Ordin Nr. 1505 - 29.12.2015

ANEXA 2a
SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORM
Nr crt.
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
cod ATC
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
A02BC01
A02BC03
A02BC03
A02BC03
A02BC03
A03AD01
A03AD01
A03FA01
A03FA01
A03FA01
A03FA01
A03FA01
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
A06AD11
A06AD11
A06AD11
DCI
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
Denumire Comerciala
forma farm.
ULTOP
OMEPRAZOL 20 mg
OMEPRAZOL LPH 20 mg
OMERAN 20
OMEPRAZOL 20 mg
CAPS. GASTROREZ.
OMEPRAZOL TERAPIA 20 mg
CAPS. GASTROREZ.
OMEPRAZOL ARENA 20 mg
CAPS. GASTROREZ.
OMEPRAZOL FARMEX 20 mg
CAPS. GASTROREZ.
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
CAPS. GASTROREZ.
OMEPRAZOL ZENTIVA 20 mg
CAPS. GASTROREZ.
OMEPRAZOL LPH 20 mg
OMERAN 20 mg
ORTANOL 40 mg
CAPS. GASTROREZ.
OMEPRAZOL AUROBINDO 40 mg
CAPS. GASTROREZ.
OMEDAR 20 mg
OMEZ 40 mg
HELICID 40 INF
LEVANT 15 mg
LANZUL
LEVANT 30 mg
LANZAP 30mg
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.
COMPR. GASTROREZ.
PULB. PT. SOL. PERF.
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
PULB. PT. SOL. PERF. FARA CONCENTRATIE
15mg
CAPS. GASTROREZ. 30mg
PAPAVERINI HYDROCHLORIDUM PAPAVERINA ARENA 100 mg COMPR.
100mg
PAPAVERINI HYDROCHLORIDUM PAPAVERINA FARMACOM 200 mg COMPR.
200 mg
METOCLOPRAMIDUM
METOCLOPRAMID
COMPR.
10mg
METOCLOPRAMIDUM
METOCLOPRAMID 10 mg
COMPR.
10mg
METOCLOPRAMIDUM
METOCLOPRAMID ARENA 10 mg COMPR.
10mg
METOCLOPRAMIDUM
METOCLOPRAMID BIOFARM 1mg/5ml SIROP
1mg/5ml
METOCLOPRAMIDUM
METOCLOPRAMID 5mg/ml SOL. INJ.
5mg/ml
ACIDUM URSODEOXYCHOLICUM* URSOFALK (R)
CAPS.
250mg
ACIDUM URSODEOXYCHOLICUM* URSOFALK (R)
CAPS.
250mg
ACIDUM URSODEOXYCHOLICUM* URSOROM 250 mg
CAPS.
250mg
ACIDUM URSODEOXYCHOLICUM* URSOFALK 500 mg
COMPR. FILM. 500mg
ACIDUM URSODEOXYCHOLICUM* URSOFALK 250 mg/5 ml
SUSP. ORALA 250mg/5ml
LACTULOSUM
DUPHALAC (R)
LICHID ORAL 66,7%
LACTULOSUM
LACTULOSE
SIROP
65%
LACTULOSUM
LACTULOSE
SIROP
65%
CAPS. GASTROREZ.
tara det.
APP
Detinator APP
Ambalaj
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 IANUARIE 2016
KRKA D.D.
SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ. P-6L
GEDEON RICHTER ROMANIA SA
ROMPHARM COMPANY SRL
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
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
DR. REDDY'S LABORATORIES
ROMANIA
CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L
AUROBINDO PHARMA (MALTA) LIMITED
MALTA
LABORMED PHARMA SA
EUROPHARM SA
SLAVIA PHARM SRL
TERAPIA SA
ARENA GROUP S.A.
FARMEX COMPANY SRL
ANTIBIOTICE S.A.
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. 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
CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ.
P6L
ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.

NEOLA PHARMA S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.
NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.
ANTIBIOTICE S.A.
ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR.
P-6L
ZENTIVA K.S.
ZENTIVA, K.S.
ZENTIVA, K.S.
P-6L
ROMASTRU TRADING S.R.L.
CEHIA
CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ.
REPUBLICA CEHA
CUTIE CU 2 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 14 CAPSULE GASTROREZISTENTE
REPUBLICA CEHA
CUTIE CU 4 BLISTERE DIN OPA-AL-PED-PE-DESICANT-PED/AL A CATE 7 CAPSULE GASTROREZISTENTE
P-6L
P-6L
P-6L
P6L
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

SLOVENIA CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L
MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L
ROMANIA
ROMANIA
CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ.
P-6L
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF.
S/P-RF
CEHIA
CEHIA
CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF.
S/P-RF
CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF.
S/P-RF
MAREA BRITANIE
CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ.
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ.
P-6L
RANBAXY UK LTD.
CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ.
P-6L
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ.
P-6L
CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
P-6L
DAR AL DAWA PHARMA S.R.L.
ZENTIVA K.S.
ZENTIVA K.S.
RANBAXY UK LTD.
MAREA BRITANIE
ROMANIA
ARENA GROUP SA ROMANIA
FARMACOM S.A.
ROMANIA
SLAVIA PHARM SRL ROMANIA
TERAPIA SA
ROMANIA
ARENA GROUP S.A. ROMANIA
BIOFARM S.A.
ROMANIA
TERAPIA SA
ROMANIA
CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L

P-6L
P-6L
CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L

CUTIE X 1 FLAC. DIN STICLA X 100 ML SIROP + MASURA DOZATOARE
P-RF
CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML
P-RF
CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L

GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS.
P-6L
ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L
DR. FALK PHARMA GMBH GERMANIA

DR. FALK PHARMA GMBH
ROMPHARM COMPANY S.R.L.
DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L
ABBOTT HEALTHCARE PRODUCTS B.V.
OLANDA
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP
FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML

Pagina 1 din 21
P6L
P6L
P-6L
P-6L
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
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
60
100
1
1
1
1
0.547200
0.547200
0.547200
0.547200
0.547200
0.547200
0.547200
0.547200
0.547200
0.547200
0.437857
0.547200
0.547200
0.331428
0.547200
0.547200
0.547200
0.547200
0.376785
0.376785
0.376785
0.547200
0.547200
1.094400
0.645714
0.535357
15.153749
15.153749
15.153749
0.273600
0.547200
0.547200
0.547200
0.217500
0.427000
0.103500
0.104000
0.104000
9.010000
2.742000
1.152400
1.152400
0.788500
2.304800
57.620055
6.899858
10.085999
3.361999
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
0.128514
0.138514
0.116800
0.246371
0.235466
0.231800
0.214466
0.147800
0.300300
0.191466
0.000000
0.108871
0.193466
0.000000
0.246371
0.246371
0.246371
0.300300
0.000000
0.000000
0.000000
0.117466
0.246371
0.097028
0.000000
0.000000
1.676251
1.686251
1.676251
0.212828
0.425657
0.294942
0.316300
0.012000
0.000000
0.000000
0.043250
0.000000
0.000000
0.000000
0.000000
0.061000
0.000000
0.376900
39.869945
3.850142
0.714001
0.228001
Val. maxima suportata de

sistemul de asigurari
sociale de sanatate / UT
beneficiaza de
compensare 90% din
pretul de referinta)
0.492480
0.492480
0.492480
0.492480
0.492480
0.492480
0.492480
0.492480
0.492480
0.492480
0.394071
0.492480
0.492480
0.298285
0.492480
0.492480
0.492480
0.492480
0.339106
0.339106
0.339106
0.492480
0.492480
0.984960
0.581142
0.481821
13.638374
13.638374
13.638374
0.246240
0.492480
0.492480
0.492480
0.195750
0.384300
0.093150
0.093600
0.093600
8.109000
2.467800
1.037160
1.037160
0.709650
2.074320
51.858049
6.209872
9.077399
3.025799
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.183234
0.193234
0.171520
0.301091
0.290186
0.286520
0.269186
0.202520
0.355020
0.246186
0.043786
0.163591
0.248186
0.033143
0.301091
0.301091
0.301091
0.355020
0.037679
0.037679
0.037679
0.172186
0.301091
0.206468
0.064572
0.053536
3.191626
3.201626
3.191626
0.240188
0.480377
0.349662
0.371020
0.033750
0.042700
0.010350
0.053650
0.010400
0.901000
0.274200
0.115240
0.176240
0.078850
0.607380
45.631951
4.540128
1.722601
0.564201
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
cod ATC
DCI
B03AA07
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
B03AB05
COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT
B03AB05
B03AB05
B03AB05
B03AB05
B03AB05
B03AEN1
COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM)
B03BB01
ACIDUM FOLICUM
DIGOXINUM
DIGOXINUM
DIGOXINUM
DIGOXINUM
CHINIDINI SULFAS
CHINIDINI SULFAS
CHINIDINI SULFAS
CHINIDINI SULFAS
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
PROPAFENONUM
AMIODARONUM
AMIODARONUM
AMIODARONUM
AMIODARONUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
NITROGLYCERINUM
A06AD11
A06AD11
A06AD11
A07AA02
A07EC01
A07EC01
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
A07EC02
B01AA07
B01AA07
B01AC05
B01AC05
B02BA01
B03AA07
C01AA05
C01AA05
C01AA05
C01AA05
C01BA01
C01BA01
C01BA01
C01BA01
C01BC03
C01BC03
C01BC03
C01BC03
C01BC03
C01BD01
C01BD01
C01BD01
C01BD01
100 C01DA02
101 C01DA02
102 C01DA02
103 C01DA02
104 C01DA02
Denumire Comerciala
LACTULOSE-MIP 650 mg/ml

LACTULAK 660 mg/ml
NISTATINA
SULFASALAZIN EN
SALAZIDIN GR 500 mg
PENTASA 1 g
PENTASA 500mg
forma farm.
concentratie
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
SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 250mg
MESALAZINA SOFARFARM 400 mg COMPR. GASTROREZISTENTE 400mg
PENTASA 1000mg
SUPOZ.
1000mg
SALOFALK 1 g
SUPOZ.
1g
SALOFALK (R) 250 mg
SUPOZ.
250mg
SALOFALK (R) 500 mg
SUPOZ.
500mg
SALOFALK 4 g/ 60 ml
SUSP. RECTALA 4g/60ml
TROMBOSTOP 2 mg
COMPR.
2mg
SINTROM 4 mg
COMPR.
4mg
TICLODIN
COMPR. FILM. 250mg
IPATON
COMPR. FILM. 250mg
FITOMENADION 10 mg/ml SOL. INJ.
10mg/ml
FERROGRADUMET (R)
TARDYFERON 80 mg
DRAJ. ELIB. PREL. 80mg
MALTOFER
COMPR. MAST. 100mg
FER ROMPHARM 50 mg/ml PIC. ORALE, SOL. 50mg/ml
FERGLUROM FORTE 50 mg/ml PICATURI ORALE, SOL. 50mg/ml
FERRUM HAUSMANN (R)
PICATURI ORALE-SOL. 50mg/ml
FERRUM HAUSMANN (R)
SIROP
10mg/ml
FERGLUROM 50mg/5ml
SIROP
50mg/5ml
SORBIFER DURULES
COMPR. FILM. 100mg+60mg
ACIFOL 5 mg
COMPR. FILM. 5mg
DIGOXIN SOPHARMA 0,25 mg COMPR.
0,25 mg
DIGOXIN ZENTIVA 0,25 mg COMPR.
0,25mg
DIGOXIN 0,5 mg/2 ml
SOL. INJ.
0,5mg/2ml
DIGOXIN ZENTIVA 0,5 mg/2ml SOL. INJ.
0,5mg/2ml
CHINIDINA ARENA 200 mg COMPR.
200mg
200mg
200mg
200mg
PROPAFENONA ARENA 150 mg COMPR.
150mg
PROPAFENONA ARENA 150 mg COMPR.
150mg
RYTMONORM (R)
COMPR. FILM. 150mg
PROPAFENON AL 150
COMPR. FILM. 150mg
RYTMONORM
SOL. INJ.
70mg/20ml
CORDARONE 200 mg
COMPR.
200mg
AMIODARONA LPH 200 mg COMPR.
200mg
AMIODARONA ARENA 200 MG COMPR.
200mg
CORDARONE 200 mg
COMPR.
200mg
NITROMINT 2,6 mg
COMPR. ELIB. PREL. 2,6mg
NITROGLICERINA 0,5 mg
COMPR. SUBLING. 0,5mg
NITRODERM (R) TTS 5
SIST. TERAP. TRANSDERM.
25mg
NITROMINT
SPRAY SUBLINGUAL 0,4mg/doza
NITROMINT
SPRAY SUBLINGUAL 0,4mg/doza
Detinator APP
MIP PHARMA GMBH GERMANIA

MIP PHARMA GMBH GERMANIA
ANTIBIOTICE SA
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP
P-6L
P-6L
ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE

ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.
P-6L
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
FERRING GMBH
FERRING GMBH
GERMANIA CUTIE CU 6 BLIST. AL/AL X 10 COMPR. CU ELIB. PREL. P6L
CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ.
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. ROMANIA

FERRING GMBH
GERMANIA
CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE
P6L
P6L
P6L
CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI
P-6L

DR. FALK PHARMA GMBH GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L
CUTIE X 2 FOLII PVC/PE X 5 SUPOZ.

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.

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
AC HELCOR SRL
ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM.
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM.
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML
TEOFARMA SRL
ITALIA
LAB. PIERRE FABRE FRANTA
VIFOR FRANCE S.A. FRANTA
ROMANIA
ROMANIA
P-RF
P-RF
P-RF
P-RF
S/P-RF
P-6L
CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MASTIC.
P-6L
CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 30 ML PIC. ORALE, SOL.
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.

ABBOTT GMBH&CO.KG GERMANIA
P-6L
CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL.
CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE GRADATA DE LA 2,5 - 20 ML
GERMANIA
P-6L
CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L
BIOFARM S.A.
CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 ML PICATURI ORALE, SOLUTIE
VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON CU PICURATOR X 30 ML
VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON X 150 ML + O MASURA DOZATOARE
BIOFARM S.A.
ROMANIA
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM.
ZENTIVA S.A.
ROMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM.
CN UNIFARM S.A.
ROMANIA CUTIE X 20 COMPRIMATE
ZENTIVA S.A.
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ.
ZENTIVA S.A.
ROMANIA
ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 20 COMPR.
ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR.
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
ALIUD PHARMA GMBH & CO.KG
P-6L
CUTIE X 4 BLIST. X 25 COMPR. FILM.
P6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
PRF
P-RF
S/P-RF
S/P-RF
P-RF
PRF
PRF
PRF
P-RF
P-RF
P-RF
P-RF
CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. P-RF
FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ.

SANOFI-AVENTIS FRANCE FRANTA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR.
SANOFI-AVENTIS FRANCE
P-RF
LABORMED PHARMA SA ROMANIA
P-RF
EGIS PHARMACEUTICALS P.L.C.
ZENTIVA SA
UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL.

ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE
P-RF
P-RF
P-6L
P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC P-6L
UNGARIA
UNGARIA
CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L

CUTIE X 1 FLACON DIN PLASTIC X 10G (180 DOZE) SPRAY SUBLINGUAL
Pagina 2 din 21
P-6L
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
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
20
25
5
5
20
20
30
50
20
100
50
100
5
30
30
30
30
60
20
10
1
1
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
0.267267
0.267267
3.340000
0.282000
0.228972
0.636035
8.780000
9.120000
9.120000
9.120000
6.080000
0.307800
0.255666
0.138802
0.138800
1.652000
1.652000
0.641350
0.641350
0.641350
0.639400
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
beneficiaza de
compensare 100%
din pretul de
referinta)
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
1.509233
0.420733
0.000000
0.000000
0.186694
0.107298
0.000000
0.000000
4.920000
6.860000
4.310000
0.000000
0.000000
0.061698
0.000000
0.000000
0.000000
0.000650
0.045650
0.024650
0.000000
0.011100
0.000000
0.194200
0.000000
0.000000
0.177084
0.012750
0.000000
0.177084
0.044284
0.112098
0.000001
0.000000
0.000000

beneficiaza de
compensare 90% din
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
0.240540
0.240540
3.006000
0.253800
0.206074
0.572431
7.902000
8.208000
8.208000
8.208000
5.472000
0.277020
0.230099
0.124921
0.124920
1.486800
1.486800
0.577215
0.577215
0.577215
0.575460
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
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
1.535960
0.447460
0.334000
0.028200
0.209592
0.170902
0.878000
0.912000
5.832000
7.772000
4.918000
0.030780
0.025567
0.075579
0.013880
0.165200
0.165200
0.064785
0.109785
0.088785
0.063940
0.044040
0.032940
0.227140
0.032940
0.735800
0.206276
0.041942
0.025367
0.206276
0.059373
0.120939
0.155801
1.273000
1.273000
cod ATC
DCI
153 C03DA01
ISOSORBIDI DINITRAS
ISOSORBIDI DINITRAS
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
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
FUROSEMIDUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
SPIRONOLACTONUM
154 C03EB01
COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM)
155 C03EB01
156 C03EB01
157 C03EB01
158 C04AD03
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
106 C01DA08
107 C01DA14
108 C01DA14
109 C01DA14
110 C01DA14
111 C01EA01
112 C01EA01
113 C02AB01
114 C02AC01
115 C02AC01
116 C02AC01
117 C03AA03
118 C03BA11
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 C03CA01
138 C03CA01
139 C03CA01
140 C03CA01
141 C03CA01
142 C03CA01
143 C03CA01
144 C03CA01
145 C03DA01
146 C03DA01
147 C03DA01
148 C03DA01
149 C03DA01
150 C03DA01
151 C03DA01
152 C03DA01
159 C04AD03
160 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.
INDAPAMIDA SOPHARMA 1,5 mg
SERDIMID 2,5 mg
INDAPAMIDA TERAPIA 1,5 mg

INDAPAMIDA TERAPIA 2,5mg
COMPR. CU ELIB. PRELUNGITA

INDAPAMID SR ZENTIVA 1,5 mg
COMPR. ELIB. PREL
INDAPAMIDA MYLAN 1,5 mg

TERTENSIF SR 1,5 mg
INDAPAMID LPH 1,5 mg
INDAPAMID MCC 1,5 mg
IDUREN SR 1,5 mg
DIUREMID SR 1,5 mg
INDAPAMIDA TEVA 1,5 mg
COMPR. ELIB. PREL.
INDAPAMIDA SR TORRENT 1,5 mg
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
INDAPAMID LPH (R) 2,5 mg COMPR. FILM.

INDAPAMID SR 1,5 mg LAROPHARM
RAWEL SR 1,5 mg
IMPAMID SR 1,5 mg
INDAPAMIDA ACTAVIS 1,5 mg
COMPR. FILM. ELIB. PREL.

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.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
CAPS.
SPIRONOLACTONA ARENA 25 mg CAPS.
SPIRONOLACTONA LPH 25 mg CAPS.
VEROSPIRON
CAPS.
SPIRONOLACTONA BIOEEL 25 mg COMPR.
SPIRONOLACTONA TERAPIA 25 mg
ALSPIRON 25 mg
ALSPIRON 50 mg
DIUROCARD 50 mg/20 mg
DIUREX 50
DIOCOR 50 mg/20 mg
DIOCOR 50 mg/20 mg
PENTOXI RETARD 400 mg
PENTOXI RETARD 400 mg
PENTOXIFILINA SR ZENTIVA 400 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
Prescriptie
Nr crt.
105 C01DA08
cant.
UT/
Pret de
tara det.
amba referinta / UT
laj
(RON)
concentratie
APP
Detinator 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
1,5mg
2,5mg
1,5mg
2,5mg
1,5 mg
1,5 mg
1,5mg
1,5mg
1,5mg
1,5mg
1,5mg
1,5mg
1,5mg
2,5mg
1,5 mg
1,5mg
1,5mg
1,5mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
10mg/ml
100mg
25mg
25mg
50mg
50mg
25mg
25mg
25mg
50mg
50mg/20 mg
50mg/20mg
50mg/20mg
50mg/20mg
400mg
400mg
400mg
ABBOTT LABORATORIES GMBH
GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL.
ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L

ROMANIA CUTIE CU 4 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L
ZENTIVA S.A
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
UNGARIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
SLAVIA PHARM S.R.L. ROMANIA
SINTOFARM SA
ARENA GROUP SA
ARENA GROUP S.A.
ZENTIVA SA
CUTIE X 1 FLAC. X 50 COMPR.

