUENT
CREMA
CREMA
SOL. CUT.
CREMA
CREMA
CREMA

concentratie

20mg
20mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
200mg
200mg
200mg
10mg
10mg
10mg/10mg
10mg/10mg
10mg/10mg
10mg/10mg
10mg/5mg
10mg/5mg
10mg/5mg
10mg/5mg
20mg/10mg
20mg/5mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
50micrograme/0,5mg/g

Detinator APP

Ambalaj

TORRENT PHARMA SRL ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

ANTIBIOTICE S.A.
ZENTIVA K.S.

ROMANIA

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

P6L
P6L

REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

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


CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM.

P6L
P6L

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

P6L

ROMANIA
KRKA D.D. NOVO MESTO SLOVENIA
GEDEON RICHTER ROMANIA SA ROMANIA
TEVA PHARMACEUTICALS S.R.L.

ACTAVIS GROUP PTC EHF.

ISLANDA

TERAPIA SA
TERAPIA SA

ROMANIA
ROMANIA

MALTA
MEDOCHEMIE LTD. CIPRU

AUROBINDO PHARMA (MALTA) LIMITED

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF


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

P6L

LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L


TORRENT PHARMA SRL ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

ANTIBIOTICE S.A.

ROMANIA

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

P6L

ASTRAZENECA UK LTD.

MAREA BRITANIE

SANDOZ S.R.L.

ROMANIA
KRKA D.D. NOVO MESTO SLOVENIA
GEDEON RICHTER ROMANIA SA ROMANIA

CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM.

P-6L

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

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

P6L
P6L
P6L

ACTAVIS GROUP PTC EHF.

ISLANDA

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

TERAPIA SA
TERAPIA SA

ROMANIA
ROMANIA

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

MALTA
MEDOCHEMIE LTD. CIPRU

AUROBINDO PHARMA (MALTA) LIMITED

CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM.

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF


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

P6L

LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L


TORRENT PHARMA SRL ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L


SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC/AL X 10 COMPR. P-6L
FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR.
GEDEON RICHTER ROMANIA SA

ROMANIA

PFIZER EUROPE MA EEIG

MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM.

ROMANIA
KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. PVC-PE-PVDC-PE-PVC/AL X 30 COMPR.

P-RF

PRF
P-6L

ACTAVIS GROUP PTC EHF.

ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L
P6L
P6L

PFIZER EUROPE MA EEIG

MAREA BRITANIE CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM.

P-6L

GEDEON RICHTER ROMANIA SA

ROMANIA

P6L

GEDEON RICHTER ROMANIA SA

CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM.

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM.

ACTAVIS GROUP PTC EHF.

ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L

KRKA, D.D., NOVO MESTO SLOVENIA

ROMANIA
ROMANIA

CUTIE X BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE P6L

CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM.

P6L
P6L

NOVARTIS PHARMA GMBH GERMANIA

CUTIE X 1 BLIST. X 14 COMPR.

P-RF

RANBAXY UK LIMITED
RANBAXY UK LIMITED

MAREA BRITANIE

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

MAREA BRITANIE

CUTIE X 4 BLIST. AL/PVDC-PVC X 7 COMPR.

GEDEON RICHTER ROMANIA SA


GEDEON RICHTER ROMANIA SA

CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM.

P-RF

ACTAVIS GROUP HF ISLANDA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR.


SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 7 COMPR.

P-RF

ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR.


ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.

P-RF

GEDEON RICHTER ROMANIA SA

LEO PHARMA A/S

DANEMARCA

CUTIE CU 1 FLAC. PEID CU DUZA DIN PEJD SI CAPAC DIN PEID X 15 G GEL

P-RF

P-RF

PRF

DANEMARCA CUTIE CU 1 TUB DIN AL/EPOXIFENOL X 15 G UNGUENT

P-RF

ACTAVIS GROUP PTC EHF.

ISLANDA

CUTIE X 3 BLIST. AL/PVC-PVDC X 10 CAPS.

P-RF

LEO PHARMA A/S


LEO PHARMA A/S
CN UNIFARM

DANEMARCA

CUTIE X 1 TUB DIN AL X 15 G CREMA


CUTIE X 1 TUB DIN AL X 15 G UNGUENT

P-RF

50micrograme/0,5mg/g LEO PHARMACEUTICAL PRODUCTS

10mg
20mg/g
20mg/g
1%
1,5 mg/g
5mg/ml
5%
0,1%
0,1%
EMULSIE CUT. 0.1%
SOL. CUT. 0,1%
CREMA
1mg/g
CREMA
1mg/g
UNGUENT 1mg/g
UNGUENT 1mg/g
CREMA
1mg/g

Tara det.
APP

Prescriptie

Nr. crt

GLAXOSMITHKLINE (GSK) SRL


ASTELLAS PHARMA EUROPE BV

MEDA AB
ASTELLAS PHARMA EUROPE BV
ASTELLAS PHARMA EUROPE BV
ASTELLAS PHARMA EUROPE BV
ASTELLAS PHARMA EUROPE BV

MERCK SHARP & DOHME

DANEMARCA

ROMANIA BORCAN X 500 G CREMA


ROMANIA CUTIE X 1 TUB X 5 G CREMA

OLANDA
SUEDIA CUTIE X 12 PLICURI DIN POLIESTER/AL X 250 MG CREMA
OLANDA CUTIE X 1 TUB DIN AL X 30 G
OLANDA CUTIE X 1 TUB DIN AL X 30 G
OLANDA CUTIE X 1 FLACON X 30 G
OLANDA CUTIE X 1 FLACON PICURATOR DIN PP X 30 ML
ROMANIA CUTIE X 1 TUB DIN AL X 15 G
CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE

ANTIBIOTICE SA

P-RF

PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF

ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG. P6L


MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G
P-RF
ANTIBIOTICE SA
ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNG. P6L
INTENDIS GMBH
GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF

Pagina 8 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
1,501151
30
1,501151
30
1,748666
30
1,589000
30
1,522333
30
1,096000
28
1,746785
28
2,784285
28
2,784285
30
2,499000
28
1,640357
28
1,335000
30
2,620000
30
2,498000
28
0,375287
28
0,375287
30
0,327333
30
0,375287
28
0,375287
28
0,375287
28
0,375287
30
0,375287
28
0,375287
28
0,375287
30
0,375287
30
0,375287
20
0,381500
20
0,383500
20
0,370000
28
4,156410
30
3,728666
30
0,571332
30
0,571332
30
0,571332
30
0,571332
30
0,571332
30
0,548666
30
0,548666
30
0,548666
30
0,571332
30
0,571332
14
1,267321
30
1,267321
28
1,267321
28
0,712142
14
1,267321
28
1,267321
28
1,185357
1 53,860000
1 53,945000
30
1,581666
1 11,170000
1 11,170000
1 100,400000
1 44,916785
1 78,810000
12 21,387500
1 11,799999
1 11,799999
1 11,799999
1 11,230000
1
3,530000
1
3,530000
1
3,530000
1
3,530000
1 21,360500

0,511849
0,355182
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,260784
0,828284
0,000000
0,397046
0,008284
1,428998
1,428998
0,652379
0,651141
0,313284
1,041379
1,017046
0,000000
0,000000
0,000000
1,283232
0,000000
0,465001
0,102668
0,102668
0,068001
0,272668
0,000000
0,000000
0,000000
0,587668
0,327334
1,170536
0,317345
0,317679
0,000000
0,081964
0,317679
0,000000
0,000000
0,255000
0,000000
0,000000
0,000000
0,000000
33,423215
0,000000
0,000000
0,220001
0,190001
1,000001
0,000000
1,910000
0,000000
1,910000
0,000000
3,709500

0,750575
0,750575
0,874333
0,794500
0,761166
0,548000
0,873392
1,392142
1,392142
1,249500
0,820178
0,667500
1,310000
1,249000
0,187643
0,187643
0,163666
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,187643
0,190750
0,191750
0,185000
2,078205
1,864333
0,285666
0,285666
0,285666
0,285666
0,285666
0,274333
0,274333
0,274333
0,285666
0,285666
0,633660
0,633660
0,633660
0,356071
0,633660
0,633660
0,592678
26,930000
26,972500
0,790833
5,585000
5,585000
50,200000
22,458392
39,405000
10,693750
5,899999
5,899999
5,899999
5,615000
1,765000
1,765000
1,765000
1,765000
10,680250

1,262425
1,105758
0,874333
0,794500
0,761167
0,548000
0,873393
1,392143
1,392143
1,249500
0,820179
0,667500
1,310000
1,249000
2,448428
1,015928
0,163667
0,584690
0,195928
1,616642
1,616642
0,840023
0,838785
0,500928
1,229023
1,204690
0,190750
0,191750
0,185000
3,361437
1,864333
0,750667
0,388334
0,388334
0,353667
0,558334
0,274333
0,274333
0,274333
0,873334
0,613000
1,804197
0,951006
0,951340
0,356071
0,715625
0,951340
0,592679
26,930000
27,227500
0,790833
5,585000
5,585000
50,200000
55,881608
39,405000
10,693750
6,120001
6,090001
6,900001
5,615000
3,675000
1,765000
3,675000
1,765000
14,389750

1,351035
1,351035
1,573799
1,430100
1,370099
0,986400
1,572106
2,505856
2,505856
2,249100
1,476321
1,201500
2,358000
2,248200
0,337758
0,337758
0,294599
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,337758
0,343350
0,345150
0,333000
3,740769
3,355799
0,514198
0,514198
0,514198
0,514198
0,514198
0,493799
0,493799
0,493799
0,514198
0,514198
1,140588
1,140588
1,140588
0,640927
1,140588
1,140588
1,066821
48,474000
48,550500
1,423499
10,053000
10,053000
90,360000
40,425106
70,929000
19,248750
10,619999
10,619999
10,619999
10,107000
3,177000
3,177000
3,177000
3,177000
19,224450

0,661965
0,505298
0,174867
0,158900
0,152234
0,109600
0,174679
0,278429
0,278429
0,249900
0,164036
0,133500
0,262000
0,249800
2,298313
0,865813
0,032734
0,434575
0,045813
1,466527
1,466527
0,689908
0,688670
0,350813
1,078908
1,054575
0,038150
0,038350
0,037000
1,698873
0,372867
0,522135
0,159802
0,159802
0,125135
0,329802
0,054867
0,054867
0,054867
0,644802
0,384468
1,297269
0,444078
0,444412
0,071215
0,208697
0,444412
0,118536
5,386000
5,649500
0,158167
1,117000
1,117000
10,040000
37,914894
7,881000
2,138750
1,400001
1,370001
2,180001
1,123000
2,263000
0,353000
2,263000
0,353000
5,845550

cod ATC

DCI

524 D07AC14
525 D07AC14
526 D07AC14
527 D07AC14
528 D07AC17
529 D07AC17
530 D07AD01
531 D07AD01
532 D07AD01
533 D07CA01
534 D07CC01
535 D07XC03
536 D07XC03
537 D10AD54
538 D10AD54
539 D10AX03
540 D10AX03
541 D10AX03
542 D10AX03
543 D10BA01
544 D10BA01
545 D10BA01
546 G01AA51
547 G01AA51
548 G01AA51
549 G01AF12
550 G01AF12
551 G01AF12
552 G01AF15
553 G01AF20
554 G01AF20
555 G01AF20
556 G01AF20
557 G01AF20
558 G02CB03
559 G02CB03
560 G03CA09
561 G03CA09
562 G03CX01
563 G03DA04
564 G03DA04
565 G03DA04
566 G03DA04
567 G03DA04
568 G03DA04
569 G03DA04
570 G03DA04
571 G03DB01
572 G03DC03
573 G03FA17
574 G03FB01
575 G03FB08
576 G03GA05
577 G03GA05
578 G03GA05
579 G03GA05
580 G03GA06
581 G03GA06
582 G03GA06
583 G03GA06
584 G03GA07
585 G03GB02
586 G03XC01
587 G04BD04
588 G04BD07

Denumire Comerciala

ADVANTAN 1mg/g crema


METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g
METHYLPREDNISOLONUM ACEPONAT ADVANTAN MILK 1mg/g
METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1mg/g unguent
METHYLPREDNISOLONUM ACEPONAT ADVANTAN 1 mg/g unguent
FLUTICASONUM PROPIONAT
CUTIVATE
FLUTICASONUM PROPIONAT
CUTIVATE
CLOBETASOLUM*
DERMOVATE 0,5 mg/g
CLOBETASOLUM*
DERMOVATE (R)
CLOBETASOLUM*
DERMOVATE 0,5 mg/g
COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H
COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram
COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC 1mg+5mg/gram
COMBINATII (MOMETASONUM + AC. SALICILICUM) ELOSALIC 1mg+5mg/gram
COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL
COMBINATII (ISOTRETINOINUM + ERITROMICINUM) ISOTREXIN GEL
ACIDUM AZELAICUM
SKINOREN
ACIDUM AZELAICUM
SKINOREN
ACIDUM AZELAICUM
SKINOREN 150mg/g
ACIDUM AZELAICUM
SKINOREN 150mg/g
ISOTRETINOINUM**
ROACCUTANE 10 mg
ISOTRETINOINUM**
SOTRET 10 mg
ISOTRETINOINUM**
SOTRET 20 mg
COMBINATII
MACMIROR COMPLEX
COMBINATII
POLYGYNAX
COMBINATII
MACMIROR COMPLEX
FENTICONAZOLUM
LOMEXIN 1000 mg
FENTICONAZOLUM
LOMEXIN 600 mg
FENTICONAZOLUM
LOMEXIN CREMA VAGINALA
BUTOCONAZOLUM
GYNOFORT 2%
COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLODIN
COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON
COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON
COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON
COMBINATII (METRONIDAZOLUM+CLOTRIMAZOLUM) MECLON
CABERGOLINUM*
DOSTINEX
CABERGOLINUM*
DOSTINEX
PROMESTRIENUM*
COLPOTROPHINE 10 mg
PROMESTRIENUM*
COLPOTROPHINE 10mg/g
TIBOLONUM**
LIVIAL (R) 2,5 mg
PROGESTERONUM*
UTROGESTAN (R) 100 mg
PROGESTERONUM*
AREFAM 100 mg
PROGESTERONUM*
AREFAM 100 mg
PROGESTERONUM*
UTROGESTAN (R) 200 mg
PROGESTERONUM*
AREFAM 200 mg
PROGESTERONUM*
AREFAM 200 mg
PROGESTERONUM*
PROGESTOGEL 10 mg/g
PROGESTERONUM*
MASTOPROFEN 10 mg/g
DYDROGESTERONUM*
DUPHASTON 10 mg
LYNESTRENOLUM*
ORGAMETRIL 5 mg
COMBINATII**
ANGELIQ
COMBINATII**
CYCLO-PROGYNOVA
COMBINATII**
FEMOSTON 2/10
FOLLITROPINUM ALFA****#
GONAL - f 75 UI (5,5 g)
FOLLITROPINUM ALFA****#
GONAL-f 300 UI/0,5 ml ( 22 g/0,5 ml)
FOLLITROPINUM ALFA****#
GONAL-f 450 UI/0,75 ml (33 g/0,75 ml)
FOLLITROPINUM ALFA****#
GONAL-f 900 UI/1,5ml (66 g/1,5 ml)
FOLLITROPINUM BETA****#
PUREGON 300UI/0,36 ml
FOLLITROPINUM BETA****#
PUREGON 300UI/0,36 ml
FOLLITROPINUM BETA****#
PUREGON 900UI/1,08 ml
FOLLITROPINUM BETA****#
PUREGON 900UI/1,08 ml
LUTROPINUM ALFA****#
LUVERIS 75UI
CLOMIFENUM
CLOSTILBEGYT
RALOXIFENUM
EVISTA 60mg
OXYBUTYNINUM
DRIPTANE ( R ) 5 mg
TOLTERODINUM**#
UROFLOW 1

523 D07AC14 METHYLPREDNISOLONUM ACEPONAT

forma farm.

concentratie

CREMA

1mg/g
EMULSIE CUT. 1mg/g
EMULSIE CUT. 1mg/g
UNGUENT 1mg/g
UNGUENT 1mg/g
CREMA
0,05%
UNGUENT 0,005%
CREMA
0,5mg/g
SOL. CUT. 0,05%
UNGUENT 0,5mg/g
CREMA
20mg/g+10mg/g
CREMA
20mg/1mg pe gram
UNGUENT 1mg+50mg/gram
UNGUENT 1mg+50mg/gram
GEL
0,05%/0,2%
GEL
0.5mg/g+20mg/g
CREMA
200mg/g
CREMA
200mg/g
GEL
150mg/g
GEL
150mg/g
CAPS. MOI 10mg
CAPS. MOI 10mg
CAPS. MOI 20mg

Detinator APP

GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA

GLAXO WELLCOME UK LIMITED

MAREA BRITANIE

GLAXO WELLCOME UK LIMITED

MAREA BRITANIE

GLAXO WELLCOME UK LTD. MAREA BRITANIE

LEO PHARMA A/S


LEO PHARMA A/S

CUTIE X 1 TUB X 50 G
CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA

P-RF
P-RF

PRF

GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT

P-RF

GERMANIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT

P-RF

CUTIE X 1 TUB DIN AL X 15 G CREMA


CUTIE X 1 TUB DIN AL X 15 G UNGUENT

P-RF

CUTIE CU 1 TUB AL X 25 G CREMA

P-RF

P-RF

DANEMARCA
DANEMARCA

CUTIE CU 1 TUB AL X 25 G UNGUENT


CUTIE X 1 TUB DIN AL X 15 G CREMA
CUTIE X 1 TUB DIN AL X 15 G CREMA

P-RF
P-RF
P-RF

MERCK SHARP & DOHME ROMANIA

P-RF

MERCK SHARP & DOHME

CUTIE X 1 TUB DIN AL X 15 G


ROMANIA CUTIE X 1 TUB DIN AL X 45 G
MAREA BRITANIE CUTIE X 1 TUB DIN AL X 30 G GEL
ROMANIA CUTIE X 1 TUB DIN AL X 30 G GEL

P-RF

GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA

P-RF

GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA

P-RF

STIEFEL LABORATORIES LTD.


GLAXOSMITHKLINE (GSK) SRL

INTENDIS GMBH
BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG

GERMANIA
GERMANIA

ROCHE ROMANIA SRL ROMANIA


TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA

CREMA

FARA CONCENTRATIE

ALFA WASSERMANN SPA

CREMA VAG.

FARA CONCENTRATIE

ALFA WASSERMAN SPA

OVULE

500mg/100mg ALFA WASSERMAN SPA

SOL. VAGINALA

FARA CONCENTRATIE

CAPS. MOI VAG.

GERMANIA

GLAXO WELLCOME UK LTD. MAREA BRITANIE

CREMA VAG.
CREMA VAG.
COMPR. VAG.

CAPS. MOI VAG.

GERMANIA

GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLACON CU PICURATOR DIN PP X 25 ML P-RF

POLICHEM SA
FARA CONCENTRATIE LAB. INNOTECH INT.
10g/400000UI POLICHEM SA
1000mg
RECORDATI SPA
600mg
RECORDATI SPA
2%
RECORDATI SPA
20mg/g
GEDEON RICHTER ROMANIA SA
500mg/200mg ARENA GROUP S.A.

CREMA VAG.

Ambalaj

BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG

CAPS. MOI VAG. 500mg/200000UI


CAPS. MOI VAG.

Tara det.
APP

Prescriptie

Nr. crt

ALFA WASSERMAN SPA

CUTIE X 1 TUB AL X 50 G GEL


CUTIE X 1 TUB AL X 50 G GEL

P-RF
P-RF

P-RF
P-RF

CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. MOI P-RF


CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF
CUTIE X 3 BLIST. PE-PVDC-PVC/HARTIE-AL X 10 CAPS. MOI P-RF

LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG. P-RF

FRANTA

CUTIE X 2 BLIST. AL/PVC X 6 CAPS. MOI. VAG. P-RF

LUXEMBURG CUTIE X 1 TUB DIN AL CREMA VAG. X 30 G + APLICATOR

ITALIA
ITALIA
ITALIA
ROMANIA
ROMANIA

ITALIA
ITALIA
ITALIA
ITALIA

P-RF

CUTIE X 1 BLIST. PVC/PVDC-AL X 2 CAPS. VAG. MOI P-RF


CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE P-RF

CUTIE X 1 TUB AL + APLICATOR X 78 G CREMA P-RF


CUTIE X 1 APLICATOR PREUMPLUT UNIDOZA DIN PP CU 5 G CREMA VAG.

P-RF

CUTIE X 2 BLIST. TRANSPARENT DIN AL/PVC X 5 COMPR. VAG. P-RF

CUTIE X 1 TUB DIN AL X 30 G

P-RF

CUTIE X 1 TUB DIN AL X 30 G CREMA VAG. + 6 APLICATOARE DIN POLIPROPILENA

P-RF

CUTIE X 2 FOLII PVC-PE X 5 OVULE

P-RF

CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE

P-RF

COMPR.
0,5mg
PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 2 COMPR.
P-RF
COMPR.
0,5mg
PFIZER EUROPE MA EEG MAREA BRITANIE CUTIE X 1 FLAC. X 8 COMPR.
P-RF
CAPS. VAG. 10mg
LABORATOIRE THERAMEX MONACO CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. VAG. PRF
CREMA VAG. 10mg/g
LABORATOIRE THERAMEX MONACO CUTIE CU 1 TUB DIN AL X 15 G CREMA VAGINALA PRF
COMPR.
2,5mg
ORGANON NV
OLANDA CUTIE X 1 BLIST. X 28 COMPR.
P-RF
CAPS. MOI 100mg
LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI P-6L
CAPS. MOI 100mg
MEDICO UNO PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L
CAPS. MOI 100mg
PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI
P-6L
CAPS. MOI 200mg
LAB. BESINS INTERNATIONAL FRANTA CUTIE X 2 BLIST. AL/PVC X 7 CAPS. MOI P-6L
CAPS. MOI 200mg
MEDICO UNO PHARMA KFT. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L
CAPS. MOI 200mg
PHARMASWISS CESK REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L
GEL
10mg/g
LABORATOIRES BESINS INTERNATIONAL
FRANTA CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE PRF
GEL
10mg/g
ANTIBIOTICE SA
ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GEL P6L
COMPR. FILM. 10mg
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM.
P-RF
COMPR.
5mg
ORGANON NV
OLANDA CUTIE X 1 BLIST. X 30 COMPR.
P-6L
COMPR. FILM. 1mg+2mg
BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P6L
DRAJ.
FARA CONCENTRATIE BAYER PHARMA AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P-6L
COMPR. FILM. FARA CONCENTRATIE ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA
P-RF
PULB. + SOLV. PT. SOL. INJ.
75UI
MERCK SERONO EUROPE LIMITED MAREA BRITANIE
P-RF/R
300UI/0,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE
P-RF/R
450UI/0,75ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE
P-RF/R
900UI/1,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE
P-RF/R
SOL. INJ.
300UI/0,36ml N. V. ORGANON
OLANDA CUTIE X 1 CARTUS + 6 ACE
PR/PRF
SOL. INJ.
300UI/0,36ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS + 6 ACE
PR/PRF
SOL. INJ.
900UI/1,08ml N. V. ORGANON
OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF
SOL. INJ.
900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF
PULB+SOLV.PT.SOL.INJ 75UI
SERONO EUROPE LTD. MAREA BRITANIE
P-RF/R
COMPR.
50mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 COMPR. P-RF
COMPR. FILM. 60mg
DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR) P-RF
COMPR.
5mg
LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. P-6L
COMPR. FILM. 1mg
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GAL

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV.

SOL. INJ. IN STILOU INJECTOR PREUMPLUT

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM.

SOL. INJ. IN STILOU INJECTOR PREUMPLUT

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA

SOL. INJ. IN STILOU INJECTOR PREUMPLUT

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ.+ 1 FLAC. A 2 ML SAU 3 ML X 1 ML SOLV.

Pagina 9 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
30
30
30
12
12
1
2
1
1
1
10
1
1
10
5
2
8
10
1
28
30
30
30
14
30
30
1
1
20
30
28
21
28
1
1
1
1
1
1
1
1
1
10
28
60
28

21,360500
33,540000
33,540000
21,360500
21,360500
10,080000
10,080000
6,592499
5,410000
6,592499
21,030000
15,445000
16,387500
48,760000
37,580000
37,580000
30,710000
30,710000
38,387500
38,387500
1,070583
1,066666
2,141166
1,860416
1,860416
34,650000
17,380091
10,428054
27,112942
1,738009
1,151700
9,980000
13,340000
1,151700
1,151700
5,505249
5,505249
0,967250
14,390000
1,586071
0,565333
0,549000
0,549000
1,130666
1,130666
1,130666
16,162500
7,120000
1,113000
0,258333
2,062500
0,383809
0,536963
105,302120
421,208483
631,812725
1.263,625450

403,900000
403,900000
1.263,120000
1.263,120000

131,710000
1,770000
2,345357
0,357500
0,421683

3,709500
0,000000
0,000000
3,709500
3,709500
0,000000
0,000000
5,877501
0,000000
2,647501
0,000000
6,815000
0,402500
0,000000
0,000000
0,000000
0,000000
0,000000
10,062500
10,062500
0,518083
0,000000
0,007834
1,360417
0,705417
0,000000
9,184909
4,621946
8,997058
32,241991
0,406300
0,000000
0,000000
2,683300
3,412300
5,289751
4,407251
0,023750
0,000000
0,000000
0,279667
0,000000
0,000000
0,822905
0,098000
0,098000
5,767500
0,000000
0,000000
0,000000
0,000000
0,000000
0,459465
27,227880
84,441517
103,967275
120,794550
0,000000
0,000000
17,140000
17,140000
0,000000
0,000000
0,000000
0,000000
0,394388

10,680250
16,770000
16,770000
10,680250
10,680250
5,040000
5,040000
3,296249
2,705000
3,296249
10,515000
7,722500
8,193750
24,380000
18,790000
18,790000
15,355000
15,355000
19,193750
19,193750
0,535291
0,533333
1,070583
0,930208
0,930208
17,325000
8,690045
5,214027
13,556471
0,869004
0,575850
4,990000
6,670000
0,575850
0,575850
2,752624
2,752624
0,483625
7,195000
0,793035
0,282666
0,274500
0,274500
0,565333
0,565333
0,565333
8,081250
3,560000
0,556500
0,129166
1,031250
0,191904
0,268481
52,651060
210,604241
315,906362
631,812725
201,950000
201,950000
631,560000
631,560000
65,855000
0,885000
1,172678
0,178750
0,210841

14,389750
16,770000
16,770000
14,389750
14,389750
5,040000
5,040000
9,173751
2,705000
5,943751
10,515000
14,537500
8,596250
24,380000
18,790000
18,790000
15,355000
15,355000
29,256250
29,256250
1,053375
0,533333
1,078417
2,290625
1,635625
17,325000
17,874955
9,835973
22,553529
33,110996
0,982150
4,990000
6,670000
3,259150
3,988150
8,042376
7,159876
0,507375
7,195000
0,793036
0,562334
0,274500
0,274500
1,388238
0,663333
0,663333
13,848750
3,560000
0,556500
0,129167
1,031250
0,191905
0,727947
79,878940
295,045759
419,873638
752,607275
201,950000
201,950000
648,700000
648,700000
65,855000
0,885000
1,172679
0,178750
0,605230

19,224450
30,186000
30,186000
19,224450
19,224450
9,072000
9,072000
5,933249
4,869000
5,933249
18,927000
13,900500
14,748750
43,884000
33,822000
33,822000
27,639000
27,639000
34,548750
34,548750
0,963524
0,959999
1,927049
1,674374
1,674374
31,185000
15,642081
9,385248
24,401647
1,564208
1,036530
8,982000
12,006000
1,036530
1,036530
4,954724
4,954724
0,870525
12,951000
1,427463
0,508799
0,494100
0,494100
1,017599
1,017599
1,017599
14,546250
6,408000
1,001700
0,232499
1,856250
0,345428
0,483266
94,771908
379,087634
568,631452
1.137,262905
363,510000
363,510000
1.136,808000
1.136,808000
118,539000
1,593000
2,110821
0,321750
0,379514

5,845550
3,354000
3,354000
5,845550
5,845550
1,008000
1,008000
6,536751
0,541000
3,306751
2,103000
8,359500
2,041250
4,876000
3,758000
3,758000
3,071000
3,071000
13,901250
13,901250
0,625142
0,106667
0,221951
1,546459
0,891459
3,465000
10,922919
5,664752
11,708353
32,415792
0,521470
0,998000
1,334000
2,798470
3,527470
5,840276
4,957776
0,120475
1,439000
0,158608
0,336201
0,054900
0,054900
0,935972
0,211067
0,211067
7,383750
0,712000
0,111300
0,025834
0,206250
0,038381
0,513162
37,758092
126,562366
167,148548
247,157095
40,390000
40,390000
143,452000
143,452000
13,171000
0,177000
0,234536
0,035750
0,436557

cod ATC

589 G04BD07
590 G04BD08
591 G04BD08
592 G04BD08
593 G04BD08
594 G04BD08
595 G04BD09
596 G04BD09
597 G04CA01
598 G04CA01
599 G04CA01
600 G04CA01
601 G04CA02
602 G04CA02
603 G04CA02
604 G04CA02
605 G04CA02
606 G04CA02
607 G04CB01
608 G04CB01
609 G04CB02
610 H01AA02
611 H01AC01
612 H01AC01
613 H01AC01
614 H01AC01
615 H01AC01
616 H01AC01
617 H01CC01
618 H01CC01
619 H01CC02
620 H02AA02
621 H02AB01
622 H03BB02
623 H03BB02
624 H03BB02
625 J01CR01
626 J01CR04
627 J01CR04
628 J01FA02
629 J01FA02
630 J01FA02
631 J01FA10
632 J01FA10
633 J01FA10
634 J01FA10
635 J01FA10
636 J01FA10
637 J01FA10
638 J01FA10
639 J01FA10
640 J01FA10
641 J01FA10
642 J01FA10
643 J01FA10
644 J01FA10
645 J01FA10
646 J01FA10
647 J01FA10
648 J01FA10
649 J01FA10
650 J01FA10
651 J01FA10
652 J01FA10
653 J01FF01
654 J01FF01

DCI

TOLTERODINUM**#
SOLIFENACINUM SUCCINATE**#
SOLIFENACINUM SUCCINATE**#
SOLIFENACINUM SUCCINATE**#
SOLIFENACINUM SUCCINATE**#
SOLIFENACINUM SUCCINATE**#
TROSPIUM
TROSPIUM
ALFUZOSINUM
ALFUZOSINUM
ALFUZOSINUM
ALFUZOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
FINASTERIDUM*
FINASTERIDUM*
DUTASTERIDUM*
TETRACOSACTIDUM
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
SOMATROPINUM***#
GANIRELIXUM***#
GANIRELIXUM***#
CETRORELIXUM***#
FLUDROCORTISONUM
BETAMETHASONUM
THIAMAZOLUM
THIAMAZOLUM
THIAMAZOLUM
AMPICILLINUM + SULBACTAM
SULTAMICILLINUM
SULTAMICILLINUM
SPIRAMYCINUM
SPIRAMYCINUM
SPIRAMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM

Denumire Comerciala

UROFLOW 2
VESICARE 10 mg
SOLIFENACIN ACTAVIS 10 mg
VESICARE 5 mg
ASOLFENA 5 mg
SOLIFENACIN ACTAVIS 5 mg
INKONTAN 15 mg
INKONTAN 30 mg
ALFURAN MR 10 mg
XATRAL SR 10 mg
XATRAL SR 10 mg
XATRAL LP 5 mg
TAMSOL 0,4 mg
FOKUSIN
CONTIFLO MR
TAMSULOSIN AUROBINDO 400 micrograme

TAMSULOSIN TEVA 400 g


OMNIC TOCAS (R) 0,4
PROSCAR 5 mg
FINASTERIDA ARENA 5 mg
AVODART 0,5 mg
SYNACHTEN DEPOT
GENOTROPIN 16 UI/ml (5,3 mg/ml)
ZOMACTON
NUTROPINAq 10 mg/2 ml
OMNITROPE 3,3mg/ml
OMNITROPE 6,7mg/ml
NORDITROPIN SIMPLEXx 10 mg/1,5ml
ORGALUTRAN 0.25mg/0,5ml
ORGALUTRAN 0.25mg/0,5ml
CETROTIDE 0,25 mg
ASTONIN H
DIPROPHOS
THYROZOL 10 mg
THYROZOL 20mg
THYROZOL 5 mg
AMPIPLUS 1000 mg/500 mg
UNASYN
UNASYN
ROVAMYCINE (R) 1,5 Mil. UI
ROVAMYCINE (R) 3 Mil. UI
ROVAMYCINE 3 Mil. UI
AZATRIL 250 mg
SUMAMED 250 mg
SUMAMED 125 mg
AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE

AZITROMICINA TERAPIA 250 mg


AZITROMICINA TERAPIA 250 mg
SUMAMED 500 mg
AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE

AZIBIOT 500 mg
AZITROMICINA TERAPIA 500 mg
AZITROMICINA TERAPIA 500 mg
AZITROX (R) 500
AZATRIL 500 mg
AZITROMICINA ARENA 500 mg
AZITROMICINA TERAPIA 600 mg
AZITROMICINA TERAPIA 600 mg
AZITROX 200 mg/5 ml
AZITROMICINA SANDOZ 100 mg/5 ml
AZITROMICINA SANDOZ 200 mg/5 ml
SUMAMED FORTE
SUMAMED FORTE
SUMAMED FORTE
DALACIN C 150 mg
DALACIN C 300 mg

forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. FILM. ELIB. PREL.

CAPS. ELIB. MODIF.


CAPS. ELIB. MODIF.

CAPS. ELIB. PREL.

concentratie

2mg
10mg
10mg
5mg
5mg
5mg
15mg
30mg
10mg
10mg
10mg
5mg
0,4mg
0,4mg
0,4mg

CAPS. ELIB. PREL. 400micrograme

400 g
COMPR. FILM. ELIB. PREL. 0,4mg
COMPR. FILM. 5mg
COMPR. FILM. 5mg
CAPS. MOI 0,5mg
SUSP. INJ. 1mg/ml
COMPR. CU ELIB. PRELUNGITA

PULB. + SOLV. PT. SOL. INJ.


PULB. + SOLV. PT. SOL. INJ.

SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ. IN CARTUS

SOL. INJ.
SOL. INJ.

16UI/ml (5,3mg/ml)

1000mg/500mg

COMPR. FILM. 375mg


PULB. PT. SUSP. ORALA

250mg/5ml

COMPR. FILM. 1,5 M ui


COMPR. FILM. 3M ui
COMPR. FILM. 3MilU.I.

CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PULB. + SOLV. SUSP. ORALA

PULB. PT. SUSP. ORALA


PULB. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA

CAPS.
CAPS.

P6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L

ASTELLAS PHARMA EUROPE BV


KRKA, TOVARNA ZDRAVIL, D.D. NOVO MESTO

SLOVENIA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

ACTAVIS GROUP PTC EHF.

ACTAVIS GROUP PTC EHF.


PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H.

PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H.

TERAPIA SA
SANOFI-AVENTIS ROMANIA S.R.L.
SANOFI-AVENTIS ROMANIA S.R.L.
SANOFI-AVENTIS ROMANIA S.R.L.
GEDEON RICHTER ROMANIA SA

250mg
250mg
125mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
600mg
600mg
200mg/5ml
100mg/5ml
200 mg/5 ml
200mg/5ml
200mg/5ml
200mg/5ml
150mg
300mg

CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L


CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L

P6L

ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. P6L


AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

ZENTIVA KS
CEHIA
RANBAXY UK LTD. MAREA BRITANIE
AUROBINDO PHARMA (MALTA) LIMITED MALTA

CUTIE X 3 BLIST. PVC-ACLAR/AL X 10 COMPR. ELIB. PREL.

P-6L

CUTIE X 3 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-6L


CUTIE CU 1 BLIST. PVC/AL CU 30 COMPR. ELIB. PREL. P-6L
CUTIE X 2 BLIST. PVC/AL X 14 COMPR. FILM. ELIB. PREL.

P-6L

CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL.

P-6L

CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF.

P-6L

CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL. P-6L


CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 CAPS. ELIB. PREL.

P6L
P6L

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. CU ELIB. PRELUNG.

ASTELLAS PHARMA EUROPE BV

OLANDA

CUTIE X 3 FOLII AL/AL X 10 COMPR. FILM. ELIB. PREL. P-6L

MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM.

ARENA GROUP S.A. ROMANIA


GLAXOSMITHKLINE (GSK) SRL

P-6L

CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L

ROMANIA CUTIE X 3 BLIST.PVC-PVDC/AL X 10 CAPS. MOI P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FIOLA DIN STICLA X 1 ML SUSP. INJ.

S/P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ.

P-RF

GERMANIA

PR/PRF

0,25mg/0,5ml MERCK SHARP & DOHME

PULB. PT. SOL. INJ./PERF.

SUSP. INJ. I.M.

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

OLANDA
ISLANDA
OLANDA

ASTELLAS PHARMA EUROPE BV

FERRING GMBH
IPSEN PHARMA
SANDOZ GMBH
SANDOZ GMBH
NOVO NORDISK A/S
0,25mg/0,5ml N. V. ORGANON

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

COMPR.

Ambalaj

REPUBLICA CEHA

Detinator APP

ZENTIVA K.S.

4mg (12ui)
10mg/2ml
3,3mg/ml
6,7mg/ml
10mg/1,5ml

0,25mg
0,1mg
7mg/ml
10mg
20mg
5mg

PULB+SOLV. PT. SOL. INJ.

Tara det.
APP

Prescriptie

Nr. crt

CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV.

FRANTA CUTIE X 1 CARTUS X 2 ML. SOL. INJ.


AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ.
AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ.

P-RF/R
P-RF/R
P-RF/R

DANEMARCA CUTIE X 1 CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ.

P-RF

OLANDA

CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT

P-RF/R

MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT

P-RF/R

SERONO EUROPE LTD.

MAREA BRITANIE

P-RF

MERCK KGAA

GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR.

P-RF

MERCK SHARP & DOHME ROMANIA

CUTIE X 5 FIOLE X 1 ML

P-RF

MERCK KGAA
MERCK KGAA
MERCK KGAA
ANTIBIOTICE S.A.

GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L

ROMANIA

CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF.

PR, PRF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 2 BLIST. AL/PVC/PVDC X 6 COMPR.

P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID CU PULBERE PT. 60 ML SUSP. ORALA

LAB. AVENTIS
LAB. AVENTIS

FRANTA
FRANTA
FRANTA

LABORATOIRES AVENTIS

CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII + 7 ACE PT. INJECTII SUBCUTANATE + 14 TAMPOANE IMBIBATE IN ALCOOL

GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-6L


GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L

P-RF

CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM.

P-RF

CUTIE X 2 BLIST. AL/PVC X 5 COMPR. FILM.

P-RF

CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM.

PRF

BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS.


PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS.
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM.

P-RF

SANDOZ S.R.L.
TERAPIA SA
TERAPIA SA

P-RF

BALKANPHARMA RAZGRAD AD

ROMANIA
ROMANIA
ROMANIA
PLIVA LJUBLJANA D.O.O. SLOVENIA
SANDOZ S.R.L.
ROMANIA
KRKA D.D. NOVO MESTO SLOVENIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA

ZENTIVA K.S.
ACTAVIS GROUP PTC EHF.

CEHIA
ISLANDA

ARENA GROUP S.A.


TERAPIA SA
TERAPIA SA
ZENTIVA S.A.
SANDOZ SRL
SANDOZ SRL

CUTIE X 1 BLIST. X 6 COMPR. FILM.

P-RF
P-RF

CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM. P-RF


CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR. FILM. P-RF

CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM.

P-RF

CUTIE X 1 BLIST. X 3 COMPR. FILM.