P-6L
P-6L
P-6L
P-6L
P6L
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
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.
SOPHARMA PLC
TERAPIA SA
TERAPIA SA
ZENTIVA S.A.
MYLAN S.A.S.
LES LAB. SERVIER
ROMANIA
ROMANIA
ROMANIA
CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL.
P6L
FRANTA
FRANTA
CUTIE CU BLIST DIN PVC/AL X 30 COMPR. ELIB. PREL.
P-6L
CUTIE X 3 BLIST. AL/PVC X 10COMPR. CU ELIB. PREL.
P-6L
LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L
MAGISTRA C&C SRL ROMANIA

VIM SPECTRUM SRL ROMANIA

CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L
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
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
GLENMARK PHARMACEUTICALS SRL
KRKA D.D. NOVO MESTO SLOVENIA
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL.
P-6L
ROMANIA
P-6L
ACTAVIS GROUP PTC EHF.
ISLANDA
CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. CU ELIB. PRELUNGITA
P-6L

CUTIE X 1 FLAC. DIN PEID X 20 COMPR.
CUTIE X 2 BLIST. X 10 COMPR.
P-6L
MAGISTRA C&C S.R.L. ROMANIA

ZENTIVA SA
ROMANIA
BIO EEL SRL
ROMANIA
ZENTIVA SA
ROMANIA
GEDEON RICHTER ROMANIA SA ROMANIA
LABORMED PHARMA S.A. ROMANIA
BIO EEL SRL
ROMANIA
TERAPIA SA
ROMANIA
AC HELCOR PHARMA SRL ROMANIA
TERAPIA SA
ROMANIA
SANIENCE S.R.L.
ROMANIA
SANIENCE S.R.L.
ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
ZENTIVA AS
SLOVACIA
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. P-6L

CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L
CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L
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 4 BLIST. X 10 COMPR. CU ELIB. PREL. P-6L
CUTIE X 2 BLIST. X 10 COMPR. FILM. ELIB. PREL.
P-6L
P-6L
Pagina 3 din 21
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
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
0.209031
0.209031
0.209031
0.173200
0.279809
0.279809
0.466349
0.279809
0.466349
0.279809
0.268000
0.279809
0.279809
0.279809
0.279809
0.279809
0.264666
0.279809
0.466349
0.279809
0.264666
0.279809
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
beneficiaza de
compensare 100%
din pretul de
referinta)
0.000000
0.000000
0.302841
0.151841
0.489262
0.509484
10.297500
0.000000
0.000000
0.030969
0.046969
0.046769
0.000000
0.069857
0.042191
0.054984
0.069857
0.048651
0.069857
0.000000
0.258524
0.069857
0.069857
0.069857
0.069857
0.000000
0.069857
0.054984
0.070191
0.000000
0.069857
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

beneficiaza de
compensare 90% din
0.027900
0.061499
0.261143
0.261143
0.391714
0.391514
37.811250
34.722000
0.498960
0.188127
0.188127
0.188127
0.155880
0.251828
0.251828
0.419714
0.251828
0.419714
0.251828
0.241200
0.251828
0.251828
0.251828
0.251828
0.251828
0.238199
0.251828
0.419714
0.251828
0.238199
0.251828
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.003100
0.006834
0.331857
0.180857
0.532786
0.552986
14.498750
3.858000
0.055440
0.051873
0.067873
0.067673
0.017320
0.097838
0.070172
0.101619
0.097838
0.095286
0.097838
0.026800
0.286505
0.097838
0.097838
0.097838
0.097838
0.026467
0.097838
0.101619
0.098172
0.026467
0.097838
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
162 C04AD03
163 C04AD03
164 C04AD03
165 C04AD03
166 C04AD03
167 C04AD03
168 C07AA05
169 C07AA05
170 C07AA05
171 C07AA05
172 C07AA05
173 C07AA07
174 C07AA07
175 C07AA07
176 C07AA07
177 C07AB02
178 C07AB02
179 C07AB02
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
DCI
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
PENTOXIFYLLINUM
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
METOPROLOLUM
METOPROLOLUM
METOPROLOLUM
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
ANGIOPENT 600 mg
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
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
25mg
METOPROLOL 25 mg
COMPR.
25mg
25mg
25mg
METOPROLOL LAROPHARM 50 mg COMPR.
50mg
BETAPROL 50 mg
COMPR.
50mg
EGILOK 50 mg
COMPR.
50mg
50mg
METOPROLOL 50 mg
COMPR.
50mg
50mg
50mg
50mg
METOPROLOL 50 mg
COMPR.
50mg
METOPROLOL AL 50
COMPR.
50mg
50mg
METOSUCCINAT SANDOZ 190 mg COMPR. ELIB. MODIF. 190mg
METOSUCCINAT SANDOZ 47,5 mg COMPR. ELIB. MODIF. 47,5mg
METOSUCCINAT SANDOZ 95 mg COMPR. ELIB. MODIF. 95mg
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
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
PENTOXIFILINA SR ZENTIVA 400 mg
COMPR. ELIB. PREL.
Detinator APP
Ambalaj
Prescriptie
Nr crt.
161 C04AD03
tara det.
APP
ZENTIVA AS
ZENTIVA AS
ZENTIVA AS
SLOVACIA
SLOVACIA
SLOVACIA
P-6L
P-6L
P-6L
LANNACHER HEILMITTEL GES.M.B.H.
AUSTRIA
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L
ROMANIA
ROMANIA
BIO EEL S.R.L.
ROMANIA
SINTOFARM SA
ROMANIA
BIO EEL SRL
ROMANIA
SINTOFARM SA
ROMANIA
ALIUD PHARMA GMBH GERMANIA
AC HELCOR PHARMA SRL
CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
P-6L
LABORMED PHARMA S.A.
CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL
P-6L

WORWAG PHARMA GMBH & CO. KG
CUTIE X 2 BLIST., AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L

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

SLAVIA PHARMA S.R.L.

ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
ZENTIVA S.A.
LABORMED PHARMA SA
MAGISTRA C & C SRL
ARENA GROUP S.A.

LABORMED PHARMA SA
LAROPHARM SRL
LABORMED PHARMA SA
MAGISTRA C & C SRL
TERAPIA SA
VIM SPECTRUM SRL
ARENA GROUP S.A.
ROMANIA
UNGARIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
UNGARIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE
P6L
CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR.
P-6L

P-6L
P-6L

P-6L

ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR.
ZENTIVA S.A.
HEXAL AG
HEXAL AG
HEXAL AG
TERAPIA SA
P-6L
CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 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
ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L

GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L
ROMANIA
MALTA
AUROBINDO PHARMA (MALTA) LIMITED MALTA
ASTRAZENECA AB SUEDIA
HEXAL AG
GERMANIA
HEXAL AG
GERMANIA
HEXAL AG
GERMANIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL.
P-6L
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L

CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L

CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF.
P-6L
P-6L
P-6L
P-6L
Pagina 4 din 21
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
50
50
100
50
20
60
20
50
50
50
50
50
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
30
30
30
20
30
30
30
30
30
30
30
30
0.426200
0.648425
0.648425
0.648425
0.318000
0.318166
0.648425
0.025800
0.025800
0.099600
0.099600
0.103200
0.412800
0.206400
0.206400
0.206400
0.077000
0.221400
0.221400
0.221400
0.221400
0.221400
0.221400
0.221400
0.221400
0.221400
0.221400
0.221400
0.055349
0.055349
0.055349
0.055349
0.055349
0.110700
0.110700
0.110700
0.110700
0.110700
0.110700
0.110700
0.110700
0.110700
0.110700
0.110700
0.420660
0.105164
0.210330
0.221400
0.221400
0.110700
0.221400
0.110700
0.420660
0.105164
0.210330
0.365666
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.000000
0.053575
0.029875
0.027375
0.000000
0.000000
0.174575
0.041600
0.056200
0.000000
0.000000
0.000000
0.146000
0.311100
0.130100
0.120600
0.000000
0.074933
0.075100
0.024600
0.075100
0.074933
0.074933
0.075100
0.020933
0.069100
0.074933
0.074933
0.043151
0.043151
0.043317
0.043317
0.042984
0.071800
0.071633
0.071800
0.053633
0.071633
0.133300
0.061800
0.071633
0.071800
0.040966
0.071633
0.083340
0.110502
0.148003
0.075100
0.074933
0.070633
0.234600
0.269300
0.083340
0.110502
0.148003
0.000000

beneficiaza de
compensare 90% din
0.383580
0.583582
0.583582
0.583582
0.286200
0.286349
0.583582
0.023220
0.023220
0.089640
0.089640
0.092880
0.371520
0.185760
0.185760
0.185760
0.069300
0.199260
0.199260
0.199260
0.199260
0.199260
0.199260
0.199260
0.199260
0.199260
0.199260
0.199260
0.049814
0.049814
0.049814
0.049814
0.049814
0.099630
0.099630
0.099630
0.099630
0.099630
0.099630
0.099630
0.099630
0.099630
0.099630
0.099630
0.378594
0.094647
0.189297
0.199260
0.199260
0.099630
0.199260
0.099630
0.378594
0.094647
0.189297
0.329099
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.042620
0.118418
0.094718
0.092218
0.031800
0.031817
0.239418
0.044180
0.058780
0.009960
0.009960
0.010320
0.187280
0.331740
0.150740
0.141240
0.007700
0.097073
0.097240
0.046740
0.097240
0.097073
0.097073
0.097240
0.043073
0.091240
0.097073
0.097073
0.048686
0.048686
0.048852
0.048852
0.048519
0.082870
0.082703
0.082870
0.064703
0.082703
0.144370
0.072870
0.082703
0.082870
0.052036
0.082703
0.125406
0.121019
0.169036
0.097240
0.097073
0.081703
0.256740
0.280370
0.125406
0.121019
0.169036
0.036567
cod ATC
218 C07AB03
219 C07AB03
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
DCI
ATENOLOLUM
ATENOLOLUM
ATENOLOLUM
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
Denumire Comerciala
ATENOLOL LPH 100 mg

ATENOLOL ARENA 100 MG
ATENOLOL LPH 50 mg
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
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
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
P-6L
P-6L
P-6L
P-6L
P-6L
COMPR. FILM. 20mg
FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM.
P-6L
COMPR.
COMPR.
COMPR.
COMPR.
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR.
P-6L
ISLANDA CUTIE X 3 BLIST. X 10 COMPR.
P-6L
P-6L
ISLANDA CUTIE X 3 BLIST. X 10 COMPR.
P-6L
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.

CORYOL 12,5 mg
TALLITON (R) 12,5 mg
Ambalaj

Prescriptie
Nr crt.
217 C07AB03
tara det.
concentratie
APP
Detinator APP
100mg
100mg
50mg
50mg
50mg
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
10mg
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
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
GERMANIA
GERMANIA
MERCK KGAA
ANTIBIOTICE S.A.
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L

MALTA
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM.
KRKA, D.D., NOVO MESTO SLOVENIA
MERCK KGAA
MERCK KGAA
GERMANIA
GERMANIA
P-6L/S
P-6L
P-6L
P6L
P6L
CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L
P6L
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L
CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM.
MERCK KGAA
GERMANIA
GERMANIA
GERMANIA
MERCK KGAA
ANTIBIOTICE S.A.
GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM.
P-6L
P-6L

MALTA
MERCK KGAA
GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM.
UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
P-6L
P-6L
P6L
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. P-6L
CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM.

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

ANTIBIOTICE S.A.
ROMANIA
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
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 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

KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L
P-6L

VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
ANTIBIOTICE S.A.
SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L
HEXAL AG
Pagina 5 din 21
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
20
20
20
30
20
28
30
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
0.365000
0.324500
0.204000
0.204000
0.185000
0.332100
0.332100
0.231000
0.166050
0.122333
0.332100
0.332100
0.332100
0.332100
0.332100
0.332100
0.332100
0.332100
0.332100
0.083025
0.083025
0.083025
0.083025
0.166050
0.160333
0.166050
0.166050
0.166050
0.166050
0.166050
0.166050
0.246149
0.246149
0.246149
0.246149
0.246149
0.246149
0.246149
0.246149
0.246149
0.492299
0.355000
0.492299
0.492299
0.492299
0.492299
0.492299
0.317333
0.123074
0.123074
0.123074
0.123074
0.123074
0.123074
0.123074
0.123074
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.000000
0.000000
0.000000
0.000000
0.000000
0.023971
0.241566
0.000000
0.086616
0.000000
0.030900
0.550900
0.169100
0.028566
0.753233
0.014566
0.140566
0.753233
0.015233
0.160308
0.291308
0.291308
0.125975
0.348950
0.000000
0.002850
0.223283
0.040283
0.106283
0.223283
0.040283
0.031184
0.588136
0.013136
0.034851
0.216184
0.089851
0.139184
0.216184
0.205851
0.434486
0.000000
0.031034
0.109701
0.031701
0.108701
0.110201
0.000000
0.266568
0.075140
0.061926
0.115259
0.104926
0.061926
0.115259
0.057259

beneficiaza de
compensare 90% din
0.328500
0.292050
0.183600
0.183600
0.166500
0.298890
0.298890
0.207900
0.149445
0.110099
0.298890
0.298890
0.298890
0.298890
0.298890
0.298890
0.298890
0.298890
0.298890
0.074722
0.074722
0.074722
0.074722
0.149445
0.144299
0.149445
0.149445
0.149445
0.149445
0.149445
0.149445
0.221534
0.221534
0.221534
0.221534
0.221534
0.221534
0.221534
0.221534
0.221534
0.443069
0.319500
0.443069
0.443069
0.443069
0.443069
0.443069
0.285599
0.110766
0.110766
0.110766
0.110766
0.110766
0.110766
0.110766
0.110766
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.036500
0.032450
0.020400
0.020400
0.018500
0.057181
0.274776
0.023100
0.103221
0.012234
0.064110
0.584110
0.202310
0.061776
0.786443
0.047776
0.173776
0.786443
0.048443
0.168611
0.299611
0.299611
0.134278
0.365555
0.016034
0.019455
0.239888
0.056888
0.122888
0.239888
0.056888
0.055799
0.612751
0.037751
0.059466
0.240799
0.114466
0.163799
0.240799
0.230466
0.483716
0.035500
0.080264
0.158931
0.080931
0.157931
0.159431
0.031734
0.278876
0.087448
0.074234
0.127567
0.117234
0.074234
0.127567
0.069567
cod ATC
274 C07AG02
275 C07AG02
276 C08CA01
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 C08CA01
307 C08CA01
308 C08CA01
309 C08CA01
310 C08CA01
311 C08CA01
312 C08CA02
313 C08CA02
314 C08CA02
315 C08CA02
316 C08CA02
317 C08CA02
318 C08CA02
319 C08CA02
320 C08CA02
321 C08CA02
322 C08CA02
323 C08CA05
324 C08CA05
325 C08DA01
326 C08DA01
327 C08DA01
328 C08DA01
DCI
CARVEDILOLUM
CARVEDILOLUM
CARVEDILOLUM
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
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
AMLODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
FELODIPINUM
NIFEDIPINUM
NIFEDIPINUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
Denumire Comerciala
forma farm.
concentratie
12,5mg
CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg
CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg
AMLODIPINA TEVA 10 mg COMPR.
10 mg
AMLOHEXAL 10 mg
COMPR.
10mg
TENOX (R) 10
COMPR.
10mg
AMLODIPINE MEDOCHEMIE 10 mg COMPR.
10mg
ALMACOR 10 mg
COMPR.
10mg
AMLODIPINA LPH 10 mg
COMPR.
10mg
AMLODIPINA TERAPIA 10 mg COMPR.
10mg
10mg
AMLODIPINA AUROBINDO 10 mg COMPR.
10mg
RECOTENS 10 mg
COMPR.
10mg
AMLODIPIN VIM SPECTRUM 10 mg COMPR.
10mg
AMLODIPINA ACTAVIS 10 mg COMPR.
10mg
AMLODIPINA ZENTIVA 10 mg COMPR.
10mg
NORVASC 10 mg
COMPR.
10mg
AMLODIPINA HELCOR 10 mg COMPR.
10mg
AMLODIPINA ARENA 10 mg COMPR.
10mg
AMLODIPINA VIM SPECTRUM 10 mg COMPR.
10mg
10mg
AMLODIPINA TEVA 5 mg
COMPR.
5 mg
AMLOHEXAL 5 mg
COMPR.
5mg
TENOX (R) 5
COMPR.
5mg
AMLODIPINE MEDOCHEMIE 5 mg COMPR.
5mg
ALMACOR 5 mg
COMPR.
5mg
AMLODIPINA LPH 5 mg
COMPR.
5mg
5mg
5mg
AMLODIPINA AUROBINDO 5 mg COMPR.
5mg
RECOTENS 5 mg
COMPR.
5mg
AMLODIPIN VIM SPECTRUM 5 mg COMPR.
5mg
AMLODIPINA ACTAVIS 5 mg COMPR.
5mg
AMLODIPINA ZENTIVA 5 mg COMPR.
5mg
NORVASC 5 mg
COMPR.
5mg
AMLODIPINA HELCOR 5 mg COMPR.
5mg
AMLODIPINA ARENA 5 mg COMPR.
5mg
5mg
5mg
PLENDIL
PLENDIL
COMPR. ELIB. PREL. 2,5mg
PLENDIL
SISTAR 10 mg
COMPR. FILM. ELIB. MODIF.
10mg
SISTAR 2,5 mg
2,5mg
SISTAR 5 mg
5mg
AURONAL 10 mg
FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL. 10mg
AURONAL 2,5 mg
COMPR. FILM. ELIB. PREL. 2,5mg
AURONAL 5 mg
FELODIPIN SANDOZ 5 mg COMPR. FILM. ELIB. PREL. 5mg
ADALAT CR 30
COMPR. ELIB. MODIF. 30mg
NIFEDIPIN RETARD TERAPIA 20 mg COMPR. ELIB. PREL. 20mg
VERAPAMIL ARENA 40 mg CAPS.
40mg
VERAPAMIL ARENA 80 mg CAPS.
80mg
ISOPTIN RR
CORDAMIL 40 mg
COMPR. FILM. 40mg
CARVEDILOL AUROBINDO 12,5mg COMPR. FILM.
Detinator APP
TEVA PHARMACEUTICALS S.R.L.
MALTA
MALTA
MALTA
Ambalaj
Prescriptie
Nr crt.
273 C07AG02
tara det.
APP
P6L
P6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L
KRKA D.D.
MEDOCHEMIE LTD. CIPRU
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L
ANTIBIOTICE S.A.
LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L
CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L
POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L
ICN POLFA RZESZOW S.A.

ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L
ZENTIVA K.S.
REPUBLICA CEHA
PFIZER EUROPE MA EEIG
MAREA BRITANIE
A.C. HELCOR PHARMA S.R.L.
ROMANIA

VIM SPECTRUM S.R.L. ROMANIA
TEVA PHARMACEUTICALS S.R.L. ROMANIA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR.

P6L
P6L
CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L
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.
CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L
ANTIBIOTICE S.A.
LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
TERAPIA SA
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L
CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L
POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L
ICN POLFA RZESZOW S.A.

ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L
ZENTIVA K.S.
REPUBLICA CEHA
MAREA BRITANIE
ROMANIA


P6L
P6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L
CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL.
P-6L
CUTIE 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L

CUTIE X 1 FLAC. DIN PE X, 30 COMPR. ELIB. PREL. P-6L
ROMANIA
ROMANIA
ROMANIA
UNGARIA
CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL.
P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
P-6L
UNGARIA
UNGARIA
P-6L
P-6L

CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF.
P-6L
P-6L
P-6L
HEXAL AG
GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L
BAYER PHARMA AG GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L
TERAPIA SA
ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L
ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
AC HELCOR SRL
ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM.
Pagina 6 din 21
P-6L
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
28
28
28
30
30
30
30
30
30
30
30
30
30
20
20
30
30
20
30
20
30
30
30
30
30
30
30
30
30
30
30
20
20
30
30
20
30
20
30
30
30
30
30
30
30
30
30
30
30
30
28
50
30
30
20
30
0.246149
0.285714
0.123074
0.123333
0.264299
0.264299
0.264299
0.264299
0.264299
0.264299
0.264299
0.255333
0.264299
0.264299
0.192500
0.264299
0.264299
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
0.132149
0.121500
0.132149
0.132149
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.010993
0.000000
0.056926
0.000000
0.029367
0.029367
0.029367
0.029367
0.029367
0.029367
0.029367
0.000000
0.029367
0.029201
0.000000
0.009034
0.187701
0.029201
0.029367
0.029201
0.029367
0.000000
0.238184
0.097517
0.096851
0.098851
0.238184
0.238184
0.238184
0.049184
0.131184
0.237851
0.000000
0.003851
0.437517
0.237851
0.140517
0.237851
0.238184
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

beneficiaza de
compensare 90% din
0.221534
0.257142
0.110766
0.110999
0.237869
0.237869
0.237869
0.237869
0.237869
0.237869
0.237869
0.229799
0.237869
0.237869
0.173250
0.237869
0.237869
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
0.118934
0.109350
0.118934
0.118934
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.035608
0.028572
0.069234
0.012334
0.055797
0.055797
0.055797
0.055797
0.055797
0.055797
0.055797
0.025534
0.055797
0.055631
0.019250
0.035464
0.214131
0.055631
0.055797
0.055631
0.055797
0.012534
0.251399
0.110732
0.110066
0.112066
0.251399
0.251399
0.251399
0.062399
0.144399
0.251066
0.012150
0.017066
0.450732
0.251066
0.153732
0.251066
0.251399
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
cod ATC
330 C08DA01
331 C08DA01
332 C08DA01
333 C08DB01
334 C08DB01
335 C08DB01
336 C08DB01
337 C08DB01
338 C08DB01
339 C08DB01
340 C08DB01
341 C09AA01
342 C09AA01
343 C09AA01
344 C09AA01
345 C09AA01
346 C09AA01
347 C09AA01
348 C09AA01
349 C09AA01
350 C09AA01
351 C09AA01
352 C09AA01
353 C09AA01
354 C09AA01
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 C09AA02
380 C09AA02
381 C09AA02
382 C09AA02
383 C09AA02
384 C09AA02
DCI
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
VERAPAMILUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
DILTIAZEMUM
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
Denumire Comerciala
CORDAMIL 80 mg
ISOPTIN (R) 80 mg
VERAPAMIL 40 mg
VERAPAMIL 80 mg
DILTIAZEM SR ROMPHARM 180 mg CAPS. ELIB. PREL.
DILTIAZEM SR ROMPHARM 90 mg CAPS. ELIB. PREL.
DILTIAZEM EIPICO 60 mg
DILTIAZEM LPH 60 mg
DILTIAZEM ARENA 60 mg
DILTIAZEM BIOEEL 60 mg
DILTIAZEM LPH 60 mg
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 50 mg
CAPTOPRIL 50 EEL
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 VIM SPECTRUM 10 mg
ENALAPRIL LAROPHARM 10 mg
ENALAPRIL TERAPIA 10mg

ENALAPRIL 20 mg
ENALAPRIL LPH 20 mg
ENALAPRIL LPH 20 mg
ENAP 20 mg
RENITEC 20 mg
ENALAPRIL ARENA 20 mg

ENALAPRIL 5 mg
ENAP 5 mg
RENITEC 5 mg
ENALAPRIL LPH (R) 5 mg
LABORMED PHARMA SA
MAREA BRITANIE
MAGISTRA C & C
TERAPIA SA
BIO EEL SRL
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
CUTIE X 3 BLIST. AL/PVC, X 10 COMPR.