P-RF

CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM.

P-RF

CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF


CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF

CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM.

P-RF

CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM. PRF

ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM. PRF


ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF
ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF
ROMANIA
P-RF
ROMANIA
P-RF
ROMANIA
P-RF
PLIVA LJUBLIJANA D.O.O. SLOVENIA
P-RF
PLIVA LJUBLIJANA D.O.O. SLOVENIA
P-RF
PLIVA LJUBLIJANA D.O.O. SLOVENIA
P-RF
CUTIE X 1 FLACON DIN PE CU PULBERE PENTRU 15ML SUSPENSIE ORALA RECONSTITUITA + FLACON CU SOLVENT X 7.5ML SOLVENT + 1 SERINGA PENTRU ADMINISTRAREA ORALA + O LINGURITA DOZATOARE

CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA

CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (800 MG) SUSP. ORALA

CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE

CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE

CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE

PFIZER EUROPE MA EEIG

MAREA BRITANIE

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 2 BLIST. AL/PVC X 8 CAPS.


CUTIE X 2 BLIST. AL/PVC X 8 CAPS.

Pagina 10 din 16

P-RF
P-RF

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

28
30
30
30
30
30
30
30
30
30
30
28
30
30
30
30
30
30
28
28
30
1
1
1
1
1
1
1
1
1
7
50
5
50
50
100
50
12
1
16
10
10
6
6
6
6
6
6
3
3
3
3
3
3
3
3
3
3
1
1
1
1
1
1
16
16

0,843366
3,373466
3,215000
1,686733
1,686733
1,686733
0,632524
1,265049
0,706666
1,087333
1,087333
0,582142
0,916666
0,726333
0,496666
0,909666
0,565333
1,189499
0,983124
0,876071
3,160666
5,960000
423,587000
317,690250
794,225625
384,340000
712,690000
794,225625
127,422857
127,422857
111,215714
0,403000
5,366000
0,312165
0,529400
0,156082
15,073600
2,861666
23,499996
0,637818
1,275641
1,275641
3,189105
3,189105
1,594550
3,189105
3,189105
3,189105
6,378210
4,063333
5,316666
5,576666
5,576666
5,576666
5,130000
5,576666
7,653855
7,653855
14,470000
12,722396
19,290000
19,083600
38,167200
47,709000
0,497046
0,994093

0,015205
1,316867
0,000000
2,888600
1,204933
1,203267
0,685476
0,858617
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,323501
0,321161
0,000000
0,000000
0,000000
40,873000
130,819750
157,414375
0,000000
0,000000
365,654375
16,207143
16,207143
0,000000
0,000000
0,000000
0,116835
0,000000
0,164118
0,000000
0,000000
1,820004
0,000932
1,337359
1,337359
0,102561
1,877561
2,552116
0,102561
0,102561
0,102561
2,205123
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
7,772811
7,772811
0,000000
6,617604
0,000000
3,176400
1,512800
12,651000
0,290454
0,365907

0,421683
1,686733
1,607500
0,843366
0,843366
0,843366
0,316262
0,632524
0,353333
0,543666
0,543666
0,291071
0,458333
0,363166
0,248333
0,454833
0,282666
0,594749
0,491562
0,438035
1,580333
2,980000
211,793500
158,845125
397,112812
192,170000
356,345000
397,112812
63,711428
63,711428
55,607857
0,201500
2,683000
0,156082
0,264700
0,078041
7,536800
1,430833
11,749998
0,318909
0,637820
0,637820
1,594552
1,594552
0,797275
1,594552
1,594552
1,594552
3,189105
2,031666
2,658333
2,788333
2,788333
2,788333
2,565000
2,788333
3,826927
3,826927
7,235000
6,361198
9,645000
9,541800
19,083600
23,854500
0,248523
0,497046

0,436888
3,003600
1,607500
3,731967
2,048300
2,046634
1,001738
1,491142
0,353333
0,543667
0,543667
0,291071
0,458333
0,363167
0,248333
0,454833
0,282667
0,918251
0,812723
0,438036
1,580333
2,980000
252,666500
289,664875
554,527188
192,170000
356,345000
762,767188
79,918572
79,918572
55,607857
0,201500
2,683000
0,272918
0,264700
0,242159
7,536800
1,430833
13,570002
0,319841
1,975180
1,975180
1,697114
3,472114
3,349391
1,697114
1,697114
1,697114
5,394228
2,031667
2,658333
2,788333
2,788333
2,788333
2,565000
2,788333
11,599739
11,599739
7,235000
12,978802
9,645000
12,718200
20,596400
36,505500
0,538977
0,862954

0,759029
3,036119
2,893500
1,518059
1,518059
1,518059
0,569271
1,138544
0,635999
0,978599
0,978599
0,523927
0,824999
0,653699
0,446999
0,818699
0,508799
1,070549
0,884811
0,788463
2,844599
5,364000
381,228300
285,921225
714,803062
345,906000
641,421000
714,803062
114,680571
114,680571
100,094142
0,362700
4,829400
0,280948
0,476460
0,140473
13,566240
2,575499
21,149996
0,574036
1,148076
1,148076
2,870194
2,870194
1,435095
2,870194
2,870194
2,870194
5,740389
3,656999
4,784999
5,018999
5,018999
5,018999
4,617000
5,018999
6,888469
6,888469
13,023000
11,450156
17,361000
17,175240
34,350480
42,938100
0,447341
0,894683

0,099542
1,654214
0,321500
3,057274
1,373607
1,371941
0,748729
0,985122
0,070667
0,108734
0,108734
0,058215
0,091667
0,072634
0,049667
0,090967
0,056534
0,442451
0,419474
0,087608
0,316067
0,596000
83,231700
162,588775
236,836938
38,434000
71,269000
445,076938
28,949429
28,949429
11,121572
0,040300
0,536600
0,148052
0,052940
0,179727
1,507360
0,286167
4,170004
0,064714
1,464924
1,464924
0,421472
2,196472
2,711571
0,421472
0,421472
0,421472
2,842944
0,406334
0,531667
0,557667
0,557667
0,557667
0,513000
0,557667
8,538197
8,538197
1,447000
7,889844
1,929000
5,084760
5,329520
17,421900
0,340159
0,465317

cod ATC

655 J01FF01
656 J01FF01
657 J01FF01
658 J01FF01
659 J01MA12
660 J01MA12
661 J01MA12
662 J01MA12
663 J01MA12
664 J01MA12
665 J01MA12
666 J01MA14
667 J01MA14
668 J01MA14
669 J01MA14
670 J01MA14
671 J02AC02
672 J02AC02
673 J02AC02
674 J02AC02
675 J02AC02
676 J02AC02
677 J05AB11
678 J05AB11
679 J05AB15
680 L01AA01
681 L02AE02
682 L02AE02
683 L02AE03
684 L02AE04
685 L02AE04
686 L02AE04
687 L02AE04
688 L04AX01
689 L04AX01
690 M01AC05
691 M01AC05
692 M01AE17
693 M01AE17
694 M01AE17
695 M01AE17
696 M01AE17

DCI

CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
VALACYCLOVIRUM*
VALACYCLOVIRUM*
BRIVUDINUM*#
CYCLOPHOSPHAMIDUM*
LEUPRORELINUM***#
LEUPRORELINUM***#
GOSERELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
AZATHIOPRINUM*
AZATHIOPRINUM*
LORNOXICAMUM
LORNOXICAMUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM

697 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)


698 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)
699 M01AH01
700 M01AH01
701 M01AH01
702 M01AH01
703 M01AH01
704 M01AH01
705 M01AH01
706 M01AH01
707 M01AH01
708 M01AH01
709 M01AH01
710 M01AH01
711 M01AH01
712 M01AH01
713 M01AH01
714 M01AH01
715 M01AH05
716 M01AH05
717 M01AH05
718 M01AH05
719 M01AH05
720 M01AH05

CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM

Denumire Comerciala

CLINDAMYCIN - MIP 300 mg


CLINDAMYCIN - MIP 300 mg
CLINDAMYCIN - MIP 600 mg
CLINDAMYCIN - MIP 600 mg
LEVOFLOXACINA ACTAVIS 250 mg
TAVANIC 250 mg
LEVOTOR 250 mg
FLERADAY 500 mg
LEVOFLOXACINA ACTAVIS 500 mg
TAVANIC 500 mg
LEVOTOR 500 mg
AVELOX 400 mg
MOXIFLOXACINA AUROBINDO 400 mg
MOFINACIN 400 mg
MOFIL 400 mg
MOFLAXA 400 mg
ORUNGAL
ITRACONAZOL 100 mg
OMICRAL 100 mg
MICOGAL 100 mg
ITRACONAZOL ARENA 100 mg
OMICRAL 100 mg
VALTREX 500 mg
VALACICLOVIR ARENA 500 mg
BRIVAL 125mg
ENDOXAN (R) 50 mg
LUCRIN DEPOT 11,25mg
LUCRIN DEPOT 3,75mg
ZOLADEX (R)
DIPHERELINE 0,1 mg
DIPHERELINE PR 11,25 mg
DIPHERELINE 3,75 mg
GONAPEPTYL ZILNIC 0,1 mg/ml
IMURAN
IMURAN
XEFO RAPID 8 mg
XEFO 8 mg/ 2 ml
TADOR 25 mg

forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.

COMPR.
DRAJ.
PULB. PT. SUSP. INJ. CU ELIB. PREL.

PULB. PT. SUSP. INJ. CU ELIB. PREL.

IMPLANT
LIOF. + SOLV. PT. SOL. INJ.
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

SOL. INJ.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PULB. + SOLV. PT. SOL. INJ.

DEXKETOPROFEN TROMETAMOL SANDOZ 25mg

COMPR. FILM.
COMPR. FILM.

TADOR INJECT

SOL. INJ./CONC. PT. SOL. PERF.

DEXKETOPROFEN ROMPHARM 50 mg/2 ml


DEXKETOPROFEN ROMPHARM 50 mg/2 ml

VIMOVO 500 mg/20 mg


VIMOVO 500 mg/20 mg
CELEBREX 100 mg
ALGOXIB 100 mg
ACLEXA 100 mg
CELECOXIB ACTAVIS 100 mg
CELETOR 100 mg
CALIDEM 100 mg
CELECOXIB TERAPIA 100 mg
CELEBREX 200 mg
CELEBREX 200 mg
ALGOXIB 200 mg
ACLEXA 200 mg
CELECOXIB ACTAVIS 200 mg
CELETOR 200 mg
CALIDEM 200 mg
CALIDEM 200 mg
CELECOXIB TERAPIA 200 mg
ARCOXIA 120 mg
ARCOXIA 120 mg
ARCOXIA 30 mg
ARCOXIA 60 mg
ARCOXIA 60 mg
ARCOXIA 90 mg

SOL. INJ./CONC. PT. SOL. PERF.

SOL. INJ./CONC. PT. SOL. PERF.

COMPR. ELIB. MODIF.


COMPR. ELIB. MODIF.

CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

concentratie

300mg
300mg
600mg
600mg
250mg
250mg
250mg
500 mg
500mg
500mg
500mg
400mg
400mg
400mg
400mg
400mg
100mg
100mg
100mg
100mg
100mg
100mg
500 mg
500mg
125mg
50mg
11,25mg
3,75mg
3,6mg
0,1mg
11,25mg
3,75mg
0,1mg/ml
50mg
50mg
8mg
8mg/2ml
25mg
25mg
50mg/2ml
50mg/2ml
50mg/2ml

Detinator APP

Tara det.
APP

MIP PHARMA GMBH GERMANIA


MIP PHARMA GMBH GERMANIA
MIP PHARMA GMBH GERMANIA
MIP PHARMA GMBH GERMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
TERAPIA S.A.
ROMANIA

Ambalaj

Prescriptie

Nr. crt

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

16
30
CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF
16
CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM. P-RF
30
CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF
7
CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF
7
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF
7
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/PVDC - AL X 7 COMPR. FILM. PRF
7
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-RF
7
TERAPIA S.A.
ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF
7
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF
7
BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF
5
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM. PRF
5
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF
5
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR. FILM. PRF
5
KRKA, D.D., NOVO MESTO SLOVENIA
PRF
5
JANSSEN PHARMACEUTICA N.V. BELGIA
CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF
15
SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
15
MEDICO UNO PHARMACEUTICAL SRL
ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF
15
ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF
15
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
15
PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF
15
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM. PRF
10
ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM. PRF
10
BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR.
P-RF
7
BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ.
P-RF
50
ABBVIE FARMACEUTICA S.L.U. SPANIA
PR/PRF
1
ABBVIE FARMACEUTICA S.L.U. SPANIA
PR/PRF
1
ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG S/P-RF
1
IPSEN PHARMA
FRANTA CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF
7
IPSEN PHARMA
FRANTA
S/P-RF
1
IPSEN PHARMA
FRANTA
S/P-RF
1
FERRING GMBH
GERMANIA CUTIE X 28 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF
28
ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100
ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF
100
NYCOMED AUSTRIA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L
10
NYCOMED AUSTRIA GMBH AUSTRIA
PRF
10
BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L
10
SANDOZ S.R.L.
ROMANIA CUTIE BLIST. DIN PVC-PVDC/AL X 20 COMPRIMATE FILMATE P6L
20
MENARINI INTERNATIONAL OPERATIONS S.A. LUXEMBOURG CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF.
P-RF
5
ROMPHARM COMPANY S.R.L. ROMANIA
PRF
5
ROMPHARM COMPANY S.R.L. ROMANIA
PRF
10
500 mg/20 mg ASTRA ZENECA AB SUEDIA
PRF
30
500 mg/20 mg ASTRA ZENECA AB SUEDIA
PRF
60
100mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF
30
100mg
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
100mg
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
100mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
100mg
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
100mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
100mg
TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF
30
200mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF
10
200mg
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF
30
200mg
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
200mg
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
200mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
200mg
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
PRF
30
200mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 10 CAPS. PRF
10
200mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
200mg
TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF
30
120mg
MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF
7
120mg
MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL, X 14 COMPR. FILM. P-RF
14
30mg
MERCK SHARP & DOHME ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF
28
60mg
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF
14
60mg
MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF
14
90mg
MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF
14
CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM.

P-RF

CUTIE X 5 BLIST. PVC/AL X 6 COMPR. FILM.

P-RF

CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINND 5 COMPRIMATE FILMATE

CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(23G 1)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%.

CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(22G 1)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC 70%.

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU 1 SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU O SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE

CUTIE CU 10 FLAC. DIN STICLA BRUNA CU PULB. PT. SOL. INJ. + 10 FIOLE DIN STICLA INCOLORA X 2 ML SOLV

CUTIE CU 5 FIOLE DIN STICLA BRUNA (UN SUPORT A 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF.

CUTIE CU 10 FIOLE DIN STICLA BRUNA (DOUA SUPORTURI A CATE 5 FIOLE), PREVAZUTE CU INEL DE RUPERE, CONTINAND 2 ML DE SOL. INJ./CONC. PT. SOL. PERF.

CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 30 COMPR. ELIB. MODIF.

CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 60 COMPR. ELIB. MODIF.

Pagina 11 din 16

0,883750
0,884000
1,988187
1,988187
1,555714
2,433600
1,555714
4,427142
3,280000
4,867200
3,228571
4,867200
4,867200
4,867200
4,867200
4,867200
3,194000
2,144666
2,144666
2,144666
2,144666
2,144666
4,661000
3,131000
48,002857
0,542400
630,670000
246,930000
298,459994
6,802854
765,321751
371,770000
0,911583
0,614116
0,614116
0,431999
1,178998
0,475199
0,475199
2,276000
2,276000
2,276000
1,611749
1,584666
0,586583
0,584000
0,584000
0,584000
0,584000
0,584000
0,584000
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
1,173166
2,346333
2,346333
0,586583
1,173166
1,173166
1,759749

0,000000
0,000000
0,660563
0,747146
0,000000
1,417828
0,000000
0,000000
0,000000
1,724228
0,000000
6,216800
2,338800
2,338800
2,338800
2,338800
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
4,700006
6,878574
121,558249
0,000000
21,261274
0,088184
0,088184
0,540001
7,921002
0,396801
0,091801
1,788000
0,364000
0,365000
0,081251
0,000000
0,311750
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,972834
0,640167
0,005167
0,005167
0,005167
0,005167
0,220834
0,005167
0,005167
2,212238
2,065095
2,234488
2,023262
2,023262
1,757393

0,441875
0,442000
0,994093
0,994093
0,777857
1,216800
0,777857
2,213571
1,640000
2,433600
1,614285
2,433600
2,433600
2,433600
2,433600
2,433600
1,597000
1,072333
1,072333
1,072333
1,072333
1,072333
2,330500
1,565500
24,001428
0,271200
315,335000
123,465000
149,229997
3,401427
382,660875
185,885000
0,455791
0,307058
0,307058
0,215999
0,589499
0,237599
0,237599
1,138000
1,138000
1,138000
0,805874
0,792333
0,293291
0,292000
0,292000
0,292000
0,292000
0,292000
0,292000
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
0,586583
1,173166
1,173166
0,293291
0,586583
0,586583
0,879874

0,441875
0,442000
1,654657
1,741240
0,777857
2,634628
0,777857
2,213571
1,640000
4,157828
1,614286
8,650400
4,772400
4,772400
4,772400
4,772400
1,597000
1,072333
1,072333
1,072333
1,072333
1,072333
2,330500
1,565500
24,001429
0,271200
315,335000
123,465000
153,930003
10,280001
504,219125
185,885000
21,717066
0,395242
0,395242
0,756001
8,510501
0,634401
0,329401
2,926000
1,502000
1,503000
0,887126
0,792333
0,605042
0,292000
0,292000
0,292000
0,292000
0,292000
0,292000
1,559417
1,226750
0,591750
0,591750
0,591750
0,591750
0,807417
0,591750
0,591750
3,385405
3,238262
2,527780
2,609845
2,609845
2,637268

0,795375
0,795600
1,789368
1,789368
1,400142
2,190240
1,400142
3,984427
2,952000
4,380480
2,905713
4,380480
4,380480
4,380480
4,380480
4,380480
2,874600
1,930199
1,930199
1,930199
1,930199
1,930199
4,194900
2,817900
43,202571
0,488160
567,603000
222,237000
268,613994
6,122568
688,789575
334,593000
0,820424
0,552704
0,552704
0,388799
1,061098
0,427679
0,427679
2,048400
2,048400
2,048400
1,450574
1,426199
0,527924
0,525600
0,525600
0,525600
0,525600
0,525600
0,525600
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
1,055849
2,111699
2,111699
0,527924
1,055849
1,055849
1,583774

0,088375
0,088400
0,859382
0,945965
0,155572
1,661188
0,155572
0,442715
0,328000
2,210948
0,322858
6,703520
2,825520
2,825520
2,825520
2,825520
0,319400
0,214467
0,214467
0,214467
0,214467
0,214467
0,466100
0,313100
4,800286
0,054240
63,067000
24,693000
34,546006
7,558860
198,090425
37,177000
21,352433
0,149596
0,149596
0,583201
8,038902
0,444321
0,139321
2,015600
0,591600
0,592600
0,242426
0,158467
0,370409
0,058400
0,058400
0,058400
0,058400
0,058400
0,058400
1,090151
0,757484
0,122484
0,122484
0,122484
0,122484
0,338151
0,122484
0,122484
2,446872
2,299729
2,293147
2,140579
2,140579
1,933368

cod ATC

DCI

737 M05BA07

ETORICOXIBUM
BACLOFENUM
BACLOFENUM
ACIDUM ALENDRONICUM*
ACIDUM ALENDRONICUM*
ACIDUM ALENDRONICUM*
ACIDUM ALENDRONICUM*
ACIDUM ALENDRONICUM*
ACIDUM ALENDRONICUM*
ACIDUM ALENDRONICUM*
ACIDUM RISEDRONICUM*
ACIDUM RISEDRONICUM*
ACIDUM RISEDRONICUM*
ACIDUM RISEDRONICUM*
ACIDUM RISEDRONICUM*
ACIDUM RISEDRONICUM*
ACIDUM RISEDRONICUM*

738 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)*

739 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)*

740 M05BB03

COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)*

741 N02AA05

OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
DIHYDROCODEINUM*
DIHYDROCODEINUM*
DIHYDROCODEINUM*

721 M01AH05
722 M03BX01
723 M03BX01
724 M05BA04
725 M05BA04
726 M05BA04
727 M05BA04
728 M05BA04
729 M05BA04
730 M05BA04
731 M05BA07
732 M05BA07
733 M05BA07
734 M05BA07
735 M05BA07
736 M05BA07

742 N02AA05
743 N02AA05
744 N02AA05
745 N02AA05
746 N02AA05
747 N02AA05
748 N02AA05
749 N02AA05
750 N02AA05
751 N02AA05
752 N02AA05
753 N02AA05
754 N02AA05
755 N02AA05
756 N02AA05
757 N02AA05
758 N02AA05
759 N02AA08
760 N02AA08
761 N02AA08

762 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM


763 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
764 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
765 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
766 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
767 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
768 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
769 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
770 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
771 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
772 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
773 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
774 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
775 N03AX16
776 N03AX16
777 N03AX16
778 N03AX16
779 N03AX16
780 N03AX16
781 N04BC05
782 N04BC05
783 N04BC05
784 N04BC05
785 N04BC05
786 N04BC05

PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*

Denumire Comerciala

ARCOXIA 90 mg
LIORESAL (R)
LIORESAL (R)
TEVANAT 70 mg
ACID ALENDRONIC AUROBINDO 70 mg
FOSAMAX 70 mg
ALENDRONAT SANDOZ 70 mg
ADRONIK 70 mg
ADRONIK 70 mg
ADRONIK 70 mg
RISEDRONAT TEVA 35 mg
LORINE 35mg
OSODENS 35 mg
RISEDRONAT SODIC ZENTIVA 35mg
RISEDRONAT AUROBINDO 35 mg
ACTONEL SAPTAMANAL 35 mg
ACTONEL 75 mg
FOSAVANCE 70mg/2800UI
FOSAVANCE 70mg/5600UI
FOSAVANCE 70mg/5600UI
OXYCONTIN 10 mg
OXYCONTIN 20 mg
OXYCONTIN 40 mg
OXYCONTIN 80 mg
RELTEBON 10 mg
RELTEBON 20 mg

Tara det.
forma farm. concentratie
APP
Detinator APP
COMPR. FILM. 90mg
MERCK SHARP & DOHME ROMANIA

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

10mg
25mg
70 mg
70mg
70mg
70mg
70mg
70mg
70mg
35mg
35mg
35mg
35mg
35mg
35mg
75mg

COMPR.
COMPR.
COMPR.

70mg/2800UI MERCK SHARP & DOHME


70mg/5600UI MERCK SHARP & DOHME
70mg/5600UI MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.)

P-6L

MAREA BRITANIE CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.)

P-6L

MAREA BRITANIE CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.)

P-6L

10 mg
20 mg
40 mg
80mg
10mg
20mg
20mg
40mg
40mg
80mg
80mg
10mg
20mg
40mg
40mg
60mg
80mg
80mg
120mg
60mg
90mg

AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.


AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
ISLANDA
ISLANDA

PS
PS
PS
PS

COMPR. CU ELIB. MODIF.


COMPR. CU ELIB. MODIF.
COMPR. CU ELIB. MODIF.
COMPR. CU ELIB. MODIF.

COMPR. CU ELIB. PREL.


COMPR. CU ELIB. PREL.

CLORHIDRAT DE OXICODONA TORRENT 20 mg

COMPR. CU ELIB. PREL.

RELTEBON 40 mg

COMPR. CU ELIB. PREL.

CLORHIDRAT DE OXICODONA TORRENT 40 mg

COMPR. CU ELIB. PREL.

RELTEBON 80 mg

COMPR. CU ELIB. PREL.

CLORHIDRAT DE OXICODONA TORRENT 80 mg

COMPR. CU ELIB. PREL.

OXIDOLOR 10 mg
OXIDOLOR 20 mg
OXIDOLOR 40 mg
OXICODONA SANDOZ 40 mg
OXICODONA SANDOZ 60 mg
OXIDOLOR 80 mg
OXICODONA SANDOZ 80 mg
DHC CONTINUS 120 mg
DHC CONTINUS 60 mg
DHC CONTINUS 90 mg
ZALDIAR (R)
TRAUMOBOL 37,5mg/325mg
TRAUMOBOL 37,5mg/325mg
ZALDIAR
ZALDIAR
ZALDIAR
ZALDIAR
DORETA 37,5mg/325mg
DORETA 37,5mg/325mg
LINEROL 37,5 mg/325 mg
DORETA 75 mg/650 mg
DORETA 75 mg/650 mg
PALGOTAL 75 mg/650 mg
LYRICA 150 mg
LYRICA 150 mg
LYRICA 300 mg
LYRICA 300 mg
LYRICA 75 mg
LYRICA 75 mg
OPRYMEA 0,088mg
PRAMIPEXOL ZENTIVA 0,18 mg
OPRYMEA 0,18mg
MEDOPEXOL 0,18 mg
GLEPARK 0,18 mg
PRAMIPEXOL TORRENT 0,18 mg

Ambalaj

Prescriptie

Nr. crt

COMPR. ELIB. PREL.


COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.

COMPR. FILM. 37,5mg+325mg


CAPS.
37,5mg/325mg
CAPS.
37,5mg/325mg
COMPR. FILM. 37,5mg+325mg
COMPR. FILM. 37,5mg+325mg
COMPR. FILM. 37,5mg+325mg
COMPR. FILM. 37,5mg+325mg
COMPR. FILM. 37,5mg/325mg
COMPR. FILM. 37,5mg/325mg
COMPR. FILM. 37,5mg/325mg
COMPR. FILM. 75 mg/650 mg
COMPR. FILM. 75 mg/650 mg
COMPR. FILM. 75mg/650mg

CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

150mg
150mg
300mg
300mg
75mg
75mg
0,088mg
0,18 mg
0,18mg
0,18mg
0,18mg
0,18mg

CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L


GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L
ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR. P-6L
MALTA CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR. P6L
ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L
ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM P-6L
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM. P-6L
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L
ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L
ROMANIA CUTIE X 1BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L

NOVARTIS PHARMA GMBH GERMANIA


NOVARTIS PHARMA GMBH
TEVA PHARMACEUTICALS S.R.L.
AUROBINDO PHARMA (MALTA) LIMITED

MERCK SHARP & DOHME

SANDOZ S.R.L.
ARENA GROUP S.A.
ARENA GROUP S.A.
ARENA GROUP S.A.
TEVA PHARMACEUTICALS SRL

ANTIBIOTICE S.A.
TERAPIA SA
ZENTIVA KS
AUROBINDO PHARMA (MALTA) LIMITED

ACTAVIS GROUP PTC EHF.


ACTAVIS GROUP PTC EHF.

MUNDIPHARMA GES.M.B.H
MUNDIPHARMA GES.M.B.H
MUNDIPHARMA GES.M.B.H
MUNDIPHARMA GES.M.B.H
ACTAVIS GROUP PTC EHF.
ACTAVIS GROUP PTC EHF.

REPUBLICA CEHA CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE

TORRENT PHARMA SRL ROMANIA


ACTAVIS GROUP PTC EHF.

ISLANDA

TORRENT PHARMA SRL ROMANIA


ACTAVIS GROUP PTC EHF.

ISLANDA

TORRENT PHARMA SRL ROMANIA

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.

PR, PS

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.

PR, PS

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.

PR, PS

LANNACHER HEILMITTEL GES.M.B.H.

AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL.


AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL.
AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL.

SANDOZ S.R.L.
SANDOZ S.R.L.

ROMANIA
ROMANIA

LANNACHER HEILMITTEL GES.M.B.H.

AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL.

SANDOZ S.R.L.

ROMANIA

LANNACHER HEILMITTEL GES.M.B.H.


LANNACHER HEILMITTEL GES.M.B.H.

MUNDIPHARMA GES.M.B.H
MUNDIPHARMA GES.M.B.H
MUNDIPHARMA GES.M.B.H

P-6L

MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM. P6L


ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L
ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L

CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.


CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.

P-TS
P-TS
P-TS

PS
PS
P-TS

CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.


PS
AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS
AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS
AUSTRIA CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL. PS

GRUNENTHAL GMBH GERMANIA


ROMPHARM COMPANY SRL ROMANIA
ROMPHARM COMPANY SRL ROMANIA

CUTIE X 2 BLISTERE PVC/PE/PVDC/AL X 15 CAPSULE

PRF

CUTIE CU 1 BLIST. DIN PVC/PE/PVDC/AL A 15 CAPS.

PRF

STADA ARZNEIMITTEL AG GERMANIA

CUTIE CU 1 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF

STADA ARZNEIMITTEL AG GERMANIA

CUTIE CU 2 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF

STADA ARZNEIMITTEL AG GERMANIA

CUTIE CU 3 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF

STADA ARZNEIMITTEL AG GERMANIA

CUTIE CU 5 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM. P-RF

SLOVENIA
KRKA D.D. NOVO MESTO SLOVENIA

CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

KRKA D.D. NOVO MESTO

PHARMACEUTICAL WORKS POLPHARMA SA

CUTIE X 1 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF

CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-RF

POLONIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM.

P-RF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMP.FILM. PRF

ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVCDC/AL X 30 COMPR. FILM.
PRF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 56 CAPS. (BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 14 CAPS. (BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL) P-RF
KRKA D.D.
SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF
KRKA D.D.
SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. AL/AL X 30 COMPR.

P-RF

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF

Pagina 12 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

14
50
50
4
4
2
2
12
2
4
4
4
4
4
4
4
2
4
2
4
60
60
60
60
60
60
60
60
60
60
60
60
60
60
20
20
60
20
56
56
56
10
30
15
10
20
30
50
10
20
20
10
20
30
14
56
56
14
14
56
30
30
30
30
30
30

1,759749
0,333959
0,666000
2,705000
2,487500
6,594412
4,890000
6,594412
6,594412
6,594412
2,220000
6,594412
6,594412
3,712500
3,712500
6,594412
14,130883
6,594412
6,594412
6,594412
0,437249
0,874498
1,748999
3,497999
0,437249
0,874498
0,874498
1,748999
1,748999
3,303666
3,304000
0,437249
0,874498
1,748999
1,748999
2,623501
3,303666
3,497999
1,366660
0,543750
1,024995
0,272750
0,272750
0,272750
0,272750
0,272750
0,272750
0,272750
0,272750
0,272500
0,272750
0,545000
0,545500
0,537333
3,126081
3,126081
5,731785
6,045000
1,563040
1,563040
0,087088
0,178135
0,178135
0,178135
0,178135
0,178135

1,757393
0,079241
0,000000
0,000000
0,000000
7,025588
0,000000
1,541421
2,255588
1,973088
0,000000
0,628088
0,628088
0,000000
0,000000
4,155588
19,064117
11,895588
11,080588
10,493088
0,608584
0,971835
1,086334
1,584834
0,242417
0,325668
0,325668
0,194334
0,194334
0,000000
0,000000
0,242417
0,325668
0,194334
0,297001
4,606499
0,000000
0,048501
0,792447
0,000000
0,437147
0,534250
0,240916
0,253250
0,534250
0,533750
0,517250
0,387450
0,000250
0,000000
0,251750
0,000000
0,000000
0,000000
1,254633
0,770169
0,000000
0,000000
1,069817
0,850888
0,442912
0,208531
0,248531
0,473198
0,144531
0,412531

0,879874
0,166979
0,333000
1,352500
1,243750
3,297206
2,445000
3,297206
3,297206
3,297206
1,110000
3,297206
3,297206
1,856250
1,856250
3,297206
7,065441
3,297206
3,297206
3,297206
0,218624
0,437249
0,874499
1,748999
0,218624
0,437249
0,437249
0,874499
0,874499
1,651833
1,652000
0,218624
0,437249
0,874499
0,874499
1,311750
1,651833
1,748999
0,683330
0,271875
0,512497
0,136375
0,136375
0,136375
0,136375
0,136375
0,136375
0,136375
0,136375
0,136250
0,136375
0,272500
0,272750
0,268666
1,563040
1,563040
2,865892
3,022500
0,781520
0,781520
0,043544
0,089067
0,089067
0,089067
0,089067
0,089067

2,637268
0,246221
0,333000
1,352500
1,243750
10,322794
2,445000
4,838627
5,552794
5,270294
1,110000
3,925294
3,925294
1,856250
1,856250
7,452794
26,129559
15,192794
14,377794
13,790294
0,827209
1,409084
1,960834
3,333834
0,461042
0,762917
0,762917
1,068834
1,068834
1,651833
1,652000
0,461042
0,762917
1,068834
1,171501
5,918250
1,651833
1,797501
1,475777
0,271875
0,949645
0,670625
0,377291
0,389625
0,670625
0,670125
0,653625
0,523825
0,136625
0,136250
0,388125
0,272500
0,272750
0,268667
2,817674
2,333210
2,865893
3,022500
1,851337
1,632408
0,486456
0,297599
0,337599
0,562266
0,233599
0,501599

1,583774
0,300563
0,599400
2,434500
2,238750
5,934970
4,401000
5,934970
5,934970
5,934970
1,998000
5,934970
5,934970
3,341250
3,341250
5,934970
12,717794
5,934970
5,934970
5,934970
0,393524
0,787048
1,574099
3,148199
0,393524
0,787048
0,787048
1,574099
1,574099
2,973299
2,973600
0,393524
0,787048
1,574099
1,574099
2,361150
2,973299
3,148199
1,229994
0,489375
0,922495
0,245475
0,245475
0,245475
0,245475
0,245475
0,245475
0,245475
0,245475
0,245250
0,245475
0,490500
0,490950
0,483599
2,813472
2,813472
5,158606
5,440500
1,406736
1,406736
0,078379
0,160321
0,160321
0,160321
0,160321
0,160321

1,933368
0,112637
0,066600
0,270500
0,248750
7,685030
0,489000
2,200863
2,915030
2,632530
0,222000
1,287530
1,287530
0,371250
0,371250
4,815030
20,477206
12,555030
11,740030
11,152530
0,652309
1,059285
1,261234
1,934634
0,286142
0,413118
0,413118
0,369234
0,369234
0,330367
0,330400
0,286142
0,413118
0,369234
0,471901
4,868850
0,330367
0,398301
0,929113
0,054375
0,539647
0,561525
0,268191
0,280525
0,561525
0,561025
0,544525
0,414725
0,027525
0,027250
0,279025
0,054500
0,054550
0,053734
1,567242
1,082778
0,573179
0,604500
1,226121
1,007192
0,451621
0,226345
0,266345
0,491012
0,162345
0,430345

cod ATC

787 N04BC05
788 N04BC05
789 N04BC05
790 N04BC05
791 N04BC05
792 N04BC05
793 N04BC05
794 N04BC05
795 N04BC05
796 N04BC05
797 N04BC05
798 N04BC05
799 N04BC05
800 N04BC05
801 N04BC05
802 N04BC05
803 N04BC05
804 N04BC05
805 N04BC05
806 N04BC05
807 N04BC05
808 N04BC05
809 N04BC05
810 N04BC08
811 N05AL03
812 N05BE01
813 N05BE01
814 N06AB10
815 N06AB10
816 N06AB10
817 N06AB10
818 N06AB10
819 N06AB10
820 N06AB10
821 N06AB10
822 N06AB10
823 N06AB10
824 N06AB10
825 N06AB10
826 N06AB10
827 N06AB10
828 N06AB10
829 N06AB10
830 N06AB10
831 N06AB10
832 N06AB10
833 N06AB10
834 N06AB10
835 N06AB10
836 N06AB10
837 N06AB10
838 N06AB10
839 N06AB10
840 N06AB10
841 N06AB10
842 N06AB10
843 N06AX05
844 N06AX05
845 N06AX05
846 N06AX05
847 N06AX05
848 N06AX05
849 N06AX12
850 N06AX14
851 N06AX14
852 N06AX14

DCI

PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PIRIBEDILUM**
TIAPRIDUM
BUSPIRONUM
BUSPIRONUM
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
BUPROPIONUM**#
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**

Denumire Comerciala

PRAMIPEXOL AUROBINDO 0,18 mg


MIGLASEN 0,18 mg
PRAMIPEXOL AUROBINDO 0,7 mg
PRAMIPEXOL ZENTIVA 0,7 mg
OPRYMEA 0,7mg
MEDOPEXOL 0,7 mg
GLEPARK 0,7 mg
PRAMIPEXOL TORRENT 0,7 mg
PRAMIPEXOL STADA 0,7 mg
MIGLASEN 0,7 mg
MIRAPEXIN 0,26 mg
OPRYMEA 0,26mg
CALMOLAN 0,26 mg
MIRAPEXIN 0,52 mg
OPRYMEA 0,52mg
CALMOLAN 0,52 mg
MIRAPEXIN 1,05 mg
OPRYMEA 1,05mg
OPRYMEA 1,57mg
OPRYMEA 2,10mg
MIRAPEXIN 2,1 mg
CALMOLAN 2,1 mg
MIRAPEXIN 3,15 mg
PRONORAN 50 mg
TIAPRIDAL (R) 100 mg
SPITOMIN 10 mg
SPITOMIN 5 mg
DEPRESINAL 10 mg
CIPRALEX 10 mg
ESCITIL 10 mg
ESCITALOPRAM-TEVA 10 mg
LENUXIN 10 mg
ESLOREX 10 mg
SERODEPS 10mg
ESTAN 10 mg
ESTAN 10 mg
ESCITALOPRAM ACTAVIS 10 mg
ELICEA 10 mg
ESCITALOPRAM AUROBINDO 10 mg
ESCITALOPRAM ATB 10 mg
ESCITALOPRAM TORRENT 10 mg
ESCITALOPRAM-TEVA 15 mg
ELICEA 15 mg
ESCITALOPRAM-TEVA 20 mg
SERODEPS 20mg
ESCITALOPRAM TORRENT 20 mg
ESCITALOPRAM ACTAVIS 20 mg
ELICEA 20 mg
ELICEA Q-TAB 10 mg
ELICEA Q-TAB 10 mg
ESCITALOPRAM TEVA 10 mg
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 20 mg
ELICEA Q-TAB 20 mg
ESCITALOPRAM TEVA 20 mg
TRITTICO AC 150 mg
TRITTICO AC 150 mg
TRITTICO AC 150 mg
TRITTICO AC 150 mg
TRITTICO AC 75 mg
TRITTICO AC 75 mg
ELONTRIL 150 mg
LYXIT 12,5 mg
LYXIT 12,5 mg
NOBIXAL 12,5 mg

forma farm.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.

DRAJ. ELIB. PREL.

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

COMPR. ELIB. PREL.


COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. MODIF.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

concentratie

0,18mg
0,18mg
0,7 mg
0,7 mg
0,7mg
0,7mg
0,7mg
0,7mg
0,7mg
0,7mg
0,26mg
0,26mg
0,26mg
0,52mg
0,52mg
0,52mg
1,05mg
1,05mg
1,57mg
2,10mg
2,1mg
2,1mg
3,15mg
50mg
100mg
10mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
20mg
20mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
150mg
150mg
150mg
150mg
75mg
75mg
150mg
12,5 mg
12,5 mg
12,5mg

Detinator APP
AUROBINDO PHARMA (MALTA) LIMITED

Tara det.
APP

MALTA

Ambalaj

Prescriptie

Nr. crt

CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF

NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L

MALTA CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF


ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF
KRKA D.D.
SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF

AUROBINDO PHARMA (MALTA) LIMITED

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. AL/AL X 30 COMPR.

P-RF

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF


STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR. P-RF

NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L


BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR.

P-RF

KRKA D.D.
SLOVENIA
P-RF
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.

P-RF

KRKA D.D.
SLOVENIA
P-RF
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

KRKA D.D.
KRKA D.D.
KRKA D.D.
BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.

P-RF

SLOVENIA

CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

P-RF

CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

P-RF

CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

P-RF

SLOVENIA
SLOVENIA

GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.