CUTIE X 3 BLIST. AL/AL X 10 COMPR.
forma farm. concentratie

Detinator APP
COMPR. FILM. 80mg
AC HELCOR SRL
COMPR. FILM. 80mg
ABBOTT GMBH&CO.KG
DRAJ.
DRAJ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. ELIB. PREL.
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.
COMPR.
COMPR.
40mg
80mg
180mg
90mg
60mg
60mg
60mg
60mg
60mg
90mg
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
10mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
5mg
5mg
5mg
5mg
5mg
5mg
Prescriptie
Nr crt.
329 C08DA01
tara det.
APP
Ambalaj
ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM.
GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM.
ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ.
ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 10 CAPS. ELIB. PREL.
ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 7 CAPS. ELIB. PREL.
ROMANIA CUTIE X 2, BLIST. AL/PVC X 10 COMPR.
ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR.
ROMANIA CUTIE X 2 BLIST. DIN AL/ PVC X 10 COMPR.
ROMANIA CUTIE X 6 BLIST. DIN PVC/AL X 10 COMPRIMATE
SANOFI-AVENTIS ROMANIA S.R.L.


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

LABORMED PHARMA SA
ARENA GROUP SA
BIO EEL SRL
MAGISTRA C & C
LABORMED PHARMA SA
SINTOFARM SA
ARENA GROUP SA
ARENA GROUP SA
TERAPIA SA
BIO EEL SRL
MAGISTRA C & C
LABORMED PHARMA SA
MAGISTRA C & C
LABORMED PHARMA SA
LABORMED PHARMA SA
P-6L
P-6L
P-6L
P-6L
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
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 CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L

ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L
ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L
VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L
MAGISTRA C & C
ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR.
P-6L
P-6L
MERCK SHARP & DOHME
ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.

TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR.
ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR.
MERCK SHARP & DOHME
P-6L
P-6L
P-6L
P-6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L

LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L
TERAPIA SA
ROMANIA CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L
MAGISTRA C & C
P-6L
MERCK SHARP & DOHME
ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR.

TERAPIA SA
ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR.
Pagina 7 din 21
P-6L
P-6L
P-6L
P-6L
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
30
50
50
50
30
21
20
20
50
20
60
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
30
20
28
20
30
50
20
20
20
20
20
28
30
20
20
0.197666
0.199666
0.099832
0.197600
0.781541
0.227619
0.260513
0.260513
0.260513
0.260513
0.260513
0.350333
0.037324
0.074648
0.074648
0.074648
0.074648
0.074648
0.074648
0.074648
0.138000
0.149297
0.149297
0.138000
0.149297
0.136000
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.074648
0.074648
0.074648
0.074648
0.074648
0.074648
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.000000
0.104134
0.145368
0.000000
0.411459
0.000000
0.008987
0.018987
0.017087
0.008987
0.019153
0.000000
0.080342
0.067018
0.076352
0.043852
0.043352
0.043352
0.080018
0.043852
0.000000
0.081369
0.044203
0.000000
0.006369
0.000000
0.050203
0.050036
0.049703
0.050203
0.041203
0.157131
0.050203
0.050036
0.050103
0.049903
0.050203
0.049703
0.050203
0.031905
0.031905
0.032071
0.031905
0.210333
0.031905
0.032071
0.032005
0.031905
0.031905
0.031905
0.018352
0.019352
0.069637
0.018685
0.018352
0.018352

beneficiaza de
compensare 90% din
0.177899
0.179699
0.089848
0.177840
0.703386
0.204857
0.234461
0.234461
0.234461
0.234461
0.234461
0.315299
0.033591
0.067183
0.067183
0.067183
0.067183
0.067183
0.067183
0.067183
0.124200
0.134367
0.134367
0.124200
0.134367
0.122400
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.067183
0.067183
0.067183
0.067183
0.067183
0.067183
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.019767
0.124101
0.155352
0.019760
0.489614
0.022762
0.035039
0.045039
0.043139
0.035039
0.045205
0.035034
0.084075
0.074483
0.083817
0.051317
0.050817
0.050817
0.087483
0.051317
0.013800
0.096299
0.059133
0.013800
0.021299
0.013600
0.065133
0.064966
0.064633
0.065133
0.056133
0.172061
0.065133
0.064966
0.065033
0.064833
0.065133
0.064633
0.065133
0.061765
0.061765
0.061931
0.061765
0.240193
0.061765
0.061931
0.061865
0.061765
0.061765
0.061765
0.025817
0.026817
0.077102
0.026150
0.025817
0.025817
cod ATC
386 C09AA02
387 C09AA02
388 C09AA02
389 C09AA02
390 C09AA03
391 C09AA03
392 C09AA03
393 C09AA03
394 C09AA03
395 C09AA03
396 C09AA03
397 C09AA03
398 C09AA03
399 C09AA03
400 C09AA03
401 C09AA03
402 C09AA03
403 C09AA03
404 C09AA03
405 C09AA03
406 C09AA03
407 C09AA03
408 C09AA03
409 C09AA03
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 C09AA05
434 C09AA05
435 C09AA05
436 C09AA05
437 C09AA05
438 C09AA05
439 C09AA06
440 C09AA06
DCI
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
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
Denumire Comerciala
forma farm.
COMPR.
COMPR.
ENALAPRIL LAROPHARM 5 mg COMPR.
ENALAPRIL TERAPIA 5mg COMPR.
ENAP 1,25 mg/ml
SOL. INJ./PERF.
RANOLIP
COMPR.
LISIREN 10 mg
COMPR.
LISINOPRIL SANDOZ 10 mg COMPR.
LISINOPRIL 10 MEDO
COMPR.
LISINOPRIL ACTAVIS 10 mg COMPR.
LISINOPRIL ATB 10 MG
COMPR.
TONOLYSIN 10 mg
COMPR.
TONOLYSIN 2,5 mg
COMPR.
RANOLIP
COMPR.
LISIREN 20 mg
COMPR.
LISINOPRIL SANDOZ 20 mg COMPR.
COMPR.
TONOLYSIN 20 mg
COMPR.
LISINOPRIL 20 MEDO
COMPR.
COMPR.
RANOLIP
COMPR.
LISINOPRIL 5 MEDO
COMPR.
TONOLYSIN 5 mg
COMPR.
VIVACE 10 mg
COMPR.
PIRAMIL 10 mg
COMPR.
RAMIPRIL-AC 10 mg
COMPR.
AMPRIL 10 mg
COMPR.
ZENRA 10
COMPR.
TRITACE 10
COMPR.
RAMIPRIL AUROBINDO 10 mg COMPR.
AMPRIGEN 10 mg
COMPR.
RAMIRAN 10 mg
COMPR.
RAMIRAN 10 mg
COMPR.
VIVACE 2,5 mg
COMPR.
PIRAMIL 2,5 mg
COMPR.
RAMIPRIL-AC 2,5 mg
COMPR.
AMPRIL 2,5 mg
COMPR.
ZENRA 2,5
COMPR.
TRITACE(R) 2,5
COMPR.
AMPRIGEN 2,5 mg
COMPR.
RAMIRAN 2,5 mg
COMPR.
RAMIRAN 2,5 mg
COMPR.
VIVACE 5 mg
COMPR.
PIRAMIL 5 mg
COMPR.
RAMIPRIL-AC 5 mg
COMPR.
AMPRIL 5 mg
COMPR.
ZENRA 5
COMPR.
TRITACE 5
COMPR.
RAMIPRIL AUROBINDO 5 mg COMPR.
AMPRIGEN 5 mg
COMPR.
RAMIRAN 5 mg
COMPR.
RAMIRAN 5 mg
COMPR.
ACCUPRO 10 mg
COMPR. FILM.
ACCUPRO (R) 20
COMPR. FILM.
1,25mg/ml
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40mg
5mg
5mg
5mg
5mg
10 mg
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
10mg
20mg
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
RANBAXY U.K. LIMITED
MAREA BRITANIE
AC HELCOR SRL
HEXAL AG
GERMANIA
MEDOCHEMIE ROMANIA SRL
ROMANIA
ISLANDA
ANTIBIOTICE SA
ROMANIA
ROMANIA
ROMANIA
MAREA BRITANIE
ROMANIA

CUTIE CU BLIST. PVC/AL X 30 COMPR.
Prescriptie
Nr crt.
385 C09AA02
tara det.
concentratie
APP
Detinator APP
Ambalaj
5mg
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.
5mg
SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
5mg
LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR.
5mg
TERAPIA SA
ROMANIA CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI)
P-6L
P6L
P6L
P6L
PR/PRF
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
AC HELCOR SRL
HEXAL AG
GERMANIA
ISLANDA
ANTIBIOTICE SA
P-6L
ANTIBIOTICE SA
ROMANIA
ROMANIA
ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR.
MAREA BRITANIE
P-6L
ROMANIA
ISLANDA
ROMANIA

ROMANIA
ACTAVIS GROUP HF ISLANDA

SANDOZ SRL
ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR.
AC HELCOR PHARMA SRL ROMANIA 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
P-6L
P-6L
P-6L
ZENTIVA S.A.
SANOFI - AVENTIS ROMANIA S.R.L.

P-6L
P-6L
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
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.

SANDOZ SRL
P-6L
P-6L
P-6L

P-6L
ZENTIVA S.A.
ALVOGEN IPCO S.A.R.L
LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR.
P6L
TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF
SANDOZ SRL

ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR.

P-6L
P-6L
P-6L
P-6L
ZENTIVA S.A.

MALTA
MAREA BRITANIE
P-6L
P-6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L

TERAPIA SA
TERAPIA SA
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM. P-6L
CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L
Pagina 8 din 21
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
30
20
20
20
5
30
20
30
30
30
30
28
28
30
20
30
30
30
28
20
30
30
30
30
28
28
28
30
30
28
28
28
30
30
30
28
28
30
30
28
28
30
30
30
28
28
30
30
28
28
28
30
30
30
30
30
0.074648
0.074648
0.074648
0.074648
3.204000
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.037324
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.597191
0.074648
0.074648
0.074648
0.074648
0.238214
0.302142
0.302000
0.302000
0.302142
0.464285
0.302142
0.302000
0.302000
0.302000
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.172142
0.248214
0.248000
0.248000
0.239285
0.298595
0.248214
0.248000
0.248000
0.248000
0.099531
0.199063
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.018685
0.015352
0.015352
0.018352
0.000000
0.369036
0.387703
0.120703
0.105036
0.120703
0.264036
0.237131
0.273747
0.500738
0.483905
0.080405
0.080405
0.513405
0.350333
0.129905
0.762142
0.190018
0.118018
0.118352
0.188566
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000345
0.022845
0.019036
0.022703
0.016774
0.115345
0.022703
0.022703
0.022703
0.000000
0.000000
0.000000
0.000000
0.000000
0.083190
0.000000
0.000000
0.000000
0.000000
0.302135
0.377603

beneficiaza de
compensare 90% din
0.067183
0.067183
0.067183
0.067183
2.883600
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.033591
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.537471
0.067183
0.067183
0.067183
0.067183
0.214392
0.271927
0.271800
0.271800
0.271927
0.417856
0.271927
0.271800
0.271800
0.271800
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.134367
0.154927
0.223392
0.223200
0.223200
0.215356
0.268735
0.223392
0.223200
0.223200
0.223200
0.089577
0.179156
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.026150
0.022817
0.022817
0.025817
0.320400
0.383966
0.402633
0.135633
0.119966
0.135633
0.278966
0.252061
0.277480
0.530598
0.513765
0.110265
0.110265
0.543265
0.380193
0.159765
0.821862
0.197483
0.125483
0.125817
0.196031
0.023822
0.030215
0.030200
0.030200
0.030215
0.046429
0.030215
0.030200
0.030200
0.030200
0.015275
0.037775
0.033966
0.037633
0.031704
0.130275
0.037633
0.037633
0.037633
0.017215
0.024822
0.024800
0.024800
0.023929
0.113050
0.024822
0.024800
0.024800
0.024800
0.312089
0.397510
DCI
449 C09AA09
QUINAPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
FOSINOPRILUM
450 C09BA02
COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM)
451 C09BA02
452 C09BA02
453 C09BA02
454 C09BA05
COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM)
455 C09BA05
456 C09BA05
457 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
Nr crt.
442 C09AA09
443 C09AA09
444 C09AA09
445 C09AA09
446 C09AA09
447 C09AA09
448 C09AA09
458 C09CA01
459 C09CA01
460 C09CA01
461 C09CA01
462 C09CA01
463 C09CA01
464 C09CA01
465 C09CA01
466 C09CA01
467 C09CA01
468 C09CA01
469 C09CA01
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
Denumire Comerciala
ACCUPRO (R) 5
MONOPRIL 10 mg
FOSYPRIL 10 mg

Detinator APP
COMPR. FILM. 5mg
COMPR.
COMPR.
FOSINOPRIL AUROBINDO 10 mg COMPR.
MONOPRIL 10 mg
COMPR.
MONOPRIL 20 mg
COMPR.
FOSYPRIL 20 mg
COMPR.
FOSINOPRIL AUROBINDO 20 mg COMPR.
MONOPRIL 20 mg
COMPR.
ENAP HL
COMPR.
ENAP H
COMPR.
VIMAPRIL H
COMPR.
ENAP (R) HL 20 mg/12,5 mg COMPR.
TRITACE 2,5 PLUS
COMPR.
HARTIL HCT 5 mg/25mg
COMPR.
TRITACE 5 PLUS
COMPR.
LODIAL 100mg
COMPR. FILM.
TALOSAN 100 mg
COMPR. FILM.
TALOSAN 100 mg
COMPR. FILM.
LOZAP 100
COMPR. FILM.
LORISTA 100 mg
COMPR. FILM.
LOSARTAN ZENTIVA 100 mg COMPR. FILM.
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
ZEPLAN (R) 20 mg
ZOCOR 20 mg
SINTENAL 20 mg
VASILIP 20 mg
SIMCOR 20 mg
SIMVACARD 20 mg
VASILIP (R) 40 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.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
10mg
10mg
10mg
10mg
20mg
20mg
20mg
20mg
MAREA BRITANIE
Ambalaj
Prescriptie
cod ATC
441 C09AA06
tara det.
APP
CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L
TERAPIA SA
UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR.

ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR.
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.
BRISTOL-MYERS SQUIBB
TERAPIA SA
UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR.

ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR.
MALTA
BRISTOL MYERS SQUIBB KFT
P-6L
P-6L
P-6L
P-6L
P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L

REPUBLICA CEHA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR.
P-6L
10mg+12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L
10mg+25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L
10mg/25mg VIM SPECTRUM SRL ROMANIA
CUTIE X 3 BLIST.OPA-AL-PVC/AL A CATE 10 CAPS. P-6L
20 mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L
2,5mg/12,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L
5mg/25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L
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
ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L

ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 2 BLIST. DIN PVC/AL X 15 COMPR. FILM. P6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L
ZENTIVA A.S.
SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
P-6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L
ZENTIVA A.S.
P-6L
ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPR. FILM. P6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L
ZENTIVA A.S.
P-6L
MERCK SHARP & DOHME
ROMANIA
P-6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 28 COMPR. FILM.
P6L
ZENTIVA A.S.
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM.
HEXAL AG
P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM

AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
P-6L
KRKA D.D.
P-6L
SLOVENIA
CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM.
P-6L
P-6L
P-6L
CIPLA (UK) LIMITED MAREA BRITANIE

ZENTIVA K.S.
CEHIA
CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L
AUROBINDO PHARMA LIMITED
MAREA BRITANIE
CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.
ISLANDA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L
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
ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM

ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM.
P-6L
MERCK SHARP & DOHME
P-6L
KRKA D.D.
ANTIBIOTICE SA
CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM.
P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
P-6L
SLOVENIA
P-6L
P-6L
CIPLA (UK) LIMITED MAREA BRITANIE

ZENTIVA K.S.
CEHIA
MAREA BRITANIE
ISLANDA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L
P6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
HEXAL AG
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
Pagina 9 din 21
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
30
28
30
30
28
28
30
30
28
20
20
30
20
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
0.049765
0.099531
0.099531
0.099531
0.099531
0.199063
0.199063
0.199063
0.199063
0.380925
0.380925
0.380925
0.380925
0.314285
0.374285
0.380925
0.694927
0.694927
0.694927
0.445333
0.517857
0.445333
0.334333
0.334333
0.334333
0.268000
0.347463
0.334642
0.268000
0.125296
0.125296
0.125296
0.125296
0.125296
0.125296
0.125296
0.125296
0.125296
0.125296
0.125296
0.250593
0.250593
0.250593
0.250593
0.250593
0.250593
0.250593
0.250593
0.235000
0.245357
0.246000
0.118666
0.250593
0.375890
0.501187
0.501187
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.142235
0.485826
0.281135
0.281135
0.485826
0.649865
0.352937
0.352937
0.649865
0.046075
0.086075
0.013075
0.031075
0.000000
0.000000
0.194789
0.529739
0.423073
0.423073
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.167179
0.000000
0.000000
0.198989
0.022037
0.078275
0.186370
0.198275
0.198704
0.016846
0.023275
0.022704
0.022037
0.179370
0.182621
0.090073
0.182621
0.415835
0.182407
0.182621
0.182407
0.182407
0.000000
0.000000
0.000000
0.000000
0.182407
0.107443
0.605955
0.450241

beneficiaza de
compensare 90% din
0.044788
0.089577
0.089577
0.089577
0.089577
0.179156
0.179156
0.179156
0.179156
0.342832
0.342832
0.342832
0.342832
0.282856
0.336856
0.342832
0.625434
0.625434
0.625434
0.400799
0.466071
0.400799
0.300899
0.300899
0.300899
0.241200
0.312716
0.301177
0.241200
0.112766
0.112766
0.112766
0.112766
0.112766
0.112766
0.112766
0.112766
0.112766
0.112766
0.112766
0.225533
0.225533
0.225533
0.225533
0.225533
0.225533
0.225533
0.225533
0.211500
0.220821
0.221400
0.106799
0.225533
0.338301
0.451068
0.451068
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.147212
0.495780
0.291089
0.291089
0.495780
0.669772
0.372844
0.372844
0.669772
0.084168
0.124168
0.051168
0.069168
0.031429
0.037429
0.232882
0.599232
0.492566
0.492566
0.044534
0.051786
0.044534
0.033434
0.033434
0.033434
0.026800
0.201926
0.033465
0.026800
0.211519
0.034567
0.090805
0.198900
0.210805
0.211234
0.029376
0.035805
0.035234
0.034567
0.191900
0.207681
0.115133
0.207681
0.440895
0.207467
0.207681
0.207467
0.207467
0.023500
0.024536
0.024600
0.011867
0.207467
0.145032
0.656074
0.500360
cod ATC
498 C10AA01
499 C10AA01
500 C10AA01
501 C10AA01
502 C10AA01
503 C10AA01
504 C10AA01
505 C10AA01
506 C10AA01
507 C10AA02
508 C10AA02
509 C10AA03
510 C10AA03
511 C10AB05
512 C10AB05
513 C10AB05
514 C10AB05
515 D01AC02
516 D07AA02
517 D07AC01
518 D07AC01
519 D07AC01
520 G01AF04
521 G01AF04
522 G02AB03
523 G03BA03
524 G03BA03
525 G03BA03
526 G03BA03
527 G03BA03
528 G03CA03
529 G03CA03
530 G04CAN1
531 G04CAN1
532 G04CAN1
533 G04CAN1
534 G04CAN1
535 G04CAN1
536 G04CAN1
537 G04CAN1
538 H02AB04
539 H02AB04
540 H02AB04
541 H02AB07
542 H02AB07
543 H02AB07
544 H02AB07
545 H02AB09
546 H02AB09
547 H02AB09
548 H02AB09
549 H02AB09
550 J01AA02
551 J01AA02
552 J01AA02
MEDOSTATIN
COMPR.
DCI
Denumire Comerciala
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
SIMVASTATINUM
LOVASTATINUM
LOVASTATINUM
PRAVASTATINUM
PRAVASTATINUM
FENOFIBRATUM
FENOFIBRATUM
FENOFIBRATUM
FENOFIBRATUM
MICONAZOLUM
HYDROCORTISONUM
BETAMETHASONUM
BETAMETHASONUM
BETAMETHASONUM
MICONAZOLUM
MICONAZOLUM
ERGOMETRINUM
TESTOSTERONUM*
TESTOSTERONUM*
TESTOSTERONUM*
TESTOSTERONUM*
TESTOSTERONUM*
ESTRADIOLUM*
ESTRADIOLUM*
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
DOXAZOSINUM
METHYLPREDNISOLONUM*
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
HYDROCORTISONUM*
DOXYCYCLINUM
DOXYCYCLINUM
DOXYCYCLINUM
ZEPLAN (R) 40 mg
SINTENAL 40 mg
SIMCOR 40 mg
SIMVACARD 40 mg
LOVASTATINA ARENA 20 mg COMPR.
PRAVATOR 20 mg
PRAVATOR 40 mg
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
COMPR.
COMPR.
CAPS.
CAPS. PULB. MICRONIZATA
COMPR. ELIB. MODIF.
COMPR. FILM.
CREMA
UNGUENT
CREMA
CREMA
UNGUENT
CAPS. VAG.
CAPS. VAG.
MALEAT DE ERGOMETRINA ZENTIVA 0,2 mg/ml SOL. INJ.
UNDESTOR TESTOCAPS 40 mg CAPS. MOI
ANDROGEL 50 mg
GEL
TESTIM 50 mg
GEL TRANSDERMIC
NEBIDO 1000 mg/4 ml
SOL. INJ.
NEBIDO 1000 mg/4 ml
SOL. INJ.
OESTROGEL 0,6 mg/g
GEL
CLIMARA
PLASTURE TRANSDERM.
KAMIREN (vezi G04CAN1) COMPR.
CARDURA XL 4 mg (vezi G04CAN1)
COMPR. ELIB. MODIF.
CARDURA XL 4 mg (vezi G04CAN1)
COMPR. ELIB. MODIF.
SOLU - MEDROL ACT-O-VIAL
LIOF. SI SOLV.PT.SOL.INJ
LEMOD SOLU 125 mg

LEMOD SOLU 500 mg
PREDNISON MCC 5 mg
PREDNISON ARENA 5 mg
PREDNISON 5 mg
PULB+SOLV. PT. SOL. INJ./PERF.