P-RF

G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF
BOEHRINGER INGELHEIM INTERNATIONAL GMBH

LES LABORATOIRES SERVIER


SANOFI-SYNTHELABO FRANCE

GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.

P-RF

FRANTA CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL.


FRANTA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-RF

P-RF

EGIS PHARMACEUTICALS P.L.C.

UNGARIA
UNGARIA

LANNACHER HEILMITTEL GES.M.B.H.

AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-RF

H. LUNDBECK A/S

DANEMARCA

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

P-RF

EGIS PHARMACEUTICALS P.L.C.

UNGARIA
ROMANIA
ROMANIA

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

P-RF

CEHIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

PRF

ROMANIA

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

P-RF

EGIS PHARMACEUTICALS P.L.C.

TEVA PHARMACEUTICALS S.R.L.


GEDEON RICHTER ROMANIA SA

ZENTIVA K.S.
TERAPIA SA
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
ACTAVIS GROUP PTC EHF.

CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF


CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF


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

CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM.


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

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
AUROBINDO PHARMA LIMITED

MAREA BRITANIE

ANTIBIOTICE S.A.

ROMANIA

P-RF

PRF
PRF
PRF
PRF

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


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

TORRENT PHARMA SRL ROMANIA

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

ROMANIA
KRKA, D.D., NOVO MESTO SLOVENIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
TERAPIA SA
ROMANIA
TORRENT PHARMA SRL ROMANIA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF

TEVA PHARMACEUTICALS S.R.L.

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

PRF
PRF

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF


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

P-RF

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

PRF

ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.

PRF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

PRF

KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE

PRF

KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE

PRF

CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE

PRF

CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE

PRF

CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE

PRF

CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE

PRF

CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE

PRF

CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE

PRF

ACTAVIS GROUP PTC EHF.

TEVA PHARMACEUTICALS S.R.L.

KRKA, D.D., NOVO MESTO


KRKA, D.D., NOVO MESTO
KRKA, D.D., NOVO MESTO
KRKA, D.D., NOVO MESTO
TEVA PHARMACEUTICALS S.R.L.

ANGELINI FRANCESCO SPA


ANGELINI FRANCESCO SPA
ANGELINI FRANCESCO SPA
ANGELINI FRANCESCO SPA
ANGELINI FRANCESCO SPA
ANGELINI FRANCESCO SPA

ROMANIA
SLOVENIA
SLOVENIA
SLOVENIA
SLOVENIA
ROMANIA

ITALIA
ITALIA
ITALIA
ITALIA
ITALIA
ITALIA

ROMANIA
ARENA GROUP S.A. ROMANIA
ARENA GROUP S.A. ROMANIA
ANTIBIOTICE S.A. ROMANIA

GLAXOSMITHKLINE (GSK) SRL

CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF


CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-RF
CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF
CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL. P-RF
CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-RF
CUTIE X 1 BLIST. AL/PVC X 30 COMPR. ELIB. PREL. P-RF
CUTIE CU 1 FLAC. PEID CU DESICANT X 30 COMPR. ELIB. MODIF.

P-RF

CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF


CUTIE CU BLIST. DIN PVC-PVDC/AL X 90 COMPR. FILM. PRF

CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF

Pagina 13 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
30
30
30
30
30
30
30
30
30
10
30
10
30
30
30
30
30
30
30
30
30
30
30
20
60
60
30
28
28
30
28
30
28
14
28
28
30
28
28
28
30
30
30
28
28
28
30
28
28
30
28
28
28
28
30
20
60
60
20
30
30
30
30
90
30

0,178135
0,178135
0,692748
0,692748
0,692748
0,692748
0,692748
0,692748
0,692748
0,692748
0,257306
0,257306
0,257306
0,514613
0,514613
0,514613
1,039122
1,039122
1,553735
2,078245
2,078245
2,078245
3,117367
0,618525
0,402000
0,246333
0,129916
0,778666
1,171606
0,848928
0,776000
0,848928
0,780666
0,780357
0,848571
0,848928
0,778214
0,780666
0,778214
0,765000
0,848928
1,130333
1,369000
1,370000
1,359642
2,268571
1,399642
1,406000
0,780357
0,780357
0,933666
1,369285
1,351071
1,576785
1,576785
1,369000
1,137124
1,094833
1,094833
1,137124
0,568562
0,568562
1,950333
0,460333
0,445222
0,460333

0,345198
0,335865
1,196585
1,416252
1,335252
1,341585
1,563918
1,745252
1,334585
1,754918
1,261694
0,378694
0,378694
1,638720
0,885053
0,885053
3,062878
1,085878
3,495598
2,644088
5,186755
2,644088
8,832633
0,316808
0,000000
0,000000
0,020250
0,000000
0,092679
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,126876
0,000000
0,000000
0,126876
0,076104
0,076104
0,000000
0,000000
0,000000
0,000000

0,089067
0,089067
0,346374
0,346374
0,346374
0,346374
0,346374
0,346374
0,346374
0,346374
0,128653
0,128653
0,128653
0,257306
0,257306
0,257306
0,519561
0,519561
0,776867
1,039122
1,039122
1,039122
1,558683
0,309262
0,201000
0,123166
0,064958
0,389333
0,585803
0,424464
0,388000
0,424464
0,390333
0,390178
0,424285
0,424464
0,389107
0,390333
0,389107
0,382500
0,424464
0,565166
0,684500
0,685000
0,679821
1,134285
0,699821
0,703000
0,390178
0,390178
0,466833
0,684642
0,675535
0,788392
0,788392
0,684500
0,568562
0,547416
0,547416
0,568562
0,284281
0,284281
0,975166
0,230166
0,222611
0,230166

0,434266
0,424933
1,542959
1,762626
1,681626
1,687959
1,910292
2,091626
1,680959
2,101292
1,390347
0,507347
0,507347
1,896027
1,142360
1,142360
3,582439
1,605439
4,272466
3,683211
6,225878
3,683211
10,391317
0,626071
0,201000
0,123167
0,085208
0,389333
0,678482
0,424464
0,388000
0,424464
0,390333
0,390179
0,424286
0,424464
0,389107
0,390333
0,389107
0,382500
0,424464
0,565167
0,684500
0,685000
0,679821
1,134286
0,699821
0,703000
0,390179
0,390179
0,466833
0,684643
0,675536
0,788393
0,788393
0,684500
0,695438
0,547417
0,547417
0,695438
0,360385
0,360385
0,975167
0,230167
0,222611
0,230167

0,160321
0,160321
0,623473
0,623473
0,623473
0,623473
0,623473
0,623473
0,623473
0,623473
0,231575
0,231575
0,231575
0,463151
0,463151
0,463151
0,935209
0,935209
1,398361
1,870420
1,870420
1,870420
2,805630
0,556672
0,361800
0,221699
0,116924
0,700799
1,054445
0,764035
0,698400
0,764035
0,702599
0,702321
0,763713
0,764035
0,700392
0,702599
0,700392
0,688500
0,764035
1,017299
1,232100
1,233000
1,223677
2,041713
1,259677
1,265400
0,702321
0,702321
0,840299
1,232356
1,215963
1,419106
1,419106
1,232100
1,023411
0,985349
0,985349
1,023411
0,511705
0,511705
1,755299
0,414299
0,400699
0,414299

0,363012
0,353679
1,265860
1,485527
1,404527
1,410860
1,633193
1,814527
1,403860
1,824193
1,287425
0,404425
0,404425
1,690182
0,936515
0,936515
3,166791
1,189791
3,650972
2,851913
5,394580
2,851913
9,144370
0,378661
0,040200
0,024634
0,033242
0,077867
0,209840
0,084893
0,077600
0,084893
0,078067
0,078036
0,084858
0,084893
0,077822
0,078067
0,077822
0,076500
0,084893
0,113034
0,136900
0,137000
0,135965
0,226858
0,139965
0,140600
0,078036
0,078036
0,093367
0,136929
0,135108
0,157679
0,157679
0,136900
0,240589
0,109484
0,109484
0,240589
0,132961
0,132961
0,195034
0,046034
0,044523
0,046034

cod ATC

853 N06AX14
854 N06AX14
855 N06AX21
856 N06AX21
857 N06BX16
858 N06BX18
859 N06BX18
860 N06BX18
861 N07CA01
862 N07CA01
863 N07CA01
864 N07CA01
865 N07CA01
866 N07CA01
867 N07CA01
868 N07CA01
869 N07CA01
870 N07CA01
871 N07CA01
872 N07CA01
873 N07CA01
874 N07CA01
875 N07CA01
876 N07CA01
877 N07CA01
878 N07CA01
879 N07CA01
880 N07CA01
881 N07CA01
882 N07CA01
883 N07CA01
884 N07CA01
885 N07CA01
886 N07CA01
887 N07CA52
888 N07XN03
889 N07XN03
890 N07XXN3
891 N07XXN3
892 N07XXN3
893 P01BA02
894 R01AD05
895 R01AD08
896 R01AD09
897 R01AD09
898 R01AD09
899 R01AD09
900 R01AD09
901 R03AC04
902 R03AC18
903 R03AC18
904 R03AK03
905 R03AK06
906 R03AK06
907 R03AK06

DCI

TIANEPTINUM**
TIANEPTINUM**
DULOXETINUM**
DULOXETINUM**
PRAMIRACETAMUM**#
VINPOCETINUM
VINPOCETINUM
VINPOCETINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM
BETAHISTINUM

Denumire Comerciala

NOBIXAL 12,5 mg
COAXIL (R)
CYMBALTA 30mg
CYMBALTA 60mg
PRAMISTAR
VINPOCETINA VIM SPECTRUM 5 mg
CAVINTON(R) FORTE
CAVINTON(R)
VERTIMED 16 mg
BETAHISTINA LPH 16 mg

Prescriptie

Nr. crt

Tara det.
forma farm. concentratie
APP
Detinator APP
Ambalaj
COMPR. FILM. 12,5mg
ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. PRF
DRAJ.
12,5mg
LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ. P-RF

30mg
ELI LILLY NEDERLAND BV OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL) P-RF
60mg
ELI LILLY NEDERLAND BV OLANDA CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL)
P-RF
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
CAPS.
5mg
VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L
COMPR.
10mg
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR.
P-6L
COMPR.
5mg
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-6L
COMPR.
16mg
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L
COMPR.
16mg
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg COMPR.
16mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L
EMPERIN 24 mg
COMPR.
24 mg
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR.P6L
BETAHISTINA LPH 24 mg
COMPR.
24 mg
LABORMED PHARMA SA ROMANIA CUTIE CU 6 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L
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
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
BETASERC 24 mg
COMPR.
24mg
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR.
P-6L
VERTIMED 24 mg
COMPR.
24mg
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L
VERTIMED 24 mg
COMPR.
24mg
MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 60 COMPR. P6L
VESTIBO 24 mg
COMPR.
24mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
MARBETA 24 mg
COMPR.
24mg
MEDREG S.R.O.
REPUBLICA CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR.
P6L
BETAHISTIN MCC 24 mg
COMPR.
24mg
MAGISTRA C&C SRL ROMANIA CUTIE CU 6 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L
BETAHISTINA DICLORHIDRAT AUROBINDO 24 mg COMPR.
24mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L
MARBETA 24 mg
COMPR.
24mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR.
P6L
BETASERC 24 mg
COMPR.
24mg
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 20 COMPR.
P6L
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
BETASERC 8 mg
COMPR.
8mg
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.
P-6L
BETAHISTINA LPH 8 mg
COMPR.
8mg
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
BETAHISTIN MCC 8 mg
COMPR.
8mg
MAGISTRA C&C SRL ROMANIA CUTIE CU 10 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L
MARBETA 8 mg
COMPR.
8mg
MEDREG S.R.O.
REPUBLICA CEHA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
BETAHISTINA LPH 8 mg
COMPR.
8mg
LABORMED PHARMA S.A. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg
COMPR.
8mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L
MARBETA 8 mg
COMPR.
8mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
ACUVER 8 mg/doza
SOL. ORALA 8mg/doza
AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 60 ML SOL. ORALA P-6L
ACUVER 8 mg/doza
SOL. ORALA 8mg/doza
AUSTRIA CUTIE X 1 FLAC. STICLA BRUNA X 120 ML SOL. ORALA P-6L
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
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
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
HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA**
CEREBROLYSIN 215,2 mg/ml
215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA
PR/PRF
HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA**
CEREBROLYSIN 215,2 mg/ml
215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA
PR/PRF
HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA**
CEREBROLYSIN 215,2 mg/ml
215,2mg/ml EVER NEURO PHARMA GMBH AUSTRIA
PR/PRF
HYDROXYCHLOROQUINUM
PLAQUENIL
COMPR. FILM. 200mg
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L
BUDESONIDUM*
RHINOCORT AQUA 32 micrograme/doza SPRAY NAZAL SUSP. 32micrograme/doza ASTRAZENECA AB SUEDIA
PRF
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
MOMETASONUM*
MOMETAZONA FUROAT CIPLA 50 micrograme/doza SPRAY NAZ., SUSP. 50micrograme/doza CIPLA (EU) LIMITED MAREA BRITANIE
PRF
MOMETASONUM*
KALMENTE 50 micrograme/doza
SPRAY NAZ., SUSP. 50micrograme/doza ALVOGEN IPCO S.AR.L. LUXEMBURG
PRF
MOMETASONUM*
MOMETAZONA FUROAT SANDOZ 50 micrograme/doza SPRAY NAZ.,SUSP. 50micrograme/doza SANDOZ S.R.L.
ROMANIA
PRF
MOMETASONUM*
MOMETAZONA TEVA 50 micrograme/doza SPRAY NAZ.,SUSP. 50g/doza TEVA PHARMACEUTICALS S.R.L. ROMANIA
PRF
MOMETASONUM*
NASONEX 50mcg/doza
SPRAY NAZAL SUSP. 50mcg/doza MERCK SHARP & DOHME ROMANIA
P-RF
FENOTEROLUM
BEROTEC N - 100 mcg
100mcg/doza
GERMANIA CUTIE X 1 FLACON PRESURIZAT X 200 DOZE SOL. DE INHALAT PRESURIZATA P-6L
INDACATEROLUM**
ONBREZ BREEZHALER 150 g
CAPS. CU PULB.INHAL. 150 g
NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIECU BLIST. DIN PA/AL/PVC X 30 CAPSULE (3 BIST X10)+ UN INHALATORPRF
INDACATEROLUM**
ONBREZ BREEZHALER 300 g
CAPS. CU PULB.INHAL. 300 g
NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU BLIST. DIN PA/AL/PVC X 30 CAPSULE (1 BLIST. X10)+ UN INHALATOR PRF
COMBINATII (FENOTEROLUM + IPRATROPIUM)*BERODUAL (R) N
AEROSOL SOL. INHAL. 0,020mg+0,050mg
GERMANIA
P-6L
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
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
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
CAPS. GASTROREZ.
CAPS. GASTROREZ.

CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH

CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH

SOL. INJ./CONC. PT. SOL. PERF.

CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF.

SOL. INJ./CONC. PT. SOL. PERF.

CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 5 ML SOL. INJ./CONC. PT. SOL. PERF.

SOL. INJ./CONC. PT. SOL. PERF.

CUTIE CU 10 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 1 ML SOL. INJ./CONC. PT. SOL. PERF.

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SPRAY NAZAL, SUSP. ECHIVALENT CU 120 DOZE, PREVAZUT CU POMPA DOZATOARE, APLICATOR SI CAPAC DE PROTECTIE

CUTIE CU UN FLAC. DIN PEID, PREVAZUT CU POMPA DOZATOARE MANUALA DIN PP CARE CONTINE 18 G SUSPENSIE, ECHIVALENT CU 140 DOZE

CUTIE CU 1 FLAC. PEID PREVAZUT CU POMPA DOZATOARE SI APLICATOR NAZAL CARE CONTINE SPRAY NAZAL, SUSP. PT. 140 PULVERIZARI

CUTIE CU 1 FLAC. PEID PREVAZUT CU O POMPA PULVERIZATOARE NAZALA DIN PE/PP CARE CONTINE 18 G SUSP. NAZALA CORESPUNZATOR LA 140 DOZE MASURATE

CUTIE CU 1 FLACON DIN PEID, CU POMPA DOZATOARE DIN PP SI SISTEM DE ACTIONARE X 140 DOZE SPRAY NAZAL,

CUTIE X 1 FLACON DIN PE PREVAZUT CU POMPA DOZATOARE, DISPOZITIV DE ACTIONARE DIN PP SI CAPAC, CU UN VOLUM DE 23,5 ML SUSPENSIE PT. 140 PULVERIZARI SPRAY NAZAL, SUSPENSIE

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

SOL. DE INHALAT PRESURIZATA

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

908 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE DISKUS 50 micrograme/100 micrograme

909 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE DISKUS 50 micrograme/250 micrograme

910 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE DISKUS 50 micrograme/500 micrograme

PULB. INHAL.
PULB. INHAL.
PULB. INHAL.

911 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE 25 mcg/125 mcg INHALER CFC FREE

SUSP. INHAL. PRESURIZATA

912 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERETIDE 25 mcg/50 mcg INHALER CFC FREE

SUSP. INHAL. PRESURIZATA

25mcg/50mcg GLAXOWELLCOME UK LTD.

913 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERROFLO 25 micrograme/125 micrograme/doza

SUSP. INHAL. PRESURIZATA

25micrograme/125micrograme/doz

914 R03AK06 SALMETEROLUM+FLUTICASONUM*

SERROFLO 25 micrograme/250 micrograme/doza

SUSP. INHAL. PRESURIZATA

25micrograme/250micrograme/doz

915 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie

PULB. DE INHAL.

160micrograme/4,5micrograme/in

916 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie

PULB. DE INHAL. 320micrograme/9micrograme/inha

917 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM)*

SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie

PULB. DE INHAL.

80micrograme/4,5micrograme/inh

SOL. DE INHALAT PRESURIZATA

100/6micrograme pe doza

918 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM) FOSTER

100/6 micrograme pe doza

CUTIE X 1 FLACON PRESURIZAT DIN OTEL X 200 DOZE SOLUTIE DE INHALAT PRESURIZATA

P6L
P6L

50micrograme/100micrograme

GLAXO WELLCOME UK LIMITED

MAREA BRITANIE

CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL.

50micrograme/250micrograme

GLAXOWELLCOME UK LTD.

MAREA BRITANIE

CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL.

50micrograme/500micrograme

GLAXOWELLCOME UK LTD.

MAREA BRITANIE

CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL.

25mcg/125mcg GLAXOWELLCOME UK LTD.

MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA

P-6L

MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA

P-6L

CIPLA EUROPE NV
CIPLA EUROPE NV
ASTRAZENECA AB
ASTRAZENECA AB
ASTRAZENECA AB

BELGIA
BELGIA
SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL.
SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL.
SUEDIA CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL.
CHIESI PHARMACEUTICALS GMBH AUSTRIA
CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS NTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA

CUTIE CU UN FLACON DIN AL PREVAZUT CU O VALVA DE MASURA SI DOZATOR DIN PLASTIC, CU INDICATOR PENTRU DOZA, INTRODUS NTR-O PUNGA CU SAC DE SILICAGEL A 120 DE DOZE SUSPENSIE DE INHALAT PRESURIZATA

CUTIE CU 1 FLAC. PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE, INTRODUS IN DISPOZITIVUL DE ADMINISTRARE DIN PE CU CAPAC PROTECTOR DIN PLASTIC A 180 DOZE SOL. DE INHALAT

Pagina 14 din 16

P6L

PRF
PRF

P6L
P6L
P6L
PRF

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
30
28
28
20
50
30
50
30
30
60
60
60
20
50
20
30
60
30
60
60
60
60
60
30
100
30
100
100
90
100
100
1
1
48
30
100
5
5
10
60
1
1
1
1
1
1
1
1
30
30
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

0,460333
0,460333
2,446071
4,562857
3,661500
0,163400
0,362232
0,181116
0,317360
0,317360
0,276000
0,432500
0,476041
0,476000
0,476041
0,476041
0,437000
0,437333
0,424333
0,476041
0,476041
0,354166
0,476041
0,476041
0,158680
0,158680
0,158680
0,158680
0,158680
0,158680
0,158680
0,158680
11,901037
23,802075
1,586666
1,899050
1,899050
25,828000
15,321000
3,064200
0,542833
26,220000
28,340000
22,700000
22,700000
22,700000
19,570000
22,700000
16,660000
2,685625
4,297000
33,540000
36,422000
91,055000
182,110000
36,422000
91,055000
182,110000
91,055000
36,422000
90,970000
116,890000
74,496666
148,993333
74,496666
216,080000

0,000000
0,247333
0,493929
0,000000
0,000000
0,000000
0,035434
0,070084
0,041640
0,264973
0,000000
0,000000
0,000125
0,000000
0,000159
0,256459
0,000000
0,000000
0,000000
0,000125
0,000125
0,000000
0,000125
0,232959
0,031320
0,133420
0,030986
0,031120
0,031120
0,031208
0,021020
0,031120
17,048963
16,477925
0,000000
0,468616
0,307050
0,000000
2,407000
1,004800
0,000000
0,000000
0,000000
0,010000
0,000000
0,010000
0,000000
11,100000
0,000000
1,611375
0,000000
0,000000
70,538000
44,995000
0,000000
70,538000
44,995000
0,000000
44,075000
70,958000
0,000000
0,000000
16,763334
14,796667
0,823334
0,000000

0,230166
0,230166
1,223035
2,281428
1,830750
0,081700
0,181116
0,090558
0,158680
0,158680
0,138000
0,216250
0,238020
0,238000
0,238020
0,238020
0,218500
0,218666
0,212166
0,238020
0,238020
0,177083
0,238020
0,238020
0,079340
0,079340
0,079340
0,079340
0,079340
0,079340
0,079340
0,079340
5,950518
11,901037
0,793333
0,949525
0,949525
12,914000
7,660500
1,532100
0,271416
13,110000
14,170000
11,350000
11,350000
11,350000
9,785000
11,350000
8,330000
1,342812
2,148500
16,770000
18,211000
45,527500
91,055000
18,211000
45,527500
91,055000
45,527500
18,211000
45,485000
58,445000
37,248333
74,496666
37,248333
108,040000

0,230167
0,477500
1,716965
2,281429
1,830750
0,081700
0,216550
0,160642
0,200320
0,423653
0,138000
0,216250
0,238146
0,238000
0,238180
0,494480
0,218500
0,218667
0,212167
0,238146
0,238146
0,177083
0,238146
0,470980
0,110660
0,212760
0,110326
0,110460
0,110460
0,110548
0,100360
0,110460
22,999482
28,378963
0,793333
1,418141
1,256575
12,914000
10,067500
2,536900
0,271417
13,110000
14,170000
11,360000
11,350000
11,360000
9,785000
22,450000
8,330000
2,954188
2,148500
16,770000
88,749000
90,522500
91,055000
88,749000
90,522500
91,055000
89,602500
89,169000
45,485000
58,445000
54,011667
89,293334
38,071667
108,040000

0,414299
0,414299
2,201463
4,106571
3,295350
0,147060
0,326008
0,163004
0,285624
0,285624
0,248400
0,389250
0,428436
0,428400
0,428436
0,428436
0,393300
0,393599
0,381899
0,428436
0,428436
0,318749
0,428436
0,428436
0,142812
0,142812
0,142812
0,142812
0,142812
0,142812
0,142812
0,142812
10,710933
21,421867
1,427999
1,709145
1,709145
23,245200
13,788900
2,757780
0,488549
23,598000
25,506000
20,430000
20,430000
20,430000
17,613000
20,430000
14,994000
2,417062
3,867300
30,186000
32,779800
81,949500
163,899000
32,779800
81,949500
163,899000
81,949500
32,779800
81,873000
105,201000
67,046999
134,093999
67,046999
194,472000

0,046034
0,293367
0,738537
0,456286
0,366150
0,016340
0,071658
0,088196
0,073376
0,296709
0,027600
0,043250
0,047730
0,047600
0,047764
0,304064
0,043700
0,043734
0,042434
0,047730
0,047730
0,035417
0,047730
0,280564
0,047188
0,149288
0,046854
0,046988
0,046988
0,047076
0,036888
0,046988
18,239067
18,858133
0,158667
0,658521
0,496955
2,582800
3,939100
1,311220
0,054284
2,622000
2,834000
2,280000
2,270000
2,280000
1,957000
13,370000
1,666000
1,879938
0,429700
3,354000
74,180200
54,100500
18,211000
74,180200
54,100500
18,211000
53,180500
74,600200
9,097000
11,689000
24,213001
29,696001
8,273001
21,608000

cod ATC

919 R03BA05
920 R03BA05
921 R03BA05
922 R03BA05
923 R03BA05
924 R03BA05
925 R03BA05
926 R03BA07
927 R03BA07
928 R03BA08
929 R03BA08
930 R03BB04
931 R03BB04
932 R03BB06
933 R03DA05
934 R03DA05
935 R03DA05
936 R03DA05
937 R03DA05
938 R03DC03
939 R03DC03
940 R03DC03
941 R03DC03
942 R03DC03
943 R03DC03
944 R03DC03
945 R03DC03
946 R03DC03
947 R03DC03
948 R03DC03
949 R03DC03
950 R03DC03
951 R03DC03
952 R03DC03
953 R03DC03
954 R03DC03
955 R03DC03
956 R03DC03
957 R03DC03
958 R03DC03
959 R03DC03
960 R03DC03
961 R03DC03
962 R03DC03
963 R03DC03
964 R03DC03
965 R03DC03
966 R03DC03
967 R03DC03
968 R03DC03
969 R03DC03
970 R03DC03
971 R03DC03
972 R03DC03
973 R03DC03
974 R03DC03
975 R03DC03
976 R03DC03
977 R03DC03
978 R03DX03
979 R03DX03
980 R05DA09
981 R05DA09
982 R05DA09
983 R05DA09
984 R05DA09

DCI

FLUTICASONUM PROPIONAT*
FLUTICASONUM PROPIONAT*
FLUTICASONUM PROPIONAT*
FLUTICASONUM PROPIONAT*
FLUTICASONUM PROPIONAT*
FLUTICASONUM PROPIONAT*
FLUTICASONUM PROPIONAT*
MOMETASONUM*
MOMETASONUM*
CICLESONIDUM*
CICLESONIDUM*
TIOTROPIUM*
TIOTROPIUM*
GLICOPIRONIUM BROMIDUM**
AMINOPHYLLINUM
AMINOPHYLLINUM
AMINOPHYLLINUM
AMINOPHYLLINUM
AMINOPHYLLINUM
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
FENSPIRIDUM
FENSPIRIDUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM

Denumire Comerciala

FLIXOTIDE DISKUS 100 mcg


FLIXOTIDE DISKUS 250 mcg
FLIXOTIDE DISKUS 500 mcg
FLIXOTIDE 125 INHALER CFC - Free
FLIXOTIDE (R) 50 INHALER CFC - Free
FLIXOTIDE NEBULES 0,5 mg/2 ml
FLIXOTIDE NEBULES 2 mg/2 ml
ASMANEX TWISTHALER 200 g
ASMANEX TWISTHALER 400 g
ALVESCO 160 INHALER
ALVESCO 80 INHALER
SPIRIVA 18 micrograme
SPIRIVA RESPIMAT 2,5 micrograme
SEEBRI BREEZHALER
MIOFILIN 100 mg
AMINOFILINA EEL
AMINOFILINA ARENA 100 MG
AMINOFILINA ARENA 200 MG
MIOFILIN 24mg/ml
ASTHATOR 10 mg
SINGULAIR (R)
MONTELUKAST TEVA 10 mg
MONTELUKAST TEVA 10 mg
MONTELUKAST ACTAVIS 10 mg
MONKASTA 10 mg
ASTMASAN 10 mg
STANGEN 10 mg
SOLOK 10 mg
MONART 10 mg
MONTELUKAST AUROBINDO 10 mg
MONTELUKAST ABBOTT 10 mg
ASTHATOR 4 mg
SINGULAIR
MONTELUKAST TEVA 4 mg
MONTELUKAST TEVA 4 mg
MONTELUKAST ACTAVIS 4 mg
MONKASTA 4 mg
MONTELUKAST ALVOGEN 4 mg
STANGEN 4 mg
SOLOK 4 mg
MONART 4 mg
MONTELUKAST AUROBINDO 4 mg
SINGULAIR 4 mg
MONTELUKAST ABBOTT 4 mg
ASTMASAN 4 mg
ASTHATOR 5 mg
SINGULAIR (R)
MONTELUKAST TEVA 5 mg
MONTELUKAST TEVA 5 mg
MONTELUKAST ACTAVIS 5 mg
MONKASTA 5 mg
MONTELUKAST ALVOGEN 5 mg
STANGEN 5 mg
SOLOK 5 mg
MONART 5 mg
MONTELUKAST AUROBINDO 5 mg
MONTELUKAST ABBOTT 5 mg
ASTMASAN 5 mg
ASTMASAN 4 mg
EURESPAL 80 mg
EURESPAL 2 mg/ml
TUSSIN FORTE 20 mg
ROFEDEX
TUSSIN 6,5mg/5ml
ROBITUSSIN JUNIOR
ROBITUSSIN ANTITUSSICUM

forma farm.
PULB. INHAL.
PULB. INHAL.
PULB. INHAL.
SUSP. INHAL. PRESURIZATA

concentratie
100mcg/doza
250mcg/doza
500mcg/doza
125mcg/doza

Detinator APP

Tara det.
APP

Ambalaj

Prescriptie

Nr. crt

GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE

P-RF

GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE

P-RF

GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE

P-RF

GLAXO WELLCOME UK LTD. MAREA BRITANIE

CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA

P-RF

50mcg/doza GLAXO WELLCOME UK LTD. MAREA BRITANIE


0,5mg/2ml GLAXO WELLCOME UK LIMITED MAREA BRITANIE
2mg/2ml
GLAXO WELLCOME UK LIMITED MAREA BRITANIE
PULB. INHAL. 200g/doza MERCK SHARP & DOHME ROMANIA
PULB. INHAL. 400g/doza MERCK SHARP & DOHME ROMANIA
160g/doza NYCOMED GMBH GERMANIA
80g/doza NYCOMED GMBH GERMANIA

SUSP. INHAL. PRESURIZATA

CUTIE X 1 FLACON PRESURIZAT X 120 DOZE X 50 MCG, PREVAZUT CU VALVA DOZATOARE

P-RF

SUSP. INHAL. PRIN NEBULIZATOR

CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP

PRF

SUSP. INHAL. PRIN NEBULIZATOR

CUTIE CU 2 FOLII SIGILATE POLIESTER/AL/ PEJD A CATE 5 FIOLE DIN PEJD X 2,5ML CONTINAND CATE 2ML SUSP

PRF

CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE

P-6L

CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE

P-6L

SOL. DE INHALAT PRESURIZATA

CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA

P-RF

SOL. DE INHALAT PRESURIZATA

CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA

P-RF

CUTIE CU 3 BLIST. AL/PVC/AL X 10 CAPS. CU PULB. DE INHALAT + 1 DISPOZITIV HANDIHALER

PRF

18micrograme

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA

SOL. DE INHALAT 2,5micrograme

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA
MAREA BRITANIE

CAPS. CU PULB. INHAL.

CAPS. CU PULB. INHAL.

44 micrograme

NOVARTIS EUROPHARM LTD.

CAPS.
COMPR.
COMPR.
COMPR.
SOL. INJ.
COMPR.

100mg
100mg
100mg
200mg
24mg/ml
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
4 mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
4mg
80mg
2mg/ml
20mg
15mg/5ml
6,5mg/5ml
3,75mg/5ml
7,5mg/5ml

ZENTIVA SA
BIO EEL SRL
ARENA GROUP SA
ARENA GROUP SA
ZENTIVA S.A.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.
COMPR. MAST.

GRANULE
COMPR. CU ELIBERARE PRELUNGITA

SIROP
COMPR.
SIROP
SIROP
SOL. ORALA
SOL. ORALA

ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
TORRENT PHARMA S.R.L. ROMANIA
MERCK SHARP & DOHME ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
ACTAVIS GROUP PTC EHF.

CUTIE CU 1 AMBALAJ UNIC CU UN INHALATOR RESPIMAT SI UN CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. PT. INHALAT

CUTIE CU BLIST. PERFORATE PA-AL-PVC/AL CE CONTINE 30 X 1 CAPSULA CU PULBERE PENTRU INHALAT INSOTITE DE UN INHALATOR

CUTIE X 2 BLIST. AL/PVC X 10 CAPS.


CUTIE X 2 BLIST. AL/PVC X 25 COMPR.
CUTIE X 4 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-RF
P-RF

CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM.

P6L

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

P6L
P6L
P6L
P6L
P6L
P6L

CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM.

ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.


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

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU 1 FLAC. PEID X 28 COMPR. FILM.

MALTA

P-RF

CUTIE CU BLIST. AL/AL X 28 COMPR. P6L

ROMANIA
DR. REDDY'S LABORATORIES ROMANIA
TERAPIA S.A.
ROMANIA
AUROBINDO PHARMA (MALTA) LIMITED

PRF
P-RF

CUTIE X 5 FIOLE PREVAZUTE CU INEL DE RUPERE X 10 ML SOL.INJ. S/P-RF

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. FILM.

SANDOZ S.R.L.

PRF

CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. FILM.

CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST.

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

ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST.

P6L
P6L
P6L
P6L
P6L

MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P-RF

ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L


ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L
ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L
KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE P6L
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST. P6L
TERAPIA S.A.
ROMANIA CUTIE CU BLIST. PAPVC/AL X 28 COMPR. MAST. P6L
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST.
P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L
MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L
ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L
KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST. P6L
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE P6L
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST. P6L
TERAPIA S.A.
ROMANIA CUTIE CU BLIST. PA/PVC/AL X 28 COMPR. MAST. P6L
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST.
P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L
ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L
SANDOZ S.R.L.
ROMANIA CUTIE CU 28 PLICURI PET/AL/PE CONTINAND GRANULE P6L
TEVA PHARMACEUTICALS S.R.L.
TEVA PHARMACEUTICALS S.R.L.

ACTAVIS GROUP PTC EHF.

LES LABORATOIRES SERVIER

LES LAB. SERVIER IND.


GLAXOSMITHKLINE (GSK) SRL

BIOFARM SA
ROPHARMA S.A.
PFIZER CORPORATION AUSTRIA GMBH
PFIZER CORPORATION AUSTRIA GMBH

FRANTA
FRANTA

CUTIE X 2 BLIST. AL/PVC X 15 COMPR.CU ELIBERARE PRELUGITA

P-6L

CUTIE X 1 FLACON PVC DE CULOARE BRUNA X 150 ML P-6L

ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L


ROMANIA CUTIE X 1 FLACON DIN STILCA BRUNA X 100 ML + MASURA DOZATOARE P-RF
ROMANIA
P-RF
CUTIE X 1 FLAC. X 115ML SIROP + O LINGURITA DOZATOARE GRADATA LA 1,25ML; 2,5ML SI 5 ML

AUSTRIA
AUSTRIA

CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M

P-RF

CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M

P-RF

Pagina 15 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

1 24,317999
1 60,795000
1 118,180000
1 30,397500
1 24,317999
10
0,810599
10
3,242399
1 33,613750
1 62,550000
1 89,330000
1 51,371249
30
3,536553
1 158,080000
30
4,986000
20
0,172934
50
0,140800
40
0,172934
20
0,345870
5
2,452000
28
0,913189
28
0,913189
28
0,720714
30
0,721000
30
0,826333
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,913189
28
0,528124
28
0,528124
28
0,527857
30
0,527333
30
0,434000
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,528124
28
0,660155
28
0,660155
28
0,542500
30
0,542333
30
0,483666
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,660155
28
0,560357
28
0,528124
30
0,952666
1 20,370000
20
0,352000
1
5,470000
1
2,725883
1
1,367499
1
2,734999

10,812001
6,285000
0,000000
3,612500
10,902001
1,995401
4,963601
7,016250
0,000000
0,000000
20,118751
1,827447
0,000000
0,000000
0,015066
0,000000
0,007316
0,054630
0,000000
0,803239
1,639668
0,000000
0,000000
0,000000
0,086096
0,275382
0,803239
0,803239
0,803239
0,028953
0,803239
1,060090
1,833661
0,000000
0,000000
0,000000
0,220447
1,059376
1,059018
1,040090
1,040090
1,060090
1,833661
1,059376
0,000090
1,056273
1,892702
0,000000
0,000000
0,000000
0,120202
1,056273
1,056273
1,056273
1,056273
1,056273
1,056273
0,000000
1,060090
0,000000
0,000000
0,000000
0,000000
5,444117
7,572501
6,205001

12,158999
30,397500
59,090000
15,198750
12,158999
0,405299
1,621199
16,806875
31,275000
44,665000
25,685624
1,768276
79,040000
2,493000
0,086467
0,070400
0,086467
0,172935
1,226000
0,456594
0,456594
0,360357
0,360500
0,413166
0,456594
0,456594
0,456594
0,456594
0,456594
0,456594
0,456594
0,264062
0,264062
0,263928
0,263666
0,217000
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,264062
0,330077
0,330077
0,271250
0,271166
0,241833
0,330077
0,330077
0,330077
0,330077
0,330077
0,330077
0,330077
0,280178
0,264062
0,476333
10,185000
0,176000
2,735000
1,362941
0,683749
1,367499

22,971001
36,682500
59,090000
18,811250
23,061001
2,400701
6,584801
23,823125
31,275000
44,665000
45,804376
3,595724
79,040000
2,493000
0,101533
0,070400
0,093783
0,227565
1,226000
1,259834
2,096263
0,360357
0,360500
0,413167
0,542691
0,731977
1,259834
1,259834
1,259834
0,485548
1,259834
1,324152
2,097723
0,263929
0,263667
0,217000
0,484509
1,323438
1,323080
1,304152
1,304152
1,324152
2,097723
1,323438
0,264152
1,386351
2,222780
0,271250
0,271167
0,241833
0,450280
1,386351
1,386351
1,386351
1,386351
1,386351
1,386351
0,280179
1,324152
0,476333
10,185000
0,176000
2,735000
6,807059
8,256251
7,572501

21,886199
54,715500
106,362000
27,357750
21,886199
0,729539
2,918159
30,252375
56,295000
80,397000
46,234124
3,182897
142,272000
4,487400
0,155640
0,126720
0,155640
0,311283
2,206800
0,821870
0,821870
0,648642
0,648900
0,743699
0,821870
0,821870
0,821870
0,821870
0,821870
0,821870
0,821870
0,475311
0,475311
0,475071
0,474599
0,390600
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,475311
0,594139
0,594139
0,488250
0,488099
0,435299
0,594139
0,594139
0,594139
0,594139
0,594139
0,594139
0,594139
0,504321
0,475311
0,857399
18,333000
0,316800
4,923000
2,453294
1,230749
2,461499

13,243801
12,364500
11,818000
6,652250
13,333801
2,076461
5,287841
10,377625
6,255000
8,933000
25,255876
2,181103
15,808000
0,498600
0,032360
0,014080
0,024610
0,089217
0,245200
0,894558
1,730987
0,072072
0,072100
0,082634
0,177415
0,366701
0,894558
0,894558
0,894558
0,120272
0,894558
1,112903
1,886474
0,052786
0,052734
0,043400
0,273260
1,112189
1,111831
1,092903
1,092903
1,112903
1,886474
1,112189
0,052903
1,122289
1,958718
0,054250
0,054234
0,048367
0,186218
1,122289
1,122289
1,122289
1,122289
1,122289
1,122289
0,056036
1,112903
0,095267
2,037000
0,035200
0,547000
5,716706
7,709251
6,478501

cod ATC

985 R06AE09
986 R06AE09
987 R06AE09
988 R06AE09
989 R06AE09
990 R06AE09
991 R06AE09
992 R06AX27
993 R06AX27
994 R06AX27
995 R06AX27
996 R06AX27
997 R06AX27
998 R06AX27
999 R06AX27
1000

R06AX27

1001

R06AX27

1002

R06AX27

1003

R06AX27

1004

R06AX27

1005

R06AX27

1006

R06AX27

1007

R06AX27

1008

R06AX27

1009

R06AX27

1010

S01AA11

1011

S01AA12

1012

S01AA12

1013

S01AA12

1014

S01AA12

1015

S01AA23

1016

S01AA23

1017

S01AA23

1018

S01AX11

1019

S01AX11

1020

S01BA01

1021

S01BA01

1022

S01BA01

1023

S01BA06

1024

S01CA01

1025

S01CA01

1026

S01CA01

1027

S01CA01

1028

S01CA01

1029

S01CA01

1030

S01GX09

DCI

LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
DESLORATADINUM
GENTAMICINUM
TOBRAMYCINUM
TOBRAMYCINUM
TOBRAMYCINUM
TOBRAMYCINUM
NETILMICINUM
NETILMICINUM
NETILMICINUM
OFLOXACINUM
OFLOXACINUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
BETAMETHASONUM

Denumire Comerciala

XYZAL (R)
LEVOCETIRIZINA SANDOZ 5 mg
CETIZAL 5 mg
LEVOCETIRIZINA ACTAVIS 5 mg
ZENARO 5 mg
XYZAL
ZENARO 0,5 mg/ml
DYNID 5 mg
DESLORATADINA ACTAVIS
DESLORATADINA ACTAVIS
DESLORATADINA SANDOZ 5 mg
DASSELTA
DESLORATADINA TERAPIA 5 mg
LORDESTIN 5 mg
DESLORATADINA TEVA
AERIUS 5mg
AERIUS 5mg
AERIUS 2,5mg
AERIUS 5mg
DESLORATADINA SANDOZ 0.5 mg/ml
DESLORATADINA ALVOGEN 0,5 mg/ml
DYNID 0,5 mg/ml
DESLORATADINA TEVA 0,5 mg/ml
AERIUS 0,5mg/ml
LORDESTIN 0,5 mg/ml
GENTAMICIN SULPHATE
TOBROM 3 mg/ml
TOBREX
TOBREX 2 X
TOBREX (R)
NETTACIN (R)
NETTACIN (R)
NETTAVISC 3mg/g
FLOXAL (R)
FLOXAL (R)
DEXAMETAZONA ROMPHARM 1mg/ml
DEXAMETAZONA ROMPHARM 1mg/ml
MAXIDEX (R)
OPHTAMESONE 1 mg/ml
COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX
COMBINATII ( NETILMICINUM + DEXAMETHASONUM) NETILDEX
COMBINATII (CLORAMPHENICOLUM+DEXAMETHASONUM)SPERSADEX COMP
COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) DEXATOBROM 3 mg+1 mg/ml
COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX ( R )
COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM) TOBRADEX (R)
OLOPATADINUM
OPATANOL 1mg/ml

forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

concentratie

PIC. OFT./AURIC./NAZALE SOL.