COMPR.
COMPR.
COMPR.
PREDNISON - RICHTER 5 mg COMPR.
HYDROCORTISONE ROUSSEL COMPR.
HYDROCORTISONE SUCCINAT SODIC
HIDROCORTIZON HF 500 mg
LIOF. + SOLV. PT. SOL. INJ.

PULB. + SOLV. PT. SOL. INJ./PERF.
PULB. SI SOLV. PT. SOL. INJ./PERF.
SOL. INJ. I.V.

DOXICICLINA ATB 100 mg CAPS.
DOXICICLINA ARENA
CAPS.
DOXICICLINA SANDOZ 100 mg CAPS.
HIDROCORTIZON HEMISUCCINAT
20mg
20mg
20mg
40mg
160mg
200mg
160mg
145mg
2%
1%
0,5mg/g
1mg/g
1mg/g
200mg
400mg
0,2mg/ml
40mg
50mg
50mg
1000mg/4ml
1000mg/4ml
0,6mg/g
50g/24ore
1mg
1mg
2mg
2mg
4mg
4mg
4mg
4mg
250mg/4ml
125mg
500mg
5mg
5mg
5mg
5mg
10mg
100mg
500mg
100mg
25mg/5ml
100 mg
100mg
100mg

ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR.
MAREA BRITANIE
MAREA BRITANIE
Prescriptie
Nr crt.
497 C10AA01
tara det.
APP
Detinator APP
Ambalaj
COMPR. FILM. 40mg
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM.
COMPR. FILM. 40mg
COMPR. FILM. 40mg
HEXAL AG
COMPR. FILM. 40mg
ANTIBIOTICE S.A.
COMPR. FILM. 40mg
LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
COMPR. FILM. 40mg
CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM.
COMPR. FILM. 40mg
ZENTIVA K.S.
CEHIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM.
COMPR. FILM. 40mg
AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM.
COMPR. FILM. 40mg
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
COMPR. FILM. 40mg
TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P6L
P6L
P6L
P-6L
P-6L
CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR. P-6L

CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR. P-6L
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS.

VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS.
P-6L
LAB. FOURNIER SA FRANTA

LABORATOIRES FOURNIER S.A.S. FRANTA
ANTIBIOTICE SA
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
P-6L
CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. CU ELIB. MOD.
P-6L
CUTIE X 1 TUB X 20 G
CUTIE X 1 TUB DIN AL X 15 G CREMA
CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI
CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI
P-RF
P-RF
P-RF
E.I.P.I.CO. MED S.R.L. ROMANIA

PHARCO IMPEX 93 S.R.L. ROMANIA
PHARCO IMPEX 93 S.R.L. ROMANIA
ZENTIVA S.A.
ROMANIA
CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE
N.V. ORGANON
CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI P-RF
LAB. BESINS INTERNATIONAL
FERRING GMBH
BAYER PHARMA AG
BAYER PHARMA AG
OLANDA
FRANTA
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE X 30 PLICURI DIN FOLIE PET/AL/PE X 5 G GEL P-RF
GERMANIA CUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMIC
PR/PRF
GERMANIA
CUTIE CU 1 FIOLA DIN STICLA BRUNA, CU CAPACITATEA DE 5 ML A 4 ML SOL. INJ.
S/P-RF
GERMANIA
CUTIE CU 1 FLAC. DIN STICLA BRUNA, CU CAPACITATEA DE 6 ML A 4 ML SOL. INJ.
PR/PRF
FRANTA
CUTIE CU 1 TUB AL X 80 G GEL + DISPOZITIV DE DOZARE DIN POLISTIREN
P-6L
BAYER PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM.
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR.
P-6L
P-6L
P-6L
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR.
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR.
P-6L
MAREA BRITANIE
CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL.
P-6L
MAREA BRITANIE
CUTIE X 4 BLIST. AL-PA-PVDC/AL-PVDC X 7 COMPR. ELIB. PREL.
P-6L
MAREA BRITANIE
CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV
STADA HEMOFARM S.R.L.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML

CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML
LABORATOIRES BESINS INTERNATIONAL
MAGISTRA C&C S.R.L.
ARENA GROUP SA
SINTOFARM SA
CN UNIFARM
ZENTIVA S.A.
ANTIBIOTICE S.A.
ARENA GROUP SA
SANDOZ SRL

CUTIE X 2 BLIST. AL./PVC X 10 COMPR.
CUTIE X 1 FLAC. 25 COMPR.
P-RF
S/P-RF
S/P-RF
P-RF
P-RF
P-RF
P-RF
PRF
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML
S/P-RF
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV.
PR/PRF
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV.
PR/PRF
CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B
S/P-RF
CUTIE CU 1 BLIST. PVC/AL X 10 CAPS.

CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
PRF
Pagina 10 din 21
P-RF
P-RF
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
28
0.501187
30
0.501187
30
0.501187
30
0.501187
30
0.501187
28
0.323571
28
0.337857
30
0.338000
30
0.237333
30
0.501187
10
0.167062
30
0.167062
28
0.250593
28
0.501187
30
0.754650
30
0.881000
30
0.754650
30
0.683901
1
4.636666
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
1 434.605000
1 434.350000
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.049170
0.565146
0.125479
0.605146
0.605146
0.000000
0.000000
0.000000
0.000000
0.390813
0.357938
0.727604
0.581549
0.814884
0.034350
0.000000
0.420016
0.486765
2.373334
0.000000
0.000000
2.247600
2.247600
0.000000
0.000000
0.000000
0.000000
0.000000
0.773250
0.765000
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

beneficiaza de
compensare 90% din
0.451068
0.451068
0.451068
0.451068
0.451068
0.291213
0.304071
0.304200
0.213599
0.451068
0.150355
0.150355
0.225533
0.451068
0.679185
0.792900
0.679185
0.615510
4.172999
6.903000
6.903000
3.161160
3.161160
0.928499
1.778999
1.332000
0.736499
4.116899
4.348874
391.144500
390.915000
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.099289
0.615265
0.175598
0.655265
0.655265
0.032358
0.033786
0.033800
0.023734
0.440932
0.374645
0.744311
0.606609
0.865003
0.109815
0.088100
0.495481
0.555156
2.837001
0.767000
0.767000
2.598840
2.598840
0.103167
0.197667
0.148000
0.081834
0.457434
1.256459
44.225500
43.435000
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
cod ATC
554 J01CA04
555 J01CA04
556 J01CA04
557 J01CA04
558 J01CA04
559 J01CA04
560 J01CA04
561 J01CA04
562 J01CA04
563 J01CA04
564 J01CA04
565 J01CA04
566 J01CA04
567 J01CA04
568 J01CA04
569 J01CA04
570 J01CA04
571 J01CA04
DCI
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
AMOXICILLINUM
572 J01CE02 PHENOXYMETHYLPENICILLINUM

576 J01CE08 BENZATHINI BENZYLPENICILLINUM
577 J01CE08 BENZATHINI BENZYLPENICILLINUM
578 J01CF04
579 J01CF04
580 J01CF04
581 J01CF04
582 J01CF04
583 J01CF04
584 J01CF04
585 J01CF04
586 J01CF04
587 J01CF04
588 J01CF04
589 J01CF04
590 J01CF04
591 J01CF04
592 J01CF04
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
OXACILLINUM
forma farm.
Denumire Comerciala
AMOXICILINA ARENA 250 mg CAPS.
AMOXICILINA ANTIBIOTICE 250 mg
OSPAMOX 250 mg
AMOXICILINA SANDOZ 250 mg
AMOXICILINA ANTIBIOTICE 500 mg
AMOXICILINA FORTE 500 mg

AMOXICILINA FORTE 500 mg
AMOXICILINA ARENA 500 mg
AMOXICILINA SANDOZ 500 mg
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
OSPAMOX 1000 mg
COMPR. FILM. 1000mg
OSPAMOX 500 mg
COMPR. FILM. 500mg
AMOXICILINA TERAPIA 1 g COMPR. PT. DISP. ORALA 1g
DUOMOX 1000 mg
COMPR. PT. DISPERSIE ORALA 1000mg
DUOMOX 250 mg
DUOMOX 500 mg
DUOMOX 750 mg
AMOXICILINA SANDOZ 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml
AMOXICILINA SANDOZ 250 mg/ 5 ml PULB. PT. SUSP. ORALA 250mg/5ml
OSPAMOX 250 mg/5 ml
PULB. PT. SUSP. ORALA 250mg/5ml
OSPEN (R) 1000
COMPR. FILM. 1000000ui
OSPEN 1500
OSPEN (R) 500
OSPEN 400.000 U.I./5 ml
SUSP. ORALA 400.000U.I./5ml
MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ. 1200000UI
MOLDAMIN 1200000 UI
PULB. PT. SUSP. INJ. 1200000UI
OXACILINA ARENA 250 mg CAPS.
250mg
OXACILINA 250 mg
CAPS.
250mg
OXACILINA SANDOZ 250 mg CAPS.
250mg
OXACILINA 500 mg
CAPS.
500mg
OXACILINA ARENA 500 mg CAPS.
500mg
OXACILINA FORTE 500 mg CAPS.
500mg
OXACILINA SANDOZ 500 mg CAPS.
500mg
OXACILINA ATB 1000 mg
PULB. PT. SOL. INJ./PERF. 1000mg
OXACILINA ANTIBIOTICE 500 mg
500mg
OXACILINA ANTIBIOTICE 500 mg
500mg
OXACILINA ANTIBIOTICE 1 g
1g
OXACILINA ANTIBIOTICE 1 g
1g
PULB. PT. SOL. INJ./PERF. I.M./I.V.
PULB. PT. SOL. INJ./PERF. I.M./I.V.
PULB. PT. SOL. INJ./PERF.I.M./I.V.
PULB. PT. SOL. INJ./PERF.I.M./I.V.
593 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM
AUGMENTIN SR 1000 mg/62,5 mg
AMOKSIKLAV 2 x 1000 mg
ENHANCIN 500 mg/125mg
AMOXIPLUS 500/125 mg
AUGMENTIN 500 mg/125 mg
COMPR. ELIB. PREL.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg
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.
AMOKSIKLAV QUICKTAB 1000 mg



AMOKSIKLAV 156,25mg/5ml
AMOKSIKLAV 2x
P-RF
P-RF
P-RF/S
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
SANDOZ GMBH
SANDOZ GMBH
TERAPIA SA
AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM.

AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM.
P-RF
ROMANIA
CUTIE X 3 BLIST. PVC-PVDC/AL X 7 COMPR. PT. DISP. ORALA
P-RF
ASTELLAS PHARMA EUROPE BV
OLANDA
OLANDA
OLANDA
OLANDA

P-RF

SANDOZ S.R.L.
SANDOZ S.R.L.
SANDOZ GMBH
SANDOZ GMBH
SANDOZ GMBH
SANDOZ GMBH
SANDOZ GMBH
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ARENA GROUP SA
ANTIBIOTICE SA
SANDOZ SRL
ANTIBIOTICE SA
ARENA GROUP SA
ROMANIA
ROMANIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
FARMEX COMPANY SRL ROMANIA
SANDOZ SRL
ROMANIA
ANTIBIOTICE SA
ROMANIA
ANTIBIOTICE SA
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ANTIBIOTICE SA
ROMANIA
ANTIBIOTICE SA
ROMANIA
ANTIBIOTICE SA
ROMANIA
ANTIBIOTICE SA
ROMANIA
1000mg/62,5mg BEECHAM GROUP PLC
1000mg
Prescriptie
Nr crt.
553 J01CA04
tara det.
concentratie
APP
Detinator APP
Ambalaj
250mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
250mg
ANTIBIOTICE SA
250mg
SANDOZ GMBH
AUSTRIA CUTIE X 2 BLIST. AL-PVC/PVDC X 6 CAPS.
250mg
SANDOZ SRL
500mg
ANTIBIOTICE SA
500mg
FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS.
500mg
FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS.
500mg
500mg
SANDOZ SRL
MAREA BRITANIE
P-RF
P-RF
P-RF
P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
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
P-RF
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 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 1 BLIST. X 10 CAPS.
P-RF
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF.
PRF
PRF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V.
P-RF/S
P-RF
P-RF/S
P-RF
CUTIE CU 7 BLIST. AL/PVC-AL X 4 COMPR. ELIB. PREL. P-RF
SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM.

CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM.
P-RF
500 mg/125 mg RANBAXY UK LIMITED
MAREA BRITANIE
500/125mg
ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM.
P-RF
MAREA BRITANIE
P-RF
ANTIBIOTICE S.A.
500mg/125mg BEECHAM GROUP PLC

500mg/125mg AUROBINDO PHARMA LIMITED
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
CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM.
P-RF
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.
875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE
875mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM.
P-RF
1000mg
1000mg
625mg
625mg
BIOMEDIAL PHARMA S.R.L.
CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE
P-RF
P-RF
P-RF
P-RF
PULB. PT. SUSP. ORALA
156,25mg/5ml
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.
CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 35 ML SUSP.ORALA + SERINGA DOZATOARE
P-RF
COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE
625mg
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
SANDOZ S.R.L.
BIOMEDIAL PHARMA S.R.L.
SANDOZ S.R.L.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
SLOVENIA
SLOVENIA
Pagina 11 din 21
P-RF
P-RF
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
20
20
12
20
10
10
20
10
10
12
12
21
20
20
20
20
1
1
1
12
12
12
1
1
100
20
20
20
10
10
20
10
1
100
1
100
100
1
100
1
28
14
28
14
14
14
14
14
14
14
14
14
14
14
1
1
0.308000
0.314775
0.314775
0.314775
0.483636
0.483636
0.440500
0.483636
0.483636
0.910000
0.483636
0.959047
0.967273
0.314775
0.483636
0.725455
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
1.181428
0.962142
0.590714
0.590714
0.590714
0.590714
0.590714
0.962142
1.033749
0.962142
1.033749
1.033749
0.590714
0.590714
5.986607
6.700000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
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
0.461429
0.000000
0.000357
0.000000
0.318571
0.000000
0.000000
0.000000
0.445536
0.000000
0.824108
0.824108
0.634286
0.634286
4.833393
0.000000

beneficiaza de
compensare 90% din
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
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
1.063285
0.865927
0.531642
0.531642
0.531642
0.531642
0.531642
0.865927
0.930374
0.865927
0.930374
0.930374
0.531642
0.531642
5.387946
6.030000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
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
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
0.579572
0.096215
0.059429
0.059072
0.377643
0.059072
0.059072
0.096215
0.548911
0.096215
0.927483
0.927483
0.693358
0.693358
5.432054
0.670000
cod ATC
DCI
Denumire Comerciala
forma farm.
concentratie
Detinator APP
Ambalaj
Prescriptie
Nr crt.
tara det.
APP
AMOKSIKLAV 2x
400mg+57mg/5ml LEK PHARMACEUTICALS D.D.
SLOVENIA
AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml
400mg/57mg/5ml
MALTA
AUGMENTIN BIS 400 mg/57 mg/5 ml
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
MAREA BRITANIE
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE
P-RF
MAREA BRITANIE
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE
P-RF
AUGMENTIN (R) ES
AMOKSIKLAV 312,5mg/5ml
600 mg/42,9mg/5ml SMITHKLINE BEECHAM LTD.
MAREA BRITANIE
CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE
P-RF
PULB. PT.SUSP. ORALA
312,5mg/5ml
SLOVENIA
CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE
P-RF
250mg
250mg
250mg
250mg
500mg
500mg
500mg
1000mg
500mg
125mg/5ml
125mg/5ml
125mg/5ml
250mg/5ml
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
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
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.

ROMANIA CUTIE X 2 BLIST. X 10 CAPS.
AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 CAPS.
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS.
ROMANIA CUTIE X 1 BLIST. X 10 CAPS.
ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS.
P-RF
AUSTRIA
AUSTRIA
ISLANDA
AUSTRIA
P-RF

616 J01DB01
617 J01DB01
618 J01DB01
619 J01DB01
620 J01DB01
621 J01DB01
622 J01DB01
623 J01DB01
624 J01DB01
625 J01DB01
626 J01DB01
627 J01DB01
628 J01DB01
629 J01DB01
630 J01DB01
631 J01DB05
632 J01DB05
633 J01DB05
634 J01DB05
635 J01DB05
636 J01DB05
637 J01DC02
638 J01DC02
639 J01DC02
640 J01DC02
641 J01DC02
642 J01DC02
643 J01DC02
644 J01DC02
645 J01DC02
646 J01DC02
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 J01DC04
660 J01DC04
661 J01DC04
662 J01DC04
663 J01DC04
664 J01DC04
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
CEFALEXINUM
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
CEFALEXINA ARENA 250 mg CAPS.
CEFALEXINA ATB 250 mg

OSPEXIN (R) 250 mg
CAPS.
CAPS.
CEFALEXIN SANDOZ 250 mg CAPSULE CAPS.
CEFALEXINA ATB 500 mg CAPS.
CEFALEXINA ARENA 500 mg CAPS.
CEFALEXIN SANDOZ
CAPS.
OSPEXIN 1000 mg
COMPR. FILM.
OSPEXIN 500 mg
COMPR. FILM.
KEFLEX (R) 125 mg/5 ml
GRAN. PT. SUSP. ORALA
OSPEXIN (R) 125 mg/5 ml
CEFALEXIN SANDOZ 125 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA
KEFLEX (R) 250 mg/5 ml
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
CEFUROXIMA ATB 250 mg
CEFUROXIMA AUROBINDO 250 mg

CEFUROXIMA AUROBINDO 500 mg
ZINNAT (R) 125 mg

ZINNAT (R) 250 mg
ZINNAT (R) 500 mg
ZINNAT
CEFACLOR ARENA 250 mg
CLORACEF (R) 250
CEFACLOR TERAPIA 250 mg
CLORACEF (R) FORTE 500

CEFACLOR ARENA 500 mg
CEFACLOR TERAPIA 500 mg
CECLOR MR 500 mg
CECLOR MR 750 mg
CAPS.
CAPS.
CAPS.
COMPR. FILM.
GRAN. SUSP. ORALA
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CEFACLOR TERAPIA MR 375

CEFACLOR TERAPIA MR 750
CECLODYNE (R) MR 375 mg
CECLOR (R) 125 mg/5 ml
CEFACLOR TERAPIA 125mg/5ml

CECLOR (R) 250 mg/5 ml
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.


CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE
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. PVC-PVDC/AL X 6 COMPR.FILM.
P-RF
P-RF
P-RF
P-RF
P-RF
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
ROMANIA
CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
P-RF
ISLANDA
CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE
P-RF
ROMANIA
CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
P-RF
AUSTRIA
CUTIE X 1 FLAC. X 33G GRANULE PT. 60ML SUSP.+ LINGURITA DOZATOARE X 5ML
P-RF
CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS.

P-RF
P-RF
AUROBINDO PHARMA ROMANIA S.R.L.
GLAXOWELLCOME UK LTD.
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE

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
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
PRF
CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
AUROBINDO PHARMA ROMANIA S.R.L.
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. P-RF

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

DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS.
TERAPIA SA
ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS.
DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS.
ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 10 CAPS.
TERAPIA SA
ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS.
ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL.
ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL.
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. ELIB. PREL.
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL.
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF.
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF.
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF.
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA
TERAPIA SA
ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 100 ML SUSP. ORALA
CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE
Pagina 12 din 21
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
1
1
1
1
1
1
1
20
20
12
10
10
10
10
12
12
1
1
1
1
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
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
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
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

beneficiaza de
compensare 90% din
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
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
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
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
cod ATC
666 J01DC04
667 J01DC04
668 J01DC04
669 J01DD08
670 J01DD08
671 J01DD08
672 J01DD08
DCI
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFACLORUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM
673 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM

679 J01FA01
680 J01FA01
681 J01FA01
682 J01FA01
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 J01FA09
701 J01FA09
702 J01FA09
703 J01FA09
704 J01FA09
705 J01FA09
706 J01FA09
707 J01MA01
708 J01MA01
709 J01MA02
710 J01MA02
711 J01MA02
712 J01MA02
713 J01MA02
714 J01MA02
715 J01MA02
716 J01MA02
717 J01MA02
718 J01MA02
719 J01MA02
720 J01MA02
ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
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
Denumire Comerciala
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
forma farm.
CAPS.
CAPS.
Prescriptie
Nr crt.
665 J01DC04
COMPR. FILM. 400mg

COMPR. FILM. 400mg
INN-FARM D.O.O.
INN-FARM D.O.O.
400mg/80mg ZENTIVA S.A.
SLOVENIA
SLOVENIA
CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE
PRF
CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE
PRF

400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
400mg/80mg BIO EEL SRL
400mg/80mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML
SUSP. ORALA 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE
COMPR.
200mg
ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
COMPR.
200mg
ANTIBIOTICE SA
ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR.
200mg
SANDOZ S.R.L.
ERITROMICINA ATB 200 mg COMPR.
200mg
ANTIBIOTICE SA
ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
P-RF
CLAXIRIT 500 mg
KLACID SR
KLACID (R)
KLERIMED (R) 250
KLABAX 250 mg
FROMILID 250
LEKOKLAR 250 mg
CLARITROMICINA AUROBINDO 250 mg
KLERIMED (R) 500

KLABAX 500 mg
FROMILID 500
ROCLARIN 500 mg
CLAR 500
LEKOKLAR 500 mg
CLARITROMICINA AUROBINDO 500 mg
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
CIPROFLOXACINA ARENA 100 mg
CIPROCIN 250 mg
CIPRINOL 250 mg
CIPROLEN (R) 250 mg
CUMINOL 250 mg
CIFRAN
CIPRINOL 500 mg
CIPROCIN 500 mg
CIPROLEN (R) 500 mg
COMPR.
COMPR.
COMPR.
COMPR.
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.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
cant.
UT/
Pret de
tara det.
amba referinta / UT
laj
(RON)
concentratie
APP
Detinator APP
Ambalaj
125mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE P-RF
1
8.075250
125mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF
1
6.460200
250mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE P-RF
1 16.150500
250mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF
1 12.920400
100mg
ANTIBIOTICE S.A.
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF
10
1.915987
200mg
ANTIBIOTICE SA
P-RF
10
3.609000
500mg
500mg
250mg
250mg
250mg
250mg
250mg
250mg
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
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
ISLANDA
CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL.
PRF
ABBOTT LABORATORIES LTD.
MAREA BRITANIE
CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. ELIB. PREL.
P-RF
ABBOTT S.R.L.
ITALIA
TERAPIA SA
ROMANIA 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
SANDOZ S.R.L.
P-RF
P-RF
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF
MALTA
TERAPIA SA
ROMANIA
CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.
ANTIBIOTICE S.A.
GLENMARK PHARMACEUTICALS S.R.O.
SANDOZ S.R.L.
P-RF

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

REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF
MALTA
CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF
KRKA D.D.
ABBOTT S.R.L.
ABBOTT S.R.L.
SANDOZ SRL
TERAPIA SA
TERAPIA SA
TERAPIA SA
SANDOZ S.R.L.
SLOVENIA
P-RF
CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML
P-RF
CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML
P-RF
CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP
P-RF
CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA
P-RF
CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA
P-RF
CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA
P-RF
FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. PERF.
S/P-RF
RANBAXY UK LIMITED
MAREA BRITANIE
ITALIA
ITALIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA
PRF
CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.
P-RF
ZENTIVA K.S.
CEHIA
ARENA GROUP S.A. ROMANIA CUTIE X 1 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
P-RF
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF
AC HELCOR SRL

RANBAXY UK LIMITED
MAREA BRITANIE
P-RF
P-RF
CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF

P-RF
P-RF
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM.