5mg
5mg
5mg
5mg
5mg
5mg/ml
0,5mg/ml
5mg
5 mg
5 mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
2,5mg
5mg
0,5 mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,3%
3mg/ml
3mg/ml
0,3%
0,3%
0,3%
0,3%
3mg/g
0,3%
0,3%
1mg/ml
1mg/ml
0,1%
1 mg/ml

PIC. ORALE, SOL.

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

SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
PIC. OFT., SOL
PIC. OFT., SOL
PIC. OFT.,SOL.
PICATURI OFT.-SOL.

UNG. OFT.
PIC. OFT., SOL
PICATURI OFT.-SOL.

UNG. OFT.
PICATURI OFT.-SOL.

UNG. OFT.
PIC. OFT. SUSP.
PIC. OFT. SUSP.
PICATURI OFT.-SUSP.

PIC. OFT.,SOL.

4,55 mg/1,32 mg/ml

PIC. OFT.SOL. UNIDOZA

4,55 mg/1,32 mg/ml

PICATURI OFT.-SOL.

5mg/ml+1mg/ml

Detinator APP

U.C.B. GMBH
SANDOZ S.R.L.

Tara det.
APP

Ambalaj

GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L

ROMANIA

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L


CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L

ACTAVIS GROUP PTC EHF.

ISLANDA

ZENTIVA, K.S.

REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 20 COMPR. FILM.

UCB PHARMA GMBH GERMANIA

ZENTIVA, K.S.

REPUBLICA CEHA

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

ACTAVIS GROUP PTC EHF.


ACTAVIS GROUP PTC EHF.

Prescriptie

Nr. crt

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

CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR

CUTIE X 1 FLACON DIN STICLA BRUNA CU CAPAC DIN PP PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 200ML SIROP + 1 LINGURITA DOZATOARE DE 5ML

P6L
P6L
P-6L

P6L

CUTIE CU BLIST. AL/AL X 30 COMPR. P6L

ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 10 PRF


ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X30 PRF

SANDOZ S.R.L.

ROMANIA
KRKA D.D. NOVO MESTO SLOVENIA
TERAPIA SA
ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA

CUTIE CU BLIST. NON UNIDOZA OPA-AL-PVC/AL X 30 COMPR.FILM.

P6L

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE

PRF

CUTIE CU BLIST. PCTFE-PVC/AL X 30 COMPR. FILM. P6L


CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM.

P6L

TEVA PHARMA B.V. OLANDA

CUTIE CU BLIST. DIN OPA/AL/PVC - AL X 30 COMPR. FILM.

PRF

MERCK SHARP&DOHME LTD.

MAREA BRITANIE

CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL)

P-RF

MERCK SHARP&DOHME LTD.

MAREA BRITANIE

CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL)

P-RF

MERCK SHARP&DOHME LTD.

MAREA BRITANIE

CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF

MERCK SHARP&DOHME LTD.

MAREA BRITANIE

SANDOZ S.R.L.

ROMANIA

ALVOGEN IPCO S.A.R.L

LUXEMBURG

GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

MERCK SHARP&DOHME LTD.

MAREA BRITANIE

CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL) P-RF


CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 125 ML X 120 ML, SOL. ORALA + LINGURITA DOZATOARE DE 2,5 ML SI 5 ML SAU CU SERINGA DOZATOARE DE 5 ML, MARCATA LA FIECARE 0,5ML

CUTIE CU 1 FLAC. DIN STICLA BRUNA A 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOAR

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 120 ML SOL. ORALA + 1 LINGURITA DOZATOARE SAU O SERINGA DOZATOARE ( SERINGA DOZATOARE ARE GRADATII DE 2,5 ML SI 5 ML; LINGURITA DOZATOARE ARE CAPACITATEA DE 2,5 ML SI 5 ML

CUTIE X 1 FLACON DIN STICLA PREVAZUT CU SISTEM DE SIGURANTA PENTRU COPII (PP) SI INEL DE SIGILARE, CU O LINGURITA DOZATOARE DIN PEID GRADATA LA DOZE DE 2.5ML SI 5ML, A 120ML SOLUTIE ORALA

CUTIE X 1 FLACON X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML

P6L
P6L
P6L
P6L
P-RF

ROMANIA
P6L
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML
P-RF
ROMPHARM COMPANY SRL ROMANIA CUTIE C 1 FLAC. PEJD X 5 ML PIC. OFT. SOL P-RF

GEDEON RICHTER ROMANIA SA

CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU O LINGURITA DOZATOARE GRADATA LA 2,5 ML SI 5 ML X 120 ML SOL.

S.I.F.I. SPA
S.I.F.I. SPA
S.I.F.I. SPA

BELGIA
BELGIA
BELGIA
ITALIA
ITALIA
ITALIA

DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH

GERMANIA

CUTIE X 1 FLACON DIN PEJD X 5 ML PICATURI OFT., SOL. P-RF

DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH

ALCON COUVREUR NV
ALCON COUVREUR NV
ALCON COUVREUR NV

CUTIE X 1 FLACON DIN PEJD CU PICURATOR X 5 ML PIC. OFTALMICE, SOL. P-RF

CUTIE X 1 FLAC. PEID CU PICURATOR DIN PEID X 5 ML P-RF

CUTIE X 1 TUB DIN AL X 3,5 G UNGUENT OFTALMIC P-RF

CUTIE X 1 FLACON X 5ML

P-RF

CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML

P-RF

CUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR

P-RF

GERMANIA

CUTIE X 1 TUB DIN AL PREVAZUT CU APLICATOR X 3 GP-RF

ROMANIA
ROMANIA

CUTIE X 1 FLAC. DIN PEID X 10 ML PIC. OFT., SUSPENSIE

P-RF

ROMPHARM COMPANY SRL

CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT., SUSPENSIE

P-RF

ALCON COUVREUR NV

BELGIA

CUTIE X 1 FLACON PICURATOR DIN PE X 5 ML

P-RF

DAR AL DAWA PHARMA S.R.L.

ROMANIA

ROMPHARM COMPANY SRL

S.I.F.I. SPA
S.I.F.I. SPA

ITALIA
ITALIA
LABORATOIRES THEA FRANTA

CUTIE CU 1 FLAC. PEJD, PREVAZUT CU APLICATOR PT. PICURARE DIN PEJD A 10 ML PIC. OFT., AURICULARE, NAZALE SOL.

P6L

CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFT.SOL. P-RF


CUTIE X 20 FLAC. UNIDOZA DIN PEJD X 0,3 ML PIC.OFT. SOL.

P-RF

CUTIE X 1 FLACON X 5 ML SOL. OFT. + PICURATOR P-RF

3mg+1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEJD A 5 ML + PICURATOR P-RF
PICATURI OFT.-SUSP. 3mg+1mg/ml ALCON COUVREUR NV BELGIA
CUTIE X 1 FLACON PICURATOR PEJD X 5 ML P-RF
UNG. OFT. 3 mg/1 mg/g ALCON COUVREUR NV BELGIA CUTIE X 1 TUB AL, PREVAZUT CU APLICATOR PEID X 3,5 G P-RF
PIC. OFT., SOL. 1mg/ml
ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML
P-RF
PIC. OFT. SUSP.

NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (*) se iniiaza de medicul de specialitate in limita competenei i poate fi prescris n continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii;
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii i cu aprobarea
comisiilor de la nivelul Caselor Judeene de Asigurri de Sntate;
- 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;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (2) se prescrie numai in etapa pregtitoare pentru colonoscopie;
- Pentru medicamentele corespunztoare DCI-urilor notate cu (#) regulile de prescriere sunt stabilite prin Contractul Cadru.

Pagina 16 din 16

Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
Val. maxima suportata
Co-plata maxima a
asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt. de sistemul de asigurari asiguratului / UT (pt.
asiguratii care
sociale de sanatate / UT
asiguratii care
sociale de sanatate / UT
asiguratii care
cant.
beneficiaza de
(pt. asiguratii care
beneficiaza de
(pt. asiguratii care
beneficiaza de
UT/
Pret de
compensare 100%
beneficiaza de
compensare 50%
beneficiaza de
compensare 90%
amba referinta / UT
din pretul de
compensare 50% din
din pretul de
compensare 90% din
din pretul de
laj
(RON)
referinta)
pretul de referinta)
referinta)
pretul de referinta)
referinta)

30
10
10
10
20
1
1
30
10
30
30
30
30
30
30
10
30
30
30
1
1
1
1
1
1
1
1
1
1
1
1
15
1
1
1
1
1
1
1
1
20
1
1
1
1
1

0,863333
0,561000
0,561000
0,362000
0,561000
20,196000
20,196000
0,359833
0,322000
0,322666
0,350333
0,359833
0,359833
0,359833
0,359833
0,359833
0,359833
0,179916
0,359833
10,630000
10,620000
10,630000
10,630000
10,630000
10,630000
4,710000
4,080000
4,080000
4,080000
3,060000
14,710000
1,297769
21,629497
10,895000
14,680000
10,120000
5,382500
5,382500
4,670000
8,160750
0,489645
8,160750
5,050000
7,770000
5,712525
28,000000

0,000000
0,000000
0,000000
0,000000
0,000000
5,534000
3,644000
0,162500
0,000000
0,000000
0,000000
0,003167
0,193167
0,179500
0,130167
0,487167
0,491167
0,807750
0,627833
0,000000
0,000000
0,000000
0,000000
5,720000
0,000000
0,000000
0,000000
3,810000
15,810000
5,580000
0,000000
0,703564
12,080503
3,325000
0,000000
0,000000
0,107500
3,057500
0,000000
24,409250
2,171855
4,799250
0,000000
0,000000
7,357475
0,000000

0,431666
0,280500
0,280500
0,181000
0,280500
10,098000
10,098000
0,179916
0,161000
0,161333
0,175166
0,179916
0,179916
0,179916
0,179916
0,179916
0,179916
0,089958
0,179916
5,315000
5,310000
5,315000
5,315000
5,315000
5,315000
2,355000
2,040000
2,040000
2,040000
1,530000
7,355000
0,648884
10,814748
5,447500
7,340000
5,060000
2,691250
2,691250
2,335000
4,080375
0,244822
4,080375
2,525000
3,885000
2,856262
14,000000

0,431667
0,280500
0,280500
0,181000
0,280500
15,632000
13,742000
0,342417
0,161000
0,161333
0,175167
0,183084
0,373084
0,359417
0,310084
0,667084
0,671084
0,897708
0,807750
5,315000
5,310000
5,315000
5,315000
11,035000
5,315000
2,355000
2,040000
5,850000
17,850000
7,110000
7,355000
1,352449
22,895252
8,772500
7,340000
5,060000
2,798750
5,748750
2,335000
28,489625
2,416678
8,879625
2,525000
3,885000
10,213738
14,000000

0,776999
0,504900
0,504900
0,325800
0,504900
18,176400
18,176400
0,323849
0,289800
0,290399
0,315299
0,323849
0,323849
0,323849
0,323849
0,323849
0,323849
0,161924
0,323849
9,567000
9,558000
9,567000
9,567000
9,567000
9,567000
4,239000
3,672000
3,672000
3,672000
2,754000
13,239000
1,167992
19,466547
9,805500
13,212000
9,108000
4,844250
4,844250
4,203000
7,344675
0,440680
7,344675
4,545000
6,993000
5,141272
25,200000

0,086334
0,056100
0,056100
0,036200
0,056100
7,553600
5,663600
0,198484
0,032200
0,032267
0,035034
0,039151
0,229151
0,215484
0,166151
0,523151
0,527151
0,825742
0,663817
1,063000
1,062000
1,063000
1,063000
6,783000
1,063000
0,471000
0,408000
4,218000
16,218000
5,886000
1,471000
0,833341
14,243453
4,414500
1,468000
1,012000
0,645750
3,595750
0,467000
25,225325
2,220820
5,615325
0,505000
0,777000
7,928728
2,800000

ANEXA 2c

NR.CRT

COD ATC

DCI

Denumire Comerciala

forma farm.

concentratie

DETINATOR APP

TARA
DET. APP

AMBALAJ

Prescriptie

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
DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEAST SUBLIST SE ELIBEREAZ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZ DE PRESCRIPIE MEDICAL CU REINERE N FARMACIE
VALABIL NCEPND CU 01 OCTOMBRIE 2015

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,226000
0,350000
0,138800
1,652000
1,652000
0,173200
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000
0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
0,077000
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,098500
0,098500
0,098666

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,125200
0,000000
0,125200
0,083200
0,000000
0,000000
0,000000
0,075400
0,078333
0,000000
0,032001
0,000000
0,111800
0,000000
0,157001
0,000000
0,203933
0,204100
0,153600
0,204100
0,203933
0,203933
0,204100
0,149933
0,198100
0,203933
0,203933
0,000000
0,000000
0,000000

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


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38

B01AA07
B01AA07
C01AA05
C01AA05
C01AA05
C03AA03
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01

C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02

ACENOCUMAROLUM
ACENOCUMAROLUM
DIGOXINUM
DIGOXINUM
DIGOXINUM
HYDROCHLOROTHIAZIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM

TROMBOSTOP 2 mg
SINTROM 4 mg
DIGOXIN ZENTIVA 0,25 mg
DIGOXIN 0,5 mg/2 ml
DIGOXIN ZENTIVA 0,5 mg/2ml
NEFRIX 25 mg
FUROSEMID MCC 40 mg
FUROSEMID SLAVIA
FUROSEMID ZENTIVA
FUROSEMID LPH 40 mg
FUROSEMID ARENA 40 mg
FUROSEMID BIOEEL 40 mg
FUROSEMID LPH 40 mg
FUROSEMID 20 mg/2 ml
VEROSPIRON

COMPR.
COMPR.
COMPR.
SOL. INJ.
SOL. INJ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
CAPS.
SPIRONOLACTONA ARENA 25 mg CAPS.
SPIRONOLACTONA LPH 25 mg CAPS.
VEROSPIRON
CAPS.
SPIRONOLACTONA ARENA 50 mg CAPS.
SPIRONOLACTONA BIOEEL 25 mg COMPR.
SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM.
ALSPIRON 25 mg
COMPR. FILM.
ALSPIRON 50 mg
COMPR. FILM.
BLOXAN
COMPR.
BETAPROL 100 mg
COMPR.
EGILOK 100 mg
COMPR.
METOPROLOL LPH 100 mg COMPR.
METOPROLOL LAROPHARM 100 mg COMPR.
METOPROLOL 100 mg
COMPR.
METOPROLOL TERAPIA 100 mg COMPR.
METOPROLOL VIM SPECTRUM 100 mg COMPR.
METOPROLOL ARENA 100 MG COMPR.
METOPROLOL 100 mg
COMPR.
METOPROLOL AL 100
COMPR.
METOPROLOL ZENTIVA 100 mg COMPR.
EGILOK 25 mg
COMPR.
METOPROLOL LPH 25 mg
COMPR.
METOPROLOL 25 mg
COMPR.

2mg
4mg
0,25mg
0,5mg/2ml
0,5mg/2ml
25mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
10mg/ml
100mg
25mg
25mg
50mg
50mg
25mg
25mg
25mg
50mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
25mg
25mg
25mg

TERAPIA SA

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-RF

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.

P-RF

ZENTIVA S.A.
ZENTIVA S.A.
ZENTIVA S.A.
ZENTIVA SA
MAGISTRA C&C S.R.L.

SLAVIA PHARM SRL


ZENTIVA SA
LABORMED PHARMA SA

ARENA GROUP S.A.


BIO EEL SRL
LABORMED PHARMA SA

ZENTIVA SA
GEDEON RICHTER ROMANIA SA

ARENA GROUP S.A.


LABORMED PHARMA S.A.
GEDEON RICHTER ROMANIA SA

ARENA GROUP S.A.


BIO EEL SRL
TERAPIA SA
AC HELCOR PHARMA SRL
AC HELCOR PHARMA SRL

ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF


ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ.S/P-RF
ROMANIA
S/P-RF
ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L
ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L
ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L
ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ROSU SI PORTOCALIU)X 2 ML SOL. INJ.

KRKA D.D. NOVO MESTO SLOVENIA


AC HELCOR PHARMA SRL
EGIS PHARMACEUTICALS P.L.C.

LABORMED PHARMA SA

LAROPHARM SRL
MAGISTRA C & C SRL

TERAPIA SA
VIM SPECTRUM SRL
ARENA GROUP SA

ROMANIA
UNGARIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR.

CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

SLAVIA PHARMA S.R.L.


ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.

ZENTIVA S.A.

P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L


P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L


EGIS PHARMACEUTICALS P.L.C.
UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L
MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L

Pagina 1 din 39

30
20
25
5
5
25
20
20
20
20
20
20
30
5
30
50
60
30
30
20
50
20
20
30
30
20
30
20
30
30
20
30
20
30
30
20
20
30

0,226000
0,350000
0,138800
1,652000
1,652000
0,173200
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000
0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
0,077000
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,092400
0,098500
0,098500
0,098666

39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87

DCI

COD ATC

C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB02
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB07
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AB12
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02

METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
BISOPROLOLUM
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
NEBIVOLOLUM**
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM

Denumire Comerciala

forma farm.

METOPROLOL ARENA 25 MG COMPR.


METOPROLOL LPH 25 mg
COMPR.
METOPROLOL LAROPHARM 50 mg COMPR.
BETAPROL 50 mg
COMPR.
EGILOK 50 mg
COMPR.
METOPROLOL LPH 50 mg
COMPR.
METOPROLOL 50 mg
COMPR.
METOPROLOL TERAPIA 50 mg COMPR.
METOPROLOL VIM SPECTRUM 50 mg COMPR.
METOPROLOL ARENA 50 MG COMPR.
METOPROLOL 50 mg
COMPR.
METOPROLOL AL 50
COMPR.
METOPROLOL ZENTIVA 50 mg COMPR.

concentratie

25mg
25mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg
METOPROLOL TARTRAT AUROBINDO 100 mg
COMPR. FILM.
100mg
METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM.
50mg
BETALOC (R) ZOK 100 mg
COMPR. FILM. ELIB. PREL. 100mg
BETALOC (R) ZOK 50 mg
COMPR. FILM. ELIB. PREL. 50mg
METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg
METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg
METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg
BETALOC
SOL. INJ./PERF. 5mg/5ml
BOREZ 10 mg
COMPR. FILM.
10 mg
CONCOR COR 10 mg
COMPR. FILM.
10mg
CONCOR COR 10 mg
COMPR. FILM.
10mg
SOBYC 10 mg
COMPR. FILM.
10mg
BOREZ 2,5 mg
COMPR. FILM.
2,5 mg
CONCOR COR 2,5 mg
COMPR. FILM.
2,5mg
CONCOR COR 2,5 mg
COMPR. FILM.
2,5mg
SOBYC 2,5 mg
COMPR. FILM.
2,5mg
CONCOR COR 5 mg
COMPR. FILM.
5mg
CONCOR COR 5 mg
COMPR. FILM.
5mg
SOBYC 5 mg
COMPR. FILM.
5mg
NEBILET (R)
COMPR.
5mg
NEBIVOLOL ACTAVIS 5 mg COMPR.
5mg
X-PRESSOL 5 mg
COMPR.
5mg
NOLET 5 mg
COMPR.
5mg
NEBIVOLOL TEVA 5 mg
COMPR.
5mg
NEBIVOLOL TEVA 5 mg
COMPR.
5mg
NEBINORM 5 mg
COMPR.
5mg
NEBIVOLOL SANDOZ 5 mg COMPR.
5mg
NEBIVOLOL TERAPIA 5mg
COMPR.
5mg
NEBIVOLOL TORRENT 5 mg COMPR.
5mg
CARVEDILOL SANDOZ 12,5 mg COMPR.
12,5 mg
DILATREND (R) 12,5 mg
COMPR.
12,5mg
CORYOL 12,5 mg
COMPR.
12,5mg
TALLITON (R) 12,5 mg
COMPR.
12,5mg
CARVEDILOL LPH 12,5 mg
COMPR.
12,5mg
CARVEDILOL VIM SPECTRUM 12,5mg COMPR.
12,5mg

DETINATOR APP

ARENA GROUP S.A. ROMANIA


LABORMED PHARMA SA ROMANIA
LAROPHARM SRL
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
EGIS PHARMACEUTICALS P.L.C.
UNGARIA
LABORMED PHARMA SA ROMANIA
MAGISTRA C & C SRL ROMANIA
TERAPIA SA
ROMANIA
VIM SPECTRUM SRL ROMANIA
ARENA GROUP S.A. ROMANIA
SLAVIA PHARMA S.R.L. ROMANIA
ALIUD PHARMA GMBH GERMANIA

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE X 3 BLIST. AL/PVC X 20 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR.

P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-6L

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

P-6L

P-6L
P-6L
P-6L

P-6L
P-6L
P-6L
P-6L
P-6L

ZENTIVA S.A.
TERAPIA SA

ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L


ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L
ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L
ASTRAZENECA AB SUEDIA CUTIE X 5 FIOLE X 5 ML SOL.INJ. I.V./PERF. S
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L

ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L

MERCK KGAA
MERCK KGAA

GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L


GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L
BERLIN CHEMIE AG MENARINI GROUP

GERMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.

P-6L

ACTAVIS S.R.L.

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L


LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. PVC- PE- PVDC/AL X 10 COMPR. P-6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P-6L
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L

SANDOZ S.R.L.
TERAPIA S.A.

ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L


ROMANIA CUTIE X 2 BLIST. PVC/AL X 14 COMPR. P-6L
TORRENT PHARMA SRL ROMANIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. P6L
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L

UNGARIA

CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.

P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-6L

EGIS PHARMACEUTICALS P.L.C.

Pagina 2 din 39

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

30
60
20
30
20
30
30
30
20
30
20
30
30
20
30
30
30
30
30
30
30
5
30
30
30
30
30
30
30
30
30
30
30
28
30
30
30
28
30
30
28
28
30
30
28
28
30
30
20

0,098666
0,098333
0,181999
0,181999
0,181999
0,164333
0,181999
0,181999
0,172500
0,181999
0,181999
0,151666
0,181999
0,092400
0,092400
0,181333
0,092400
0,181999
0,504000
0,215666
0,358333
4,086000
0,277200
0,277200
0,277200
0,277200
0,243333
0,250800
0,250800
0,209000
0,146799
0,146799
0,146799
0,274800
0,274800
0,274800
0,274800
0,274800
0,229000
0,229000
0,274800
0,274800
0,274800
0,277333
0,308570
0,259285
0,281000
0,308570
0,308570

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,098666
0,098333
0,181999
0,181999
0,181999
0,164333
0,181999
0,181999
0,172500
0,181999
0,181999
0,151666
0,181999
0,092400
0,092400
0,181333
0,092400
0,181999
0,504000
0,215666
0,358333
4,086000
0,277200
0,277200
0,277200
0,277200
0,243333
0,250800
0,250800
0,209000
0,146799
0,146799
0,146799
0,274800
0,274800
0,274800
0,274800
0,274800
0,229000
0,229000
0,274800
0,274800
0,274800
0,277333
0,308570
0,259285
0,281000
0,308570
0,308570

0,000000
0,000000
0,000501
0,000334
0,000501
0,000000
0,000334
0,062001
0,000000
0,000334
0,000501
0,000000
0,000334
0,204100
0,203933
0,000000
0,363600
0,198001
0,000000
0,000000
0,000000
0,000000
0,085800
0,808133
0,808133
0,070133
0,000000
0,123533
0,123533
0,000000
0,242534
0,242534
0,059534
0,372342
0,088200
0,145866
0,145866
0,145557
0,000000
0,000000
0,145557
0,145557
0,145866
0,000000
0,525715
0,000000
0,000000
0,153763
0,027430

88
89
90
91
92
93
94
95
96
97
98
99

DCI

COD ATC
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02
C07AG02

100 C07AG02
101 C07AG02
102 C07AG02
103 C07AG02
104 C07AG02
105 C07AG02
106 C07AG02
107 C07AG02
108 C07AG02
109 C07AG02
110 C09AA01
111 C09AA01
112 C09AA01
113 C09AA01
114 C09AA01
115 C09AA01
116 C09AA01
117 C09AA01
118 C09AA01
119 C09AA01
120 C09AA01
121 C09AA01
122 C09AA01
123 C09AA01
124 C09AA02
125 C09AA02
126 C09AA02
127 C09AA02
128 C09AA02
129 C09AA02
130 C09AA02
131 C09AA02
132 C09AA02
133 C09AA02
134 C09AA02
135 C09AA02
136 C09AA02

CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
CAPTOPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM

Denumire Comerciala

GLADYCOR 12,5 mg
MIOCARVIL 12,5 mg
CARVEDILOL HELCOR 12,2 mg

DILATREND (R) 25 mg
CORYOL 25 mg
TALLITON (R) 25 mg
CARVEDILOL LPH 25 mg
GLADYCOR 25 mg
MIOCARVIL 25 mg
CARVEDILOL HELCOR 25 mg
CARVEDILOL SANDOZ 25 mg
DILATREND (R) 6,25 mg
CORYOL (R)
TALLITON 6,25 mg
CARVEDILOL LPH 6,25 mg
CARVEDILOL VIM SPECTRUM 6,25 mg

GLADYCOR 6,25 mg
MIOCARVIL 6,25 mg
CARVEDILOL SANDOZ 6,25 mg
CARVEDILOL AUROBINDO 12,5mg

CARVEDILOL AUROBINDO 25mg


CARVEDILOL AUROBINDO 6,25mg

CAPTOPRIL MCC 12,5 mg


CAPTOPRIL 25 mg
CAPTOPRIL 25 EEL
CAPTOPRIL - AC 25 mg
CAPTOPRIL MCC 25 mg
CAPTOPRIL LPH 25 mg
CAPTOPRIL SINTOFARM 25 mg

CAPTOPRIL ARENA 25 mg
CAPTOPRIL ARENA 50 mg
CAPTOPRIL 50 mg
CAPTOPRIL 50 EEL
CAPTOPRIL - AC 50 mg
CAPTOPRIL MCC 50 mg
CAPTOPRIL LPH 50 mg
ENALAPRIL 10 mg
ENALAPRIL LPH 10 mg
ENALAPRIL LPH 10 mg
ENAP 10 mg
ENALAPRIL SLAVIA 10 mg
RENITEC 10 mg
ENALAPRIL TERAPIA 10 mg
ENALAPRIL ARENA 10mg
ENALAPRIL ARENA 10mg
ENALAPRIL ARENA 10mg
ENALAPRIL VIM SPECTRUM 10 mg

ENALAPRIL LAROPHARM 10 mg

ENALAPRIL 20 mg

forma farm.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

concentratie

12,5mg
12,5mg
12,5mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
6,25mg
12,5mg
25mg
6,25mg
12,5mg
25mg
25mg
25mg
25mg
25mg
25mg
25mg
50 mg
50mg
50mg
50mg
50mg
50mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20mg

DETINATOR APP

AMBALAJ

ANTIBIOTICE S.A.

ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR.


SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.

Prescriptie

NR.CRT

TARA
DET. APP

P-6L
P-6L
P-6L
P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L

UNGARIA

CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.

P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

ANTIBIOTICE S.A.

P-6L

EGIS PHARMACEUTICALS P.L.C.

ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR.


SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR.
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR.
EGIS PHARMACEUTICALS P.L.C.
UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
ANTIBIOTICE S.A.
ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR.
HEXAL AG
GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR.
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
MAGISTRA C & C
ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR.
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
BIO EEL SRL
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
MAGISTRA C & C
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
SINTOFARM SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
BIO EEL SRL
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
MAGISTRA C & C
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
MAGISTRA C & C
ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/AL X 10 COMPR.
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR.

P-6L
P-6L

P6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

P6L
P6L
P6L
P6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L

SLAVIA PHARM SRL ROMANIA


ROMANIA
TERAPIA SA
ROMANIA
ARENA GROUP SA ROMANIA
ARENA GROUP SA ROMANIA
ARENA GROUP SA ROMANIA
VIM SPECTRUM SRL ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA
MERCK SHARP & DOHME

Pagina 3 din 39

CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L

CUTIE X 2 BLIST. AL/AL X 14 COMPR.

P-6L

CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L

CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L


CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L
CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L

CUTIE X 2 BLIST. X 10 COMPR.

P-6L

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

30
30
20
28
28
30
30
30
30
20
30
28
28
30
30
20
30
30
30
28
28
28
30
30
20
20
30
30
30
20
20
30
20
20
30
30
20
30
20
20
20
28
20
30
50
100
20
20
20

0,308570
0,308570
0,308570
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,317333
0,216000
0,198214
0,185000
0,216000
0,216000
0,216000
0,216000
0,180333
0,257142
0,285714
0,180000
0,117666
0,141600
0,141600
0,118500
0,118000
0,118000
0,141600
0,118500
0,138000
0,163200
0,163200
0,138000
0,155666
0,136000
0,199500
0,199333
0,199000
0,199500
0,190500
0,228600
0,199500
0,199333
0,199400
0,199200
0,199500
0,199000
0,330500

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,308570
0,308570
0,308570
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,342856
0,317333
0,216000
0,198214
0,185000
0,216000
0,216000
0,216000
0,216000
0,180333
0,257142
0,285714
0,180000
0,117666
0,141600
0,141600
0,118500
0,118000
0,118000
0,141600
0,118500
0,138000
0,163200
0,163200
0,138000
0,155666
0,136000
0,199500
0,199333
0,199000
0,199500
0,190500
0,228600
0,199500
0,199333
0,199400
0,199200
0,199500
0,199000
0,330500

0,144430
0,153763
0,143430
0,583929
0,012144
0,180477
0,259144
0,259477
0,258144
0,259644
0,000000
0,173642
0,000000
0,000000
0,022333
0,012000
0,015666
0,022333
0,000000
0,000000
0,000000
0,000000
0,000000
0,000066
0,009400
0,000000
0,000000
0,000000
0,013066
0,000000
0,000000
0,067466
0,030300
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,077828
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

DCI

COD ATC

137 C09AA02
138 C09AA02
139 C09AA02
140 C09AA02
141 C09AA02
142 C09AA02
143 C09AA02
144 C09AA02
145 C09AA02
146 C09AA02
147 C09AA02
148 C09AA02
149 C09AA02
150 C09AA02
151 C09AA02
152 C09AA02
153 C09AA02
154 C09AA03
155 C09AA03
156 C09AA03
157 C09AA03
158 C09AA03
159 C09AA03
160 C09AA03
161 C09AA03
162 C09AA03
163 C09AA03
164 C09AA03
165 C09AA03
166 C09AA03
167 C09AA03
168 C09AA03
169 C09AA03
170 C09AA03
171 C09AA03
172 C09AA03
173 C09AA03
174 C09AA03
175 C09AA03
176 C09AA03
177 C09AA05
178 C09AA05
179 C09AA05
180 C09AA05
181 C09AA05
182 C09AA05
183 C09AA05
184 C09AA05
185 C09AA05

ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
LISINOPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM

Denumire Comerciala

forma farm.

ENALAPRIL LPH 20 mg
ENAP 20 mg
RENITEC 20 mg
ENALAPRIL TERAPIA 20 mg
ENALAPRIL ARENA 20 mg
ENALAPRIL ARENA 20 mg
ENALAPRIL SLAVIA 20 mg

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ./PERF.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

ENALAPRIL LAROPHARM 20 mg

ENALAPRIL 5 mg
ENAP 5 mg
RENITEC 5 mg
ENALAPRIL LPH (R) 5 mg
ENALAPRIL TERAPIA 5 mg
ENALAPRIL ARENA 5 mg
ENALAPRIL SLAVIA 5 mg
ENALAPRIL LAROPHARM 5 mg

ENAP 1,25 mg/ml


RANOLIP
LISIREN 10 mg
LISINOPRIL SANDOZ 10 mg
LISIGAMMA 10 mg
LISINOPRIL 10 MEDO
LISINOPRIL ACTAVIS 10 mg
LISINOPRIL ATB 10 MG
TONOLYSIN 10 mg
TONOLYSIN 2,5 mg
RANOLIP
LISIREN 20 mg
LISINOPRIL SANDOZ 20 mg
LISIGAMMA 20 mg
LISINOPRIL ACTAVIS 20 mg
LISINOPRIL ATB 20 MG
TONOLYSIN 20 mg
LISINOPRIL 20 MEDO
LISINOPRIL ATB 40 MG
RANOLIP
LISIGAMMA 5 mg
LISINOPRIL 5 MEDO
LISINOPRIL ACTAVIS 5 mg
TONOLYSIN 5 mg
VIVACE 10 mg
PIRAMIL 10 mg
RAMIPRIL-AC 10 mg
AMPRIL 10 mg
ZENRA 10
TRITACE 10
RAMIPRIL AUROBINDO 10 mg
AMPRIGEN 10 mg
RAMIPRIL TEVA 10 mg

concentratie

20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
1,25mg/ml
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40mg
5mg
5mg
5mg
5mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L


KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L
MERCK SHARP & DOHME

CUTIE X 2 BLIST. AL/AL X 14 COMPR.

TERAPIA SA
ARENA GROUP SA
ARENA GROUP SA

ROMANIA
ROMANIA
ROMANIA
ROMANIA
SLAVIA PHARM S.R.L. ROMANIA
LAROPHARM SRL
ROMANIA
MAGISTRA C & C
ROMANIA

CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L

P-6L

CUTIE X 3 BLIST. PVC/AL X 10 COMPR.


CUTIE X 5 BLIST. PVC/AL X 10 COMPR.
CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.

P-6L

CUTIE X 2 BLIST. X 10 COMPR.

P-6L

P-6L

P6L
P6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L
MERCK SHARP & DOHME

ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.

P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L

TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L
LAROPHARM SRL
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L
KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.

PR/PRF

RANBAXY U.K. LIMITED

MAREA BRITANIE

CUTIE X 3 BLIST. X 10 COMPR.

P-6L

AC HELCOR SRL
HEXAL AG

ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-6L

GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

MEDOCHEMIE ROMANIA SRL

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE CU BLIST. PVC/AL X 30 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
CUTIE X 2 BLIST. AL/PVC X 14 COMPR.

P-6L

GEDEON RICHTER ROMANIA SA

ROMANIA
ISLANDA
ROMANIA
ROMANIA
ROMANIA

RANBAXY U.K. LIMITED

MAREA BRITANIE

CUTIE X 3 BLIST. X 10 COMPR.

P-6L

AC HELCOR SRL
HEXAL AG

ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.

P-6L

GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

ACTAVIS GROUP PTC EHF.

CUTIE CU BLIST. PVC/AL X 30 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
CUTIE X 2 BLIST. PVDC/AL X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

ANTIBIOTICE SA

ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

RANBAXY U.K. LIMITED

MAREA BRITANIE

CUTIE X 3 BLIST. X 10 COMPR.

P-6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L

ACTAVIS GROUP PTC EHF.

ANTIBIOTICE SA
GEDEON RICHTER ROMANIA SA

ANTIBIOTICE SA
GEDEON RICHTER ROMANIA SA

MEDOCHEMIE ROMANIA SRL

ROMANIA
ISLANDA
GEDEON RICHTER ROMANIA SA ROMANIA
ACTAVIS GROUP HF ISLANDA
SANDOZ SRL
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
MEDOCHEMIE ROMANIA SRL

ACTAVIS GROUP PTC EHF.

P-6L
P-6L
P-6L
P-6L

P-6L
P-6L
P-6L
P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L


CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L
CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L

CUTIE X 4 BLIST. AL/AL X 7 COMPR.

P-6L

CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

ZENTIVA S.A.

P-6L

SANOFI - AVENTIS ROMANIA S.R.L.

ROMANIA CUTIE X 2 BLIST. X 14 COMPR.


ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR.

P-6L
P-6L

ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L


TEVA PHARMACEUTICALS S.R.L.