AC HELCOR SRL
Pagina 13 din 21
P-RF
P-RF
5
10
20
20
20
20
1
1
20
20
20
20
7
5
14
14
14
14
14
14
14
14
14
20
20
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
7.663950
7.663950
0.360750
0.348000
0.360750
0.360750
4.710000
4.205531
0.367500
0.388478
0.388478
0.388478
1.942391
1.942391
0.971195
0.971195
0.971195
0.971195
0.842142
0.756428
1.911428
1.942391
1.921428
1.849000
1.942391
1.911428
1.642142
1.942391
23.854500
14.312700
12.820000
12.820000
47.709000
28.625400
28.625400
39.540000
1.179000
1.226700
0.245340
0.245340
0.613350
0.613350
0.613350
0.613350
0.613350
0.613350
0.613350
1.183000
0.920000
1.226700
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
0.109022
0.033522
0.109022
0.491894
1.805609
0.975947
0.200947
0.115947
0.264519
0.000000
0.000000
0.000000
0.096894
0.000000
0.000000
0.413609
0.000000
0.000000
0.491894
6.125500
5.407300
0.000000
0.000000
5.301000
4.244600
1.234600
0.000000
0.000000
0.850300
3.625660
3.158660
0.069650
0.093650
0.069650
0.095650
0.106650
0.067650
0.024650
0.000000
0.000000
0.095300

beneficiaza de
compensare 90% din
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
0.349630
0.349630
0.349630
1.748151
1.748151
0.874075
0.874075
0.874075
0.874075
0.757927
0.680785
1.720285
1.748151
1.729285
1.664100
1.748151
1.720285
1.477927
1.748151
21.469050
12.881430
11.538000
11.538000
42.938100
25.762860
25.762860
35.586000
1.061100
1.104030
0.220806
0.220806
0.552015
0.552015
0.552015
0.552015
0.552015
0.552015
0.552015
1.064700
0.828000
1.104030
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
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
0.147870
0.072370
0.147870
0.686134
1.999849
1.073067
0.298067
0.213067
0.361639
0.084215
0.075643
0.191143
0.291134
0.192143
0.184900
0.607849
0.191143
0.164215
0.686134
8.510950
6.838570
1.282000
1.282000
10.071900
7.107140
4.097140
3.954000
0.117900
0.972970
3.650194
3.183194
0.130985
0.154985
0.130985
0.156985
0.167985
0.128985
0.085985
0.118300
0.092000
0.217970
cod ATC
722 J01MA02
723 J01MA02
724 J01MA02
725 J01MA02
726 J01MA02
727 J01MA02
728 J01MA02
729 J01MA02
730 J01MA03
731 J01MA06
732 J01MA06
733 J01MA06
734 J01MB02
735 J01XD01
736 J01XD01
737 J01XD01
738 J01XD01
739 J01XD01
740 J01XD01
741 J01XD01
742 J01XD01
743 J01XD01
744 J01XD01
745 J01XD01
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 J02AC01
771 J02AC01
772 J02AC01
773 J02AC01
774 J02AC01
775 J02AC01
776 J02AC01
DCI
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
PEFLOXACINUM
NORFLOXACINUM
NORFLOXACINUM
NORFLOXACINUM
ACIDUM NALIDIXICUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
METRONIDAZOLUM
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
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CIPROFLOXACINA ARENA 500 mg COMPR. FILM.
CIPRINOL 750 mg
COMPR. FILM.
Denumire Comerciala
CUMINOL 500 mg
CIFRAN
CIPRO QUIN (R)
CIPROBAY XR 1000 mg
CIPROBAY XR 500 mg
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
METRONIDAZOL A 5 g/l
METRONIDAZOL B 5 g/l
METRONIDAZOL B 5 g/l
CAPS.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
FLUCONAZOL AUROBINDO 50 mg
SOL. PERF.
SOL. PERF.
SOL. PERF.
SOL. PERF.
SOL. PERF.
SOL. PERF.
SOL. PERF.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
DIFLUCAN 10 mg/ml
METRONIDAZOL BRAUN 5mg/ml

FLUCOVIM 100
FUNGOLON 100 mg
FLUCONAZOLE TEVA 100 mg
FLUCOVIM 150
DIFLUCAN 150 mg
FLUCORIC 150 mg
FLUCONAZOL SANDOZ (R) 150
FLUCONAZOL 150 mg
FLUCONAZOL MEDOCHEMIE 150 mg
FLUCONAZOL BIOGALENICA 150 mg
FLUCONAZOL ARENA 150 MG

FLUCONAZOL ACTAVIS 150 mg
FLUCONAZOL LPH 150 mg

FLUCONAZOL ROMPHARM 150 mg
FLUCONAZOL ZENTIVA 150 mg

FLUCONAZOL ZENTIVA 150 mg
FLUCOVIM 50
DIFLUCAN 50 mg
FLUCORIC 50 mg
FLUCONAZOL SANDOZ (R) 50
FLUCONAZOL 50 mg
FLUCONAZOL MEDOCHEMIE 50 mg
FLUCONAZOL ARENA 50 MG
FLUCONAZOL LPH 50 mg
concentratie
500mg
500mg
500mg
500mg
500mg
750mg
750mg
1000 mg
500 mg
400mg
400mg
400mg
400mg
500mg
250mg
250mg
250mg
250mg
5g/l
5g/l
5g/l
5g/l
5mg/ml
5mg/ml
5mg/ml
100mg
100mg
100mg
100mg
150mg
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
RANBAXY UK LIMITED
MAREA BRITANIE
Detinator APP
Prescriptie
Nr crt.
721 J01MA02
tara det.
APP
Ambalaj
P-RF
ANTIBIOTICE SA
P-RF
P-RF
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.
P-RF
P-RF
P-RF
P-RF
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF

KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
P-RF
ZENTIVA SA
LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML
INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML
INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML
INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML
P-RF
P-RF
P-RF
P-RF
P-RF
S/P-RF
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
P-RF
MALTA
CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF
VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS.
MAREA BRITANIE
TERAPIA SA
SANDOZ SRL
ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.

GERMANIA
ROMANIA
MEDOCHEMIE ROMANIA SRL ROMANIA
LABORATOARELE PROF.DR.MORAIT S.R.L.
ROMANIA

ZENTIVA K.S.
ZENTIVA K.S.
P-RF
P-RF
P-RF
P-RF

P-RF
P-RF
P-RF
P-RF
ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS.

ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS.
MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS.
PRF
REPUBLICA CEHA
CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 1 CAPS.
P-RF
REPUBLICA CEHA
P-RF

VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS.
P-RF
MAREA BRITANIE
TERAPIA SA
SANDOZ SRL
ROMANIA
ROMANIA
MEDOCHEMIE ROMANIA SRL ROMANIA
MALTA
MAREA BRITANIE
PRF
PRF
PRF
P-RF
P-RF
P-RF
CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF
P-RF
P-RF

P-RF
P-RF
P-RF
PRF
CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF

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
Pagina 14 din 21
PRF
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
10
10
10
10
20
10
10
7
3
10
20
20
20
30
30
30
20
20
12
1
12
1
10
10
20
4
16
7
7
1
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
1.226700
0.911000
1.226700
0.957000
0.852000
1.031000
1.840050
2.453400
1.226700
1.226700
0.804000
0.792000
0.804000
1.013000
0.238666
0.238666
0.301762
0.301762
8.667500
8.953750
8.499166
8.953750
4.476875
4.476875
4.476875
3.078000
2.178750
3.078000
3.078000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
4.617000
5.834285
1.539000
1.539000
1.539000
1.527142
1.539000
1.539000
1.539000
1.539000
1.539000
1.539000
10.773000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.144300
0.000000
0.144300
0.000000
0.000000
0.000000
2.030950
10.100885
8.326633
1.664300
0.012000
0.000000
0.076000
0.000000
0.000000
0.000000
0.065738
0.065738
0.000000
0.496250
0.000000
0.286250
0.530125
0.530125
0.278625
3.324500
0.000000
1.593428
0.342000
2.543000
6.413000
2.543000
2.543000
1.703000
2.543000
2.543000
1.963000
2.543000
2.543000
2.543000
2.543000
1.623000
2.543000
2.543000
0.000000
1.241000
2.738142
1.241000
0.000000
0.426714
1.239571
0.853857
1.241000
1.241000
0.171000
18.797000

beneficiaza de
compensare 90% din
1.104030
0.819900
1.104030
0.861300
0.766800
0.927900
1.656045
2.208060
1.104030
1.104030
0.723600
0.712800
0.723600
0.911700
0.214799
0.214799
0.271585
0.271585
7.800750
8.058375
7.649249
8.058375
4.029187
4.029187
4.029187
2.770200
1.960875
2.770200
2.770200
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
4.155300
5.250856
1.385100
1.385100
1.385100
1.374427
1.385100
1.385100
1.385100
1.385100
1.385100
1.385100
9.695700
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.266970
0.091100
0.266970
0.095700
0.085200
0.103100
2.214955
10.346225
8.449303
1.786970
0.092400
0.079200
0.156400
0.101300
0.023867
0.023867
0.095915
0.095915
0.866750
1.391625
0.849917
1.181625
0.977813
0.977813
0.726313
3.632300
0.217875
1.901228
0.649800
3.004700
6.874700
3.004700
3.004700
2.164700
3.004700
3.004700
2.424700
3.004700
3.004700
3.004700
3.004700
2.084700
3.004700
3.004700
0.583429
1.394900
2.892042
1.394900
0.152715
0.580614
1.393471
1.007757
1.394900
1.394900
0.324900
19.874300
cod ATC
778 J05AB01
779 J05AB01
780 J05AB01
781 J05AB01
782 J05AB01
783 J05AB01
784 J05AB01
785 J05AB01
786 J05AB01
787 J05AB01
788 J05AB01
789 M01AB01
790 M01AB01
791 M01AB01
792 M01AB01
793 M01AB01
794 M01AB01
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 M01AB05
812 M01AB05
813 M01AB05
814 M01AB05
815 M01AB05
816 M01AB05
817 M01AB05
818 M01AB05
DCI
FLUCONAZOLUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
ACICLOVIRUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
INDOMETACINUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
Denumire Comerciala
SOL. PERF.
CAPS.
CAPS.
CAPS.
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
DICLAC (R) 75 ID
VOLTAREN (R) RETARD
REFEN (R) RETARD
VOLTAREN (R) 50
DICLOFENAC 50 mg
DICLOFENAC HELCOR 50 mg
VOLTAREN RAPID (R)

DICLOFENAC ARENA 25 mg
VOLTAREN (R)
TRATUL (R)
DICLOFENAC 75 mg
REFEN 75 mg
CLAFEN 100 mg
VOLTAREN (R)
DICLOFENAC 100 mg
DICLOFENAC SODIC 100 mg
DICLOFENAC SINTOFARM 12,5 mg
DICLOFENAC SINTOFARM 12,5 mg
VOLTAREN (R)
KETOROL
KETOROLACUM TROMETHAMIN KETANOV 10 mg
KETOROLACUM TROMETHAMIN KETANOV
KETOROLACUM TROMETHAMIN KETOROL
819 M01AB15 KETOROLACUM TROMETHAMIN

820 M01AB15
821 M01AB15
822 M01AB15
KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml
KETOROLAC TROMETAMOL ROMPHARM 30 mg/ml
825 M01AB16
826 M01AB16
827 M01AC02
828 M01AC02
829 M01AC02
830 M01AC02
831 M01AC06
832 M01AC06
ACECLOFENACUM
ACECLOFENACUM
TENOXICAMUM
TENOXICAMUM
TENOXICAMUM
TENOXICAMUM
MELOXICAMUM
MELOXICAMUM
forma farm.
DIFLAZON 2mg/ml
ACICLOVIR 200 mg
ACICLOVIR ARENA 200 mg
ACICLOVIR FARMEX 200 mg
ACICLOVIR ARENA 400 mg
AFLAMIL 100mg
ACE-TAB 100 mg
TENOXICAM LPH 20 mg
TENOXICAM ARENA 20 mg
NEO - ENDUSIX (R)
NEO - ENDUSIX (R)
MOVALIS (R) 15 mg
MOVALIS (R) 15 mg
COMPR. ELIB. MODIF.

COMPR. FILM. GASTROREZ.
DRAJ.
DRAJ. GASTROREZ.
DRAJ. GASTROREZ.
DRAJ. GASTROREZ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ./PERF.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
SUPOZ.
COMPR. FILM.
COMPR. FILM.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
COMPR. FILM.
COMPR. FILM.
CAPS.
COMPR.
COMPR. FILM.
COMPR.
COMPR.
concentratie
2mg/ml
200mg
200mg
200mg
400mg
200mg
200mg
200mg
200mg
200mg
400mg
250mg
25mg
25mg
50mg
50mg
50mg
50mg
150mg
75mg
100mg
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
30mg/ml
30mg/ml
100mg
100mg
20mg
20mg
20mg
20mg
15mg
15mg
Detinator APP
Ambalaj
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML
Prescriptie
Nr crt.
777 J02AC01
tara det.
APP
S/PR-F
SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.

FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS.
ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS.
TERAPIA SA
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR.
P-RF
UNGARIA
LAROPHARM S.R.L. ROMANIA
EGIS PHARMACEUTICALS P.L.C. UNGARIA
CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR.
P-RF
P-RF
CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF.
S/P-RF
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
CEHIA
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
ROMANIA
CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL
P-6L
PHARMASWISS CESKA REPUBLIKA S.R.O.
TERAPIA SA
HEXAL AG
CUTIE X 2 BLIST., PVC/AL, X 10 CAPS.

P-6L
P-6L
P-6L
CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ. P-6L
P-6L
CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L
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
CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL.
P-6L
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
ROMANIA
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

CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ.
P-6L
CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ.
P-6L
CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF

GEROT PHARMAZEUTIKA GES.M.B.H.
AUSTRIA
CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ.
P-RF
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.
CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ.
ROMANIA
TERAPIA SA
ROMANIA
TERAPIA SA
ROMANIA
DR. REDDY'S LABORATORIES ROMANIA
ROMPHARM COMPANY S.R.L. ROMANIA
P-6L
CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM.
P-6L
CUTIE X 10 FIOLE X 1 ML
P-RF
CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ.
P-RF
CUTIE CU 5 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ.
PRF
CUTIE CU 10 FIOLE DIN STICLA BRUNA, PREVAZUTE CU INEL DE RUPERE X 1 ML SOL. INJ.
PRF
CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR. P-6L

CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM.
P6L
P-6L
ANFARM HELLAS S.A. PHARMACEUTICALS

GRECIA CUTIE X 1 BLIST. X 10 COMPR. FILM.
GRECIA CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV.
BOEHRINGER INGELHEIM INTERNATIONAL GMBH
GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR.
P-6L
P-6L
Pagina 15 din 21
P-6L
P-6L
P-RF
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
1
20
20
20
10
20
20
20
20
20
10
5
20
30
20
6
10
10
20
30
20
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
5
10
20
20
20
20
10
1
20
10
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
0.163000
0.252450
0.252450
0.126225
0.117000
0.117000
0.126225
0.063112
0.117000
0.117000
0.984600
1.094000
0.984600
0.842000
0.570000
0.652500
0.570000
0.572000
0.081562
0.081562
0.326250
0.084149
0.084149
1.312800
1.312800
1.312800
1.312800
0.126225
0.126225
0.324000
0.324000
0.324000
1.965500
0.324000
0.324000
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
0.000000
0.292550
0.102050
0.054275
0.000000
0.000000
0.116775
0.134554
0.000000
0.000000
0.697400
0.000000
0.109400
0.000000
0.000000
0.225500
0.000000
0.000000
0.525104
0.519438
0.633750
0.265851
0.441851
1.254200
0.721200
0.721200
0.721200
0.609275
0.352275
0.248500
0.408000
0.334000
3.674500
0.230000
0.231000

beneficiaza de
compensare 90% din
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
0.146700
0.227205
0.227205
0.113602
0.105300
0.105300
0.113602
0.056800
0.105300
0.105300
0.886140
0.984600
0.886140
0.757800
0.513000
0.587250
0.513000
0.514800
0.073405
0.073405
0.293625
0.075734
0.075734
1.181520
1.181520
1.181520
1.181520
0.113602
0.113602
0.291600
0.291600
0.291600
1.768950
0.291600
0.291600
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
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
0.016300
0.317795
0.127295
0.066898
0.011700
0.011700
0.129398
0.140866
0.011700
0.011700
0.795860
0.109400
0.207860
0.084200
0.057000
0.290750
0.057000
0.057200
0.533261
0.527595
0.666375
0.274266
0.450266
1.385480
0.852480
0.852480
0.852480
0.621898
0.364898
0.280900
0.440400
0.366400
3.871050
0.262400
0.263400
cod ATC
834 M01AC06
835 M01AC06
836 M01AC06
837 M01AC06
838 M01AC06
839 M01AC06
840 M01AC06
841 M01AC06
842 M01AC06
843 M01AC06
844 M01AC06
845 M01AC06
846 M01AC06
847 M01AC06
848 M01AC06
849 M01AC06
850 M01AC06
851 M01AE03
852 M01AE03
853 M01AE03
854 M01AE03
855 M01AE03
856 M01AE03
857 M01AE03
858 M01AE03
859 M01AE03
860 M01AE03
861 M01AE03
862 M01AE03
863 M04AA01
864 M04AA01
865 M04AC01
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
DCI
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
MELOXICAMUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
KETOPROFENUM
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
Denumire Comerciala
forma farm.
MELOXICAM LPH 15 mg
COMPR.
MELOXICAM SANDOZ 15 mg COMPR.
MELOXICAM MCC 15 mg
COMPR.
MELOXICAM VIM SPECTRUM 15 mg COMPR.
Meloxicam Zentiva 15 mg comprimate COMPR.
MELOXICAM LPH 15 mg
COMPR.
MOVALIS (R) 7,5 mg
COMPR.
MOVALIS (R) 7,5 mg
COMPR.
MELOXICAM LPH 7,5 mg
COMPR.
MELOXICAM SANDOZ 7,5 mg COMPR.
MELOXICAM MCC 7,5 mg
COMPR.
MELOXICAM VIM SPECTRUM 7,5 mg COMPR.
MELOXICAM LPH 7,5 mg
COMPR.
MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ.
MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ.
MELOX 15 mg/1,5 ml
SOL. INJ.
MOVALIS 15mg/1,5ml
SOL. INJ.
MELOXICAM 15 mg
SUPOZ.
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
KETOPROFEN SR TERAPIA 100 MG CAPS. ELIB. PREL. 100mg
KETONAL (R) DUO 150 mg CAPS. ELIB. PREL. 150mg
KETOPROFEN SR TERAPIA 200 MG CAPS. ELIB. PREL. 200mg
KETONAL RETARD
PROFENID (R) 100 mg
COMPR. FILM. 100mg
KETOPROXIN 100 mg
COMPR. FILM. 100mg
KETOPROXIN 50 mg
COMPR. FILM. 50mg
KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ.
100 mg/2ml
KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ.
100 mg/2ml
KETONAL 100 mg/ 2 ml
SOL. INJ.
100mg/2ml
KETOPROFEN TERAPIA 100MG/2ML SOL. INJ./CONC. SOL. PERF. 100mg/2ml
KETOMAG
SUPOZ.
100mg
MILURIT 100 mg
COMPR.
100mg
MILURIT 300 mg
COMPR.
300mg
COLCHICINA
COMPR.
1mg
TRAMADOL
CAPS.
50mg
K-ALMA (R)
CAPS.
50mg
TRAMADOL ARENA
CAPS.
50mg
TRAMACALM
CAPS.
50mg
TRAMADOL ZENTIVA 50 mg CAPS.
50mg
TRAMAG 50
COMPR.
50mg
TRAMADOL EEL
COMPR.
50mg
TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg
TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg
MABRON RETARD 100 mg COMPR. ELIB. PREL. 100mg
TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg
TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg
TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg
HEXAL AG
Prescriptie
Nr crt.
833 M01AC06
tara det.
concentratie
APP
Detinator APP
Ambalaj
15mg
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-6L
P-6L
MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
P-6L
ZENTIVA AS
CEHIA
P-6L
ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L
P-6L
P-6L
HEXAL AG
P-6L
P-6L
P-6L
MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIAT. AL/PVC X 10 COMPR. P-6L

VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P6L
PRF
PRF
CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ.
CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ.
CUTIE CU 1 BLIST. DIN PVC A 5 FIOLE TRANSPARENTE DIN STICLA CU CAPACITATEA DE 2 ML, CONTINAND 1,5 ML
PRF
GERMANIA 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.
SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L
LAB. AVENTIS
FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM.
P-6L
P-6L
P-6L
P-6L
P-6L
ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L

AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF
SLOVENIA CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF.
TERAPIA SA
MAGISTRA C & C
ROMANIA
ROMANIA
UNGARIA
UNGARIA
ROMANIA

BIOFARM SA
KRKA D.D.
SLOVENIA
ANTIBIOTICE SA
ROMANIA
ROMANIA
ZENTIVA A.S.
MAGISTRA C & C
BIO EEL SRL
SLOVACIA
ROMANIA
ROMANIA
P-RF
P-RF
CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L

P-6L
P-6L
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
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.
ZENTIVA AS
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL.
P-RF
CIPRU
CIPRU
CIPRU
CIPRU
AUSTRIA
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
PRF
PRF
SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL.
CIPRU
CIPRU
CIPRU
CIPRU
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA
P-RF
PRF
PRF
PRF
PRF
PRF
PRF
PRF
PRF
Pagina 16 din 21
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
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
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
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
1.963333
1.964000
1.965500
1.965500
0.759249
0.297000
0.712800
0.644000
0.712800
0.431333
0.280500
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
0.000000
0.000000
0.000500
1.058500
0.877417
0.000000
0.133700
0.000000
0.066700
0.000000
0.000000
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

beneficiaza de
compensare 90% din
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
1.766999
1.767600
1.768950
1.768950
0.683324
0.267300
0.641520
0.579600
0.641520
0.388199
0.252450
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
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
0.196334
0.196400
0.197050
1.255050
0.953342
0.029700
0.204980
0.064400
0.137980
0.043134
0.028050
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
cod ATC
890 N02AX02
891 N02AX02
892 N02AX02
893 N02AX02
894 N02AX02
895 N02AX02
896 N02AX02
897 N02AX02
898 N02AX02
899 N02AX02
900 N02CC01
901 N02CC01
902 N02CC01
903 N02CC01
904 N02CC01
905 N02CC01
906 N03AF01
907 N03AF01
908 N03AF01
909 N03AF01
910 N03AF01
911 N03AF01
912 N03AF01
913 N03AF01
914 N03AF01
915 N03AF01
916 N03AF01
917 N03AF01
918 N03AF01
919 N03AF01
920 N03AF01
921 N03AF01
922 N03AF01
923 N03AF01
924 N03AF01
925 N03AF01
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 N03AX12
940 N03AX12
941 N03AX12
942 N03AX12
943 N03AX12
944 N03AX12
DCI
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
CARBAMAZEPINUM
CARBAMAZEPINUM
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
Denumire Comerciala
MABRON RETARD 200 mg

TRADOLAN 50 mg
TRAMADOL RETARD 150 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
CARBAMAZEPINA SLAVIA 200 mg
CARBAMAZEPINA TERAPIA 200 mg
CARBEPSIL 400mg
TIMONIL RETARD 150 mg

NEUROTOP (R) RETARD 300 mg
TEGRETOL CR 200
TEGRETOL CR 400
TIMONIL SIROP
GABAPENTIN AUROBINDO 100 mg
GABAGAMMA 100 mg
GRIMODIN 100 mg
GABAPENTINA PFIZER 100 mg
GABAPENTIN ARENA 100 mg
GABAGAMMA 300 mg
GABARAN 300 mg
GABALEPT 300 mg
GRIMODIN 300 mg
GABAGAMMA 400 mg
GABARAN 400 mg
GABALEPT 400 mg
GRIMODIN 400 mg
forma farm.
COMPR. ELIB. PREL.
COMPR. FILM.
COMPR. ORODISPERSABILE
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SUPOZ.
COMPR. DISP.
COMPR. DISP.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. CU ELIBERARE PRELUNGITA
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
SUSP. ORALA
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
concentratie
200mg
50mg
150mg
200mg
50mg
50mg
100mg
100mg
50mg/ml
50mg/ml
100mg
100mg
50mg
100mg
100mg
50mg
50mg
200mg
200mg
200mg
200mg
200mg
200mg
200mg
200mg
200mg
200mg
400mg
400mg
150mg
300mg
600mg
300mg
600mg
200mg
400mg
100mg/5ml
100 mg
100mg
100mg
100mg
100mg
100mg
300 mg
300mg
300mg
300mg
300mg
300mg
300mg
300mg
400 mg
400mg
400mg
400mg
400mg
Detinator APP
Ambalaj
Prescriptie
Nr crt.
889 N02AX02
tara det.
APP

LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM.
PRF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
P-RF
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
S/P-RF
SLOVENIA CUTIE X 5 FIOLE X 1 ML

SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ.
S/P-RF
S/P-RF
P-RF
GLAXO WELLCOME UK LIMITED
MAREA BRITANIE
CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP.
P-RF
MAREA BRITANIE
CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP.
P-RF
P-RF
ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM.
PRF
P-RF
ISLANDA 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



BIO EEL SRL
ROMANIA
TERAPIA S.A.
ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR.
AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR.
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.
P-6L/S
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
PRF
P-6L
P-6L
DESITIN ARZNEIMITTEL GMBH
GERMANIA
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA
GERMANIA
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA
GERMANIA
P6L
P6L
P6L
GEROT PHARMAZEUTIKA GMBH
AUSTRIA
AUSTRIA
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
CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL.
P-6L
P-6L
GERMANIA
CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE
P-6L
MAREA BRITANIE
CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS.
P6L
GERMANIA
P-6L
UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L

CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L
MAREA BRITANIE
MAREA BRITANIE

MAREA BRITANIE

P6L
CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L
CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS.
GERMANIA
RANBAXY UK LTD.
MAREA BRITANIE
CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L
PLIVA LJUBLJANA D.O.O. SLOVENIA
P-6L
P-6L
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
MAREA BRITANIE

MAREA BRITANIE

P6L
CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L
GERMANIA
RANBAXY UK LTD.
MAREA BRITANIE
PLIVA LJUBLJANA D.O.O. SLOVENIA

UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS.
Pagina 17 din 21
P-6L
P-6L
P-6L
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
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
50
50
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
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
0.141800
0.141800
0.141800
0.141800
0.141800
0.140000
0.141800
0.141800
0.141800
0.141800
0.283600
0.283600
0.106349
0.212699
0.425399
0.212699
0.425399
0.141800
0.283600
23.360000
0.149200
0.164279
0.164279
0.164279
0.164279
0.164279
0.447800
0.492840
0.492840
0.492840
0.492840
0.447400
0.433000
0.492840
0.597600
0.657121
0.657121
0.657121
0.657121
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
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
0.076400
0.000033
0.000000
0.000000
0.000000
0.000000
0.000200
0.000200
0.000000
0.000000
0.108600
0.108400
0.197451
0.199901
0.306201
0.143301
0.260601
0.205600
0.320400
0.000000
0.000000
0.029821
0.412221
0.303521
0.288421
0.243054
0.000000
0.263260
0.853760
0.026860
0.082660
0.000000
0.000000
0.404493
0.000000
0.535979
0.851879
0.035379
0.372212

beneficiaza de
compensare 90% din
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
0.127620
0.127620
0.127620
0.127620
0.127620
0.126000
0.127620
0.127620
0.127620
0.127620
0.255240
0.255240
0.095714
0.191429
0.382859
0.191429
0.382859
0.127620
0.255240
21.024000
0.134280
0.147851
0.147851
0.147851
0.147851
0.147851
0.403020
0.443556
0.443556
0.443556
0.443556
0.402660
0.389700
0.443556
0.537840
0.591408
0.591408
0.591408
0.591408
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
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
0.090580
0.014213
0.014180
0.014180
0.014180
0.014000
0.014380
0.014380
0.014180
0.014180
0.136960
0.136760
0.208086
0.221171
0.348741
0.164571
0.303141
0.219780
0.348760
2.336000
0.014920
0.046249
0.428649
0.319949
0.304849
0.259482
0.044780
0.312544
0.903044
0.076144
0.131944
0.044740
0.043300
0.453777
0.059760
0.601692
0.917592
0.101092
0.437925
cod ATC
946 N03AX12
947 N03AX12
948 N03AX12
949 N03AX12
950 N03AX12
951 N05AD01
952 N05AD01
953 N05AD01
954 N05AD01
955 N05AD01
956 N05AD01
957 N05AD01
958 N05AD01
959 N05BA01
960 N05BA01
961 N05BA01
962 N05BA01
963 N05BA01
964 N05BA01
965 N05BA01
966 N05BA03
967 N05BA03
968 N05BA03
969 N05BA03
970 N05BA03
971 N05BA06
972 N05BA08
973 N05BA08
974 N05BA08
975 N05BA08
976 N05BA08
977 N05BA08
978 N05BA12
979 N05BA12
980 N05BA12
981 N05BA12
982 N05BA12
983 N05BA12
984 N05BA12
985 N05BA12
986 N05BA12
987 N05BA12
988 N05BA12
989 N05BA12
990 N05BA12
991 N05BA12
992 N05BA12
993 N05BA12
994 N05BA12
995 N05BA12
996 N05BA12
997 N05BA12
998 N05BA12
999 N05BA12
1,000
N05BA12
DCI
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*
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*
ALPRAZOLAMUM*
ALPRAZOLAMUM*
forma farm.
Denumire Comerciala
GABAPENTINA PFIZER 400 mg CAPS.
GABAPENTIN ARENA 400 mg CAPS.
GABARAN 600 mg
COMPR. FILM.
GRIMODIN 600 mg
COMPR. FILM.
GABARAN 800 mg
COMPR. FILM.
concentratie
400mg
400mg
400mg
600mg
600mg
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
BROMAZEPAM LPH 1,5 mg COMPR.
1,5mg
BROMAZEPAM LPH 3 mg
COMPR.
3mg
BROMAZEPAM SLAVIA 3 mg COMPR.
3mg
BROMAZEPAM ARENA 3 mg COMPR.
3mg
BROMAZEPAM LPH 3 mg
COMPR.
3mg
XANAX 0,25 mg
COMPR.
0,25mg
ALPRAZOLAM LPH (R) 0,25 mg COMPR.
0,25mg
0,25mg
PRAZOLEX (R) 0,25 mg
COMPR.
0,25mg
FRONTIN 0,25 mg
COMPR.
0,25mg
ALPRAZOLAM ATB 0,25 mg COMPR.
0,25mg
0,25mg
0,25mg
XANAX 0,5 mg
COMPR.
0,5mg
0,5mg
0,5mg
FRONTIN 0,5 mg
COMPR.
0,5mg
PRAZOLEX (R) 0,5 mg
COMPR.
0,5mg
0,5mg
0,5mg
0,5mg
XANAX 1 mg
COMPR.
1mg
ALPRAZOLAM LPH (R) 1 mg COMPR.
1mg
ALPRAZOLAM LPH (R) 1 mg COMPR.
1mg
PRAZOLEX (R) 1 mg
COMPR.
1mg
FRONTIN 1mg
COMPR.
1mg
ALPRAZOLAM ATB 1 mg
COMPR.
1mg
ALPRAZOLAM ATB 1 mg
COMPR.
1mg
Detinator APP
Prescriptie
Nr crt.
945 N03AX12
tara det.
APP
Ambalaj
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
50
100
ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L
60
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
30
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L
60
RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
30
LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
20
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF
30
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF
30
JANSSEN PHARMACEUTICA N.V. BELGIA
CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF
25
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL.
PRF
1
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF
1
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML
P-RF
5
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF
5
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-RF
20
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF
30
LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
20
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE X 2 ML
S/P-RF
5
TERAPIA SA
S/P-RF
5
DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF
5
DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 PUNGI X 1 TUB X 2,5 ML + CANULA S/P-RF
5
ARENA GROUP SA ROMANIA CUTIE X 2 BLISTERE PVC/AL X 10 COMPRIMATE P-RF
20
ARENA GROUP SA ROMANIA CUTIE X 5 BLISTERE PVC/AL X 10 COMPRIMATE P-RF
50
LAROPHARM SRL ROMANIA CUTIE X 1 BLIST. X 20 COMPR.
P-RF
20
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
20
LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF/S
30
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-RF
50
20
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF
30
20
SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF
10
ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF
10
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. PRF
30
PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF
30
P-RF
20
P-RF
30
30
EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR.
P-RF
30
ANTIBIOTICE S.A.
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. PRF
10
ANTIBIOTICE S.A.
20
ANTIBIOTICE S.A.
30
30
P-RF
30
P-RF
20
P-RF
30
30
ANTIBIOTICE S.A.
10
ANTIBIOTICE S.A.
20
ANTIBIOTICE S.A.
30
30
P-RF
30
P-RF
20
30
P-RF
30
ANTIBIOTICE S.A.
10
ANTIBIOTICE S.A.
20
MAREA BRITANIE
MAREA BRITANIE
Pagina 18 din 21
0.596200
0.577100
0.657121
0.985682
0.985682
1.314243
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
0.131875
0.128000
0.128000
0.105500
0.039562
0.039562
0.079125
0.079125
0.079125
0.079125
0.065937
0.065937
0.065937
0.065937
0.065937
0.065937
0.065937
0.065937
0.131875
0.131875
0.131875
0.131875
0.131875
0.131875
0.131875
0.131875
0.263750
0.263333
0.263500
0.263750
0.263750
0.263000
0.263750
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.000000
0.000000
0.464545
1.194318
0.882151
2.290757
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
0.026125
0.000000
0.000000
0.033500
0.071438
0.071438
0.028875
0.020875
0.028875
0.028875
0.126729
0.059063
0.058729
0.059396
0.059396
0.059063
0.059563
0.059396
0.174791
0.066791
0.067125
0.067458
0.067458
0.068125
0.068625
0.067458
0.141916
0.000000
0.000000
0.000250
0.000250
0.000000
0.000750

beneficiaza de
compensare 90% din
0.536580
0.519390
0.591408
0.887113
0.887113
1.182818
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
0.118687
0.115200
0.115200
0.094950
0.035605
0.035605
0.071212
0.071212
0.071212
0.071212
0.059343
0.059343
0.059343
0.059343
0.059343
0.059343
0.059343
0.059343
0.118687
0.118687
0.118687
0.118687
0.118687
0.118687
0.118687
0.118687
0.237375
0.236999
0.237150
0.237375
0.237375
0.236700
0.237375
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.059620
0.057710
0.530258
1.292887
0.980720
2.422182
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
0.039313
0.012800
0.012800
0.044050
0.075395
0.075395
0.036788
0.028788
0.036788
0.036788
0.133323
0.065657
0.065323
0.065990
0.065990
0.065657
0.066157
0.065990
0.187979
0.079979
0.080313
0.080646
0.080646
0.081313
0.081813
0.080646
0.168291
0.026334
0.026350
0.026625
0.026625
0.026300
0.027125
cod ATC
N05BA12
1,002
N05CD02
1,003
N05CD02
1,004
N05CD02
1,005
N05CD02
1,006
N05CD02
1,007
N05CD02
1,008
N05CF01
1,009
N05CF02
1,010
N05CF02
1,011
N05CF02
1,012
N05CF02
1,013
N05CF02
1,014
N05CF02
1,015
N05CF02
1,016
N06AA04
1,017
N06AA04
1,018
N06AA09
1,019
N06AA12
1,020
N06AB03
1,021
N06AB03
1,022
N06AB03
1,023
N06AB03
1,024
N06AB03
1,025
N06AB04
1,026
N06AB04
1,027
N06AB05
1,028
N06AB05
1,029
N06AB05
1,030
N06AB05
1,031
N06AB05
1,032
N06AB06
1,033
N06AB06
1,034
N06AB06
1,035
N06AB06
1,036
N06AB06
1,037
N06AB06
1,038
N06AB06
1,039
N06AB06
1,040
N06AB06
1,041
N06AB06
1,042
N06AB06
1,043
N06AB06
1,044
N06AB06
1,045
N06AB06
1,046
N06AB06
1,047
N06AB08
1,048
N06AB08
1,049
N06AX11
1,050
N06AX11
1,051
N06AX11
1,052
N06AX11
1,053
N06AX11
1,054
N06AX11
1,055
N06AX11
1,056
N06AX11
DCI
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*
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*
Denumire Comerciala
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
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
ZOLPIDEM AUROBINDO 10 mg COMPR. FILM.
STILNOX 10 mg
COMPR. FILM.
ANAFRANIL (R) 10 mg
ANAFRANIL (R) 25 mg
DRAJ.
DRAJ.
AMITRIPTILINA ARENA 25 mg COMPR. FILM.
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
SERLIFT 100 mg
ASENTRA (R)
SETALOFT 100 mg
ZOLOFT 100 mg
ADJUVIN 100 mg
STIMULOTON 100 mg
DRAJ.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. DISP.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
SERTRALINA ARENA 100 mg COMPR. FILM.
SERLIFT 50 mg
COMPR. FILM.
ASENTRA (R)
COMPR. FILM.
SETALOFT 50 mg
COMPR. FILM.
ZOLOFT 50 mg
COMPR. FILM.
ADJUVIN 50 mg
COMPR. FILM.
STIMULOTON 50 mg
COMPR. FILM.
SERTRALINA ARENA 50 mg COMPR. FILM.
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
CONC. PT. SOL. ORALA
COMPR. FILM.
COMPR. FILM.
COMPR. DISP.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
MIRTAZAPINA AUROBINDO 15 mg
MIRZATEN Q-TAB 30 mg
concentratie
1mg
2,5mg
2.5mg
5mg
5mg
5mg
5mg
7,5mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
25mg
25mg
25mg
20mg
20mg
20mg
20mg
20mg
10mg
20mg
20mg
20 mg
20mg
20mg
40mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
20mg/ml
100mg
50mg
30mg
15mg
30mg
30mg
30mg
45mg
15mg
30mg
Ambalaj
Prescriptie
Nr crt.
1,001
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.
PRF

P-RF
FRANTA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. FILM.

SLOVENIA CUTIE X 1 BLIST. X 10 COMPR. FILM.
P-RF
P-RF

ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM.
MALTA
Detinator APP
ANTIBIOTICE S.A.
LABORMED PHARMA SA
LABORMED PHARMA SA
LABORMED PHARMA SA
LABORMED PHARMA SA
SANOFI AVENTIS
ANTIBIOTICE S.A.
tara det.
APP
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF
CUTIE X 3 BLIST. AL/PVC X 10 DRAJ.

P-RF
P-RF
P-RF
ARENA GROUP S.A. ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. FILM.

TERAPIA SA
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.
ANTIBIOTICE S.A.
ELI LILLY SA
SPANIA CUTIE X 2 BLIST. PVC-PE-ACLAR/AL X 14 COMPR. DISP.
P-RF

P-RF

ANTIBIOTICE SA
ROMANIA CUTIE CU 3 BLIST. DIN PVC-PE-PVDC/AL X 10 COMPR. FILM.
P-RF

ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. AL/AL X 10 COMPR. FILM.
P-RF
SANDOZ S.R.L.
TERAPIA SA
KRKA D.D.
ROMANIA CUTIE CU BLIST. DIN AL/PVC X 30 COMPR.FILM.

P-RF
P-RF
ISLANDA
CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF
MAREA BRITANIE
CUTIE X BLISTERE DIN AL/PVC X 28 COMPRIMATE FILMATE
P-RF
AUSTRIA
CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
PRF

SMITHKLINE BEECHAM
MAREA BRITANIE
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
PRF
P-RF
P-RF
UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.

ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.
TERAPIA SA
P-RF
KRKA D.D.
P-RF
ISLANDA
MAREA BRITANIE
CUTIE X BLIST. DIN AL/PVC X 28 COMPR. FILM.
P-RF
AUSTRIA
PRF
ARENA GROUP SA
MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML CONC. PT. SOL. ORALA + 1 PIPETA GRADATA
OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.

OLANDA CUTIE X 2 BLIST. PVC/PVDC X 15 COMPR. FILM.
OLANDA
NV ORGANON
KRKA D.D.
SLOVENIA
ACTAVIS GROUP HF. ISLANDA
ZENTIVA KS
CEHIA
MAREA BRITANIE
P-RF
CUTIE, CU BLISTERE DIN PVC-PVDC/AL X 28 COMPR. FILM. P-RF
UNGARIA CUTIE X 3 BLIST. X 10 COMPR. FILM.