Pagina 4 din 39

ROMANIA

CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

20
20
28
20
30
50
20
20
20
20
28
20
20
30
20
20
5
30
20
30
30
30
30
30
28
28
30
20
30
30
30
30
28
20
30
30
30
30
30
28
28
28
30
30
28
28
28
30
30

0,330500
0,330500
0,396600
0,330500
0,330666
0,330600
0,330500
0,330500
0,093000
0,094000
0,108000
0,093000
0,093000
0,093333
0,090000
0,090000
3,204000
0,305199
0,305199
0,270000
0,298000
0,254333
0,270000
0,305199
0,305199
0,311071
0,454800
0,454800
0,379000
0,447333
0,379000
0,454800
0,454800
0,428500
1,359333
0,231199
0,225000
0,192666
0,193000
0,231199
0,238214
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,330500
0,330500
0,396600
0,330500
0,330666
0,330600
0,330500
0,330500
0,093000
0,094000
0,108000
0,093000
0,093000
0,093333
0,090000
0,090000
3,204000
0,305199
0,305199
0,270000
0,298000
0,254333
0,270000
0,305199
0,305199
0,311071
0,454800
0,454800
0,379000
0,447333
0,379000
0,454800
0,454800
0,428500
1,359333
0,231199
0,225000
0,192666
0,193000
0,231199
0,238214
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856
0,285856

0,000000
0,000000
0,112328
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,036285
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,213134
0,231801
0,000000
0,000000
0,000000
0,000000
0,108134
0,081229
0,000000
0,344533
0,327700
0,000000
0,000000
0,000000
0,357200
0,194128
0,000000
0,000000
0,033467
0,000000
0,000000
0,000000
0,032015
0,000000
0,016286
0,016144
0,016144
0,016286
0,178429
0,016286
0,016144
0,016144

COD ATC

186 C09AA05
187 C09AA05
188 C09AA05
189 C09AA05
190 C09AA05
191 C09AA05
192 C09AA05
193 C09AA05
194 C09AA05
195 C09AA05
196 C09AA05
197 C09AA05
198 C09AA05
199 C09AA05
200 C09AA05
201 C09AA05
202 C09AA05
203 C09AA05
204 C09AA05
205 C09AA05
206 C09AA05
207 C09AA05
208 C09CA03
209 C09CA03
210 C09CA03
211 C09CA03
212 C09CA03
213 C09CA03
214 C09CA03
215 C09CA03
216 C09CA03
217 C09CA03
218 C09CA03
219 C09CA03
220 C09CA03
221 C09CA03
222 C09CA03
223 C09CA03
224 C09CA03
225 C09CA03
226 C09CA03
227 C09CA03
228 C09CA03
229 C09CA03
230 C09CA03
231 C09CA03
232 C09CA03
233 C09CA06
234 C09CA06

DCI

RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
VALSARTANUM**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**

Denumire Comerciala

RAMIRAN 10 mg
RAMIRAN 10 mg
VIVACE 2,5 mg
PIRAMIL 2,5 mg
RAMIPRIL-AC 2,5 mg
AMPRIL 2,5 mg
ZENRA 2,5
TRITACE(R) 2,5
AMPRIGEN 2,5 mg
RAMIRAN 2,5 mg
RAMIRAN 2,5 mg
VIVACE 5 mg
PIRAMIL 5 mg
RAMIPRIL-AC 5 mg
AMPRIL 5 mg
ZENRA 5
TRITACE 5
RAMIPRIL AUROBINDO 5 mg
AMPRIGEN 5 mg
RAMIPRIL TEVA 5 mg
RAMIRAN 5 mg
RAMIRAN 5 mg
VALSARTAN TEVA 160 mg
VALSARTAN TEVA 80 mg
WENZELL 160 mg
WENZELL 160 mg
VALSARGAMMA 160 mg
DIOVAN 160 mg
VALSACOR 160 mg
AVASSAN 160 mg
VALSARTAN ZENTIVA 160 mg
VAPRESS 160 mg
VAPRESS 160 mg
DIOVAN 40 mg
AVASSAN 40 mg
VAPRESS 40 mg
VAPRESS 40 mg
WENZELL 80 mg
WENZELL 80 mg
VALSARGAMMA 80 mg
DIOVAN 80 mg
VALSACOR 80 mg
AVASSAN 80 mg
VALSARTAN ZENTIVA 80 mg
VAPRESS 80 mg
VAPRESS 80 mg
DIOVAN 3 mg/ml
ATACAND
TANDESAR 16 mg

forma farm.

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
SOL. ORALA
COMPR.
COMPR.

concentratie

10mg
10mg
2,5 mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
2,5mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
160mg
80mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
3mg/ml
16mg
16mg

DETINATOR APP

TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF
SANDOZ SRL
AC HELCOR PHARMA SRL

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L


ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L
ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L
ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

ZENTIVA S.A.
SANOFI - AVENTIS ROMANIA S.R.L.

ROMANIA CUTIE X 2 BLIST. X 14 COMPR.


ROMANIA CUTIE X 2 BLIST. X 14 COMPR.

P-6L
P-6L

ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L


TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L

TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L
SANDOZ SRL
ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L

ZENTIVA S.A.

P-6L

SANOFI - AVENTIS ROMANIA S.R.L.

ROMANIA CUTIE X 2 BLIST. X 14 COMPR.


ROMANIA CUTIE X 2 BLIST. X 14 COMPR.
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR.

P-6L
P-6L

ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L


TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L

ROMASTRU TRADING S.R.L.

ROMANIA
ROMANIA
ROMANIA
ROMANIA

WORWAG PHARMA GMBH & CO. KG

GERMANIA

TEVA PHARMACEUTICALS S.R.L.


TEVA PHARMACEUTICALS S.R.L.

ROMASTRU TRADING S.R.L.

CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L


CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 CAPS. P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM.

P-6L

CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.

P-6L

KRKA D.D. NOVO MESTO SLOVENIA

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

TERAPIA S.A.
ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU

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

P6L
P6L

CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.P-6L

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

P6L
P6L
P6L
P6L
P6L
P6L

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

P-6L

CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 30 COMPR. FILM.

P-6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P6L

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

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

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM.

TERAPIA S.A.
ROMANIA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU
ROMASTRU TRADING S.R.L. ROMANIA
ROMASTRU TRADING S.R.L. ROMANIA

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

GERMANIA

WORWAG PHARMA GMBH & CO. KG

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

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L

KRKA D.D. NOVO MESTO SLOVENIA

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

TERAPIA S.A.
ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU

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

NOVARTIS PHARMA GMBH GERMANIA

ASTRAZENECA AB
TERAPIA SA
Pagina 5 din 39

SUEDIA
ROMANIA

P6L
P6L

CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.P-6L

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

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


CUTIE X 1 FLACON DIN STICLA BRUNA X 160ML SOLUTIE ORALA + 1 TRUSA DE ADMINISTRARE (ADAPTOR PENTRU FLACON + 1 SERINGA DOZATOARE A 5ML + 1 MASURA DOZATOARE A 30ML )

P6L
P6L
P-6L

CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L


CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

30
30
28
28
30
30
28
28
30
30
30
28
28
30
30
28
28
28
30
30
30
30
28
28
28
30
30
28
28
28
28
28
28
28
28
28
28
28
30
30
28
28
28
28
28
28
1
28
28

0,285856
0,285856
0,149642
0,172142
0,168333
0,172000
0,166071
0,179570
0,172000
0,172000
0,172000
0,172142
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,459642
0,409285
0,551570
0,551570
0,551570
0,551570
0,534285
0,551570
0,551570
0,551570
0,551570
0,495856
0,495856
0,413214
0,413214
0,462856
0,462856
0,462856
0,462856
0,437857
0,462856
0,462856
0,385714
0,385714
41,420000
0,840000
0,840000

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,285856
0,285856
0,149642
0,172142
0,168333
0,172000
0,166071
0,179570
0,172000
0,172000
0,172000
0,172142
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,206570
0,459642
0,409285
0,551570
0,551570
0,551570
0,551570
0,534285
0,551570
0,551570
0,551570
0,551570
0,495856
0,495856
0,413214
0,413214
0,462856
0,462856
0,462856
0,462856
0,437857
0,462856
0,462856
0,385714
0,385714
41,420000
0,840000
0,840000

0,016144
0,016144
0,000000
0,000000
0,000000
0,000000
0,000000
0,085072
0,000000
0,000000
0,000000
0,000000
0,041644
0,041430
0,041430
0,032715
0,175215
0,041644
0,041430
0,032763
0,041430
0,041430
0,000000
0,000000
0,518787
0,518763
0,209763
1,042358
0,000000
0,518787
0,010215
0,220572
0,220572
2,072358
1,083786
0,000000
0,000000
0,340001
0,339810
0,148810
0,732144
0,000000
0,340001
0,060001
0,000000
0,000000
0,000000
0,741785
0,222500

COD ATC

235 C09CA06
236 C09CA06
237 C09CA06
238 C09CA06
239 C09CA06
240 C09CA06
241 C09CA06
242 C09CA06
243 C09CA06
244 C09CA06
245 C09CA06
246 C09CA06
247 C09CA06
248 C09CA06
249 C09CA06
250 C09CA06
251 C09CA06
252 C09CA06
253 C09CA06
254 C09CA06
255 C09CA06
256 C09CA06
257 C09CA06
258 C09CA06
259 C09CA06
260 C09CA06
261 C09CA06

DCI

CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**
CANDESARTANUM CILEXETIL**

forma farm.
Denumire Comerciala
CANDESARTAN SANDOZ 16 mg COMPR.

KARBIS 16 mg
CANDESARTAN TORRENT 16 mg

ATACAND 16mg
CANZENO 16mg
CANDESARTAN LABORMED 16 mg
CANDESARTAN AUROBINDO 16 mg

CADEXYL 16 mg
CANDESARTAN CILEXETIL MCC 16 mg

ATACAND 32 mg
KARBIS 32 mg
CANDESARTAN TORRENT 32 mg

ATACAND 32 mg
CANZENO 32mg
CADEXYL 32 mg
CANDESARTAN CILEXETIL MCC 32 mg

ATACAND
TANDESAR 8 mg
CANDESARTAN SANDOZ 8 mg

KARBIS 8 mg
CANDESARTAN TORRENT 8 mg

ATACAND 8mg
CANZENO 8mg
CANDESARTAN LABORMED 8 mg
CANDESARTAN AUROBINDO 8 mg

CADEXYL 8 mg
CANDESARTAN CILEXETIL MCC 8 mg

concentratie

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
32mg
32mg
32mg
32mg
32mg
32mg
32mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg

COMPR.
COMPR.

2mg
4mg

DETINATOR APP

SANDOZ SRL

AMBALAJ

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

Prescriptie

NR.CRT

TARA
DET. APP

P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
TORRENT PHARMA S.R.L.

ASTRAZENECA AB
ZENTIVA K.S.

ROMANIA
SUEDIA

CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR.

REPUBLICA CEHA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L

ROMANIA
MALTA
NEOLA PHARMA SRL ROMANIA
MAGISTRA C&C S.R.L. ROMANIA
ASTRAZENECA AB SUEDIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L


P-6L

LABORMED PHARMA S.A.

CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR. P6L

AUROBINDO PHARMA (MALTA) LIMITED

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L


CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L
CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L
CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. P-6L

KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L

ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L


ASTRAZENECA AB SUEDIA CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L
MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L
ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. P-6L
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. P-6L
TORRENT PHARMA S.R.L.

KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
TORRENT PHARMA S.R.L.

ASTRAZENECA AB
ZENTIVA K.S.

ROMANIA
SUEDIA

CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR.

REPUBLICA CEHA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L


P-6L

ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. P6L


MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. P6L
MAGISTRA C&C S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L
LABORMED PHARMA S.A.

AUROBINDO PHARMA (MALTA) LIMITED

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

28
30
30
28
30
28
30
28
30
28
30
30
28
30
28
30
28
28
28
30
30
28
30
28
30
28
30

0,840000
0,840000
0,700000
0,840000
0,840000
0,840000
0,840000
0,840000
0,840000
0,723600
0,723600
0,603000
0,723600
0,723600
0,723600
0,723600
0,637200
0,531071
0,531071
0,531000
0,531000
0,637200
0,531000
0,531071
0,531000
0,531071
0,531000

0,840000
0,840000
0,700000
0,840000
0,840000
0,840000
0,840000
0,840000
0,840000
0,723600
0,723600
0,603000
0,723600
0,723600
0,723600
0,723600
0,637200
0,531071
0,531071
0,531000
0,531000
0,637200
0,531000
0,531071
0,531000
0,531071
0,531000

0,158928
0,222000
0,000000
0,741785
0,026000
0,222142
0,172333
0,222500
0,222000
1,505685
0,725400
0,000000
1,505685
0,239400
0,634257
0,725400
0,179942
0,000000
0,000000
0,000000
0,000000
0,179942
0,000000
0,000000
0,000000
0,000000
0,000000

30
20

0,226000
0,350000

0,226000
0,350000

0,000000
0,000000

30
30
28
28
28
28
28
28
28
28

9,342333
9,342333
0,460714
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,422142

9,342333
9,342333
0,460714
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,422142

0,000000
0,000000
0,000000
1,141287
0,039144
0,600215
0,130572
0,130572
0,112358
0,000000

2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2


1
2

B01AA07
B01AA07

ACENOCUMAROLUM
ACENOCUMAROLUM

TROMBOSTOP 2 mg
SINTROM 4 mg

TERAPIA SA

ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-RF

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.

P-RF

Tratamentul se iniiaz de ctre medicul n specialitatea cardiologie, chirurgie cardiovascular i chirurgie vascular.

3. BOLNAVI CU PROCEDURI INTERVENTIONALE PERCUTANE, NUMAI DUPA IMPLANTAREA UNEI PROTEZE ENDOVASCULARE (STENT)- G3
1
2
3
4
5
6
7
8
9
10

B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04

CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***

PLAVIX 300mg
PLAVIX 300mg
ZYLLT
PLAVIX 75mg
CLOPIDOGREL MYLAN 75mg
TROGRAN 75 mg
CLOPIGAMMA 75 mg
CLOPIGAMMA 75 mg
PLAVOCORIN 75 mg

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CLOPIDOGREL ACTAVIS 75 mg COMPR. FILM.

300mg
300mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg

SANOFI PHARMA - BRISTOL MYERS SQUIBB

SANOFI CLIR SNC

FRANTA
FRANTA

CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA)

P-RF

CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA)

P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA/AL/PVC-AL X 28 COMPR. FILM. P-RF

FRANTA
FRANTA

CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-RF

MYLAN S.A.S.
GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

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

WORWAG PHARMA GMBH & CO. KG

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

P-RF

WORWAG PHARMA GMBH & CO. KG

GERMANIA

P-RF

SANDOZ S.R.L.

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


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

SANOFI PHARMA - BRISTOL MYERS SQUIBB

ACTAVIS GROUP PTC EHF.

Pagina 6 din 39

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

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

P-RF

P-RF
P-RF

11
12
13
14
15
16
17
18
19

COD ATC

DCI

B01AC04

CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***

B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04

Denumire Comerciala

forma farm.

DEFROZYP 75 mg
TESSYRON 75 mg

COMPR. FILM.
COMPR. FILM.
CLOPIDOGREL DR. REDDY'S 75 mg COMPR. FILM.
CLOPIDOGREL TERAPIA 75 mg COMPR. FILM.
DEPLATT 75 mg
COMPR. FILM.
TROMBEX 75 mg
COMPR. FILM.
TROMBEX 75 mg
COMPR. FILM.
CLOPIDOGREL AUROBINDO 75 mg COMPR. FILM.
PLAVIX 75mg
COMPR. FILM.

concentratie

75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

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


GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM.
P-RF
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-RF
TERAPIA S.A.
ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF
ZENTIVA K.S.
CEHIA
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 30 COMPRIMATE FILMATEP-RF
ZENTIVA K.S.
CEHIA
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 90 COMPRIMATE FILMATEP-RF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF
SANOFI CLIR SNC
FRANTA CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF
LABORMED PHARMA S.A.

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

28
30
30
30
30
30
90
28
28

0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570

0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570
0,506570

0,600215
0,182096
0,599763
0,599763
0,412763
0,074430
0,055430
0,087358
1,141287

140
168
168
56
56
30
28
30
30
30
30
30
1
1
1
5
1
5
1
1
1
1
1
1
1
1
1
1
1
1
1
50

2,333071
1,949464
5,206845
10,544464
13,558214
2,836666
3,403999
32,970399
27,475333
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400

2,333071
1,949464
5,206845
10,544464
13,558214
2,836666
3,403999
32,970399
27,475333
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,959572
8,027267
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
34,512400
0,000000
72,090000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea cardiologie, chirurgie cardiovascular i chirurgie vascular.

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


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

J05AB04
J05AB04
J05AB04
J05AB04
J05AB04
J05AF05
J05AF05
J05AF07

RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
LAMIVUDINUM****
LAMIVUDINUM****

REBETOL 200 mg
COPEGUS 200mg
MODERIBA 200 mg
MODERIBA 400 mg
MODERIBA 600 mg
LAMIVUDINE TEVA 100 mg
ZEFFIX 100 mg
TENOFOVIRUM DISOPROXIL FUMARATE**** VIREAD 245mg

J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE**** TENOFOVIR DISOPROXIL TEVA 245 mg


J05AF08
J05AF10
J05AF10
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AB04
L03AB04
L03AB05
L03AB05
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB11
N04BB01

ADEFOVIRUM DIPIVOXILUM****
ENTECAVIRUM****
ENTECAVIRUM****
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
INTERFERONUM ALFA 2A****
INTERFERONUM ALFA 2A****
INTERFERONUM ALFA 2B****
INTERFERONUM ALFA 2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2A****
AMANTADINUM**

HEPSERA
BARACLUDE 0,5mg
BARACLUDE 1mg
ZARZIO 30MU/0,5ml
ZARZIO 48MU/0,5ml
TEVAGRASTIM 30MUI/0,5ml
NIVESTIM 30 MU/0,5 ml
TEVAGRASTIM 48MUI/0,8ml
NIVESTIM 48 MU/0,5 ml
ROFERON A
ROFERON A
INTRON A 18 milioane U.I.
INTRON A 30 milioane U.I.
PEGINTRON 100 g
PEGINTRON 100 g
PEGINTRON 120 g
PEGINTRON 120 g
PEGINTRON 150 g
PEGINTRON 150 g
PEGINTRON 50 g
PEGINTRON 50 g
PEGASYS 180 mcg/0,5ml
VIREGYT (R)- K

CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR. FILM.
COMPR. FILM.
SOL. INJ. /PERF. IN SERINGA PREUMPLUTA

SOL. INJ. /PERF. IN SERINGA PREUMPLUTA

200mg
200mg
200mg
400mg
600mg
100 mg
100mg
245mg
245mg
10mg
0,5mg
1mg
60MU/ml
96MU/ml

MERCK SHARP & DOHME

MAREA BRITANIE

CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )

P-RF/R

ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR.
PRF

ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF
TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R
GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R
CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM P-RF/R

GILEAD SCIENCE INTERNATIONAL LIMITED

MAREA BRITANIE

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

GILEAD SCIENCE INTERNATIONAL LIMITED

MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 30 COMPR.

P-RF/R

BRISTOL-MYERS SQUIBB PHARMA EEIG

MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA)

P-RF/R

BRISTOL-MYERS SQUIBB PHARMA EEIG

MAREA BRITANIE

CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA)

P-RF/R

SANDOZ GMBH
SANDOZ GMBH

AUSTRIA
AUSTRIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

CUTIE CU 1 FLAC. DIN PED CU CAPAC CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM.

PR

SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ.
SOL. INJ.

300mcg/0,5ml TEVA GENERICS GMBH GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF.S/P-RF/R

300g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF

480mcg/0,8ml TEVA GENERICS GMBH GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF.S/P-RF/R

SOL. INJ. PEN MULTIDOZA

18 milioane U.I. MERCK SHARP & DOHME


30 milioane U.I. MERCK SHARP & DOHME

SOL. INJ. PEN MULTIDOZA

480g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF
3Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR
9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR
MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE

P-RF/R

MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE

P-RF/R

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

MERCK SHARP & DOHME

MAREA BRITANIE

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

MERCK SHARP & DOHME

MAREA BRITANIE

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

MERCK SHARP & DOHME

MAREA BRITANIE

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

MERCK SHARP & DOHME

MAREA BRITANIE

PULB. + SOLV. PT. SOL. INJ.

100g
100g
120g
120g
150g
150g
50g
50g

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

SOL. INJ. IN SERINGA PREUMPLUTA

180mcg/0,5ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CAPS.

100mg

EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 1 FLAC. X 50 CAPS.

PULB. + SOLV. PT. SOL. INJ.


PULB. + SOLV. PT. SOL. INJ.
PULB. + SOLV. PT. SOL. INJ.
PULB. + SOLV. PT. SOL. INJ.
PULB. + SOLV. PT. SOL. INJ.
PULB. + SOLV. PT. SOL. INJ.
PULB. + SOLV. PT. SOL. INJ.

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC

Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie / boli infectioase si nefrologie (doar pentru pacientii cu afectare renala consecutiva infectiei cu virusuri hepatitice)
Pagina 7 din 39

PR
PR
PR
PR
PR
PR
PR
PR
P-RF/R

P-6L

DCI

COD ATC

Denumire Comerciala

forma farm.

concentratie

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR.

P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

5. HEPATITA AUTOIMUNA - G5
1
2
3
4
5
6
7
8

H02AB04
H02AB04
H02AB04
H02AB04
H02AB04

L04AX01
L04AX01
L04AX01

METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM

MEDROL A 16
MEDROL 32
SOLU - MEDROL ACT-O-VIAL
LEMOD SOLU 125 mg
LEMOD SOLU 500 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg

COMPR.
COMPR.
LIOF. SI SOLV.PT.SOL.INJ
PULB+SOLV. PT. SOL. INJ./PERF.
PULB+SOLV. PT. SOL. INJ./PERF.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

16mg
32mg
250mg/4ml
125mg
500mg
50mg
50mg
75mg

50
20
1
1
1
100
100
100

0,543200
1,234000
20,480000
8,810000
31,020000
0,702300
0,702300
0,788900

0,543200
1,234000
20,480000
8,810000
31,020000
0,702300
0,702300
0,788900

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

P6L
P6L
P6L

100
50
50
60
100
1

0,946200
0,946200
0,788600
0,788500
2,681700
97,490000

0,946200
0,946200
0,788600
0,788500
2,681700
97,490000

0,206200
0,267200
0,000000
0,000000
0,000000
0,000000

OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L


E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML
P-6L
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML
P-6L
MIP PHARMA GMBH GERMANIA
P-6L
MIP PHARMA GMBH GERMANIA
P-6L
ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L
ALFA WASSERMANN SPA ITALIA
CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM. P-RF
ALFA WASSERMANN SPA ITALIA
CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF
ALFA WASSERMANN SPA ITALIA
P-RF
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ZENTIVA SA
ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
BIO EEL SRL
ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P-6L
ZENTIVA SA
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L
ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L

1
1
1
1
1
1
12
36
1
20
20
20
20
20
20
30
5
30
50

10,750000
10,800000
3,590000
17,230000
33,340000
6,730000
2,625833
2,413333
19,810000
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000

10,750000
10,800000
3,590000
17,230000
33,340000
6,730000
2,625833
2,413333
19,810000
0,156500
0,156500
0,187800
0,157000
0,187800
0,187800
0,157666
1,260000
0,753000
0,258000

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,125200
0,000000
0,125200
0,083200
0,000000
0,000000
0,000000
0,075400

ROMANIA
STADA HEMOFARM S.R.L. ROMANIA
STADA HEMOFARM S.R.L.

CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV

S/P-RF

CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML

S/P-RF

ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.


ASPEN PHARMA TRADING LIMITED
EBEWE PHARMA GES.M.B.H. NFG KG

IRLANDA
AUSTRIA

P-RF

CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML

S/P-RF

CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

S/P-RF

CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.

PR

Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie

6. CIROZA BILIARA PRIMARA, COLANGITA SCLEROZANTA PRIMITIVA, HEPATITA CRONICA SI CIROZE DE ALTE ETIOLOGII CU COLESTAZA - G6
1
2
3
4
5
6

A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02

ACIDUM URSODEOXYCHOLICUM
ACIDUM URSODEOXYCHOLICUM
ACIDUM URSODEOXYCHOLICUM
ACIDUM URSODEOXYCHOLICUM
ACIDUM URSODEOXYCHOLICUM
ACIDUM URSODEOXYCHOLICUM

URSOFALK (R)
URSOFALK (R)
URSOSAN
URSOROM 250 mg
URSOFALK 500 mg
URSOFALK 250 mg/5 ml

CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
SUSP. ORALA

250mg
250mg
250mg
250mg
500mg
250mg/5ml

LICHID ORAL
SIROP
SIROP
SIROP
SIROP
SOL. ORALA
COMPR. FILM.
COMPR. FILM.

66,7%
65%
65%
650mg/ml
650mg/ml
660 mg/ml
200mg
200mg
200mg/10ml
40mg
40mg
40mg
40mg
40mg
40mg
40mg
10mg/ml
100mg
25mg

DR. FALK PHARMA GMBH GERMANIA


DR. FALK PHARMA GMBH GERMANIA
PRO. MED. CS PRAHA AS
ROMPHARM COMPANY S.R.L.

CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L


CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L
CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L

CEHIA
ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS.

DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.


DR. FALK PHARMA GMBH GERMANIA

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP

Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie

7. CIROZA HEPATICA - G7
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19

A06AD11
A06AD11
A06AD11
A06AD11
A06AD11
A06AD11
A07AA11
A07AA11
A07AA11
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03CA01
C03DA01
C03DA01

LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
LACTULOSUM
RIFAXIMINUM
RIFAXIMINUM
RIFAXIMINUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
SPIRONOLACTONUM
SPIRONOLACTONUM

DUPHALAC (R)
LACTULOSE
LACTULOSE
LACTULOSE-MIP 650 mg/ml
LACTULOSE-MIP 650 mg/ml
LACTULAK 660 mg/ml
NORMIX 200 mg
NORMIX 200 mg
NORMIX 200mg/10ml
FUROSEMID MCC 40 mg
FUROSEMID SLAVIA
FUROSEMID ZENTIVA
FUROSEMID LPH 40 mg
FUROSEMID ARENA 40 mg
FUROSEMID BIOEEL 40 mg
FUROSEMID LPH 40 mg
FUROSEMID 20 mg/2 ml
VEROSPIRON

GRAN. PT. SUSP. ORALA

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
CAPS.
SPIRONOLACTONA ARENA 25 mg CAPS.

ABBOTT HEALTHCARE PRODUCTS B.V.

CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP

CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP

CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML

Pagina 8 din 39

20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56

COD ATC
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01
C03DA01

J05AB04
J05AB04
J05AB04
J05AB04
J05AB04
J05AF05
J05AF05
J05AF08
J05AF10
J05AF10
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AB04
L03AB04
L03AB05
L03AB05
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB11
N04BB01

DCI

SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
RIBAVIRINUM****
LAMIVUDINUM****
LAMIVUDINUM****
ADEFOVIRUM DIPIVOXILUM****
ENTECAVIRUM****
ENTECAVIRUM****
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
FILGRASTIMUM (G-CSF)**
INTERFERONUM ALFA 2A****
INTERFERONUM ALFA 2A****
INTERFERONUM ALFA 2B****
INTERFERONUM ALFA 2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2A****
AMANTADINUM**

forma farm.
Denumire Comerciala
SPIRONOLACTONA LPH 25 mg CAPS.

VEROSPIRON

CAPS.
SPIRONOLACTONA ARENA 50 mg CAPS.
SPIRONOLACTONA BIOEEL 25 mg COMPR.
SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM.
ALSPIRON 25 mg
COMPR. FILM.
ALSPIRON 50 mg
COMPR. FILM.
REBETOL 200 mg
CAPS.
COPEGUS 200mg
COMPR. FILM.
MODERIBA 200 mg
COMPR. FILM.
MODERIBA 400 mg
COMPR. FILM.
MODERIBA 600 mg
COMPR. FILM.
LAMIVUDINE TEVA 100 mg COMPR. FILM.
ZEFFIX 100 mg
COMPR. FILM.
HEPSERA
COMPR.
BARACLUDE 0,5mg
COMPR. FILM.
BARACLUDE 1mg
COMPR. FILM.
ZARZIO 30MU/0,5ml
ZARZIO 48MU/0,5ml
TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF.
NIVESTIM 30 MU/0,5 ml
SOL. INJ./PERF.
TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF.
NIVESTIM 48 MU/0,5 ml
SOL. INJ./PERF.
ROFERON A
SOL. INJ.
ROFERON A
SOL. INJ.
INTRON A 18 milioane U.I.
SOL. INJ. PEN MULTIDOZA
INTRON A 30 milioane U.I.
SOL. INJ. PEN MULTIDOZA
PEGINTRON 100 g
PULB. + SOLV. PT. SOL. INJ.
PEGINTRON 100 g
PULB. + SOLV. PT. SOL. INJ.
PEGINTRON 120 g
PULB. + SOLV. PT. SOL. INJ.
PEGINTRON 120 g
PULB. + SOLV. PT. SOL. INJ.
PEGINTRON 150 g
PULB. + SOLV. PT. SOL. INJ.
PEGINTRON 150 g
PULB. + SOLV. PT. SOL. INJ.
PEGINTRON 50 g
PULB. + SOLV. PT. SOL. INJ.
PEGINTRON 50 g
PULB. + SOLV. PT. SOL. INJ.
PEGASYS 180 mcg/0,5ml
SOL. INJ. IN SERINGA PREUMPLUTA
VIREGYT (R)- K
CAPS.
SOL. INJ. /PERF. IN SERINGA PREUMPLUTA

SOL. INJ. /PERF. IN SERINGA PREUMPLUTA

concentratie

25mg
50mg
50mg
25mg
25mg
25mg
50mg
200mg
200mg
200mg
400mg
600mg
100 mg
100mg
10mg
0,5mg
1mg
60MU/ml
96MU/ml

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
ARENA GROUP S.A. ROMANIA
BIO EEL SRL
ROMANIA
TERAPIA SA
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
AC HELCOR PHARMA SRL ROMANIA

CUTIE CU 6 BLIST. PVC/AL X 10 CAPS.

P6L

CUTIE X 3 BLIST. AL/PVC X 10 CAPS.

P-6L

MERCK SHARP & DOHME

CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )

LABORMED PHARMA S.A.

MAREA BRITANIE

CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L


CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
P-RF/R

ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR.
PRF

ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF
TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R
GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R
GILEAD SCIENCE INTERNATIONAL LIMITED

MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 30 COMPR.

P-RF/R

BRISTOL-MYERS SQUIBB PHARMA EEIG

MAREA BRITANIE CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA)

P-RF/R

BRISTOL-MYERS SQUIBB PHARMA EEIG

MAREA BRITANIE

CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA)

P-RF/R

SANDOZ GMBH
SANDOZ GMBH

AUSTRIA
AUSTRIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

300mcg/0,5ml TEVA GENERICS GMBH GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF.S/P-RF/R

300g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF

480mcg/0,8ml TEVA GENERICS GMBH GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML SOL. INJ. SAU PERF.S/P-RF/R

480g/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.P-RF
3Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR
9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR
18 milioane U.I. MERCK SHARP & DOHME
30 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

MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE

P-RF/R

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

100g
100g
120g
120g
150g
150g
50g
50g

MERCK SHARP & DOHME

MAREA BRITANIE

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

MERCK SHARP & DOHME

MAREA BRITANIE

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

MERCK SHARP & DOHME

MAREA BRITANIE

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

MERCK SHARP & DOHME

MAREA BRITANIE

MERCK SHARP & DOHME

MAREA BRITANIE CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV.

180mcg/0,5ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

100mg

EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 1 FLAC. X 50 CAPS.

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT

CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC

PR
PR
PR
PR
PR
PR
PR
PR
P-RF/R

P-6L

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

60
30
30
20
50
20
20
140
168
168
56
56
30
28
30
30
30
1
1
1
5
1
5
1
1
1
1
1
1
1
1
1
1
1
1
1
50

0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
6,248214
6,248214
5,206845
10,544464
13,558214
2,836666
3,403999
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400

0,258000
0,441666
0,529999
0,222500
0,258000
0,215000
0,529999
6,248214
6,248214
5,206845
10,544464
13,558214
2,836666
3,403999
41,273333
57,113666
61,447000
110,870000
170,380000
127,437600
106,198000
195,360000
162,800000
87,430000
178,400000
390,310000
604,410000
674,210000
674,210000
794,880000
794,880000
975,890000
975,890000
370,000000
370,000000
781,040000
0,354400

0,078333
0,000000
0,032001
0,000000
0,111800
0,000000
0,157001
1,633857
1,549643
0,000000
0,000000
0,000000
0,000000
0,959572
0,000000
0,000000
0,000000
0,000000
0,000000
34,512400
0,000000
72,090000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

10
10
5
5
5
5

1,975000
3,345000
9,078000
4,936000
9,074000
4,936000

1,975000
3,345000
9,078000
4,936000
9,074000
4,936000

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

Tratamentul se iniiaz de ctre medicul in specialitatea gastroenterologie sau boli infectioase

8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10
1
2
3
4
5
6

A04AA01
A04AA01
A04AA01
A04AA01
A04AA01
A04AA01

ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**

OSETRON 4 mg
OSETRON 8 mg
OSETRON 8 mg SOLUTIE INJECTABILA
OSETRON 4 mg SOLUTIE INJECTABILA

EMESET 8 mg/4 ml
EMESET 4 mg/2 ml

COMPR. FILM.
COMPR. FILM.
SOL. INJ.
SOL. INJ.
SOL. INJ./PERF.
SOL. INJ./PERF.

4mg
8mg
2mg/ml
2mg/ml
2mg/ml
2mg/ml

DR. REDDY'S LABORATORIES


DR. REDDY'S LABORATORIES
DR. REDDY'S LABORATORIES
DR. REDDY'S LABORATORIES

CIPLA (UK) LIMITED


CIPLA (UK) LIMITED
Pagina 9 din 39

ROMANIA
ROMANIA
ROMANIA
ROMANIA

CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF


CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X 10 COMPR. FILM. P-RF

CUTIE X 1 BLIST. AL/PVC X 5 FIOLE X 4 ML SOL. INJ.

S/P-RF

CUTIE 1 BLIST. AL/PVC X 5 FIOLE X 2 ML SOL. INJ.

S/P-RF

MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 4ML SOL. INJ. / PERF.S/P-RF
MAREA BRITANIE CUTIE X 5 FIOLE STICLA + INEL RUPERE X 2ML SOL. INJ/ PERF. S/P-RF

7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55

COD ATC

A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA05
A04AA05
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
B03XA02
G03HA01

H02AB02
H02AB02
H02AB02
H02AB02

DCI

GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
PALONOSETRONUM**
PALONOSETRONUM**
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM BETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
EPOETINUM ZETA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
DARBEPOETINUM ALFA***
CYPROTERONUM**
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM

forma farm.
Denumire Comerciala
GRANISETRON ACTAVIS 1 mg COMPR. FILM.

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

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

SOL. INJ. IN SERINGA PREUMPLUTA

30000 UI/0,6ml ROCHE REGISTRATION LTD.

GRANISETRON TEVA 1mg/1ml CONC. PT. SOL. PERF./INJ.


GRANISETRON TEVA 3mg/3ml CONC. PT. SOL. PERF./INJ.
GRANISETRON KABI 1 mg/ml SOL. INJ.

RETACRIT 10000UI/1,0ml
RETACRIT 2000UI/0,6ml
RETACRIT 30000UI/0,75ml
RETACRIT 3000UI/0,9ml
RETACRIT 40000UI/1,0ml
RETACRIT 4000UI/0,4ml
RETACRIT 5000UI/0,5ml
RETACRIT 6000UI/0,6ml
RETACRIT 8000UI/0,8ml
ARANESP 100mcg/0,5ml
ARANESP 10mcg/0,4ml
ARANESP 150mcg/0,3ml
ARANESP 20mcg/0,5ml
ARANESP 300mcg/0,6ml
ARANESP 30mcg/0,3ml
ARANESP 40mcg/0,4ml
ARANESP 500mcg/ml
ARANESP 50mcg/0,5ml
ARANESP 60mcg/0,3ml
ARANESP 80mcg/0,4ml
ANDROCUR
DEXAMED
DEXAMETAZONA ROMPHARM 4 mg/ml
DEXAMETAZONA ROMPHARM 4 mg/ml
DEXAMETAZONA ROMPHARM 4 mg/ml

CAPS. MOI
SOL. INJ.
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA

ISLANDA
UNGARIA
ROMANIA

AMBALAJ

SOL. INJ. IN SERINGA PREUMPLUTA

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
GRANISETRON ACTAVIS 2 mg COMPR. FILM.
GRANORED 2 mg
COMPR. FILM.

NEORECORMON 10000UI/0,6ml
NEORECORMON 2000UI/0,3ml
NEORECORMON 30000UI/0,6ml
NEORECORMON 4000UI/0,3ml
NEORECORMON 5000UI/0,3ml

DETINATOR APP

1mg
ACTAVIS GROUP PTC EHF.
1mg
EGIS PHARMACEUTICALS P.L.C.
1mg
DR. REDDY'S LABORATORIES
1mg
ALVOGEN IPCO S.A.R.L
2mg
ACTAVIS GROUP PTC EHF.
2mg
DR. REDDY'S LABORATORIES
1mg/1ml
TEVA PHARMACEUTICALS S.R.L.
3mg/3ml
TEVA PHARMACEUTICALS S.R.L.
1mg/ml
FRESENIUS KABI ROMANIA SRL
500mcg
HELSINN BIREX PHARMACEUTICALS LTD.
250 mcg/5ml HELSINN BIREX PHARMACEUTICALS LTD.
1000UI/0,5ml SANDOZ GMBH
2000UI/1,0ml SANDOZ GMBH
30000UI/0,75ml SANDOZ GMBH
3000UI/0,3ml SANDOZ GMBH
40 000UI/ml JOHNSON & JOHNSON D.O.O.
40000 UI/1 ml SANDOZ GMBH
4000UI/0,4ml SANDOZ GMBH
5000UI/0,5ml SANDOZ GMBH

GRANEGIS 1 mg
GRANORED 1 mg
SETROGEN 1 mg

ALOXI 500mcg
ALOXI
BINOCRIT 1000UI/0,5ml
BINOCRIT 2000UI/1,0ml
BINOCRIT 30000UI/0,75ml
BINOCRIT 3000UI/0,3ml
EPREX 40000 UI/ml
BINOCRIT 40000 UI/1 ml
BINOCRIT 4000UI/0,4ml
BINOCRIT 5000UI/0,5ml

concentratie

Prescriptie

NR.CRT

TARA
DET. APP

S/P-RF/R

S/P-RF/R

S/P-RF/R

SLOVENIA

CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ.

S/P-RF

AUSTRIA
AUSTRIA
AUSTRIA

CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ.

P-RF/R

MAREA BRITANIE

SOL. INJ. IN SERINGA PREUMPLUTA

10000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE

SOL. INJ. IN SERINGA PREUMPLUTA


SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA

COMPR.
COMPR.
SOL. INJ.
SOL. INJ.
SOL. INJ.

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

ISLANDA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF


ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF./INJ. S
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3 ML CONC. PT. SOL. PERF./INJ. S
ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ. PR
IRLANDA CUTIE X BLISTER DIN POLIAMIDA/AL/PVC X 1 CAPSULA MOALE PRF
IRLANDA CUTIE X 1 FLAC. DIN STICLA X 5 ML SOL. INJ. P-RF
AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ.
AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ.
AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. P-RF/R
AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ.

SOL. INJ. IN SERINGA PREUMPLUTA

SOL. INJ. IN SERINGA PREUMPLUTA

CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF

LUXEMBURG CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. PRF

4000UI/0,3ml
5000UI/0,3ml

SOL. INJ. IN SERINGA PREUMPLUTA

CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF

CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML SOL. INJ. S/P-RF/R


CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ. S/P-RF/R

CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC

S/P-RF/R

ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE

S/P-RF/R

ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE

S/P-RF/R

PR
2000UI/0,6ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR
30000UI/0,75ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ. PR
3000UI/0,9ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,9ML SOL. INJ. PR
40000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR
4000UI/0,4ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,4ML SOL. INJ. PR
5000UI/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL. INJ. PR
6000UI/0,6ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR
8000UI/0,8ml HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA X 0,8ML SOL. INJ. PR
100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R
10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R
150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X 0,3 ML P-RF/R
20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R
300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R
30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R
40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R
500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML P-RF/R
50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML P-RF/R
60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,3 ML P-RF/R
80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,4 ML P-RF/R
50mg
BAYER PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF
0,5mg
CN UNIFARM S.A.
ROMANIA CUTIE CU 10 BLISTERE X 10 COMPRIMATE PRF
4mg/ml
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF
4mg/ml
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 25 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. PRF
4mg/ml
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ.
PRF
Pagina 10 din 39

CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ.

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

10
10
10
10
10
10
5
5
5
1
1
6
6
1
6
1
1
6
6
6
6
1
6
6
1
1
1
1
1
1
1
1
1
4
4
4
4
1
4
4
1
4
4
4
50
100
10
25
100

11,747000
12,136000
14,096400
14,096400
24,501000
28,198000
14,580000
33,974000
28,870000
288,130000
329,720000
21,785000
45,386666
488,460000
68,290000
912,804000
760,670000
87,998333
107,725000
280,040000
59,898333
999,550000
108,236666
154,340000
228,050000
51,940000
533,260000
73,980000
693,880000
98,650000
123,300000
140,320000
196,010000
647,495000
78,342500
962,400000
143,647500
1.960,260000

206,655000
269,612500
3.219,860000

321,740000
395,560000
521,557500
2,250800
0,190800
0,832000
0,816800
0,736400

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

11,747000
12,136000
14,096400
14,096400
24,501000
28,198000
14,580000
33,974000
28,870000
288,130000
329,720000
21,785000
45,386666
488,460000
68,290000
912,804000
760,670000
87,998333
107,725000
280,040000
59,898333
999,550000
108,236666
154,340000
228,050000
51,940000
533,260000
73,980000
693,880000
98,650000
123,300000
140,320000
196,010000
647,495000
78,342500
962,400000
143,647500
1.960,260000
206,655000
269,612500
3.219,860000
321,740000
395,560000
521,557500
2,250800
0,190800
0,832000
0,816800
0,736400

0,000000
0,000000
4,408600
3,092600
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
99,806000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

COD ATC

DCI

H02AB02

DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
POSACONAZOLUM**
POSACONAZOLUM**
CASPOFUNGINUM**
CASPOFUNGINUM**
ANAGRELIDUM***
ANAGRELIDUM***
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
MORPHYNUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM

H02AB02
H02AB02
H02AB02
H02AB02
H02AB02

J02AC02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC03
J02AC03
J02AC03
J02AC03
J02AC04
J02AC04
J02AX04
J02AX04
L01XX35
L01XX35
L04AD01
L04AD01
L04AD01
L04AD01
L04AD01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA05
N02AA05
N02AA05
N02AA05
N02AA05
N02AA05

100 N02AA05
101 N02AA05
102 N02AA05
103 N02AA05
104 N02AA05

Denumire Comerciala

forma farm.

SOL. INJ.
DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ.
DEXAMETAZONA ROMPHARM 4 mg/ml SOL. INJ.
DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ.
DEXAMETHASONE SODIUM PHOSPHATE SOL. INJ.
DEXAMED
SOL. INJ.
ORUNGAL
CAPS.
ITRACONAZOL 100 mg
CAPS.
OMICRAL 100 mg
CAPS.
MICOGAL 100 mg
CAPS.
ITRACONAZOL ARENA 100 mg CAPS.
OMICRAL 100 mg
CAPS.
VFEND 200mg
COMPR. FILM.
VFEND 50mg
COMPR. FILM.
VFEND 200mg
PULB. PT. SOL. PERF.
VFEND 40 mg/ml
PULB. PT. SUSP. ORALA
NOXAFIL 100mg
CAPS. GASTROREZ.
NOXAFIL 40mg/ml
SUSP. ORALA
CANCIDAS 50 mg
PULB. PT. CONC. PT. SOL. PERF.
CANCIDAS 70 mg
PULB. PT. CONC. PT. SOL. PERF.
THROMBOREDUCTIN
CAPS.
THROMBOREDUCTIN
CAPS.
EQUORAL 100 mg
CAPS. MOI
SANDIMMUN NEORAL (R)
CAPS. MOI
EQUORAL 25 mg
CAPS. MOI
SANDIMMUN NEORAL (R)
CAPS. MOI
EQUORAL 50 mg
CAPS. MOI
MST CONTINUS 100 mg
COMPR. ELIB. MODIF.
MST CONTINUS 10 mg
COMPR. ELIB. MODIF.
MST CONTINUS 200 mg
COMPR. ELIB. MODIF.
MST CONTINUS 30 mg
COMPR. ELIB. MODIF.
MST CONTINUS 60 mg
COMPR. ELIB. MODIF.
SEVREDOL 10 mg
COMPR. FILM.
SEVREDOL 20 mg
COMPR. FILM.
VENDAL (R) RETARD 100 mg COMPR. FILM. ELIB. PREL.
VENDAL (R) RETARD 30 mg COMPR. FILM. ELIB. PREL.
VENDAL (R) RETARD 60 mg COMPR. FILM. ELIB. PREL.
MORFINA ZENTIVA 20 mg/ml SOL. INJ.
OXYCONTIN 10 mg
COMPR. CU ELIB. MODIF.
OXYCONTIN 20 mg
COMPR. CU ELIB. MODIF.
OXYCONTIN 40 mg
COMPR. CU ELIB. MODIF.
OXYCONTIN 80 mg
COMPR. CU ELIB. MODIF.
RELTEBON 10 mg
COMPR. CU ELIB. PREL.
RELTEBON 20 mg
COMPR. CU ELIB. PREL.
DEXAMETAZONA ROMPHARM 4 mg/ml

CLORHIDRAT DE OXICODONA TORRENT 20 mg COMPR. CU ELIB. PREL.

RELTEBON 40 mg

COMPR. CU ELIB. PREL.

CLORHIDRAT DE OXICODONA TORRENT 40 mg COMPR. CU ELIB. PREL.

RELTEBON 80 mg

COMPR. CU ELIB. PREL.

CLORHIDRAT DE OXICODONA TORRENT 80 mg COMPR. CU ELIB. PREL.

concentratie

4mg/ml
4mg/ml
4mg/ml
8mg
8mg
8mg/2ml
100mg
100mg
100mg
100mg
100mg
100mg
200mg
50mg
200mg
40mg/ml
100mg
40mg/ml
50mg
70mg
0,5mg
0,5mg
100mg
25mg
25mg
50mg
50mg
100mg
10mg
200mg
30mg
60mg
10mg
20mg
100mg
30mg
60mg
20mg/ml
10 mg
20 mg
40 mg
80mg
10mg
20mg
20mg
40mg
40mg
80mg
80mg

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 25 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. PRF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.
PRF
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF
MEDOCHEMIE LTD. CIPRU
CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF
JANSSEN PHARMACEUTICA N.V. BELGIA
CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF
SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS.
P-RF
ROMPHARM COMPANY SRL ROMANIA CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF
PHARMASWISS CESKA REPUBLIKA S.R.O.
REPUBLICA CEHA CUTIE X 3 BLIST. AL/AL X 5 CAPS.
P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-RF
PFIZER LIMITED
MAREA BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML
P-RF
PFIZER LIMITED
MAREA BRITANIE
P-RF
MERCK SHARP & DOHME LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR
ROMPHARM COMPANY S.R.L.

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA PT. ADM. ORALA (5 ML) + 1 ADAPTOR

MERCK SHARP & DOHME

MAREA BRITANIE

CUTIE X 1 FLAC. X 105ML SUSP. ORALA

MERCK SHARP & DOHME

MAREA BRITANIE

CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF.

MERCK SHARP & DOHME

MAREA BRITANIE

CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF.

AUSTRIA CUTIE X 1 FLAC. DIN PE X 42 CAPS.


AUSTRIA CUTIE X 1 FLAC. DIN PE X 100 CAPS.
TEVA CZECH INDUSTRIES S.R.O. CEHIA
CUTIE X 5 BLIST. X 10 CAPS. MOI
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
TEVA CZECH INDUSTRIES S.R.O. CEHIA
CUTIE X 5 BLIST. X 10 CAPS. MOI
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
TEVA CZECH INDUSTRIES S.R.O. CEHIA
CUTIE X 5 BLIST. X 10 CAPS. MOI
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM.
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE X 1 ML
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
MUNDIPHARMA GES.M.B.H AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
ACTAVIS GROUP PTC EHF. ISLANDA
ACTAVIS GROUP PTC EHF. ISLANDA
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.
ACTAVIS GROUP PTC EHF. ISLANDA
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.
ACTAVIS GROUP PTC EHF. ISLANDA
TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.

P-RF/R

S
S

ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH

P-RF

ORPHA-DEVEL HANDELS UND VERTRIEBS GMBH

P-RF/S

Pagina 11 din 39

S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF

P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS
P-TS

PS
PS
PS
PS

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

CUTIE CU BLIST. CU INCHIDERE SECURIZATA PT. COPII DIN PVC/PVDC/AL/PET/HARTIE X 60 COMPR. ELIB. PREL.

PR, PS

PR, PS

PR, PS

PR, PS

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

10
25
100
100
5
10
15
15
15
15
15
15
28
28
1
1
24
1
1
1
42
100
50
50
50
50
50
60
60
60
60
60
60
60
30
30
30
5
60
60
60
60
60
60
60
60
60
60
60

1,387000
1,327200
1,246200
1,256100
1,380000
1,425000
2,573599
2,144666
2,144666
2,144666
2,144666
2,144666
132,002857
36,496071
512,920000
2.266,130000

147,492083
2.660,080000
1.396,750000
1.801,340000

16,829761
14,483900
6,232400
1,784400
1,487000
3,040560
2,533800
2,910799
0,626333
6,769666
0,925599
1,944000
0,751599
1,219500
2,425666
0,771333
1,620000
1,720000
0,815599
1,440199
2,331999
3,964399
0,679666
1,200166
1,200166
1,943333
1,943333
3,303666
3,304000

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

1,387000
1,327200
1,246200
1,256100
1,380000
1,425000
2,573599
2,144666
2,144666
2,144666
2,144666
2,144666
132,002857
36,496071
512,920000
2.266,130000
147,492083
2.660,080000
1.396,750000
1.801,340000
16,829761
14,483900
6,232400
1,784400
1,487000
3,040560
2,533800
2,910799
0,626333
6,769666
0,925599
1,944000
0,751599
1,219500
2,425666
0,771333
1,620000
1,720000
0,815599
1,440199
2,331999
3,964399
0,679666
1,200166
1,200166
1,943333
1,943333
3,303666
3,304000

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,620401
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,574000
0,000000
0,788040
0,000000
0,628367
0,000000
0,000000
0,184234
0,300333
0,114734
0,000000
0,000000
0,000000
0,000000
0,000000
0,230234
0,406134
0,503334
1,118434
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

DCI

OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
DIHYDROCODEINUM
DIHYDROCODEINUM
DIHYDROCODEINUM
PETHIDINUM
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM

106 N02AA05
107 N02AA05
108 N02AA05
109 N02AA05
110 N02AA05
111 N02AA05
112 N02AA08
113 N02AA08
114 N02AA08
115 N02AB02
116 N02AB03
117 N02AB03
118 N02AB03
119 N02AB03
120 N02AB03
121 N02AB03
122 N02AB03
123 N02AB03
124 N02AB03
125 N02AB03
126 N02AB03
127 N02AB03
128 N02AB03
129 N02AB03
130 N02AB03
131 N02AB03
132 N02AB03
133 N02AB03
134 N02AB03
135 N02AB03
136 N02AB03
137 N02AX02
138 N02AX02
139 N02AX02
140 N02AX02
141 N02AX02
142 N02AX02
143 N02AX02
144 N02AX02
145 N02AX02
146 N02AX02
147 N02AX02
148 N02AX02
149 N02AX02
150 N02AX02
151 N02AX02
152 N02AX02
153 N02AX02

Denumire Comerciala

forma farm.

OXIDOLOR 10 mg
OXIDOLOR 20 mg
OXIDOLOR 40 mg
OXICODONA SANDOZ 40 mg
OXICODONA SANDOZ 60 mg
OXIDOLOR 80 mg
OXICODONA SANDOZ 80 mg
DHC CONTINUS 120 mg
DHC CONTINUS 60 mg
DHC CONTINUS 90 mg
MIALGIN (R) 100 mg/2 ml
LUNALDIN 100 micrograme
LUNALDIN 200 micrograme
LUNALDIN 300 micrograme
LUNALDIN 400 micrograme
LUNALDIN 600 micrograme
LUNALDIN 800 micrograme

COMPR. ELIB. PREL.

FENTANYL TTS SANDOZ 100 mcg/h

PLASTURE TRANSDERMIC

FENTANYL ACTAVIS 100micrograme/h

PLASTURE TRANSDERMIC

100micrograme/h

ALGOGESIC 100 micrograme/ora

PLASTURE TRANSDERMIC

100micrograme/ora

DOLFORIN 100 g/ORA

PLASTURE TRANSDERMIC

FENTANYL TTS SANDOZ 25 mcg/h

PLASTURE TRANSDERMIC

100g/ora
25mcg/h

COMPR. ELIB. PREL.


COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.

SOL. INJ.

concentratie

10mg
20mg
40mg
40mg
60mg
80mg
80mg
120mg
60mg
90mg
50mg/ml

COMPR. SUBLING. 100micrograme


COMPR. SUBLING. 200micrograme
COMPR. SUBLING. 300micrograme
COMPR. SUBLING. 400micrograme
COMPR. SUBLING. 600micrograme
COMPR. SUBLING. 800micrograme

100mcg/h

FENTANYL ACTAVIS 25micrograme/h PLASTURE TRANSDERMIC 25micrograme/h

ALGOGESIC 25 micrograme/ora

PLASTURE TRANSDERMIC

25micrograme/ora

DOLFORIN 25 g/ORA

PLASTURE TRANSDERMIC

FENTANYL TTS SANDOZ 50 mcg/h

PLASTURE TRANSDERMIC

25g/ora
50mcg/h

FENTANYL ACTAVIS 50micrograme/h PLASTURE TRANSDERMIC 50micrograme/h

ALGOGESIC 50 micrograme/ora

PLASTURE TRANSDERMIC

50micrograme/ora

DOLFORIN 50 g/ORA

PLASTURE TRANSDERMIC

FENTANYL TTS SANDOZ 75 mcg/h

PLASTURE TRANSDERMIC

50g/ora
75mcg/h

ALGOGESIC 75 micrograme/ora

PLASTURE TRANSDERMIC

75micrograme/ora

DOLFORIN 75 g/ORA
TRAMADOL
K-ALMA (R)
TRAMADOL ARENA
TRAMACALM
TRAMADOL ZENTIVA 50 mg
TRAMAG 50
TRAMADOL EEL
TRAMADOL RETARD 100 mg

PLASTURE TRANSDERMIC

75g/ora
50mg
50mg
50mg
50mg
50mg
50mg
50mg
100mg
100mg
100mg
100mg
100mg
100mg
150mg
150mg
150mg
150mg

CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR.
COMPR.
COMPR. ELIB. PREL.

TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL.

MABRON RETARD 100 mg


MABRON RETARD 100 mg
MABRON RETARD 100 mg
MABRON RETARD 100 mg
TRADOLAN RETARD 150 mg

COMPR. ELIB. PREL.


COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.

TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL.

MABRON RETARD 150 mg


MABRON RETARD 150 mg

COMPR. ELIB. PREL.


COMPR. ELIB. PREL.

DETINATOR APP

AUSTRIA
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
SANDOZ S.R.L.
ROMANIA
SANDOZ S.R.L.
ROMANIA
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
SANDOZ S.R.L.
ROMANIA
MUNDIPHARMA GES.M.B.H AUSTRIA
MUNDIPHARMA GES.M.B.H AUSTRIA
MUNDIPHARMA GES.M.B.H AUSTRIA
ZENTIVA SA
ROMANIA
GEDEON RICHTER PLC. UNGARIA
GEDEON RICHTER PLC. UNGARIA
GEDEON RICHTER PLC. UNGARIA
GEDEON RICHTER PLC. UNGARIA
GEDEON RICHTER PLC. UNGARIA
GEDEON RICHTER PLC. UNGARIA
SANDOZ S.R.L.
ROMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
ZENTIVA K.S.
REPUBLICA CEHA
GEDEON RICHTER ROMANIA SA ROMANIA
SANDOZ S.R.L.
ROMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
ZENTIVA K.S.
REPUBLICA CEHA
GEDEON RICHTER ROMANIA SA ROMANIA
SANDOZ S.R.L.
ROMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
ZENTIVA K.S.
REPUBLICA CEHA
GEDEON RICHTER ROMANIA SA ROMANIA
SANDOZ S.R.L.
ROMANIA
ZENTIVA K.S.
REPUBLICA CEHA
GEDEON RICHTER ROMANIA SA ROMANIA
KRKA D.D.
SLOVENIA
ANTIBIOTICE SA
ROMANIA
ARENA GROUP S.A. ROMANIA
A.C. HELCOR PHARMA S.R.L. ROMANIA
ZENTIVA A.S.
SLOVACIA
MAGISTRA C & C
ROMANIA
BIO EEL SRL
ROMANIA
LANNACHER HEILMITTEL GES.M.B.H.

AMBALAJ

Prescriptie

COD ATC

105 N02AA05

NR.CRT

TARA
DET. APP

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

P-TS

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

P-TS

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

P-TS

CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.

PS
PS

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

P-TS

CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.

CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL.

PS
PS
PS
PS

CUTIE X 5 FIOLE DIN STICLA X 2 ML

P-TS

CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.

CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL.


CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL.

CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE

PRF

CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE

PRF

CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE

PRF

CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE

PRF

CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE

PRF

CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE

PRF

CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS

CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC

PS
PS

CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC

P-TS

CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC

CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS

CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC

PS
PS

CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC

P-TS

CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC

CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS

CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC

PS
PS

CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC

P-TS

CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC

CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC P-TS


CUTIE CU 5 PLICURI COMPOZITE ALCATUITE DIN PET-ADEZIV-AL-SURLYN X 1 PLASTURE TRANSDERMIC

PS

CUTIE X 5 PLICURI DIN PES-AL-PP X 1 PLASTURE TRANSDERMIC

P-TS

CUTIE X 2 BLIST. AL/PVC X 10 CAPS.


CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
CUTIE X 2 BLIST. AL/PVC X 10 CAPS.

P-RF

CUTIE CU 1 BLIST. PVC/AL X 10 CAPS.

P-RF

CUTIE X 2 BLIST. AL/PVC X 10 CAPS.

P-RF

CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-RF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL.

PRF

ZENTIVA AS
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.

SLOVACIA

CIPRU
CIPRU
CIPRU
CIPRU
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
ZENTIVA AS
SLOVACIA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU
Pagina 12 din 39

P-RF
P-RF

P-RF

CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF


CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF


CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

60
60
60
20
20
60
20
56
56
56
5
10
10
10
10
10
10
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
20
20
20
10
20
20
20
30
30
10
30
10
30
30
30
10
30

0,679666
1,200166
1,943333
2,046000
7,230000
3,303666
3,546500
2,159107
0,543750
1,462142
1,942000
29,404000
27,380000
27,968000
27,968000
27,968000
27,968000
31,884000
26,570000
31,884000
31,884000
10,538400
8,782000
10,538400
10,538400
16,424000
15,444000
18,532800
18,532800
30,532000
32,076000
32,076000
0,299500
0,341400
0,341400
0,341400
0,284500
0,341400
0,341400
0,632400
0,630333
0,527000
0,528000
0,527000
0,528000
0,949599
0,904333
0,792000
0,791333

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,679666
1,200166
1,943333
2,046000
7,230000
3,303666
3,546500
2,159107
0,543750
1,462142
1,942000
29,404000
27,380000
27,968000
27,968000
27,968000
27,968000
31,884000
26,570000
31,884000
31,884000
10,538400
8,782000
10,538400
10,538400
16,424000
15,444000
18,532800
18,532800
30,532000
32,076000
32,076000
0,299500
0,341400
0,341400
0,341400
0,284500
0,341400
0,341400
0,632400
0,630333
0,527000
0,528000
0,527000
0,528000
0,949599
0,904333
0,792000
0,791333

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
2,056000
0,000000
7,800000
7,800000
1,231600
0,000000
1,813600
3,653600
0,000000
0,000000
4,927200
6,529200
0,000000
0,000000
0,000000
0,000000
0,057100
0,125600
0,043600
0,000000
0,057100
0,042100
0,021266
0,000000
0,000000
0,000000
0,000000
0,000000
0,168401
0,000000
0,000000
0,000000

DCI

COD ATC

154 N02AX02
155 N02AX02
156 N02AX02
157 N02AX02
158 N02AX02
159 N02AX02
160 N02AX02
161 N02AX02
162 N02AX02
163 N02AX02
164 N02AX02
165 N02AX02
166 N02AX02
167 N02AX02
168 N02AX02
169 N02AX02
170 N02AX02
171 N07BC02
172 N07BC02
173 R05DA04
174 R05DA04
175 R05DA04
176 R05DA04
177 R05DA04
178 R05DA04
179 V03AC01
180 V03AC03
181 V03AC03
182 V03AC03

TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
METHADONUM
METHADONUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
DEFEROXAMINUM**3)
DEFERASIROXUM***
DEFERASIROXUM***
DEFERASIROXUM***

Denumire Comerciala

forma farm.

MABRON RETARD 150 mg


MABRON RETARD 150 mg
TRADOLAN RETARD 200 mg
MABRON RETARD 200 mg
MABRON RETARD 200 mg
MABRON RETARD 200 mg
MABRON RETARD 200 mg
TRADOLAN 50 mg
TRAMADOL RETARD 150 mg
TRAMADOL RETARD 200 mg
TRAMADOL ZENTIVA 50 mg
TRAMADOL ZENTIVA 50 mg
MABRON
MABRON
TRAMADOL
TRAMADOL
TRAMADOL
SINTALGON 2,5 mg
METADON BIOEEL 5 mg
FOSFAT DE CODEINA 15 mg
CODEINA FOSFORICA
FARMACOD
CODEINA FOSFAT
CODEINA FOSFAT LPH 15 mg

COMPR. ELIB. PREL.


COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.

COMPR. FILM.
COMPR. FILM. ELIB. PREL.
COMPR. FILM. ELIB. PREL.
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE

SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SUPOZ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
CODEINA FOSFAT MCC 15 mg COMPR.
DESFERAL
PULB. PT. SOL. INJ./PERF.
EXJADE 125mg
COMPR. DISP.
EXJADE 250mg
COMPR. DISP.
EXJADE 500mg
COMPR. DISP.

concentratie

DETINATOR APP

AMBALAJ

150mg
150mg
200mg
200mg
200mg
200mg
200mg
50mg
150mg
200mg
50mg
50mg
100mg
100mg
50mg/ml
50mg/ml
100mg
2,5mg
5mg
15mg
15mg
15mg
15mg
15mg
15mg
500mg
125mg
250mg
500mg

MEDOCHEMIE LTD. CIPRU


MEDOCHEMIE LTD. CIPRU
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA

100 mg
100mg
100mg
100 mg/ml
100mg
250mg/5ml
200mg
200mg
200mg
200mg
200mg
200mg
200mg
200mg
400mg

ZENTIVA SA
ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR.
SC ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 10 COMPR.

Prescriptie

NR.CRT

TARA
DET. APP

CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

CUTIE CU 3 BLISTERE DIN PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF

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

KRKA D.D. NOVO MESTO SLOVENIA

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.

P-RF

KRKA D.D. NOVO MESTO SLOVENIA

CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL.

P-RF

REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE

PRF

ZENTIVA, A.S.
ZENTIVA, A.S.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
KRKA D.D.
KRKA D.D.
KRKA D.D.
ZENTIVA S.A.
BIO EEL SRL
SINTOFARM SA
BIO EEL SRL
FARMACOM SA
SLAVIA PHARM SRL

REPUBLICA SLOVACA

CIPRU
CIPRU

CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE

PRF

CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF

CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF

SLOVENIA CUTIE X 5 FIOLE X 1 ML


SLOVENIA CUTIE X 5 FIOLE X 2 ML
SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ.
ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR.

S/P-RF
S/P-RF

P-RF

P-TS

ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
LABORMED PHARMA SA ROMANIA
MAGISTRA C & C SRL ROMANIA

CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR. P-TS

NOVARTIS PHARMA GMBH GERMANIA

CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF.


S/P-RF

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL)

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL)

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL)

CUTIE X 3 BLIST. AL/PVC X 10 COMPR.


CUTIE X 1 BLIST. AL/PVC X 25 COMPR.

P-RF

CUTIE X 2 BLIST. X 10 COMPR.

P-RF

CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


CUTIE X 1 BLIST. AL/PVC X 20 COMPR.
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

P-RF

P-RF

P-RF
P-RF

PR
PR
PR

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

10
30
30
10
30
10
30
30
30
30
10
10
5
100
5
5
5
50
50
30
25
20
20
20
20
10
28
28
28

0,792000
0,791333
1,170666
1,055000
1,055333
1,055000
1,055333
0,330333
0,949599
1,266000
0,341400
0,341400
1,675320
1,396100
1,024000
1,675320
1,158000
0,506400
0,326000
0,181200
0,181200
0,151000
0,173500
0,165500
0,181200
13,266000
27,555357
52,592500
95,897142

0,792000
0,791333
1,170666
1,055000
1,055333
1,055000
1,055333
0,330333
0,949599
1,266000
0,341400
0,341400
1,675320
1,396100
1,024000
1,675320
1,158000
0,506400
0,326000
0,181200
0,181200
0,151000
0,173500
0,165500
0,181200
13,266000
27,555357
52,592500
95,897142

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,335734
0,430000
0,056600
0,056600
0,200680
0,000000
0,000000
1,042680
0,000000
0,000000
0,000000
0,019133
0,024000
0,000000
0,000000
0,000000
0,008300
0,000000
0,000000
0,000000
0,000000

25
10
30
5
20
5
50
60
50
50
50
20
20
20
50

0,142800
0,119000
0,142800
2,274000
0,144000
14,054000
0,168000
0,141833
0,141800
0,141800
0,141800
0,140000
0,142000
0,142000
0,392200

0,142800
0,119000
0,142800
2,274000
0,144000
14,054000
0,168000
0,141833
0,141800
0,141800
0,141800
0,140000
0,142000
0,142000
0,392200

0,039600
0,000000
0,044200
0,000000
0,000000
0,000000
0,050200
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

Tratamentul se iniiaz de ctre medicul n specialitatea oncologie sau hematologie.


9. EPILEPSIE - G11
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

N03AA02
N03AA02
N03AA02
N03AA02
N03AB02
N03AB02
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01

PHENOBARBITALUM
PHENOBARBITALUM
PHENOBARBITALUM
PHENOBARBITALUM
PHENYTOINUM
PHENYTOINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM

FENOBARBITAL ZENTIVA 100 mg COMPR.


FENOBARBITAL ARENA 100mg COMPR.
FENOBARBITAL ARENA 100mg COMPR.

SOL. INJ.
FENITOINA RICHTER 100 mg COMPR.
PHENHYDAN 250 mg/5 ml
SOL. INJ.
TEGRETOL (R) 200
COMPR.
CARBAMAZEPINA LPH (R) 200 mg COMPR.
CARBAMAZEPINA LPH 200 mg COMPR.
CARBAVIM
COMPR.
CARBEPSIL 200mg
COMPR.
CARBAMAZEPIN
COMPR.
CARBAMAZEPIN EEL
COMPR.
CARBAMAZEPINA ARENA 200 mg COMPR.
CARBEPSIL 400mg
COMPR.
FENOBARBITAL ZENTIVA 100 mg/ml

P-RF
P-RF

ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLISTERE DIN PVC/AL A CTE 10 COMPRIMATE P-RF
ZENTIVA S.A
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
DESITIN ARZNEIMITTEL GMBH

GERMANIA

CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 5 ML SOL. INJ.

P-RF

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L

LABORMED PHARMA SA ROMANIA

CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE

P-6L/S

LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR.

P-6L

VIM SPECTRUM SRL ROMANIA


AC HELCOR PHARMA SRL ROMANIA
SLAVIA PHARM SRL ROMANIA
BIO EEL SRL
ROMANIA
ARENA GROUP SA ROMANIA
AC HELCOR PHARMA SRL ROMANIA

Pagina 13 din 39

CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L

CUTIE X 5 BLIST. X 10 COMPR.

P-6L

CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L


CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L

CUTIE X 5 BLIST. X 10 COMPR.

P-6L

16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64

COD ATC

N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF02
N03AF02
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01

N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11

DCI

CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
OXCARBAZEPINUM
OXCARBAZEPINUM
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**

Denumire Comerciala

CARBAMAZEPINA ARENA 400 mg

TIMONIL RETARD 150 mg


TIMONIL RETARD 300 mg
TIMONIL RETARD 600 mg
NEUROTOP (R) RETARD 300 mg
NEUROTOP (R) RETARD 600 mg

TEGRETOL CR 200
TEGRETOL CR 400
TIMONIL SIROP
TRILEPTAL (R) 300 mg
TRILEPTAL (R) 600 mg
ORFIRIL LONG 150 mg
CONVULEX (R) 150 mg
CONVULEX 150 mg
CONVULEX (R) 300 mg
CONVULEX 300 mg
CONVULEX (R) 500 mg
CONVULEX 500 mg
DEPAKINE CHRONO 300 mg
DEPAKINE (R) CHRONO 500 mg

DEPAKINE 200 mg
ORFIRIL LONG 1000 mg
DEPAKINE
DEPAKINE
LAMOTRIX 100 mg
PLEXXO (R) 100 mg
LAMICTAL 100 mg
LAMOTRIX 200 mg
LAMICTAL 25 mg
LAMOTRIX 50 mg
LAMOTRIN 100 mg
LAMOTRIN 50 mg
LAMICTAL 2 mg
LAMICTAL 5 mg
TOPRAN 100 mg
TOPIRAMAT TEVA 100 mg
TOPIRAMAT ACTAVIS 100 mg
LUSITRAX 100mg
TORLEPTA 100 mg
NEXTOP 100 mg
TOPAMAX 100 mg
TOPILEX 100 mg
TOPIRAMAT TEVA 200 mg
NEXTOP 200 mg
TOPRAN 25 mg
TOPIRAMAT TEVA 25 mg
TOPIRAMAT ACTAVIS 25 mg
LUSITRAX 25 mg
TORLEPTA 25 mg

forma farm.

COMPR.

concentratie

400mg
COMPR. CU ELIB. PRELUNGITA 150mg
COMPR. CU ELIBERARE PRELUNGITA 300mg
COMPR. CU ELIBERARE PRELUNGITA 600mg
COMPR. ELIB. PREL. 300mg
COMPR. ELIB. PREL. 600mg
COMPR. FILM. ELIB. PREL. 200mg
COMPR. FILM. ELIB. PREL. 400mg
SUSP. ORALA
100mg/5ml
COMPR. FILM.
300mg
COMPR. FILM.
600mg
CAPS. ELIB. PREL. 150mg
CAPS. MOI GASTROREZ. 150mg
CAPS. MOI GASTROREZ. 150mg
CAPS. MOI GASTROREZ. 300mg
CAPS. MOI GASTROREZ. 300mg
CAPS. MOI GASTROREZ. 500mg
CAPS. MOI GASTROREZ. 500mg
COMPR. ELIB. PREL. 300mg
COMPR. ELIB. PREL. 500mg
COMPR. GASTROREZ. 200mg
MINICOMPR. ELIB. PREL. 1000mg
SIROP
57,64mg/ml
SIROP
57,64mg/ml
COMPR.
100mg
COMPR.
100mg
COMPR.
100mg
COMPR.
200mg
COMPR.
25mg
COMPR.
50mg
COMPR. DISP.
100mg
COMPR. DISP.
50mg
COMPR. DISP./MAST. 2mg
COMPR. DISP./MAST. 5mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
100mg
COMPR. FILM.
200mg
COMPR. FILM.
200mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg
COMPR. FILM.
25mg

DETINATOR APP

AMBALAJ

ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.


DESITIN ARZNEIMITTEL GMBH
DESITIN ARZNEIMITTEL GMBH
DESITIN ARZNEIMITTEL GMBH

Prescriptie

NR.CRT

TARA
DET. APP

P-6L

P6L
GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L
GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L
GERMANIA

AUSTRIA
AUSTRIA

CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA

CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL

P-6L

CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL.

P-6L

NOVARTIS PHARMA GMBH GERMANIA

CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL.

P-6L

NOVARTIS PHARMA GMBH GERMANIA

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

P-6L

GERMANIA

CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE

P-6L

GEROT PHARMAZEUTIKA GMBH


GEROT PHARMAZEUTIKA GMBH

DESITIN ARZNEIMITTEL GMBH

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.

P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.

P-6L

DESITIN ARZNEIMITTEL GMBH

GERMANIA

GEROT PHARMAZEUTIKA GMBH

SANOFI-AVENTIS FRANCE

AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
FRANTA
FRANTA
FRANTA

DESITIN ARZNEIMITTEL GMBH

GERMANIA

GEROT PHARMAZEUTIKA GES.M.B.H.

GEROT PHARMAZEUTIKA GMBH


GEROT PHARMAZEUTIKA GES.M.B.H.

GEROT PHARMAZEUTIKA GMBH


GEROT PHARMAZEUTIKA GES.M.B.H.

SANOFI-AVENTIS FRANCE
SANOFI-AVENTIS FRANCE

CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L

CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ.

P-6L

CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ.

P6L

CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ.

P-6L

CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ.

P6L

CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ.

P-6L

CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L

CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL.

P-6L

CUTIE X 1 FLAC. PP X 30 COMPR. FILM. ELIB. PREL.

P-RF

CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L


CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG.

P-6L

FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA


SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE
MEDOCHEMIE LTD. CIPRU
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR.

P-6L

CUTIE CU BLIST. PVC/AL X 28 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE CU BLIST. PVC/AL X 28 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

SANOFI - AVENTIS FRANCE

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE

MEDOCHEMIE LTD. CIPRU


THE WELLCOME FOUNDATION LTD. MAREA BRITANIE

MEDOCHEMIE LTD. CIPRU


ACTAVIS GROUP HF. ISLANDA
ACTAVIS GROUP HF. ISLANDA

P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L


CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST.

P-6L

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST.

P-6L

TERAPIA SA

ROMASTRU TRADING S.R.L.

ROMANIA
ROMANIA
ROMANIA
ROMANIA

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

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

P-RF

TORRENT PHARMA S.R.L.

ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

JOHNSON & JOHNSON D.O.O.

SLOVENIA

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


CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.

P6L
P6L

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

ROMASTRU TRADING S.R.L.

AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

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

TEVA PHARMACEUTICALS S.R.L.

ACTAVIS S.R.L.

LANNACHER HEILMITTEL GES.M.B.H.

TEVA PHARMACEUTICALS S.R.L.

TORRENT PHARMA S.R.L.

TERAPIA SA
TEVA PHARMACEUTICALS S.R.L.

ACTAVIS S.R.L.

Pagina 14 din 39

CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L


CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.

P-RF

CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF


CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF

CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L


CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.

P-RF

CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF


CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF

P-RF

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

20
50
50
50
50
50
50
30
1
50
50
50
100
100
100
100
100
100
100
30
40
50
1
1
30
30
28
30
28
30
30
30
30
30
60
30
60
30
30
30
28
30
30
30
60
30
60
30
30

0,392000
0,303800
0,412600
0,731600
0,356000
0,686000
0,168000
0,470400
23,360000
0,887000
1,372200
0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000
18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,632400
0,632400
0,632400
0,632400
0,632400
0,527000
0,632400
0,632400
2,972333
3,566799
0,242799
0,242799
0,242799
0,242799
0,242799

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,392000
0,303800
0,412600
0,731600
0,356000
0,686000
0,168000
0,470400
23,360000
0,887000
1,372200
0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000
18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,632400
0,632400
0,632400
0,632400
0,632400
0,527000
0,632400
0,632400
2,972333
3,566799
0,242799
0,242799
0,242799
0,242799
0,242799

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,179400
0,133600
0,000000
0,000000
0,000000
0,127840
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,067700
0,103240
0,000000
0,000000
0,000000
0,000000
0,028066
0,000000
0,501757
0,000000
0,000000
0,086667
0,000000
0,000000
0,000000
0,000000
0,350266
0,345933
0,347433
0,382933
0,382933
0,000000
0,879385
0,381933
0,000000
1,601534
0,147534
0,133534
0,147367
0,148201
0,147534

65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

COD ATC

N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12
N03AX12

100 N03AX12
101 N03AX14
102 N03AX14
103 N03AX14
104 N03AX14
105 N03AX14
106 N03AX14
107 N03AX14
108 N03AX14
109 N03AX14
110 N03AX14
111 N03AX14
112 N03AX14
113 N03AX14

DCI

TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**

Denumire Comerciala

NEXTOP 25 mg
TOPAMAX 25 mg
TOPILEX 25 mg
TOPRAN 50 mg
TOPIRAMAT TEVA 50 mg
TOPIRAMAT ACTAVIS 50 mg
LUSITRAX 50 mg
TORLEPTA 50 mg
NEXTOP 50 mg
TOPAMAX 50 mg
TOPILEX 50 mg
GABAPENTIN AUROBINDO 100 mg

GABAGAMMA 100 mg
GRIMODIN 100 mg
GABAPENTINA PFIZER 100 mg
GABAPENTINA PFIZER 100 mg

GABAPENTIN ARENA 100 mg


GABAPENTIN AUROBINDO 300 mg

GABAGAMMA 300 mg
GABARAN 300 mg
GABALEPT 300 mg
GRIMODIN 300 mg
GABAPENTINA PFIZER 300 mg
GABAPENTINA PFIZER 300 mg

GABAPENTIN ARENA 300 mg


GABAPENTIN AUROBINDO 400 mg

GABAGAMMA 400 mg
GABARAN 400 mg
GABALEPT 400 mg
GRIMODIN 400 mg
GABAPENTINA PFIZER 400 mg
GABAPENTINA PFIZER 400 mg

GABAPENTIN ARENA 400 mg


GABARAN 600 mg
GRIMODIN 600 mg
GABARAN 800 mg
LEVETIRACETAM TORRENT 1000 mg

LEVETIRACETAM TERAPIA 1000 mg

KEPPRA 1000 mg
LEVETIRACETAM ACTAVIS 1000mg

LEVETIRACETAM TEVA 1000mg

TRUND 1000 mg
EPILETAM 1000 mg
LEVETIRACETAM AUROBINDO 1000 mg

MYAKELL 1000 mg
NORMEG 1000 mg
LEVELANZ 1000 mg
LEVELANZ 1000 mg
LEVETIRACETAM TEVA 250 mg

forma farm.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.

concentratie

25mg
25mg
25mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
100 mg
100mg
100mg
100mg
100mg
100mg
300 mg
300mg
300mg
300mg
300mg
300mg
300mg
300mg
400 mg
400mg
400mg
400mg
400mg
400mg
400mg
400mg
600mg
600mg
800mg
1000 mg
1000 mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
250 mg

Prescriptie

NR.CRT

DETINATOR APP

TARA
DET. APP

TORRENT PHARMA S.R.L.

ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

JOHNSON & JOHNSON D.O.O.

SLOVENIA

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


CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.

P6L
P6L

AMBALAJ

ROMASTRU TRADING S.R.L.

AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

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

P-RF

TORRENT PHARMA S.R.L.

ROMANIA

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.

P-6L

JOHNSON & JOHNSON D.O.O.

SLOVENIA

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

P6L

LANNACHER HEILMITTEL GES.M.B.H.

AUSTRIA

CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.

P6L

AUROBINDO PHARMA LIMITED

MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS.

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L

LANNACHER HEILMITTEL GES.M.B.H.

TERAPIA SA
TEVA PHARMACEUTICALS S.R.L.

ACTAVIS S.R.L.

CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM. P-6L


CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.

CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM. P-RF

EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

PFIZER EUROPE MA EEIG

MAREA BRITANIE

P6L
P-6L

CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L


CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L

ARENA GROUP S.A. ROMANIA

CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS.

AUROBINDO PHARMA LIMITED

CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS.

MAREA BRITANIE

P-RF

CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-RF

P6L
P6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L

RANBAXY UK LTD.

MAREA BRITANIE

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS.

P-6L

PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L


EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L

ARENA GROUP S.A. ROMANIA

CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS.

AUROBINDO PHARMA LIMITED

CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS.