P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
CUTIE X 5 BLIST. AL/PVC-PA-POLIESTER PERFORAT PT. ELIB. UNEI UNIT. DOZATE X 6 COMPR. DISP.
P-RF
CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.
PRF
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF

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

CUTIE CU 3 BLIST. ALBE OPACE DIN PVC-PVDC/AL-PVDC X 10 COMPR. FILM.
PRF
CUTIE CU BLIST. PA-AL-PVC/AL-POLIESTER-HARTIE X 30 COMPR. ORODISPERSABILE
P-RF
CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 30 COMPR. ORODISPERSABILE
P-RF
Pagina 19 din 21
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
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
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
0.263750
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
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
0.490166
0.245083
0.481666
0.490166
0.481333
0.735249
0.245083
0.490166
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.000250
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
0.110894
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
1.695167
0.606583
0.000000
0.327500
0.000000
1.388417
0.605583
0.004834

beneficiaza de
compensare 90% din
0.237375
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
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
0.441149
0.220574
0.433499
0.441149
0.433199
0.661724
0.220574
0.441149
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.026625
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
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
1.744184
0.631092
0.048167
0.376517
0.048134
1.461942
0.630092
0.053851
cod ATC
N06AX11
1,058
N06AX11
1,059
N06AX11
1,060
N06AX16
1,061
N06AX16
1,062
N06AX16
1,063
N06AX16
1,064
N06AX16
1,065
N06AX16
1,066
N06AX16
1,067
N06AX16
1,068
N06AX16
1,069
N06AX16
1,070
N06AX16
1,071
N06AX16
1,072
N06AX16
1,073
N06AX16
1,074
N06AX16
1,075
N06AX16
1,076
N06AX16
1,077
N06AX16
1,078
N06AX16
1,079
N06AX16
1,080
N06AX16
1,081
N06AX16
1,082
N06AX16
1,083
N06AX16
1,084
N06AX16
1,085
N06AX16
1,086
N06AX16
1,087
N07AA01
1,088
N07AA01
1,089
P01AB02
1,090
P01AB02
1,091
P01AB02
1,092
P01AB02
1,093
P02CA03
1,094
P02CA03
1,095
P02CA03
1,096
P02CA03
1,097
P02CA03
1,098
P02CA03
1,099
P02CE01
1,100
P02CE01
1,101
P02CE01
1,102
P02CE01
1,103
R01AD01
1,104
R03AC02
1,105
R03AC02
1,106
R03AC02
1,107
R03BA01
1,108
R03BA02
1,109
R03BA02
1,110
R03BA02
1,111
R03BA02
1,112
R03BA02
DCI
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
TINIDAZOLUM
TINIDAZOLUM
TINIDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
ALBENDAZOLUM
LEVAMISOLUM
LEVAMISOLUM
LEVAMISOLUM
LEVAMISOLUM
BECLOMETASONUM
SALBUTAMOLUM
SALBUTAMOLUM
SALBUTAMOLUM
BECLOMETASONUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
BUDESONIDUM*
Denumire Comerciala
forma farm.
MAREA BRITANIE
P-RF
ANTIBIOTICE S.A.
ROMANIA
CUTIE X 5 BLIST. AL/AL X 6 COMPR. ORODISPERSABILE
P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL.
PRF
COMPR.
COMPR.
COMPR.
COMPR.
SPRAY NAZ.,SUSP.
100mcg/doza
CHIESI FARMACEUTICI SPA
ITALIA
CUTIE X 1 FLACON DIN PET X 30 ML SPRAY NAZ.,SUSP., PREVAZUT CU POMPA DOZATOARE
P-RF
MAREA BRITANIE
CUTIE X 1 FALC. DIN STICLA BRUNA X 10 ML SOL. DE INHAL.
P-6L
MAREA BRITANIE
CUTIE X 1 FLACON PRESURIZAT DIN AL PREVAZUT CU VALVA DOZATOARE X 200 DOZE + DISPOZITIV DE ADMINISTRA
P-RF
MAREA BRITANIE
CUTIE X 1 FLAC. AL + VALVA DOZATOARE + DISP. ADM. X 200 DOZE SUSP. INHAL. PRESURIZATA
P-6L
CUTIE X 1 FLACON PRESURIZAT DIN AL X 200 DOZE, PREVAZUT CU VALVA DOZATOARE + DISPOZITIV DE ADM., "SPASER JET" CU CAPAC
P-RF
ZULIN 30 mg
EFECTIN EP 150 mg
ELIFY EP 150 mg
IVRYX 150mg
VELAXIN 150 mg
ALVENTA 150mg
CAPS. ELIB. PREL.
VENLAFAXINA ACTAVIS 150 mg

VENLAFAXINA ARENA EP 150 mg
VENLAFAXINA TERAPIA 150 mg
CAPS. ELIB. PREL.
FOBILESS 37,5 mg
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.

CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.

CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
VENLAFAXINA ARENA EP 37,5 mg CAPS. ELIB. PREL.
EFECTIN EP 75 mg
ELIFY EP 75 mg
IVRYX 75mg
IVRYX 75mg
VELAXIN 75 mg
ALVENTA 75 mg
FOBILESS 75 mg
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.

CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
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
ARGOFAN 75 SR
NEOSTIGMINA LPH 15 mg
COMPR. ELIB. PREL.
TINIZOL (R) 500 mg (J01XD02)

TIPROGYN 500 (vezi J01XD02)
TINIZOL (R) 500 mg (J01XD02)
TIPROGYN 500 (vezi J01XD02)
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
ALBENDAZOL VIM SPECTRUM 200 mg
COMPR.
COMPR.
COMPR. ELIB. PREL.
COMPR.
COMPR.
COMPR. FILM.
COMPR.FILM
SUSP. ORALA
VERMIGAL NOVO 400 mg/10 ml SUSP. ORALA
VENTOLIN 100 INHALER CFC-FREE
ASTHALIN INHALER
CLENIL (R) JET 250 mcg
FRENOLYN 200
FRENOLYN 200
PULMICORT TURBUHALER 200 mcg/doza
FRENOLYN 400
BUDIAIR 200 mcg
Ambalaj
DECARIS 150 mg
LEVAMISOL ARENA 150 mg
DECARIS 50 mg
LEVAMISOL ARENA 50 mg
RINOCLENIL 100
VENTOLIN (R)
Detinator APP
30mg
30mg
45mg
150 mg
150 mg
150 mg
150mg
150mg
150mg
150mg
150mg
150mg
37,5mg
37,5mg
75 mg
75 mg
75 mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
37,5mg
50mg
75mg
150mg
75mg
15mg
15mg
500mg
500mg
500mg
500mg
200mg
400mg
200mg
200 mg
0,4g/10ml
400mg/10ml
150mg
150mg
50mg
50mg
ESKAZOLE
DUADOR 200 mg
ALBENDAZOL LPH 200 mg
ZENTEL 0,4 g/10 ml
concentratie
Prescriptie
Nr crt.
1,057
tara det.
APP
SOL. INHAL. 5mg/ml

SUSP. INHAL. PRESURIZATA
SOL. INHALAT PRESURIZATA
PULB. INHAL.
PULB. INHAL.
PULB. INHAL.
PULB. INHAL.
SOL. DE INHALAT PRESURIZATA
CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF
NEOLA PHARMA S.R.L. ROMANIA
CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL.
UNGARIA
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL.
ISLANDA
P-RF
CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF

P-RF
CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF

TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
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
P-RF
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL.
PRF
MAREA BRITANIE
CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF
CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF

UNGARIA
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.
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.
ZENTIVA A.S.
AUSTRIA
ISLANDA
P-RF
CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF
P-RF

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
SLOVACIA
SLOVACIA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL.
P-RF
P-RF
ROMANIA
ROMANIA
ROMANIA
ROMANIA

CUTIE CU BLIST. PVC/AL X 60 COMPR. P-6L
P-RF
CUTIE X 1 BLIST. X 4 COMPR.FILM.
P6L
P-RF
CUTIE X 1 BLIST. X 4 COMPR.FILM.
P6L
GLAXO SMITHKLINE EXPORT LTD. MAREA BRITANIE

ZENTIVA S.A.
AC HELCOR SRL
ZENTIVA S.A.
AC HELCOR SRL
P-RF

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
BIOFARM S.A.
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 10 ML SUSP. ORALA
PRF

P-RF
ROMANIA
100mcg/doza GLAXOWELLCOME UK LTD.

100mcg/doza CIPLA (UK) LIMITED
250mcg/doza CHIESI FARMACEUTICI SPA
200 mcg/doza MEDOCHEMIE ROMANIA SRL
200mcg/doza ASTRAZENECA AB
200 mcg/doza CHIESI FARMACEUTICI SPA
ITALIA
P-RF
P-RF
P-RF
P-RF
ROMANIA CUTIE X 1 PUNGA, X 1 INHALATOR X 100 DOZE

ROMANIA CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 200 DOZE
P-RF
SUEDIA
CUTIE X 1 FLACON MULTIDOZA DIN PEID X 100 DOZE PULB. INHAL.
P-RF
ROMANIA
CUTIE CU 1 PUNGA DIN POLISTIREN/AL/PE CONTINAND 1 INHALATOR TIP MIAT-HALER X 100 DOZE
P-RF
ITALIA
CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA + VALVA DOZATOARE + DISPOZITIV DE ADMINISTRA
P-RF
Pagina 20 din 21
P-RF
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
30
0.490166
30
0.485333
30
0.735249
28
1.153452
30
0.998333
28
0.860714
28
1.153452
30
0.554666
28
0.856428
30
1.153452
30
1.153452
30
1.153452
30
0.288363
30
0.288363
28
0.576726
30
0.576726
28
0.576726
28
0.576726
28
0.576726
30
0.326000
30
0.576726
28
0.576726
30
0.576726
30
0.576726
30
0.576726
30
0.288363
30
0.384484
30
0.576726
30
0.665000
30
0.391000
20
0.694624
60
0.688833
4
0.603524
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.385500
0.000000
0.522751
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
0.017376
0.000000
0.356476
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

beneficiaza de
compensare 90% din
0.441149
0.436799
0.661724
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
0.625161
0.619949
0.543171
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
0.434517
0.048534
0.596276
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
0.086839
0.068884
0.416829
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
cod ATC
R03BA02
1,114
R03BB01
1,115
R03CC02
1,116
R03CC02
1,117
R03DA04
1,118
R03DA04
1,119
R03DX05
1,120
R03DX05
1,121
R05DA04
1,122
R05DA04
1,123
R05DA04
1,124
R05DA04
1,125
R05DA04
1,126
R05DA04
1,127
R06AB04
1,128
R06AE07
1,129
R06AE07
1,130
R06AE07
1,131
R06AX17
1,132
R06AX17
1,133
R06AX17
1,134
R06AX17
1,135
R06AX17
1,136
R06AX17
1,137
S01BC03
1,138
S01BC03
1,139
S01BC03
BUDESONIDUM*
IPRATROPII BROMIDUM*
SALBUTAMOLUM
SALBUTAMOLUM
THEOPHYLLINUM
THEOPHYLLINUM
OMALIZUMABUM**
OMALIZUMABUM**
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CHLORPHENAMINUM
CETIRIZINUM
CETIRIZINUM
CETIRIZINUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
KETOTIFENUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
1,140
S01CA05
COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM)
1,141
S01CA05
COMBINATII (CLORAMPHENICOLUM+BETHAMETASONUM)
Denumire Comerciala
BUDIAIR 200 mcg JET
forma farm.
concentratie
200mcg/doza
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
XOLAIR 150 mg
SOL INJ.
150mg
XOLAIR 75 mg
SOL INJ.
75mg
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
BETABIOPTAL
PICATURI OFT.SUSP. 0,2g+0,5g/100ml
BETABIOPTAL
UNG. OFT. 0,2g+0,5g/100g
IPRAVENT INHALER 20mcg/doza
Detinator APP
Ambalaj
Prescriptie
DCI
Nr crt.
1,113
tara det.
APP
ITALIA
CUTIE X 1 FLACON X 200 DOZE SOL. DE INHALAT PRESURIZATA = VALVA DOZATOARE + DISPOZITIV JET DE ACTION
P-RF
CIPLA (UK) LIMITED
MAREA BRITANIE
CUTIE X 1 FLACON AL PRESURIZAT X 200 DOZE SUSP.DE INHALAT PRESURIZATA
P-6L
CUTIE X 1 FLAC. DIN STICLA BRUNA X 125 ML SIROP
P-6L
MAREA BRITANIE
CUTIE X 5 FIOLE DIN STICLA X 1 ML
P-6L
KRKA D.D.
KRKA D.D.
SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.

SLOVENIA CUTIE X 4 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.
NOVARTIS EUROPHARM LTD.
MAREA BRITANIE
CUTIE CU 1 SERINGA PREUMPLUTA X 1ML SOLUTIE INJECTABILA
PR/PRF
MAREA BRITANIE
CUTIE CU 1 SERINGA PREUMPLUTA X 0.5ML SOLUTIE INJECTABILA
PR/PRF
SINTOFARM SA
BIO EEL SRL
FARMACOM SA
SLAVIA PHARM SRL

ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
KRKA D.D.
LABORMED PHARMA SA
MAGISTRA C & C SRL

LABORMED PHARMA SA
UCB PHARMA GMBH GERMANIA

AC HELCOR SRL
ROMANIA
LAROPHARM SRL ROMANIA
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-6L
CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L

CUTIE CU 1 FLAC. DIN STICLA BRUNA + PICURATOR DIN PEJD X 20 ML PIC. ORALE, SOL.
P-6L
P6L

P-6L
P-6L
CUTIE X 2 BLIST. PVC X 10 COMPR
P6L
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
ROMANIA
FLACON PICURATOR DIN PEJD X 5 ML PIC. OFT., SOL.
P-6L
CUTIE X 1 FLACON DIN PE X 10 ML PIC. OFTALMICE, SOL., PREVAZUT CU PICURATOR
P-6L
CUTIE X 1 FLAC. PEJD X 5 ML PICATURI OFT.-SOL. + PICURATOR PEJD + CAPAC CU INEL DE SIGURANTA
P-6L
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
UNIMED PHARMA LTD. SLOVACIA

LABORATOIRES THEA FRANTA
THEA FARMA S.P.A. ITALIA

THEA FARMA S.P.A. ITALIA
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
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 corespunzatoare 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 (1) se efectueaza pentru pacienii cu intoleran la acidum acetylsalicylicum.
Pagina 21 din 21
1 66.167500
1 13.080000
1
3.050000
5
0.740000
40
0.243500
40
0.362500
1 1,536.080000
1 789.875000
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
8.122500
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
65.505000
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

beneficiaza de
compensare 90% din
59.550750
11.772000
2.745000
0.666000
0.219150
0.326250
1,382.472000
710.887500
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
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 90%
din pretul de
referinta)
14.739250
1.308000
0.305000
0.074000
0.024350
0.036250
153.608000
144.492500
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
ANEXA 2b
SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM
Nr. crt
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
61
cod ATC
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC02
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A02BC05
A03AB06
A06AD15
A06AD15
A07AA11
A07AA11
A07AA11
A07EA06
A07EA06
A07XA04
A07XA04
A07XA04
A08AB01
A08AB01
A11CC03
A11CC03
DCI
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
PANTOPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
ESOMEPRAZOLUM
OTILONIUM BROMIDUM
MACROGOLUM*2)
MACROGOLUM*2)
RIFAXIMINUM
RIFAXIMINUM
RIFAXIMINUM
BUDESONIDUM**#
BUDESONIDUM**#
RACECADOTRILUM
RACECADOTRILUM
RACECADOTRILUM
ORLISTATUM****
ORLISTATUM****
ALFACALCIDOLUM
ALFACALCIDOLUM
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 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 TORRENT 20 mg
ESOMEPRAZOL TEVA 20 mg
PRAGASTROL 20 mg
NEXIUM 40 mg
PRAGASTROL 40 mg
ESOMEPRAZOL TERAPIA 20mg
ESOMEPRAZOL TERAPIA 40mg
NEXIUM 10 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
forma farm.
concentratie
20mg
COMPR. GASTROREZ. 20 mg
COMPR. GASTROREZ. 40 mg
20mg
40mg
PULB. PT. SOL. INJ. 40mg
20mg
40mg
10mg
PULB. PT. SOL. PERF./INJ. 40mg
COMPR. FILM. 40mg
COMPR. GASTROREZISTENTE
GRAN. GASTROREZ. PT. SUSP.ORALA
FARA CONCENTRATIE
FARA CONCENTRATIE
COMPR. FILM. 200mg

COMPR. FILM. 200mg
CAPS. GASTROREZ.
SPUMA RECTALA
CAPS.
PULB. PT. SOL. ORALA
CAPS.
CAPS.
CAPS. MOI
CAPS. MOI
Detinator APP
NYCOMED GMBH
NYCOMED GMBH
Tara det.
APP
Ambalaj
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 IANUARIE 2016
GERMANIA
CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ.
P-6L
GERMANIA
CUTIE X 6 BLIST. AL/AL IN SUPORT DE CARTON X 5 COMPR. FILM. GASTROREZ.
P-6L
P-6L
ROMANIA
CUTIE X 2 BLIST. DIN OPA-AL-PVC/AL X 14 COMPR. FILM. GASTROREZISTENTE
ZENTIVA K.S.
REPUBLICA CEHA
CUTIE CU BLIST. NYLON/AL/PVC/AL A CATE 28 COMPR. GASTROREZ.
P6L
ROMANIA
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ
P-6L
KRKA D.D., NOVO MESTO
SLOVENIA
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR.
P-6L
CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ.
P6L
CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. GASTROREZ.
P6L
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. GASTROREZ.
P6L
MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. GASTROREZ.
P6L
NEOLA PHARMA SRL ROMANIA

TERAPIA S.A.
ROMANIA
TORRENT PHARMA S.R.L. ROMANIA
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.
P6L
ROMANIA
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. GASTROREZ
P-6L
SLOVENIA
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 15 COMPR. GASTR.
P-6L
ROMANIA
ROMANIA
ROMANIA
NEOLA PHARMA SRL ROMANIA
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
CUTIE CU 3 BLIST. AL/AL X 10 COMPR. GASTROREZ.
P6L
CUTIE CU BLIST. PVC-PCTFE-PVDC/AL X 28 COMPR. GASTROREZ.
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 DE CARTON CU BLIST. DIN AL/AL CU RANFORSARE DIN CARTON X 30 COMPR. GASTROREZ.
P6L
CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE
P6L
TERAPIA S.A.
TERAPIA S.A.
ANTIBIOTICE SA
MALTA
TAKEDA GMBH
GERMANIA
G.L. PHARMA GMBH AUSTRIA
P6L
CUTIE CU BLIST. AL/AL X 30 COMPR. GASTROREZISTENTE
P6L
SLOVENIA
CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ.
P-RF
NYCOMED GMBH
TAKEDA GMBH
GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ.
S/P-RF
GERMANIA
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
ZENTIVA K.S.
CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ.
P-6L
CUTIE CU BLIST. OPA-AL-PE+DESICANT/AL+ PE X 28 CAPS. GASTROREZ.
P-6L
CUTIE CU BLIST. PA-AL-PVC/AL X 28 CAPS. GASTROREZ.
P-6L
REPUBLICA CEHA
ZENTIVA K.S.
REPUBLICA CEHA
SANDOZ SRL
ROMANIA
CUTIE X 2 BLIST. X 7 COMPR. FILM. GASTROREZ. P-6L

CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ.
P-6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 56 COMPR. GASTROREZ. P6L
ROMANIA
LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ.
SANDOZ SRL
ROMANIA
CUTIE CU BLIST. AL/AL X 14 COMPR. GASTROREZ.
P6L
P6L
CUTIE X 2 BLIST. AL/PVC X 7 COMPR. FILM. GASTROREZ.
P-6L
CUTIE CU BLIST. AL/AL X14 COMPR. GASTROREZ.
P-6L
LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ.
P6L
TERAPIA S.A.
TERAPIA S.A.
ASTRAZENECA AB
SANDOZ S.R.L.
ROMANIA
ROMANIA
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
SUEDIA
PHARMACEUTICAL WORKS POLPHARMA SA
ROMANIA
POLONIA
A. MENARINI IND. FARM. RIUNITE SRL
ITALIA
ALFA WASSERMANN SPA
200mg/10ml ALFA WASSERMANN SPA

3mg
2mg/doza
100mg
LABORATOIRES FOURNIER S.A.S.
10mg
LABORATOIRES FOURNIER S.A.S.
30mg
LAB. FOURNIER SA
120mg
ROCHE REGISTRATION LTD.
120mg
0,25mcg
0,25g
SANDOZ S.R.L.
P6L
CNP PHARMA GMBH GERMANIA

CNP PHARMA GMBH GERMANIA
ALFA WASSERMANN SPA
CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CONTINAND PULB. PT. SOL. INJ./PERF.
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
P-RF
ITALIA
ITALIA
ITALIA
CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM.
P-RF
CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML
P-RF
GERMANIA
CUTIE X 10 BLIST. PVC-PVDC/AL X 10 CAPS. CU PELETE GASTROREZ.
P-RF
GERMANIA
CUTIE X 1 FLAC. DIN AL X 14 DOZE X 1,2G SPUMA RECTALA, 14 APLICATOARE LUBREFIANTE PVC SI 14 PUNGI PL
P-RF
FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 CAPS.