MAREA BRITANIE

P-6L

CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L

P6L
P6L

WORWAG PHARMA GMBH & CO. KG

GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L

RANBAXY UK LTD.

MAREA BRITANIE

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS.

P-6L

PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L


EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

PFIZER EUROPE MA EEIG

MAREA BRITANIE

ARENA GROUP S.A. ROMANIA


RANBAXY UK LTD. MAREA BRITANIE
EGIS PHARMACEUTICALS P.L.C.
UNGARIA
RANBAXY UK LTD. MAREA BRITANIE
TORRENT PHARMA S.R.L. ROMANIA
TERAPIA S.A.
ROMANIA
UCB PHARMA SA
BELGIA
ACTAVIS GROUP PTC EHF. ISLANDA
TEVA PHARMA
OLANDA

P-6L

CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L


CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L
CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS.

P6L

CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L


CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L
CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMP.FILM. PRF

CUTIE X 30 COMPR. FILM.1 (BLIST. AL/PVC)

P-RF

CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF


CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF
CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM.

PRF

UNGARIA
AUROBINDO PHARMA (MALTA) LIMITED MALTA
ROMASTRU TRADING SRL ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA

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

PRF

CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.

PRF

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

PRF

CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM.

PRF

ABBOTT LABORATORIES LTD.

MAREA BRITANIE

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

PRF

ABBOTT LABORATORIES LTD.

MAREA BRITANIE

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

TEVA PHARMA

OLANDA

CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

EGIS PHARMACEUTICALS P.L.C.

Pagina 15 din 39

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

30
28
30
60
30
60
30
30
30
28
30
50
100
60
50
100
60
50
100
50
100
60
50
100
60
50
100
50
100
60
50
100
60
30
60
30
30
30
30
30
30
60
30
30
30
30
28
28
30

0,202333
0,242799
0,242799
0,413599
0,413599
0,413599
0,413599
0,413599
0,344666
0,413599
0,413599
0,149200
0,179040
0,179040
0,179040
0,179040
0,179040
0,447800
0,519600
0,519600
0,519600
0,519600
0,447400
0,433000
0,519600
0,597600
0,692520
0,692520
0,692520
0,692520
0,596200
0,577100
0,692520
2,180000
1,867833
3,605000
1,878799
1,878799
1,878799
1,864000
1,878799
1,784333
1,878799
1,878799
1,878799
1,565666
1,878799
1,878799
0,472666

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,202333
0,242799
0,242799
0,413599
0,413599
0,413599
0,413599
0,413599
0,344666
0,413599
0,413599
0,149200
0,179040
0,179040
0,179040
0,179040
0,179040
0,447800
0,519600
0,519600
0,519600
0,519600
0,447400
0,433000
0,519600
0,597600
0,692520
0,692520
0,692520
0,692520
0,596200
0,577100
0,692520
2,180000
1,867833
3,605000
1,878799
1,878799
1,878799
1,864000
1,878799
1,784333
1,878799
1,878799
1,878799
1,565666
1,878799
1,878799
0,472666

0,000000
0,358272
0,146867
0,229067
0,226734
0,212401
0,250401
0,233067
0,000000
0,608186
0,233401
0,000000
0,015060
0,397460
0,288760
0,273660
0,228293
0,000000
0,236500
0,827000
0,836700
0,055900
0,000000
0,000000
0,377733
0,000000
0,500580
0,816480
1,062580
0,336813
0,000000
0,000000
0,429146
0,000000
0,000000
0,000000
1,285867
1,635201
3,247534
0,000000
0,050201
0,000000
1,635201
1,502534
1,635201
0,000000
1,634772
1,634772
0,000000

COD ATC

114 N03AX14
115 N03AX14
116 N03AX14
117 N03AX14
118 N03AX14
119 N03AX14
120 N03AX14
121 N03AX14
122 N03AX14
123 N03AX14
124 N03AX14
125 N03AX14
126 N03AX14
127 N03AX14
128 N03AX14
129 N03AX14
130 N03AX14
131 N03AX14
132 N03AX14
133 N03AX14
134 N03AX14
135 N03AX14
136 N03AX14
137 N03AX14
138 N03AX14
139 N03AX14
140 N03AX14
141 N03AX14
142 N03AX14
143 N03AX14
144 N03AX14
145 N03AX14
146 N03AX16
147 N03AX16
148 N03AX16
149 N03AX16
150 N03AX16
151 N03AX16
152 N03AX17
153 N03AX17
154 N03AX17
155 N03AX17

DCI

LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
STIRIPENTOLUM**
STIRIPENTOLUM**
STIRIPENTOLUM**
STIRIPENTOLUM**

Denumire Comerciala

forma farm.

COMPR. FILM.
LEVETIRACETAM TERAPIA 250 mg COMPR. FILM.
KEPPRA 250 mg
COMPR. FILM.
LEVETIRACETAM ACTAVIS 250mg COMPR. FILM.
TRUND 250 mg
COMPR. FILM.
EPILETAM 250 mg
COMPR. FILM.
LEVETIRACETAM AUROBINDO 250 mg COMPR. FILM.
MYAKELL 250 mg
COMPR. FILM.
LEVELANZ 250 mg
COMPR. FILM.
LEVELANZ 250 mg
COMPR. FILM.
LEVETIRACETAM TORRENT 500 mg COMPR. FILM.
LEVETIRACETAM TERAPIA 500 mg COMPR. FILM.
KEPPRA 500 mg
COMPR. FILM.
LEVETIRACETAM ACTAVIS 500mg COMPR. FILM.
LEVETIRACETAM TEVA 500 mg COMPR. FILM.
TRUND 500 mg
COMPR. FILM.
EPILETAM 500 mg
COMPR. FILM.
LEVETIRACETAM AUROBINDO 500 mg COMPR. FILM.
MYAKELL 500 mg
COMPR. FILM.
NORMEG 500 mg
COMPR. FILM.
LEVELANZ 500 mg
COMPR. FILM.
LEVELANZ 500 mg
COMPR. FILM.
LEVETIRACETAM TORRENT 750 mg COMPR. FILM.
MYAKELL 750 mg
COMPR. FILM.
LEVETIRACETAM TORRENT 250 mg

LEVETIRACETAM DESITIN 1000 mg

GRANULE ACOPERITE, IN PLIC UNIDOZA

LEVETIRACETAM DESITIN 250 mg

GRANULE ACOPERITE, IN PLIC UNIDOZA

LEVETIRACETAM DESITIN 500 mg

GRANULE ACOPERITE, IN PLIC UNIDOZA

LEVETIRACETAM DESITIN 750 mg

GRANULE ACOPERITE, IN PLIC UNIDOZA

LEVETIRACETAM ACTAVIS GROUP 100mg/ml

KEPPRA 100 mg/ml


TRUND 100 mg/ml
LEVETIRACETAM RATIOPHARM 100mg/ml

LYRICA 150 mg
LYRICA 150 mg
LYRICA 300 mg
LYRICA 300 mg
LYRICA 75 mg
LYRICA 75 mg
DIACOMIT 250mg
DIACOMIT 500mg
DIACOMIT 250mg
DIACOMIT 500mg

SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
PULB. PT. SUSP. ORALA
PULB. PT. SUSP. ORALA

concentratie

250 mg
250 mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
500 mg
500 mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
750 mg
750mg
1000mg
250mg
500mg
750mg
100 mg/ml
100mg/ml
100mg/ml
100mg/ml
150mg
150mg
300mg
300mg
75mg
75mg
250mg
500mg
250mg
500mg

DETINATOR APP

Prescriptie

NR.CRT

TARA
DET. APP

AMBALAJ

ACTAVIS GROUP PTC EHF.

ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF


ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF
BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF
ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

TORRENT PHARMA S.R.L.

TERAPIA S.A.
UCB PHARMA SA

CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM.

PRF

UNGARIA
AUROBINDO PHARMA (MALTA) LIMITED MALTA
ROMASTRU TRADING SRL ROMANIA

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

PRF

CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM.

PRF

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

PRF

ABBOTT LABORATORIES LTD.

MAREA BRITANIE

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

PRF

ABBOTT LABORATORIES LTD.

MAREA BRITANIE

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

TORRENT PHARMA S.R.L.

P-RF

TEVA PHARMA

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


ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM.
BELGIA CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC)
ISLANDA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM.
OLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM.

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM.

PRF

UNGARIA
AUROBINDO PHARMA (MALTA) LIMITED MALTA
ROMASTRU TRADING SRL ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA

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

PRF

CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM.

PRF

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

PRF

CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM.

PRF

ABBOTT LABORATORIES LTD.

MAREA BRITANIE

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

PRF

ABBOTT LABORATORIES LTD.

MAREA BRITANIE

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

TORRENT PHARMA S.R.L.

ROMANIA
ROMANIA

CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.

PRF

ROMASTRU TRADING SRL

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

PRF

DESITIN ARZNEIMITTEL GMBH

GERMANIA

CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE

PRF

DESITIN ARZNEIMITTEL GMBH

GERMANIA

CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE

PRF

DESITIN ARZNEIMITTEL GMBH

GERMANIA

CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE

PRF

DESITIN ARZNEIMITTEL GMBH

GERMANIA

CUTIE CU 60 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE

PRF

ACTAVIS GROUP PTC EHF.

UCB PHARMA SA

ISLANDA
BELGIA

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

RATIOPHARM GMBH
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
BIOCODEX
BIOCODEX
BIOCODEX
BIOCODEX

GERMANIA

EGIS PHARMACEUTICALS P.L.C.

TERAPIA S.A.
UCB PHARMA SA
ACTAVIS GROUP PTC EHF.

EGIS PHARMACEUTICALS P.L.C.

Tratamentul se iniiaz de ctre medicul n specialitatea neurologie i neurologie pediatric.

10. BOALA PARKINSON - G12

Pagina 16 din 39

MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE

FRANTA
FRANTA
FRANTA
FRANTA

PRF
PRF
PRF
PRF

PRF

CUTIE X 1 FLACON DIN STICLA BRUNA A 300ML PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + 1 SERINGA PENTRU ADMINISTRARE ORALA A 10ML

CUTIE X 1 FLACON X 300 ML SOL. ORALA + SERINGA PT. ADMIN. ORALA

P-RF

CUTIE X 1 FLACON DIN STICLA BRUNA X 300ML SOLUTIE ORALA, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII DIN PP + O SERINGA DOZATAOARE (PP, PE) DE 10ML SI UN ADAPTOR PT. SERINGA PE

CUTIE CU UN FLACON DIN STICLA BRUNA A 300 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII + O SERINGA PENTRU ADMINISTRARE ORALA GRADATA A 10ML

CUTIE X 14 CAPS., (BLIST. PVC/AL)


CUTIE X 56 CAPS., (BLIST. PVC/AL)
CUTIE X 56 CAPS. (BLIST. PVC/AL)
CUTIE X 14 CAPS. (BLIST. PVC/AL)
CUTIE X 14 CAPS., (BLIST. PVC/AL)
CUTIE X 56 CAPS., (BLIST. PVC/AL)
CUTIE X 1 FLAC. DIN PP X 60 CAPS.
CUTIE X 1 FLAC. DIN PP X 60 CAPS.
CUTIE X 60 PLICURI HARTIE/AL/PE
CUTIE X 60 PLICURI HARTIE/AL/PE

PRF
PRF

P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF/R
P-RF/R
P-RF/R
P-RF/R

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

30
30
30
30
60
30
30
30
28
28
30
30
30
30
30
60
30
30
30
30
28
28
30
30
30
30
30
60
1
1
1
1
14
56
56
14
14
56
60
60
60
60

0,525999
0,525999
0,525999
0,477666
0,438333
0,525999
0,525999
0,525999
0,525999
0,525999
0,673599
0,673599
0,673599
0,645000
0,561333
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
2,362000
2,834400
1,878799
0,525999
0,673599
2,834400
61,270000
73,524000
61,270000
61,270000
4,380714
3,896250
5,731785
6,045000
2,632857
2,413928
12,749333
25,643166
12,749333
25,643166

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,525999
0,525999
0,525999
0,477666
0,438333
0,525999
0,525999
0,525999
0,525999
0,525999
0,673599
0,673599
0,673599
0,645000
0,561333
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
0,673599
2,362000
2,834400
1,878799
0,525999
0,673599
2,834400
61,270000
73,524000
61,270000
61,270000
4,380714
3,896250
5,731785
6,045000
2,632857
2,413928
12,749333
25,643166
12,749333
25,643166

0,204001
0,430334
0,897667
0,000000
0,000000
0,430334
0,224334
0,430334
0,425429
0,425429
0,660067
1,076067
1,882401
0,000000
0,000000
0,228067
1,076067
0,709067
1,076067
0,135401
1,075686
1,075686
0,000000
0,423600
1,635201
0,362667
1,076067
0,042766
0,000000
15,986000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49

COD ATC

N04AA01
N04BA02
N04BA02
N04BA02
N04BA02

DCI

Denumire Comerciala

TRIHEXYPHENIDYLUM

ROMPARKIN (R) 2 mg
COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR HBS
COMBINATII (LEVODOPUM+BENSERAZIDUM)** MADOPAR 200mg/50mg
COMBINATII (LEVODOPUM+CARBIDOPUM)** ISICOM 250 mg/25 mg
COMBINATII (LEVODOPUM+CARBIDOPUM)** DUODOPA

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***

STALEVO 100 mg/25 mg/200 mg

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***

STALEVO 125 mg/31,25 mg/200 mg

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***

STALEVO 150 mg/37,5 mg/200 mg


STALEVO 200 mg/50 mg/200 mg
STALEVO 50 mg/12,5 mg/200 mg

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***

STALEVO 75 mg/18,75 mg/200 mg

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***

N04BB01
N04BC01
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05

AMANTADINUM**
BROMOCRIPTINUM
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**

VIREGYT (R)- K
BROCRIPTIN (N04BC01)
ROPINIROL TEVA 2 mg
REQUIP-MODUTAB 2 mg
ROPINIROL TEVA 4 mg
REQUIP-MODUTAB 4 mg
ROPINIROL TEVA 8 mg
REQUIP-MODUTAB 8 mg
ROLPRYNA EP 2 mg
ROLPRYNA EP 4 mg
ROLPRYNA EP 8 mg
ROPINIROL AUROBINDO 2 mg

ROPINIROL ACTAVIS 2 mg
ROPINIROL AUROBINDO 4 mg

ROPINIROL ACTAVIS 4 mg
ROPINIROL AUROBINDO 8 mg

ROPINIROL ACTAVIS 8 mg
OPRYMEA 0,088mg
PRAMIPEXOL ZENTIVA 0,18 mg

OPRYMEA 0,18mg
MEDOPEXOL 0,18 mg
GLEPARK 0,18 mg
PRAMIPEXOL TORRENT 0,18 mg
PRAMIPEXOL AUROBINDO 0,18 mg

MIGLASEN 0,18 mg
PRAMIPEXOL AUROBINDO 0,7 mg

PRAMIPEXOL ZENTIVA 0,7 mg

OPRYMEA 0,7mg
MEDOPEXOL 0,7 mg
GLEPARK 0,7 mg
PRAMIPEXOL TORRENT 0,7 mg

PRAMIPEXOL STADA 0,7 mg


MIGLASEN 0,7 mg
MIRAPEXIN 0,26 mg
OPRYMEA 0,26mg
CALMOLAN 0,26 mg
MIRAPEXIN 0,52 mg
OPRYMEA 0,52mg

forma farm.

COMPR.

concentratie

2mg

DETINATOR APP

TERAPIA SA

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L


CAPS. ELIB. MODIF. 100mg+25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 CAPS. CU ELIB. MODIF. P-6L
COMPR.
200mg+50mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L
COMPR.
250mg/25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 10 BLIST. PP/AL X 10 COMPR. P-6L
GEL INT.
FARA CONCENTRATIE ABBVIE DEUTSCHLAND GMBH & CO. KG GERMANIA CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC S/P-RF
COMPR. FILM.
100mg/25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
125mg/31,25mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF
COMPR. FILM.
150mg/37,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
200mg/50mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
50mg/12,5mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM. P-RF
COMPR. FILM.
75mg/18,75mg/200mg ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF
CAPS.
100mg
EGIS PHARMACEUTICALS P.L.C.
UNGARIA CUTIE X 1 FLAC. X 50 CAPS.
P-6L
DRAJ.
2,5mg
BIOFARM SA
ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF
COMPR. CU ELIB. PREL. 2mg
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF
COMPR. CU ELIB. PREL. 2mg
SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF
COMPR. CU ELIB. PREL. 4mg
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF
COMPR. CU ELIB. PREL. 4mg
SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF
COMPR. CU ELIB. PREL. 8mg
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF
COMPR. CU ELIB. PREL. 8mg
SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL. P-RF
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
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
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
COMPR. ELIB. PREL. 2 mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF
COMPR. ELIB. PREL. 2mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL.
PRF
COMPR. ELIB. PREL. 4 mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF
COMPR. ELIB. PREL. 4mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL.
PRF
COMPR. ELIB. PREL. 8 mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL. PRF
COMPR. ELIB. PREL. 8mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL.
PRF
COMPR.
0,088mg
KRKA D.D.
SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
COMPR.
0,18 mg
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF
COMPR.
0,18mg
KRKA D.D.
SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
COMPR.
0,18mg
MEDOCHEMIE LTD. CIPRU
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
COMPR.
0,18mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF
COMPR.
0,18mg
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF
COMPR.
0,18mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF
COMPR.
0,18mg
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L
COMPR.
0,7 mg
AUROBINDO PHARMA (MALTA) LIMITED MALTA
CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF
COMPR.
0,7 mg
ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF
COMPR.
0,7mg
KRKA D.D.
SLOVENIA CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
COMPR.
0,7mg
MEDOCHEMIE LTD. CIPRU
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
COMPR.
0,7mg
GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF
COMPR.
0,7mg
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF
COMPR.
0,7mg
STADA ARZNEIMITTEL AG GERMANIA CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR. P-RF
COMPR.
0,7mg
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L
COMPR. ELIB. PREL. 0,26mg
BOEHRINGER INGELHEIM INTERNATIONAL GMBH
GERMANIA CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
COMPR. ELIB. PREL. 0,26mg
KRKA D.D.
SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF
COMPR. ELIB. PREL. 0,26mg
G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF
COMPR. ELIB. PREL. 0,52mg
BOEHRINGER INGELHEIM INTERNATIONAL GMBH
GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
COMPR. ELIB. PREL. 0,52mg
KRKA D.D.
SLOVENIA CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA P-RF

Pagina 17 din 39

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

50
0,562400
100
0,588700
30
0,786333
100
0,773600
7 452,308571
100
2,742400
100
2,742400
100
2,847700
100
3,069200
100
2,532700
100
2,840600
50
0,354400
40
0,549000
30
0,916333
28
1,099285
30
1,773000
28
2,127428
30
3,044666
28
3,653570
28
0,916071
28
1,772857
28
3,044642
28
0,916071
28
0,916071
28
1,772857
28
1,772857
28
3,044642
28
3,044642
30
0,530000
30
0,386666
30
0,387199
30
0,387199
30
0,322666
30
0,387199
30
0,387199
30
0,387199
30
1,889333
30
2,109000
30
2,028000
30
2,034333
30
2,256666
30
2,267199
30
2,027333
30
2,267199
10
0,763200
30
0,636000
10
0,636000
30
1,679599
30
1,399666

0,562400
0,588700
0,786333
0,773600
452,308571
2,742400
2,742400
2,847700
3,069200
2,532700
2,840600
0,354400
0,549000
0,916333
1,099285
1,773000
2,127428
3,044666
3,653570
0,916071
1,772857
3,044642
0,916071
0,916071
1,772857
1,772857
3,044642
3,044642
0,530000
0,386666
0,387199
0,387199
0,322666
0,387199
0,387199
0,387199
1,889333
2,109000
2,028000
2,034333
2,256666
2,267199
2,027333
2,267199
0,763200
0,636000
0,636000
1,679599
1,399666

0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,265000
0,000000
0,462929
0,000000
0,869287
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,039467
0,264134
0,000000
0,203467
0,136134
0,126801
0,000000
0,000000
0,000000
0,000000
0,000000
0,170801
0,000000
0,180467
0,755800
0,000000
0,000000
0,473734
0,000000

50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71

COD ATC
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC09
N04BC09
N04BC09
N04BC09
N04BD01
N04BD01
N04BD02

N04BX02
N04BX02
N04BX02
N04BX02
N04BX02
N05AH02
N05AH02

DCI

PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
ROTIGOTINUM***
ROTIGOTINUM***
ROTIGOTINUM***
ROTIGOTINUM***
SELEGILINUM
SELEGILINUM
RASAGILINUM***
ENTACAPONUM***
ENTACAPONUM***
ENTACAPONUM***
ENTACAPONUM***
ENTACAPONUM***
CLOZAPINUM**
CLOZAPINUM**

Denumire Comerciala

CALMOLAN 0,52 mg
MIRAPEXIN 1,05 mg
OPRYMEA 1,05mg
OPRYMEA 1,57mg
OPRYMEA 2,10mg
MIRAPEXIN 2,1 mg
CALMOLAN 2,1 mg
MIRAPEXIN 3,15 mg
NEUPRO 2mg/24h
NEUPRO 4mg/24h
NEUPRO 6mg/24h
NEUPRO 8mg/24h
SELEGOS
SELEGOS
AZILECT 1mg
COMTAN 200mg
ENTACAPONE TEVA
ENCAPIA 200 mg
ENCAPIA 200 mg
ENCAPIA 200 mg
LEPONEX (R) 100 mg
LEPONEX (R) 25 mg

forma farm.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
PLASTURE TRANSDERMIC
PLASTURE TRANSDERMIC
PLASTURE TRANSDERMIC
PLASTURE TRANSDERMIC

COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.

concentratie

0,52mg
1,05mg
1,05mg
1,57mg
2,10mg
2,1mg
2,1mg
3,15mg
2mg/24h
4mg/24h
6mg/24h
8mg/24h
5mg
5mg
1mg
200mg
200mg
200mg
200mg
200mg
100mg
25mg

DETINATOR APP

G.L. PHARMA GMBH AUSTRIA

Prescriptie

NR.CRT

TARA
DET. APP

AMBALAJ
CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL.

PRF

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.

P-RF

KRKA D.D.
KRKA D.D.
KRKA D.D.

SLOVENIA
SLOVENIA
SLOVENIA

CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

P-RF

CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

P-RF

CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

P-RF

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.

G.L. PHARMA GMBH AUSTRIA


BOEHRINGER INGELHEIM INTERNATIONAL GMBH

P-RF

CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL.

PRF

GERMANIA CUTIE CU 3 BLIST.OPA-AL-PVC/AL X 10 COMPR.

P-RF

IRLANDA
IRLANDA
UCB MANUFACTURING IRELAND LTD. IRLANDA
UCB MANUFACTURING IRELAND LTD. IRLANDA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU
UCB MANUFACTURING IRELAND LTD.
UCB MANUFACTURING IRELAND LTD.

CUTIE X 28 PLASTURI TRANSDERMICI


CUTIE X 28 PLASTURI TRANSDERMICI
CUTIE X 28 PLASTURI TRANSDERMICI
CUTIE X 28 PLASTURI TRANSDERMICI

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

CUTIE X 5 BLIST. DIN AL/PVC X 10 COMPR. P-6L


CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L

TEVA PHARMA GMBH GERMANIA CUTIE X 30 COMPR.(BLIST. AL/AL)

P-RF

NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 100 COMPR. FILM.

P-RF

TEVA PHARMA B.V.


MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.

OLANDA
CIPRU
CIPRU
CIPRU

CUTIE X 1 FLAC. DIN PEID X 100 COMPR. FILM PRF


CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. PRF
CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PRF
CUTIE CU BLIST. PVC-PVDC/AL X 100 COMPR. FILM.

CUTIE X 5 BLIST. X 10 COMPR.


GERMANIA CUTIE X 5 BLIST. X 10 COMPR.

PRF

NOVARTIS PHARMA GMBH GERMANIA

P-RF

NOVARTIS PHARMA GMBH

P-RF

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

1,399666
2,550000
2,125000
5,049333
4,722333
5,666799
4,722333
11,950000
7,975714
11,431428
14,614285
17,376071
0,725200
0,701100
14,349333
1,922280
1,601900
1,779000
1,689166
1,601900
1,274200
0,386200

1,399666
2,550000
2,125000
5,049333
4,722333
5,666799
4,722333
11,950000
7,975714
11,431428
14,614285
17,376071
0,725200
0,701100
14,349333
1,922280
1,601900
1,779000
1,689166
1,601900
1,274200
0,386200

0,000000
1,552000
0,000000
0,000000
0,000000
1,598201
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,542220
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

20
0,108399
30
0,090333
30
0,108399
20
0,108399
10
2,989000
30
0,747666
1 374,090000
1 82,990000
1 61,880000
1 118,008000
1 46,730000
1 79,700000
1 98,340000
1 56,076000
1 110,680000
100
0,702300
100
0,702300
100
0,788900
20
0,712000
20
0,618500

0,108399
0,090333
0,108399
0,108399
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
0,702300
0,702300
0,788900
0,712000
0,618500

0,028601
0,000000
0,015267
0,025101
0,000000
0,000000
0,000000
0,000000
0,000000
9,082000
0,000000
0,000000
0,000000
13,944000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

30
30
30
30
30
30
30
30
28
28
28
28
50
100
30
100
100
30
60
100
50
50

Tratamentul se initiaza de catre medicul in specialitatea neurologie

11. MIASTENIA GRAVIS - G13


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

H02AB07
H02AB07
H02AB07
H02AB07

L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L04AX01
L04AX01
L04AX01
N07AA01
N07AA02

PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
NEOSTIGMINI BROMIDUM
PYRIDOSTIGMINI BROMIDUM

PREDNISON MCC 5 mg
PREDNISON ARENA 5 mg
PREDNISON 5 mg
PREDNISON - RICHTER 5 mg
METHOTREXATE PCH 10mg
METHOTREXATE PCH 2,5mg

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.

METHOTREXAT "EBEWE" 5000 mg

CONC. PT. SOL. INJ./PERF.

METHOTREXAT "EBEWE" 1000 mg

CONC. PT. SOL. INJ./PERF.

METOTREXAT EBEWE 10 mg/ml


METOTREXAT EBEWE 10 mg/ml
METOTREXAT EBEWE 10 mg/ml
METOTREXAT EBEWE 10 mg/ml

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
IMURAN
IMURAN
IMMUNOPRIN 75 mg
NEOSTIGMINA LPH 15 mg
MESTINON 60 mg

SOL. INJ. IN SERINGA PREUMPLUTA


SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA
SOL. INJ. IN SERINGA PREUMPLUTA

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
DRAJ.

5mg
5mg
5mg
5mg
10mg
2,5mg
100mg/ml
100mg/ml
10mg/ml
10mg/ml
10mg/ml
10mg/ml
50mg/ml
50mg/ml
50mg/ml
50mg
50mg
75mg
15mg
60mg

MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
SINTOFARM SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR.

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

EBEWE PHARMA GES.M.B.H. NFG KG

ROMANIA CUTIE X 10COMPR.


P6L
ROMANIA CUTIE X30 COMPRIMATE
P6L
AUSTRIA CUTIE X 1 FLACON X 50 ML
S
AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S
AUSTRIA
PR
AUSTRIA
PR
AUSTRIA
PR
AUSTRIA
PR

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE

GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE

GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE

GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

TEVA PHARMACEUTICALS S.R.L.


TEVA PHARMACEUTICALS S.R.L.
EBEWE PHARMA GES.M.B.H. NFG KG
EBEWE PHARMA GES.M.B.H. NFG KG
EBEWE PHARMA GES.M.B.H. NFG KG
EBEWE PHARMA GES.M.B.H. NFG KG
EBEWE PHARMA GES.M.B.H. NFG KG

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

P-RF
P-RF

ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

P-RF

S/P-RF

IRLANDA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF


AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PR
LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L
MEDA AB
SUEDIA CUTIE X 1 FLAC. X 20 DRAJ.
S/P-RF

ASPEN PHARMA TRADING LIMITED


EBEWE PHARMA GES.M.B.H. NFG KG

Pagina 18 din 39

COD ATC

DCI

Denumire Comerciala

forma farm.

concentratie

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR.

P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF

PFIZER EUROPE MA EEIG

MAREA BRITANIE

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,543200
1,234000
20,480000
8,810000
31,020000
0,108399
0,090333
0,108399
0,108399
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
555,760000
0,702300
0,702300
0,788900

0,543200
1,234000
20,480000
8,810000
31,020000
0,108399
0,090333
0,108399
0,108399
2,989000
0,747666
374,090000
82,990000
61,880000
118,008000
46,730000
79,700000
98,340000
56,076000
110,680000
555,760000
0,702300
0,702300
0,788900

0,000000
0,000000
0,000000
0,000000
0,000000
0,028601
0,000000
0,015267
0,025101
0,000000
0,000000
0,000000
0,000000
0,000000
9,082000
0,000000
0,000000
0,000000
13,944000
0,000000
0,000000
0,000000
0,000000
0,000000

0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000

0,227760
0,189800
0,189800
0,234500
0,234500
0,304800
0,304800
0,281400
0,365760
0,277250
1,924200
18,430000

0,127840
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,067700
0,103240
0,000000
0,000000
0,000000

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

Tratamentul se initiaza de catre medicul in specialitatea neurologie

12. SCLEROZA MULTIPLA - G14


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

H02AB04
H02AB04
H02AB04
H02AB04
H02AB04
H02AB07
H02AB07
H02AB07
H02AB07

L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01DB07

L04AX01
L04AX01
L04AX01

METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
MITOXANTRONUM***
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM

MEDROL A 16
MEDROL 32
SOLU - MEDROL ACT-O-VIAL
LEMOD SOLU 125 mg
LEMOD SOLU 500 mg
PREDNISON MCC 5 mg
PREDNISON ARENA 5 mg
PREDNISON 5 mg
PREDNISON - RICHTER 5 mg
METHOTREXATE PCH 10mg
METHOTREXATE PCH 2,5mg
METHOTREXAT "EBEWE" 5000 mg
METHOTREXAT "EBEWE" 1000 mg

METOTREXAT EBEWE 10 mg/ml


METOTREXAT EBEWE 10 mg/ml
METOTREXAT EBEWE 10 mg/ml
METOTREXAT EBEWE 10 mg/ml

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
ONKOTRONE
IMURAN
IMURAN
IMMUNOPRIN 75 mg

COMPR.
COMPR.

16mg
32mg
LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml
PULB+SOLV. PT. SOL. INJ./PERF. 125mg
PULB+SOLV. PT. SOL. INJ./PERF. 500mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
10mg
COMPR.
2,5mg
CONC. PT. SOL. INJ./PERF. 100mg/ml
CONC. PT. SOL. INJ./PERF. 100mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml
CONC. PT. SOL. INJ. 2mg/ml
COMPR. FILM.
50mg
COMPR. FILM.
50mg
COMPR. FILM.
75mg

ROMANIA
STADA HEMOFARM S.R.L. ROMANIA
MAGISTRA C&C S.R.L. ROMANIA
ARENA GROUP SA ROMANIA
SINTOFARM SA
ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA
EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA
EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA
EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA
EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA
EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA
STADA HEMOFARM S.R.L.

CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV

P-RF

CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML

S/P-RF

CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML

S/P-RF

CUTIE X 2 BLIST. AL/PVC X 10 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLIST. AL./PVC X 10 COMPR.

P-RF

CUTIE X 10COMPR.
CUTIE X30 COMPRIMATE
CUTIE X 1 FLACON X 50 ML

P6L
P6L

CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML


CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

P-RF
P-RF
P-RF

S
S
PR
PR
PR
PR

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE

GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE

GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE

GERMANIA

CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF
P-RF
P-RF

BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ.

ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

S/P-RF

ASPEN PHARMA TRADING LIMITED


EBEWE PHARMA GES.M.B.H. NFG KG

IRLANDA
AUSTRIA

CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

S/P-RF

CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.

PR

50
20
1
1
1
20
30
30
20
10
30
1
1
1
1
1
1
1
1
1
1
100
100
100

Tratamentul se iniiaz de ctre medicul din specialitatea neurologie.

13. BOLI PSIHICE (SCHIZOFRENIE, TULBURARI SCHIZOTIPALE SI DELIRANTE, TULBURARI AFECTIVE MAJORE, TULBURARI PSIHOTICE ACUTE SI BOLI PSIHICE COPII, AUTISM) - G15
1
2
3
4
5
6
7
8
9
10
11
12

N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01

ACIDUM VALPROICUM + SARURI


ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI
ACIDUM VALPROICUM + SARURI

ORFIRIL LONG 150 mg


CAPS. ELIB. PREL.
CONVULEX (R) 150 mg
CAPS. MOI GASTROREZ.
CONVULEX 150 mg
CAPS. MOI GASTROREZ.
CONVULEX (R) 300 mg
CAPS. MOI GASTROREZ.
CONVULEX 300 mg
CAPS. MOI GASTROREZ.
CONVULEX (R) 500 mg
CAPS. MOI GASTROREZ.
CONVULEX 500 mg
CAPS. MOI GASTROREZ.
DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL.
DEPAKINE (R) CHRONO 500 mg COMPR. ELIB. PREL.

DEPAKINE 200 mg
ORFIRIL LONG 1000 mg
DEPAKINE

COMPR. GASTROREZ.
MINICOMPR. ELIB. PREL.

SIROP

150mg
150mg
150mg
300mg
300mg
500mg
500mg
300mg
500mg
200mg
1000mg
57,64mg/ml

DESITIN ARZNEIMITTEL GMBH

GERMANIA

GEROT PHARMAZEUTIKA GMBH

CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG. P-6L

SANOFI-AVENTIS FRANCE

AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
FRANTA
FRANTA
FRANTA

DESITIN ARZNEIMITTEL GMBH

GERMANIA

CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG.

P-6L

SANOFI - AVENTIS FRANCE

FRANTA

CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA

P-6L

GEROT PHARMAZEUTIKA GES.M.B.H.

GEROT PHARMAZEUTIKA GMBH


GEROT PHARMAZEUTIKA GES.M.B.H.

GEROT PHARMAZEUTIKA GMBH


GEROT PHARMAZEUTIKA GES.M.B.H.

SANOFI-AVENTIS FRANCE
SANOFI-AVENTIS FRANCE

Pagina 19 din 39

CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ.

P-6L

CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ.

P6L

CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ.

P-6L

CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ.

P6L

CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ.

P-6L

CUTIE CU 10 BLIST. PVDC-PVC/AL X 10 CAPS. MOI GASTROREZ. P6L

CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL.

P-6L

CUTIE X 1 FLAC. PP X 30 COMPR. FILM. ELIB. PREL.

P-RF

CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L

50
100
100
100
100
100
100
100
30
40
50
1

13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61

COD ATC
N03AG01

N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N04AA01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01

N05AE03
N05AE03
N05AE04
N05AE04
N05AE04
N05AE04
N05AE04
N05AE04
N05AF01
N05AF05
N05AF05
N05AF05
N05AF05
N05AF05
N05AH02
N05AH02
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03

DCI

ACIDUM VALPROICUM + SARURI


LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
TRIHEXYPHENIDYLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
SERTINDOL**
SERTINDOL**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
ZIPRASIDONUM**
FLUPENTIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
CLOZAPINUM**
CLOZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**

Denumire Comerciala

DEPAKINE
LAMOTRIX 100 mg
PLEXXO (R) 100 mg
LAMICTAL 100 mg
LAMOTRIX 200 mg
LAMICTAL 25 mg
LAMOTRIX 50 mg
LAMOTRIN 100 mg
LAMOTRIN 50 mg
LAMICTAL 2 mg
LAMICTAL 5 mg
ROMPARKIN (R) 2 mg

forma farm.

SIROP
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. DISP.
COMPR. DISP.

concentratie

57,64mg/ml
100mg
100mg
100mg
200mg
25mg
50mg
100mg
50mg
COMPR. DISP./MAST. 2mg
COMPR. DISP./MAST. 5mg
COMPR.
2mg
HALOPERIDOL LAROPHARM 0,5 mg COMPR.
0,5mg
HALOPERIDOL ARENA 1 mg COMPR.
1mg
HALOPERIDOL ARENA 2 mg COMPR.
2mg
HALDOL
COMPR.
5mg
HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml
HALOPERIDOL 2 mg/ml
PIC. ORALE-SOL. 2mg/ml
HALOPERIDOL DECANOAT SOL. INJ.
50mg/ml
HALOPERIDOL RICHTER 5 mg/ml SOL. INJ.
5mg/ml
SERDOLECT 16 mg
COMPR. FILM.
16mg
SERDOLECT 4 mg
COMPR. FILM.
4mg
ZIXADOX 40 mg
CAPS.
40mg
ZYPSILA 40 mg
CAPS.
40mg
ZIXADOX 60 mg
CAPS.
60mg
ZYPSILA 60 mg
CAPS.
60mg
ZIXADOX 80 mg
CAPS.
80mg
ZYPSILA 80 mg
CAPS.
80mg
FLUANXOL DEPOT
SOL. INJ.
20mg/ml
CLOPIXOL 10 mg
COMPR. FILM.
10mg
CLOPIXOL 25 mg
COMPR. FILM.
25mg
CLOPIXOL 20 mg/ml
PIC. ORALE-SOL. 20mg/ml
CLOPIXOL (R) DEPOT
SOL. INJ.
200mg/ml
CLOPIXOL ACUPHASE (R)
SOL. INJ.
50mg/ml
LEPONEX (R) 100 mg
COMPR.
100mg
LEPONEX (R) 25 mg
COMPR.
25mg
ZALASTA 10mg
COMPR.
10mg
OLAZAX 10 mg
COMPR.
10mg
ZALASTA 5mg
COMPR.
5mg
OLAZAX 5 mg
COMPR.
5mg
ZYPREXA 10 mg
COMPR. FILM.
10mg
LAPOZAN 10 mg
COMPR. FILM.
10mg
LAPOZAN 10 mg
COMPR. FILM.
10mg
OLANZAPINA ACTAVIS 10 mg COMPR. FILM.
10mg
BLOONIS 10 mg
COMPR. FILM.
10mg
OLANZAPINA DR. REDDY'S 10 mg COMPR. FILM.
10mg
LAPOZAN 15 mg
COMPR. FILM.
15mg
EGOLANZA 15 mg
COMPR. FILM.
15mg
EGOLANZA 20 mg
COMPR. FILM.
20mg

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE


MEDOCHEMIE LTD. CIPRU
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR.

P-6L

CUTIE CU BLIST. PVC/AL X 28 COMPR.


CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
CUTIE CU BLIST. PVC/AL X 28 COMPR.
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

P-6L

SANOFI - AVENTIS FRANCE

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE

MEDOCHEMIE LTD. CIPRU


THE WELLCOME FOUNDATION LTD. MAREA BRITANIE

MEDOCHEMIE LTD. CIPRU


ACTAVIS GROUP HF. ISLANDA
ACTAVIS GROUP HF. ISLANDA

P-6L
P-6L
P-6L
P-6L
P-6L

CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L


CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST.

P-6L

THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST.

P-6L

TERAPIA SA
LAROPHARM S.R.L.
ARENA GROUP S.A.
ARENA GROUP S.A.

ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L


ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF
ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF
JANSSEN PHARMACEUTICA N.V. BELGIA
CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML
P-RF
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
P-RF
H. LUNDBECK A/S
DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF
H. LUNDBECK A/S
DANEMARCA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.

ZENTIVA K.S.

REPUBLICA CEHA

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.

ZENTIVA K.S.

REPUBLICA CEHA

P-RF

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


P-RF

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

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.

P-RF

H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S

DANEMARCA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.

P-RF

DANEMARCA

CUTIE X 1 FLAC. DIN PEJD X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDER

P-RF

DANEMARCA

CUTIE X 1 FLAC. DIN PEJD X 50 COMPR. FILM., INCHIS CU CAPAC CU FILET, PREVAZUT CU SISTEM DE INCHIDER

P-RF

DANEMARCA CUTIE X 1 FLAC. + CAPAC SECURIZAT PT. COPII X 20 ML

P-RF

CUTIE X 10 FIOLE X 1 ML
DANEMARCA CUTIE X 5 FIOLE X 1 ML
GERMANIA CUTIE X 5 BLIST. X 10 COMPR.
GERMANIA CUTIE X 5 BLIST. X 10 COMPR.

P-RF

NOVARTIS PHARMA GMBH


NOVARTIS PHARMA GMBH

DANEMARCA

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)


GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. AL/AL X 28 COMPR.

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)


GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

OLANDA
MEDOCHEMIE LTD. CIPRU
MEDOCHEMIE LTD. CIPRU
ACTAVIS GROUP PTC EHF. ISLANDA
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA
DR. REDDY'S LABORATORIES ROMANIA
MEDOCHEMIE LTD. CIPRU
EGIS PHARMACEUTICALS P.L.C.
UNGARIA
EGIS PHARMACEUTICALS P.L.C.
UNGARIA
ELI LILLY NEDERLAND BV

Pagina 20 din 39

CUTIE CU BLIST. AL/AL X 28 COMPR.

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

CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE) P-RF

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

P-RF

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

P-RF

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

P-RF

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

P-RF

CUTIE CU BLIST. AL/AL X 35 COMPR. FILM.

P-RF

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

P-RF

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

P-RF

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

P-RF

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

1
30
30
28
30
28
30
30
30
30
30
50
20
30
30
25
1
1
5
5
28
30
56
60
56
60
56
60
10
50
50
1
10
5
50
50
28
28
28
28
28
28
30
30
28
35
28
28
28

18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,562400
0,168000
0,267000
0,373333
0,299600
5,390000
6,468000
8,452000
2,206000
14,899285
3,767000
2,787500
2,787333
4,212321
4,212166
4,713750
4,330833
7,118000
0,358800
0,568000
29,290000
12,456000
9,058000
1,274200
0,386200
0,671428
0,671570
0,440357
0,446400
0,671570
0,671570
0,671570
0,563000
0,671428
0,671570
2,440713
2,440713
2,764285

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

18,430000
0,903600
0,849666
0,903600
1,768000
0,149285
0,409999
0,753000
0,341666
0,009333
0,026333
0,562400
0,168000
0,267000
0,373333
0,299600
5,390000
6,468000
8,452000
2,206000
14,899285
3,767000
2,787500
2,787333
4,212321
4,212166
4,713750
4,330833
7,118000
0,358800
0,568000
29,290000
12,456000
9,058000
1,274200
0,386200
0,671428
0,671570
0,440357
0,446400
0,671570
0,671570
0,671570
0,563000
0,671428
0,671570
2,440713
2,440713
2,764285

0,000000
0,028066
0,000000
0,501757
0,000000
0,000000
0,086667
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,432000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,070215
0,000000
0,107885
6,514858
2,413430
2,413763
0,000000
0,000000
3,746144
4,871787
5,162501
6,115000

62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

DCI

COD ATC
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03
N05AH03

100 N05AH03
101 N05AH03
102 N05AH03
103 N05AH03
104 N05AH03
105 N05AH03
106 N05AH03
107 N05AH03
108 N05AH03
109 N05AH03
110 N05AH03

OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**

Denumire Comerciala

ZYPREXA 5 mg
LAPOZAN 5 mg
LAPOZAN 5 mg
OLANZAPINA ACTAVIS 5 mg
BLOONIS 5 mg
ZALASTA 10mg
OLANZAPINE TEVA 10mg
OLANZAPINA TERAPIA 10 mg
OLAZAX DISPERZI 10 mg
LAPOZAN 10 mg
LAPOZAN 10 mg
BLOONIS 10 mg
OLANZAPINA DR. REDDY'S 10 mg

OLANZAPINA ACTAVIS 10 mg
IRROPIA 10 mg
OLANZAPINA TORRENT 10 mg
WRANELON 10 mg
OLANZAPINA AUROBINDO 10 mg

ZALASTA 15mg
OLANZAPINE TEVA 15mg
OLANZAPINA TERAPIA 15 mg
OLAZAX DISPERZI 15 mg
LAPOZAN 15 mg
BLOONIS 15 mg
OLANZAPINA DR. REDDY'S 15 mg

OLANZAPINA ACTAVIS 15 mg
IRROPIA 15 mg
OLANZAPINA TORRENT 15 mg
WRANELON 15 mg

forma farm.

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

OLANZAPINA AUROBINDO 15 mg COMPR. ORODISPERSABILE


OLANZAPINA POLPHARMA 20 mg COMPR. ORODISPERSABILE

ZALASTA 20mg
OLANZAPINE TEVA 20mg
OLANZAPINA TERAPIA 20 mg
OLAZAX DISPERZI 20 mg
BLOONIS 20 mg
OLANZAPINA DR. REDDY'S 20 mg

OLANZAPINA ACTAVIS 20 mg
IRROPIA 20 mg
OLANZAPINA TORRENT 20 mg
WRANELON 20 mg
OLANZAPINA AUROBINDO 20 mg

ZALASTA 5mg
OLANZAPINE TEVA 5mg
OLANZAPINA TERAPIA 5 mg
OLAZAX DISPERZI 5 mg
LAPOZAN 5 mg
LAPOZAN 5 mg
OLANZAPINA DR. REDDY'S 5 mg

COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE
COMPR. ORODISPERSABILE

concentratie

5mg
5mg
5mg
5mg
5mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

OLANDA CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE)


MEDOCHEMIE LTD. CIPRU
CUTIE CU BLIST. AL/AL X 28 COMPR. FILM.
MEDOCHEMIE LTD. CIPRU
CUTIE CU BLIST. AL/AL X 30 COMPR. FILM.
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM.
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.

P-RF

KRKA D.D. NOVO MESTO SLOVENIA

CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL)

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP.

P-RF

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

P-RF

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

P-RF

ELI LILLY NEDERLAND BV

TEVA PHARMA BV
TERAPIA S.A.

OLANDA
ROMANIA

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

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

MEDOCHEMIE LTD. CIPRU


CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE
P-RF
MEDOCHEMIE LTD. CIPRU
CUTIE CU BLIST. AL/AL X 50 COMPR. ORODISPERSABILE
P-RF
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
GALENICA S.A.
GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
PRF
CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE

KRKA D.D. NOVO MESTO SLOVENIA

TEVA PHARMA BV
TERAPIA S.A.

OLANDA
ROMANIA

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL)

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP.

P-RF

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

P-RF

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

P-RF

MEDOCHEMIE LTD. CIPRU


CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE
P-RF
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
GALENICA S.A.
GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
PRF
PHARMACEUTICAL WORKS POLPHARMA SA POLONIA CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 28 COMPR. ORODISP.
PRF
CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE

KRKA D.D. NOVO MESTO SLOVENIA

TEVA PHARMA BV
TERAPIA S.A.

OLANDA
ROMANIA

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL)

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP.

P-RF

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

P-RF

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

P-RF

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


DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE P-RF
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE PRF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE P-RF
GALENICA S.A.
GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE PRF
AUROBINDO PHARMA (MALTA) LIMITED MALTA
PRF
SANOFI - AVENTIS ROMANIA S.R.L.

CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE

KRKA D.D. NOVO MESTO SLOVENIA

CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL)

TEVA PHARMA BV
TERAPIA S.A.

OLANDA
ROMANIA

CUTIE X 30 COMPR. FILM. (BLIST. OPA-AL-PVC/AL) P-RF


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

P-RF

GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

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

P-RF

CUTIE CU BLIST. AL/AL X 30 COMPR. ORODISPERSABILE

P-RF

CUTIE CU BLIST. AL/AL X 50 COMPR. ORODISPERSABILE

P-RF

CUTIE CU BLIST. OPA-AL-PVC/AL X 35 COMPR. ORODISPERSABILE

P-RF

MEDOCHEMIE LTD. CIPRU


MEDOCHEMIE LTD. CIPRU
DR. REDDY'S LABORATORIES ROMANIA
Pagina 21 din 39

P-RF

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

28
28
30
30
28
28
30
28
28
30
50
28
35
28
28
28
28
28
28
30
28
28
30
28
35
28
28
28
28
28
28
28
30
28
28
28
35
28
28
28
28
28
28
30
28
28
30
50
35

0,446400
0,446400
0,446400
0,372000
0,443928
0,586071
0,671570
0,671570
0,671570
0,671570
0,671570
0,671428
0,671570
0,559642
0,671570
0,671570
0,671570
0,671570
2,033928
2,440713
2,440713
2,440713
2,440713
2,440713
2,440713
2,435000
2,440713
2,440713
2,440713
2,440713
2,764285
2,303571
2,304000
2,764285
2,764285
2,764285
2,764285
2,749642
2,764285
2,764285
2,764285
2,764285
0,440357
0,443666
0,446400
0,446400
0,446400
0,446400
0,446400

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,446400
0,446400
0,446400
0,372000
0,443928
0,586071
0,671570
0,671570
0,671570
0,671570
0,671570
0,671428
0,671570
0,559642
0,671570
0,671570
0,671570
0,671570
2,033928
2,440713
2,440713
2,440713
2,440713
2,440713
2,440713
2,435000
2,440713
2,440713
2,440713
2,440713
2,764285
2,303571
2,304000
2,764285
2,764285
2,764285
2,764285
2,749642
2,764285
2,764285
2,764285
2,764285
0,440357
0,443666
0,446400
0,446400
0,446400
0,446400
0,446400

3,342885
0,846100
2,016600
0,000000
0,000000
0,000000
0,062430
4,084501
0,358430
2,412430
2,252630
0,000000
3,746144
0,000000
0,361287
3,776644
0,362001
0,362001
0,000000
0,586953
3,426787
3,426787
3,426287
0,000001
3,426429
0,000000
0,129644
3,426787
2,030358
1,757144
6,508215
0,000000
0,000000
6,577857
3,458215
0,000357
5,624857
0,000000
3,457143
3,245000
2,111786
2,421072
0,000000
0,000000
2,060742
0,107885
0,845933
0,845800
2,016457

DCI

COD ATC

111 N05AH03
112 N05AH03
113 N05AH03
114 N05AH03
115 N05AH03
116 N05AH03
117 N05AH03
118 N05AH03
119 N05AH03
120 N05AH03
121 N05AH04
122 N05AH04
123 N05AH04
124 N05AH04
125 N05AH04
126 N05AH04
127 N05AH04
128 N05AH04
129 N05AH04
130 N05AH04
131 N05AH04
132 N05AH04
133 N05AH04
134 N05AH04
135 N05AH04
136 N05AH04
137 N05AH04
138 N05AH04
139 N05AH04
140 N05AH04
141 N05AH04
142 N05AH04
143 N05AH04
144 N05AH04
145 N05AH04
146 N05AH04
147 N05AH04
148 N05AH04
149 N05AH04
150 N05AL01
151 N05AL01
152 N05AL01
153 N05AL05
154 N05AL05
155 N05AL05
156 N05AL05
157 N05AX08
158 N05AX08
159 N05AX08

OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
OLANZAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
SULPIRIDUM
SULPIRIDUM
SULPIRIDUM
AMISULPRIDUM**
AMISULPRIDUM**
AMISULPRIDUM**
AMISULPRIDUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**

Denumire Comerciala

OLANZAPINA ACTAVIS 5 mg
IRROPIA 5 mg
OLANZAPINA TORRENT 5 mg
WRANELON 5 mg

forma farm.

concentratie

5mg
COMPR. ORODISPERSABILE 5mg
COMPR. ORODISPERSABILE 5mg
COMPR. ORODISPERSABILE 5mg
OLANZAPINA AUROBINDO 5 mg COMPR. ORODISPERSABILE 5mg
OLANZAPINA TORRENT 7,5 mg COMPR. ORODISPERSABILE 7,5mg
ZYPADHERA 210mg
210mg
ZYPADHERA 300mg
300mg
ZYPADHERA 405mg
405mg
ZYPREXA 10 mg
PULB. PT. SOL. INJ. 10mg
SEROQUEL XR 150 mg
COMPR. ELIB. PREL. 150mg
QUETIAPINA TEVA 150 mg COMPR. ELIB. PREL. 150mg
QUETIAPINA TEVA 200 mg COMPR. ELIB. PREL. 200mg
QUETIAPINA TEVA 300 mg COMPR. ELIB. PREL. 300mg
QUETIAPINA TEVA 400 mg COMPR. ELIB. PREL. 400mg
KETILEPT 100 mg
COMPR. FILM.
100mg
QUETIAPINE TEVA 100 mg COMPR. FILM.
100mg
KVENTIAX 100 mg
COMPR. FILM.
100mg
QUETROP 100 mg
COMPR. FILM.
100mg
Q MIND 100 mg
COMPR. FILM.
100mg
KATHIRA 100 mg
COMPR. FILM.
100mg
KATHIRA 150 mg
COMPR. FILM.
150mg
KETILEPT 200 mg
COMPR. FILM.
200mg
QUETIAPINE TEVA 200 mg COMPR. FILM.
200mg
KVENTIAX 200 mg
COMPR. FILM.
200mg
QUETROP 200 mg
COMPR. FILM.
200mg
Q MIND 200 mg
COMPR. FILM.
200mg
KATHIRA 200 mg
COMPR. FILM.
200mg
KATHIRA 25 mg
COMPR. FILM.
25mg
KETILEPT 300 mg
COMPR. FILM.
300mg
QUETIAPINE TEVA 300 mg COMPR. FILM.
300mg
KVENTIAX 300 mg
COMPR. FILM.
300mg
QUETROP 300 mg
COMPR. FILM.
300mg
Q MIND 300 mg
COMPR. FILM.
300mg
KATHIRA 300 mg
COMPR. FILM.
300mg
SEROQUEL XR 200 mg
COMPR. FILM. ELIB. PREL. 200mg
SEROQUEL XR 300 mg
COMPR. FILM. ELIB. PREL. 300mg
SEROQUEL XR 400 mg
COMPR. FILM. ELIB. PREL. 400mg
SEROQUEL XR 50 mg
COMPR. FILM. ELIB. PREL. 50mg
EGLONYL (R) 50 mg
CAPS.
50mg
EGLONYL 50 mg
CAPS.
50mg
EGLONYL (R) 200 mg
COMPR.
200mg
AMISULPRIDA LPH 200 mg COMPR.
200mg
MIDORA 200 mg
COMPR.
200mg
SOLIAN 200 mg
COMPR. DIVIZ. 200mg
SOLIAN 400 mg
COMPR. FILM.
400mg
RISPERIDONE TEVA 1 mg
COMPR. FILM.
1mg
SPRING 1 mg
COMPR. FILM.
1mg
RONYDAL 1 mg
COMPR. FILM.
1mg
COMPR. ORODISPERSABILE

PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

DETINATOR APP

AMBALAJ

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


ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE
GALENICA S.A.
GRECIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (2X14) COMPR. ORODISPERSABILE
AUROBINDO PHARMA (MALTA) LIMITED MALTA
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE
ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 210MG PULB. + 1 FLAC. X 3ML SOLVENT
ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 300MG PULB. + 1 FLAC. X 3ML SOLVENT
ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC X 405MG PULB. + 1 FLAC. X 3ML SOLVENT
ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 FLAC. X 10 MG PULB.PT.SOL.INJ.
ACTAVIS GROUP PTC EHF.

CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE

ASTRAZENECA UK LIMITED

MAREA BRITANIE CUTIE CU 6 BLIST. PVC-PCTFE/AL X 10 COMPR. ELIB. PREL.

ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
EGIS PHARMACEUTICALS P.L.C.
UNGARIA
TEVA PHARMACEUTICAL S.R.L. ROMANIA
TEVA PHARMACEUTICALS S.R.L.

Prescriptie

NR.CRT

TARA
DET. APP

P-RF

PRF
P-RF

PRF
PRF
P-RF
P-RF/R
P-RF/R
P-RF/R

P-RF
P-RF

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

PRF

CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL.

PRF

CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL.

PRF

CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL.

PRF

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

P-RF

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

P-RF/S

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF
GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF

ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF


NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF
EGIS PHARMACEUTICALS P.L.C.
UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF
TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 60 COMPR. FILM. P-RF/S
TORRENT PHARMA S.R.L.

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF
GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF

ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF


NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF
EGIS PHARMACEUTICALS P.L.C.
UNGARIA CUTIE X BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-RF
TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-ACLAR/AL X 60 COMPR. FILM. P-RF/S
TORRENT PHARMA S.R.L.

KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF
GLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF

ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF


NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM. PRF
TORRENT PHARMA S.R.L.

ASTRAZENECA UK LTD.

MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL.

P-RF

ASTRAZENECA UK LTD.

MAREA BRITANIE CUTIE X 6 BLIST. OPACE AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL.

P-RF

ASTRAZENECA UK LIMITED

MAREA BRITANIE CUTIE X 6 BLIST. PVC-PCTFE/AL X 10 COMPR. CU ELIB. PREL.

P-RF

ASTRAZENECA UK LTD.

MAREA BRITANIE CUTIE X 6 BLIST. OPACE DIN AL/PVC-PCTFE X 10 COMPR. FILM. ELIB. PREL.

P-RF

FRANTA
SANOFI-SYNTHELABO FRANCE FRANTA
SANOFI-SYNTHELABO FRANCE FRANTA
LABORMED PHARMA S.A. ROMANIA
TERAPIA S.A.
ROMANIA
SANOFI-AVENTIS FRANCE FRANTA
SANOFI-AVENTIS FRANCE FRANTA
TEVA PHARMACEUTICAL S.R.L. ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ROMASTRU TRADING SRL ROMANIA
SANOFI-SYNTHELABO FRANCE

Pagina 22 din 39

CUTIE X 2 BLIST. X 15 CAPS.

P-RF

CUTIE CU 1 BLIST. PVC/AL X 30 CAPS.

PRF

CUTIE X 1 BLIST. X 12 COMPR.

P-RF

CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF

CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.

P-RF

CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF


CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

28
0,446400
28
0,446400
28
0,446400
28
0,446400
28
0,446400
28
3,313571
1 650,040000
1 916,710000
1 1.223,460000
1 20,710000
60
2,451199
60
2,042666
60
2,675000
60
3,791833
60
4,493500
60
0,426799
60
0,355666
60
0,355666
60
0,426799
60
0,426799
60
0,426799
60
1,492666
60
0,602799
60
0,504833
60
0,502333
60
0,602799
60
0,602799
60
0,602799
60
0,588000
60
1,256799
60
1,051166
60
1,047333
60
1,256799
60
1,256799
60
1,256799
60
3,210000
60
4,550199
60
5,392200
60
1,104333
30
0,274333
30
0,274333
12
0,698333
30
1,522000
30
1,522000
30
1,826400
30
3,672000
60
0,303833
30
0,364599
60
0,364599

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,446400
0,446400
0,446400
0,446400
0,446400
3,313571
650,040000
916,710000
1.223,460000
20,710000
2,451199
2,042666
2,675000
3,791833
4,493500
0,426799
0,355666
0,355666
0,426799
0,426799
0,426799
1,492666
0,602799
0,504833
0,502333
0,602799
0,602799
0,602799
0,588000
1,256799
1,051166
1,047333
1,256799
1,256799
1,256799
3,210000
4,550199
5,392200
1,104333
0,274333
0,274333
0,698333
1,522000
1,522000
1,826400
3,672000
0,303833
0,364599
0,364599

0,015742
0,107885
1,598600
0,107885
0,107885
0,000000
0,000000
0,000000
0,000000
0,000000
0,635134
0,000000
0,000000
0,000000
0,000000
0,538701
0,000000
0,000000
1,033701
0,418201
0,473367
0,000000
0,347367
0,000000
0,000000
1,275034
0,813367
0,889867
0,000000
0,352867
0,000000
0,000000
1,445534
0,489701
0,700034
0,905333
1,596967
2,469300
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,437266
0,000000
0,000000
0,150401
0,050901

COD ATC

160 N05AX08
161 N05AX08
162 N05AX08
163 N05AX08
164 N05AX08
165 N05AX08
166 N05AX08
167 N05AX08
168 N05AX08
169 N05AX08
170 N05AX08
171 N05AX08
172 N05AX08
173 N05AX08
174 N05AX08
175 N05AX08
176 N05AX08
177 N05AX08
178 N05AX08
179 N05AX08
180 N05AX08
181 N05AX08
182 N05AX08
183 N05AX08
184 N05AX08
185 N05AX08
186 N05AX08
187 N05AX08
188 N05AX08
189 N05AX08
190 N05AX08
191 N05AX08
192 N05AX08
193 N05AX08
194 N05AX08
195 N05AX08
196 N05AX12
197 N05AX12
198 N05AX12
199 N05AX12
200 N05AX12
201 N05AX12
202 N05AX13
203 N05AX13
204 N05AX13
205 N05AX13
206 N05AX13
207 N05AX13
208 N05AX13

DCI

RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
RISPERIDONUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**

Denumire Comerciala

forma farm.

RISPEN 1
RISPERIDONA ARENA 1 mg
RONYDAL 1 mg
RISPEN 2
RISPERIDONE TEVA 2 mg
RISON 2 mg
SPRING 2 mg
RONYDAL 2 mg
RISPERIDONA ARENA 2 mg
RONYDAL 2 mg
TORENDO 3 mg
RISPERIDONE TEVA 3 mg
RISON 3 mg
SPRING 3 mg
RONYDAL 3 mg
RISPEN 3
RISPERIDONA ARENA 3 mg
RONYDAL 3 mg
RISPEN 4
TORENDO 4 mg
RISPERIDONE TEVA 4 mg
RISON 4 mg
SPRING 4 mg
RONYDAL 4 mg

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
RISPERIDONA MEDOCHEMIE 4 mg COMPR. FILM.
RISPERIDONA ARENA 4 mg COMPR. FILM.
RONYDAL 4 mg
COMPR. FILM.
TORENDO Q-TAB 1 mg
COMPR. ORODISPERSABILE
ESSENS OD 1 mg
COMPR. ORODISPERSABILE
TORENDO Q-TAB 2 mg
COMPR. ORODISPERSABILE
ESSENS OD 2 mg
COMPR. ORODISPERSABILE
ESSENS OD 3 mg
COMPR. ORODISPERSABILE
RISPOLEPT CONSTA 25 mg
RISPOLEPT CONSTA 37,5 mg
RISPOLEPT CONSTA 50 mg
RISPOLEPT
SOL. ORALA
ABILIFY 10mg
COMPR.
ARYZALERA 10mg
COMPR.
ABILIFY 15mg
COMPR.
ARYZALERA 15mg
COMPR.
ABILIFY MAINTENA 400mg
ABILIFY 7,5mg/ml
SOL. INJ.
INVEGA 3mg
COMPR. ELIB. PREL.
INVEGA 6mg
COMPR. ELIB. PREL.
INVEGA 9mg
COMPR. ELIB. PREL.
XEPLION
SUSP. INJ. CU ELIB. PREL.
XEPLION
SUSP. INJ. CU ELIB. PREL.
XEPLION
SUSP. INJ. CU ELIB. PREL.
XEPLION
SUSP. INJ. CU ELIB. PREL.
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

concentratie

1mg
1mg
1mg
2 mg
2mg
2mg
2mg
2mg
2mg
2mg
3mg
3mg
3mg
3mg
3mg
3mg
3mg
3mg
4 mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
1mg
1mg
2mg
2mg
3mg
25mg
37,5mg
50mg
1mg/ml
10mg
10mg
15mg
15mg
400mg
7,5mg/ml
3mg
6mg
9mg
100mg
150mg
50mg
75mg

DETINATOR APP

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

ZENTIVA KS
CEHIA
ARENA GROUP S.A. ROMANIA
NEOLA PHARMA S.R.L. ROMANIA
ZENTIVA KS
CEHIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
ACTAVIS GROUP HF. ISLANDA
ANTIBIOTICE S.A.
ROMANIA
ROMASTRU TRADING SRL ROMANIA
ARENA GROUP S.A. ROMANIA
NEOLA PHARMA S.R.L. ROMANIA

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

KRKA D.D. NOVO MESTO SLOVENIA

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

ROMANIA
ACTAVIS GROUP HF. ISLANDA
ANTIBIOTICE S.A.
ROMANIA
ROMASTRU TRADING SRL ROMANIA
ZENTIVA KS
CEHIA
ARENA GROUP S.A. ROMANIA
NEOLA PHARMA S.R.L. ROMANIA
ZENTIVA KS
CEHIA

CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

KRKA D.D. NOVO MESTO SLOVENIA

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

TEVA PHARMACEUTICALS S.R.L.

TEVA PHARMACEUTICALS S.R.L.

ACTAVIS GROUP HF.


ANTIBIOTICE S.A.
ROMASTRU TRADING SRL

MEDOCHEMIE LTD.
ARENA GROUP S.A.
NEOLA PHARMA S.R.L.

ROMANIA
ISLANDA
ROMANIA
ROMANIA
CIPRU
ROMANIA
ROMANIA

CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM.

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF


CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF


CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM.

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF

P-RF

CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF


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

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF


CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM.

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF


P-RF

CUTIE X 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF


CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF


CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM.

PRF

CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM.

P-RF

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF

KRKA D.D. NOVO MESTO SLOVENIA

CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE

P-RF

TERAPIA SA

ROMANIA

CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE

P-RF

KRKA D.D. NOVO MESTO SLOVENIA

CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE

P-RF

TERAPIA SA
TERAPIA SA

JANSSEN PHARMACEUTICA N.V.

ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF


ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE P-RF
BELGIA
S/P-RF
BELGIA
S/P-RF
BELGIA
S/P-RF
BELGIA CUTIE X 1 FLACON DIN STICLA BRUNA X 30 ML SOL. ORALA + 1 PIPETA P-RF

OTSUKA PHARMACEUTICAL EUROPE LTD.

MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR.

JANSSEN PHARMACEUTICA N.V.


JANSSEN PHARMACEUTICA N.V.
JANSSEN PHARMACEUTICA N.V.

CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE

CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE

CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE

P-RF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
OTSUKA PHARMACEUTICAL EUROPE LTD.

MAREA BRITANIE CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR.

P-RF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
OTSUKA PHARMACEUTICAL EUROPE LTD.

MAREA BRITANIE

OTSUKA PHARMACEUTICAL EUROPE LTD.

MAREA BRITANIE

BELGIA
JANSSEN-CILAG INTERNATIONAL NV BELGIA
JANSSEN-CILAG INTERNATIONAL NV BELGIA
JANSSEN CILAG INTERNATIONALL NV BELGIA
JANSSEN CILAG INTERNATIONALL NV BELGIA
JANSSEN CILAG INTERNATIONALL NV BELGIA
JANSSEN CILAG INTERNATIONALL NV BELGIA
JANSSEN-CILAG INTERNATIONAL NV

Pagina 23 din 39

CUTIE CU UN FL.X 400 MG PULB., UN FL. DE 2 ML CU SOLV., O SERINGA LUER-LOCK DE 3 ML CU AC HIPODERMIC SECURIZAT, O SERINGA JETABILA DE 3 ML CU VRF LUER-LOCK, UN ADAPTOR PENTRU FLACON, UN AC HIPODERMIC SECURIZAT SI UN AC HIPODERMIC SECURIZAT PT OBEZI

PRF

CUTIE X 1FLAC. X 1,3ML SOL.INJ

P-RF

CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL)

P-RF

CUTIEX 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL)

P-RF

CUTIE X 30 COMPR.ELIB.PREL. (BLISTER PVC/PCTFE/AL)

P-RF

CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE

PR
PR
PR
PR

CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE


CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE
CUTIE CU 1 SERINGA PREUMPLUTA SI 2 ACE

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

50
20
60
50
60
20
30
60
20
60
30
60
20
30
60
50
20
60
50
30
60
20
30
60
20
20
60
30
30
30
30
30
1
1
1
1
28
30
28
30
1
1
30
30
30
1
1
1
1

0,359600
0,364599
0,364599
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,507600
0,507600
0,423000
0,507600
0,507600
0,507600
0,507600
0,507600
0,309000
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,309000
0,364599
0,364599
0,309000
0,309000
0,507600
374,930000
530,080000
635,690000
17,330000
8,750400
7,292000
8,956399
7,463666
1.163,560000

19,950000
15,777333
16,040000
17,477333
1.463,340000
2.055,980000

944,130000
1.202,120000

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,359600
0,364599
0,364599
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,507600
0,507600
0,423000
0,507600
0,507600
0,507600
0,507600
0,507600
0,309000
0,309000
0,309000
0,257500
0,309000
0,309000
0,309000
0,309000
0,309000
0,364599
0,364599
0,309000
0,309000
0,507600
374,930000
530,080000
635,690000
17,330000
8,750400
7,292000
8,956399
7,463666
1.163,560000
19,950000
15,777333
16,040000
17,477333
1.463,340000
2.055,980000
944,130000
1.202,120000

0,000000
0,018901
0,050901
0,000000
0,222333
0,000000
0,564000
0,614333
0,530000
0,614333
0,687733
0,270066
0,000000
0,874066
0,919566
0,000000
0,851400
0,919566
0,000000
1,334333
0,795833
0,000000
1,579666
1,608833
1,503500
1,416000
1,608833
0,062067
0,070067
0,597000
0,619666
0,929733
0,000000
0,000000
0,000000
0,000000
2,732100
0,000000
2,526101
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000

DCI

CITALOPRAMUM**
CITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**

210 N06AB04
211 N06AB10
212 N06AB10
213 N06AB10
214 N06AB10
215 N06AB10
216 N06AB10
217 N06AB10
218 N06AB10
219 N06AB10
220 N06AB10
221 N06AB10
222 N06AB10
223 N06AB10
224 N06AB10
225 N06AB10
226 N06AB10
227 N06AB10
228 N06AB10
229 N06AB10
230 N06AB10
231 N06AB10
232 N06AB10
233 N06AB10
234 N06AB10
235 N06AB10
236 N06AB10
237 N06AB10
238 N06AB10
239 N06AB10
240 N06AX05
241 N06AX05
242 N06AX05
243 N06AX05
244 N06AX05
245 N06AX05
246 N06AX14
247 N06AX14
248 N06AX14
249 N06AX14
250 N06AX14
251 N06AX16
252 N06AX16
253 N06AX16
254 N06AX16
255 N06AX16
256 N06AX16
257 N06AX16

Denumire Comerciala

LINISAN 10 mg
LINISAN 20 mg
DEPRESINAL 10 mg
CIPRALEX 10 mg
ESCITIL 10 mg
ESCITALOPRAM-TEVA 10 mg
LENUXIN 10 mg
ESLOREX 10 mg
SERODEPS 10mg
ESTAN 10 mg
ESTAN 10 mg

forma farm.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
ESCITALOPRAM ACTAVIS 10 mg COMPR. FILM.
ELICEA 10 mg
COMPR. FILM.
ESCITALOPRAM AUROBINDO 10 mg COMPR. FILM.
ESCITALOPRAM ATB 10 mg COMPR. FILM.
ESCITALOPRAM TORRENT 10 mg COMPR. FILM.
ESCITALOPRAM-TEVA 15 mg COMPR. FILM.
ELICEA 15 mg
COMPR. FILM.
ESCITALOPRAM-TEVA 20 mg COMPR. FILM.
SERODEPS 20mg
COMPR. FILM.
ESCITALOPRAM TORRENT 20 mg COMPR. FILM.
ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM.
ELICEA 20 mg
COMPR. FILM.
ELICEA Q-TAB 10 mg
COMPR. ORODISPERSABILE
ELICEA Q-TAB 10 mg
COMPR. ORODISPERSABILE
ESCITALOPRAM TEVA 10 mg COMPR. ORODISPERSABILE
ELICEA Q-TAB 15 mg
COMPR. ORODISPERSABILE
ELICEA Q-TAB 15 mg
COMPR. ORODISPERSABILE
ELICEA Q-TAB 20 mg
COMPR. ORODISPERSABILE
ELICEA Q-TAB 20 mg
COMPR. ORODISPERSABILE
ESCITALOPRAM TEVA 20 mg COMPR. ORODISPERSABILE
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 150 mg
COMPR. ELIB. PREL.
TRITTICO AC 75 mg
COMPR. ELIB. PREL.
TRITTICO AC 75 mg
COMPR. ELIB. PREL.
LYXIT 12,5 mg
COMPR. FILM.
LYXIT 12,5 mg
COMPR. FILM.
NOBIXAL 12,5 mg
COMPR. FILM.
NOBIXAL 12,5 mg
COMPR. FILM.
COAXIL (R)
DRAJ.
EFECTIN EP 150 mg
CAPS. ELIB. PREL.
ELIFY EP 150 mg
CAPS. ELIB. PREL.
IVRYX 150mg
CAPS. ELIB. PREL.
VELAXIN 150 mg
CAPS. ELIB. PREL.
ALVENTA 150mg
CAPS. ELIB. PREL.

concentratie

10mg
20mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
20mg
20mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
20mg
150mg
150mg
150mg
150mg
75mg
75mg
12,5 mg
12,5 mg
12,5mg
12,5mg
12,5mg
150 mg
150 mg
150 mg
150mg
150mg
VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg
VENLAFAXINA ARENA EP 150 mg CAPS. ELIB. PREL. 150mg

DETINATOR APP

AMBALAJ

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


GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
H. LUNDBECK A/S
DANEMARCA CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM.
EGIS PHARMACEUTICALS P.L.C.
UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
ZENTIVA K.S.
CEHIA
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM.
TERAPIA SA
ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM.
MEDOCHEMIE LTD. CIPRU
CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM.
MEDOCHEMIE LTD. CIPRU
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
GEDEON RICHTER ROMANIA SA

Prescriptie

COD ATC

209 N06AB04

NR.CRT

TARA
DET. APP

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

PRF
P-RF

PRF
PRF
PRF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF
AUROBINDO PHARMA LIMITED

MAREA BRITANIE

ANTIBIOTICE S.A.

ROMANIA
TORRENT PHARMA SRL ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA

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

PRF

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


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

PRF

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF

ROMANIA
ROMANIA
TORRENT PHARMA SRL ROMANIA
ACTAVIS GROUP PTC EHF. ISLANDA
TEVA PHARMACEUTICALS S.R.L.

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF

TERAPIA SA

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

P-RF

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

PRF

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

PRF

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF
KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE

PRF

KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE

PRF

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE PRF

KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE

PRF

KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE

PRF

KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE

PRF

KRKA, D.D., NOVO MESTO SLOVENIA

CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE

PRF

ROMANIA CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE


ANGELINI FRANCESCO SPA ITALIA
CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL.
ANGELINI FRANCESCO SPA ITALIA
CUTIE X 6 BLIST. AL/PVC X 10 COMPR. ELIB. PREL.
ANGELINI FRANCESCO SPA ITALIA
CUTIE X 3 BLIST. AL/PVC X 20 COMPR. ELIB. PREL.
ANGELINI FRANCESCO SPA ITALIA
CUTIE X 2 BLIST. AL/PVCX 10 COMPR. ELIB. PREL.
ANGELINI FRANCESCO SPA ITALIA
CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL.
ANGELINI FRANCESCO SPA ITALIA
CUTIE X 1 BLIST. AL/PVC X 30 COMPR. ELIB. PREL.
ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.
ARENA GROUP S.A. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 90 COMPR. FILM.
ANTIBIOTICE S.A.
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM.
ANTIBIOTICE S.A.
ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM.
LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ.
TEVA PHARMACEUTICALS S.R.L.

PFIZER EUROPE MA EEIG

MAREA BRITANIE

CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL.

PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF

PRF
PRF
PRF
PRF
P-RF

PRF

MEDOCHEMIE LTD. CIPRU


NEOLA PHARMA S.R.L. ROMANIA
EGIS PHARMACEUTICALS P.L.C.
UNGARIA

CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF

KRKA D.D. NOVO MESTO SLOVENIA

CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL.

ISLANDA
ARENA GROUP S.A. ROMANIA

CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL.

P-RF

CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL.

P-RF

ACTAVIS GROUP PTC EHF.

Pagina 24 din 39

CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF


CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF

P-RF

cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)

30
30
30
28
28
30
28
30
28
14
28
28
30
28
28
28
30
30
30
28
28
28
30
28
28
30
28
28
28
28
30
20
60
60
20
30
30
30
90
30
30
30
28
30
28
28
30
28
30

0,246000
1,368000
0,778666
0,918000
0,848928
0,776000
0,848928
0,780666
0,780357
0,848571
0,848928
0,778214
0,780666
0,778214
0,765000
0,848928
1,018713
1,018713
1,370000
1,359642
1,631570
1,399642
1,406000
0,780357
0,780357
0,918000
1,018713
1,018713
1,576785
1,576785
1,369000
1,264000
1,094833
1,094833
1,264000
0,644666
0,644666
0,460333
0,445222
0,460333
0,460333
0,534266
0,665599
0,665599
0,665599
0,665599
0,554666
0,665599
0,665599

Val. maxima suportata de


sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)

Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)

0,246000
1,368000
0,778666
0,918000
0,848928
0,776000
0,848928
0,780666
0,780357
0,848571
0,848928
0,778214
0,780666
0,778214
0,765000
0,848928
1,018713
1,018713
1,370000
1,359642
1,631570
1,399642
1,406000
0,780357
0,780357
0,918000
1,018713
1,018713
1,576785
1,576785
1,369000
1,264000
1,094833
1,094833
1,264000
0,644666
0,644666
0,460333
0,445222
0,460333
0,460333
0,534266
0,665599
0,665599
0,665599
0,665599
0,554666
0,665599
0,665599

0,000000
0,000000
0,000000
0,346285
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,111620
0,350287
0,000000
0,000000
0,637001
0,000000
0,000000
0,000000
0,000000
0,015666
0,350572
0,332358
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,000000
0,173400
1,347258
0,332734
0,195115
0,642972
0,000000
0,190829
0,643067

DCI

COD ATC

258 N06AX16
259 N06AX16
260 N06AX16
261 N06AX16
262 N06AX16
263 N06AX16
264 N06AX16
265 N06AX16
266 N06AX16
267 N06AX16
268 N06AX16
269 N06AX16
270 N06AX16
271 N06AX16
272 N06AX16
273 N06AX16
274 N06AX16
275 N06AX16
276 N06AX16
277 N06AX16
278 N06AX21
279 N06AX21

VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
DULOXETINUM**
DULOXETINUM**

forma farm.
Denumire Comerciala
VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL.
VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL.
FOBILESS 37,5 mg
CAPS. ELIB. PREL.
VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL.
EFECTIN EP 75 mg
CAPS. ELIB. PREL.
ELIFY EP 75 mg
CAPS. ELIB. PREL.
IVRYX 75mg
CAPS. ELIB. PREL.
IVRYX 75mg
CAPS. ELIB. PREL.
VELAXIN 75 mg
CAPS. ELIB. PREL.
ALVENTA 75 mg
CAPS. ELIB. PREL.
FOBILESS 75 mg
CAPS. ELIB. PREL.
VENLAFAXINA ACTAVIS 75 mg CAPS. ELIB. PREL.
VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL.
VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL.
VENLAFAXINA TERAPIA 75 mg CAPS. ELIB. PREL.
VENLAFAXINA ARENA 37,5 mg COMPR.

VENLAFAXINA ARENA 50 mg COMPR.


VENLAFAXINA ARENA 75 mg COMPR.
ARGOFAN 150 SR
COMPR. ELIB. PREL.
ARGOFAN 75 SR
COMPR. ELIB. PREL.
CYMBALTA 30mg
CAPS. GASTROREZ.
CYMBALTA 60mg
CAPS. GASTROREZ.

concentratie

DETINATOR APP

TERAPIA S.A.
TERAPIA S.A.

AMBALAJ

Prescriptie

NR.CRT

TARA
DET. APP

150mg
150mg
37,5mg
37,5mg
75