FRANTA CUTIE X 16 PLICURI X 1 G
FRANTA CUTIE X 16 PLICURI X 3 G
P-RF
P-RF
P-RF
MAREA BRITANIE
CUTIE X 21 CAPS. TARI (BLISTER PVC/PE/PVDC)
P-RF
MAREA BRITANIE
CUTIE X 84 CAPS. TARI (BLISTER PVC/PE/PVDC)
P-RF
ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF

ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF
Pagina 1 din 17
Co-plata maxima a
Val. maxima suportata
asiguratului / UT (pt. de sistemul de asigurari Co-plata maxima a de sistemul de asigurari Co-plata maxima a
asiguratii care
sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
compensare 50% din compensare 50% din compensare 90% din compensare 90% din
laj
(RON)
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
0.729599
14
0.555000
56
0.554642
90
0.536777
14
0.472142
30
0.720000
14
1.459199
14
1.057857
56
0.835000
90
0.793000
30
1.156000
14
0.729599
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
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
0.788258
0.000000
0.000000
0.000000
0.000000
0.000000
0.671515
0.000000
0.000000
0.000000
0.000000
0.208258
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
0.254166
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
0.364799
0.277500
0.277321
0.268388
0.236071
0.360000
0.729599
0.528928
0.417500
0.396500
0.578000
0.364799
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
0.254167
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
1.153058
0.277500
0.277321
0.268389
0.236071
0.360000
1.401115
0.528929
0.417500
0.396500
0.578000
0.573058
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
0.457499
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
0.656639
0.499500
0.499177
0.483099
0.424927
0.648000
1.313279
0.952071
0.751500
0.713700
1.040400
0.656639
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
0.050834
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
0.861218
0.055500
0.055465
0.053678
0.047215
0.072000
0.817435
0.105786
0.083500
0.079300
0.115600
0.281218
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
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
A11CC03
A11CC03
DCI
ALFACALCIDOLUM
ALFACALCIDOLUM
A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#

A16AX01 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#
114 B01AC18
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**
TRIFLUSALUM
TRIFLUSALUM
115 B01AC30
COMBINATII (ACID ACETYLSALICYLICUM+DIPYRIDAMOLUM)**
116 B01AE07
DABIGATRANUM ETEXILATUM**
DABIGATRANUM ETEXILATUM**
RIVAROXABANUM**
RIVAROXABANUM**
APIXABANUM**
FONDAPARINUX SODIUM**#
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
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 B01AC04
113 B01AC18
117 B01AE07
118 B01AF01
119 B01AF01
120 B01AF02
121 B01AX05
122 B01AX05
123 B01AX05
124 B01AX05
125 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA

126 C01EB17
127 C01EB17
128 C02AC05
129 C02AC05
IVABRADINUM**
IVABRADINUM**
MOXONIDINUM
MOXONIDINUM
Denumire Comerciala
ALPHA D3 0,50 mcg

ALFACALCIDOL SANDOZ 0,5 mcg
THIOSSEN 600 (vezi N07XN03)
THIOCTACID 600T (vezi N07XN03)
FRAGMIN 10000 UI/0,4 ml
FRAGMIN15000 UI/0,6 ml
CLEXANE 2000ui anti-Xa/0,2ml
FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml
INNOHEP 10000 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
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)
AGGRENOX 200mg/25mg
PRADAXA 110mg
PRADAXA 110mg
XARELTO 10mg
XARELTO 10mg
ELIQUIS
ARIXTRA 2,5mg/0,5ml
ARIXTRA 2,5mg/0,5ml
ARIXTRA 7,5mg/0,6ml
ARIXTRA 7,5mg/0,6ml
VENOFER (R)
CORLENTOR 5mg
CORLENTOR 7,5mg
MOXOGAMMA 0,2 mg
PHYSIOTENS 0,2
forma farm.
concentratie
CAPS. MOI
CAPS. MOI
0,50mcg
0,5g
COMPR. FILM. 600mg
SOL. INJ.
25mg/ml
SOL. INJ.
10000UI/0,4ml
SOL. INJ.
12500 UI/0,5ml
SOL. INJ.
15000ui/0,6ml
SOL. INJ.
18000 UI/0,72ml
SOL. INJ.
2500ui/0,2ml
SOL. INJ.
5000ui/0,2ml
SOL. INJ.
7500ui/0,3ml
SOL. INJ.
2000ui anti-Xa/0,2ml
SOL. INJ.
SOL. INJ.
SOL. INJ.
8000UI anti-Xa/0,8ml
SOL. INJ.
2850 ui AFXa/0,3ml
SOL. INJ.
2850 ui AFXa/0,3ml
SOL. INJ.
3800 ui AFXa/0,4ml
SOL. INJ.
3800 ui AFXa/0,4ml
SOL. INJ.
5700 ui AFXa/0,6ml
SOL. INJ.
5700 ui AFXa/0,6ml
SOL. INJ.
7600 ui AFXa/0,8ml
SOL. INJ.
7600 ui AFXa/0,8ml
SOL. INJ. IN FLACOANE
10000UI anti-XA/ml
SOL. INJ. IN FLACOANE
20000 UI anti-Xa/ml
SOL. INJ. IN SERINGI PREUMPLUTE
10000UI anti-XA/ml
10000UI anti-XA/ml
20000UI anti-Xa/ml
20000UI anti-Xa/ml
20000UI anti-Xa/ml
CAPS. MOI
CAPS. MOI
SOL INJ.
SOL. INJ.
CAPS.
CAPS.
250ULS
250ULS
600ULS/2ml
600ULS/2ml
300mg
300mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
300 mg
300mg
CAPS. ELIB. MODIF.
25mg/200mg
CAPS.
CAPS.
110mg
110mg
10mg
10mg
2,5mg
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
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. INJ. IN SERINGA PREUMPLUTA
SOL. INJ./PERF.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
Detinator APP
SANDOZ S.R.L.
Prescriptie
Nr. crt
Tara det.
APP
Ambalaj
ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF
ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI PRF
AAA - PHARMA GMBH GERMANIA
CUTIE X 3 BLIST. PVC-PVDC/AL. X 10 COMPR. FILM.
P-6L
CUTIE X 5 FIOLE X 24 ML SOL.INJ.
S/P-RF
MEDA PHARMA GMBH & CO KG
GERMANIA
MAREA BRITANIE
CUTIE CU 5 BLISTERE INDIVIDUALE CONTINND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,4 ML SOLUTIE INJECTABILA
S/P-RF
MAREA BRITANIE
S/P-RF
MAREA BRITANIE
S/P-RF
MAREA BRITANIE
S/P-RF
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
S/P-RF
MAREA BRITANIE
S/P-RF
MAREA BRITANIE
S/P-RF
LAB. AVENTIS
LAB. AVENTIS
LAB. AVENTIS
LABORATOIRE AVENTIS
FRANTA
FRANTA
FRANTA
FRANTA
GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE
MAREA BRITANIE
CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ.
S/P-RF
ASPEN PHARMA TRADING LIMITED
IRLANDA
S/P-RF
MAREA BRITANIE
S/P-RF
IRLANDA
S/P-RF
MAREA BRITANIE
S/P-RF
CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML SOL. INJ.
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
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
IRLANDA
S/P-RF
MAREA BRITANIE
S/P-RF
IRLANDA
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 PRF

ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. PRF
ALFA WASSERMANN SPA
ITALIA
FRANTA
FRANTA
SANOFI PHARMA - BRISTOL MYERS SQUIBB
SANOFI CLIR SNC
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
DANEMARCA
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
PR/PRF
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
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
CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML
P-RF
CUTIE X 30X1 COMPR. FILM. (BLIST. AL/AL PERFORATE UNIDOZA)
P-RF
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.
CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM.
P-RF
REPUBLICA CEHA
P-RF
SANDOZ S.R.L.
ROMANIA
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-RF
ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM.
ROMANIA
ROMANIA
DR. REDDY'S LABORATORIES ROMANIA
TERAPIA S.A.
ROMANIA
P-RF
CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM.
P-RF
CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM.
P-RF
ZENTIVA K.S.
ZENTIVA K.S.

CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF
SANOFI CLIR SNC
CEHIA
CEHIA
MALTA
FRANTA
REPUBLICA CEHA
GALENICA S.A.
GRECIA CUTIE X 5 BLIST. X 10 CAPS.
P-RF
GERMANIA
CUTIE X 1 FLAC. DIN PP X 60 CAPS. CU ELIB.MODIF. CU SISTEM DE INCHIDERE SECURIZAT PT. COPII +DESICAN
P-6L
GERMANIA
CUTIE X 3 BLIST. (AL/AL) X 10 CAPS. (30X1 BLISTER PERFORAT UNIDOZA )
P-RF
GERMANIA
CUTIE X 6 BLIST. (AL/AL) X 10 CAPS. (60X1 BLISTER PERFORAT UNIDOZA )
P-RF
CUTIE CU BLISTERE DIN PVC-PVDC/AL CONTINND 30 COMPRIMATE FILMATE
P-RF
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
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.
P-RF
MAREA BRITANIE
CUTIE CU BLIST. PERFORATE DINPVC/PVDC/AL A 60 X 1 COMPR. FILM.
PRF
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
GLAXO GROUP LTD.
MAREA BRITANIE
IRLANDA
GLAXO GROUP LTD.
MAREA BRITANIE
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)
CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ., PREVAZUTE CU UN SISTEM AUTOMAT DE SIGURANTA, DE CULOARE PURPURIE
P-RF
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.
Pagina 2 din 17
P-6L
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
30
30
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
30
30
30
30
30
90
28
28
50
50
60
30
60
10
30
60
10
10
10
10
5
56
56
30
28
1.086333
1.086333
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
4.276281
4.276281
0.460714
1.069070
0.545714
1.069070
0.618928
0.422142
1.069070
0.688666
1.069070
1.069070
0.919333
0.581000
0.562000
0.593928
1.069070
0.534535
0.534535
0.880833
5.664666
5.664666
11.170250
11.020000
5.510000
19.409000
19.409000
58.227000
48.522499
31.080000
2.633544
3.856071
0.483666
0.836125
0.000000
0.047333
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
5.066052
5.066052
0.000000
0.578787
0.000000
0.037715
0.000000
0.000000
0.037715
0.000000
0.037263
0.037263
0.000000
0.000000
0.000000
0.000000
0.578787
0.163065
0.538465
0.000000
0.000000
0.000000
0.450750
0.000000
0.000000
0.000000
0.000000
0.293000
9.997501
0.000000
1.358956
0.000000
0.000000
0.243517
0.543166
0.543166
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
2.138140
2.138140
0.230357
0.534535
0.272857
0.534535
0.309464
0.211071
0.534535
0.344333
0.534535
0.534535
0.459666
0.290500
0.281000
0.296964
0.534535
0.267267
0.267267
0.440416
2.832333
2.832333
5.585125
5.510000
2.755000
9.704500
9.704500
29.113500
24.261249
15.540000
1.316772
1.928035
0.241833
0.418062
0.543167
0.590500
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
7.204193
7.204193
0.230357
1.113322
0.272857
0.572250
0.309464
0.211071
0.572250
0.344333
0.571798
0.571798
0.459667
0.290500
0.281000
0.296964
1.113322
0.430333
0.805733
0.440417
2.832333
2.832333
6.035875
5.510000
2.755000
9.704500
9.704500
29.406500
34.258751
15.540000
2.675728
1.928036
0.241833
0.661580
0.977699
0.977699
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
3.848652
3.848652
0.414642
0.962163
0.491142
0.962163
0.557035
0.379927
0.962163
0.619799
0.962163
0.962163
0.827399
0.522900
0.505800
0.534535
0.962163
0.481081
0.481081
0.792749
5.098199
5.098199
10.053225
9.918000
4.959000
17.468100
17.468100
52.404300
43.670249
27.972000
2.370189
3.470463
0.435299
0.752512
0.108634
0.155967
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
5.493681
5.493681
0.046072
0.685694
0.054572
0.144622
0.061893
0.042215
0.144622
0.068867
0.144170
0.144170
0.091934
0.058100
0.056200
0.059393
0.685694
0.216519
0.591919
0.088084
0.566467
0.566467
1.567775
1.102000
0.551000
1.940900
1.940900
6.115700
14.849751
3.108000
1.622311
0.385608
0.048367
0.327130
DCI
150 C07AB12
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
MOXONIDINUM
RILMENIDINUM
EPLERENONUM*#
EPLERENONUM*#
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
NEBIVOLOLUM
151 C07BB07
COMBINATII (BISOPROLOLUM+HYDROCHLOROTHIAZIDUM)
152 C07BB07
153 C07BB07
154 C07BB07
155 C08CA09
LACIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
LERCANIDIPINUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
PERINDOPRILUM
BENAZEPRILUM
BENAZEPRILUM
TRANDOLAPRILUM
TRANDOLAPRILUM
TRANDOLAPRILUM
ZOFENOPRILUM
ZOFENOPRILUM
131 C02AC05
132 C02AC05
133 C02AC05
134 C02AC05
135 C02AC05
136 C02AC05
137 C02AC05
138 C02AC06
139 C03DA04
140 C03DA04
141 C07AB12
142 C07AB12
143 C07AB12
144 C07AB12
145 C07AB12
146 C07AB12
147 C07AB12
148 C07AB12
149 C07AB12
156 C08CA13
157 C08CA13
158 C08CA13
159 C08CA13
160 C08CA13
161 C08CA13
162 C08CA13
163 C08CA13
164 C08CA13
165 C08CA13
166 C08CA13
167 C08CA13
168 C08CA13
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 C09AA04
183 C09AA04
184 C09AA04
185 C09AA04
186 C09AA04
187 C09AA04
188 C09AA04
189 C09AA04
190 C09AA07
191 C09AA07
192 C09AA10
193 C09AA10
194 C09AA10
195 C09AA15
196 C09AA15
197 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM)
Denumire Comerciala
MOXONIDINA MYLAN 0,2 mg

PHYSIOTENS 0,2 mg
MOXOGAMMA 0,3 mg
MOXOGAMMA 0,4 mg
PHYSIOTENS 0,4
PHYSIOTENS 0,4 mg
TENAXUM
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
LODOZ 2,5mg/6,25mg
LODOZ 2,5mg/6,25mg
LODOZ 5mg/6,25mg
LODOZ 5mg/6,25mg
LACIPIL 4 mg
LERCANIDIPIN ACTAVIS 10 mg
LERIDIP
LERPIN 10 mg
LERPIN 10 mg
KAPIDIN10 mg
PEGFEL 10 mg
LERCANIDIPINA ZENTIVA 10 mg
LERIDIP 20
LERPIN 20 mg
PEGFEL 20 mg
PRENESSA 2 mg
PERINDOPRIL TEVA 4 mg
VIDOTIN 4 mg
STOPRESS 4 mg
TREZEN 4 mg
TREZEN 4 mg
PRENESSA 4 mg
PRINDEX 4 mg
ERNYOM 4 mg
PERINDOPRIL TEVA 8 mg
VIDOTIN 8 mg
STOPRESS 8 mg
TREZEN 8 mg
TREZEN 8 mg
PRINDEX 8 mg
PRENESSA 8 mg
ERNYOM 8 mg
PRESTARIUM 10 mg
PERINDOPRIL TOSILAT TEVA 10 mg
PRESTARIUM 5 mg
PERINDOPRIL TOSILAT TEVA 5 mg
CIBACEN (R) 20 mg
CIBACEN (R) 5 mg
GOPTEN (R) 0,5 mg
GOPTEN (R) 2 mg
GOPTEN (R) 4 mg
ZOMEN (R) 30 mg
ZOMEN (R) 7,5 mg
COTREZEN 2 mg/0,625 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
0,2mg
0,2mg
0,3mg
0,3mg
0,4mg
0,4mg
0,4mg
0,4mg
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
Detinator APP
Ambalaj
Prescriptie
cod ATC
130 C02AC05
Nr. crt
CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM.
P6L
Tara det.
APP
GENERICS (UK) LTD
MAREA BRITANIE
GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L
GENERICS (UK) LTD
MAREA BRITANIE
P6L
ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR.FILM.
P-6L
GENERICS (UK) LTD
MAREA BRITANIE
GERMANIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L
LES LABORATOIRES SERVIER
FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
P-6L
MAREA BRITANIE
CUTIE X 3 BLIST. PERFORATE UNIDOZA PVC/AL X 10 COMPR. FILM.
P-RF
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
P6L
ACTAVIS S.R.L.

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
REPUBLICA CEHA
P-6L
SANDOZ S.R.L.
TERAPIA S.A.
ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. P6L

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. P-6L
MERCK KGAA
MERCK KGAA
GERMANIA CUTIE X 3 BLIST. PP/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
ISLANDA
CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM.
GERMANIA CUTIE X 4 BLIST. AL/PVC X 15 COMPR.FILM. P-6L
COMPR. FILM.
COMPR. FILM.
5mg/6,25mg
5mg/6,25mg
4mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20mg
20mg
20mg
20mg
20mg
2mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
4mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
10 mg
10mg
5mg
5mg
20mg
5mg
0,5mg
2mg
4mg
30mg
7,5mg
COMPR.
2 mg/0,625 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.
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.
CAPS.
CAPS.
CAPS.
GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM.

GERMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM.
P-6L
P-6L
P-6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50 COMPR. FILM. P-6L
ZENTIVA K.S.
REPUBLICA CEHA
ROMANIA
CUTIE CU BLIST. PVC-PVCDC/AL X 28 COMPR. FILM. P -6L
P-6L
ISLANDA
CUTIE CU BLIST. AL/PVDC X 30 COMPR. FILM.
P-6L
ZENTIVA K.S.
REPUBLICA CEHA
P-6L
ISLANDA
P-6L
P-6L
ROMANIA
CUTIE CU BLIST. PVC-PVCDC/AL X 28 COMPR. FILM. P -6L
ISLANDA
POLONIA
P-6L
CUTIE CU 1 BLIST. DIN PVC-PE-PVDC/AL X 30 COMPR.
P-6L
KRKA POLSKA SP. Z.O.O.
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
POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L
TERAPIA S.A.
TERAPIA S.A.
KRKA POLSKA SP. Z.O.O. POLONIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
REPUBLICA CEHA CUTIE CU BLIST. AL/AL X 30 COMPR.
P-6L
VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L
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
POLONIA CUTIE CU BLIST. ACLAR-PVC/AL X 30 COMPR. FILM. P-6L
TERAPIA S.A.
TERAPIA S.A.
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
VIM SPECTRUM S.R.L. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P6L
FRANTA
ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L
CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L
FRANTA
ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L

GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
GERMANIA CUTIE X 2 BLIST. X 14 COMPR. FILM. P-6L
NOVARTIS PHARMA GMBH


CUTIE X 1 FLAC. DIN PP X 30 COMPR. FILM. P-6L

P-6L
P-6L
P-6L
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
Pagina 3 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
28
28
30
28
30
28
28
28
30
30
30
28
30
30
30
28
30
30
28
28
30
30
30
30
30
14
30
60
50
98
30
28
30
30
30
60
50
28
30
30
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
0.383571
0.836125
0.697000
0.575000
0.772000
1.602857
0.928928
1.602857
1.003000
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
0.264299
0.528598
0.528598
0.528598
0.528598
0.528598
0.149297
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.597191
0.597191
0.597191
0.597191
0.597191
0.597191
0.597191
0.597191
0.746489
0.746489
0.373244
0.373244
0.796255
0.199063
0.074648
0.298595
0.597191
0.298595
0.074648
0.543333
0.000000
0.243517
0.000000
0.000000
0.000000
0.000000
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
0.374867
0.167101
0.153252
0.165034
0.164986
0.165034
0.165034
0.113402
0.515402
0.157402
0.172473
0.113402
0.223703
0.341405
0.079071
0.216071
0.596071
0.596071
0.189405
0.096405
0.215071
0.219809
0.093142
0.313475
1.101809
1.101809
0.027475
0.212809
0.162809
0.948511
0.118511
0.616422
0.270422
1.322316
0.584151
0.309852
0.314262
0.579951
1.249976
0.654994
0.000000
0.191785
0.418062
0.348500
0.287500
0.386000
0.801428
0.464464
0.801428
0.501500
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
0.132149
0.264299
0.264299
0.264299
0.264299
0.264299
0.074648
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.149297
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.298595
0.373244
0.373244
0.186622
0.186622
0.398127
0.099531
0.037324
0.149297
0.298595
0.149297
0.037324
0.271666
0.191786
0.661580
0.348500
0.287500
0.386000
0.801429
0.464464
0.801429
0.501500
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
0.507017
0.299251
0.285402
0.297184
0.297136
0.297184
0.297184
0.377701
0.779701
0.421701
0.436772
0.377701
0.298352
0.490703
0.228369
0.365369
0.745369
0.745369
0.338703
0.245703
0.364369
0.518405
0.391738
0.612071
1.400405
1.400405
0.326071
0.511405
0.461405
1.321756
0.491756
0.803044
0.457044
1.720444
0.683683
0.347176
0.463560
0.878547
1.399274
0.692318
0.271667
0.345213
0.752512
0.627300
0.517500
0.694800
1.442571
0.836035
1.442571
0.902700
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
0.237869
0.475738
0.475738
0.475738
0.475738
0.475738
0.134367
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.268735
0.537471
0.537471
0.537471
0.537471
0.537471
0.537471
0.537471
0.537471
0.671840
0.671840
0.335919
0.335919
0.716629
0.179156
0.067183
0.268735
0.537471
0.268735
0.067183
0.488999
0.038358
0.327130
0.069700
0.057500
0.077200
0.160286
0.092893
0.160286
0.100300
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
0.401297
0.193531
0.179682
0.191464
0.191416
0.191464
0.191464
0.166262
0.568262
0.210262
0.225333
0.166262
0.238633
0.371265
0.108931
0.245931
0.625931
0.625931
0.219265
0.126265
0.244931
0.279529
0.152862
0.373195
1.161529
1.161529
0.087195
0.272529
0.222529
1.023160
0.193160
0.653747
0.307747
1.401942
0.604058
0.317317
0.344122
0.639671
1.279836
0.662459
0.054334
cod ATC
DCI

Denumire Comerciala
PRINDEX PLUS 2 mg/0,625 mg

CO-PRENESSA 2mg/0,625 mg
DANURIT 2 mg/0,625 mg
COTREZEN 4 mg/1,25 mg
PRINDEX PLUS 4 mg/1,25mg
PANINDORIL 4 mg/1,25 mg
CO-PRENESSA 4mg/1,25 mg
DANURIT 4 mg/1,25mg
CO-PRENESSA 8 mg/2,5mg
NOLITERAX 10 mg/2,5mg
NOLIPREL ARG 2,5mg/0,625mg
209 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 2,5 mg/0,625 mg

NOLIPREL ARG FORTE 5mg/1,25mg
211 C09BA04 COMBINATII (PERINDOPRILUM+INDAPAMIDUM) PERINDOPRIL TOSILAT/INDAPAMIDA TEVA 5 mg/1,25 mg

212 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM)
213 C09BA06 COMBINATII (QUINAPRILUM+HYDROCHLOROTHIAZIDUM)
214 C09BB02 COMBINATII (NITRENDIPINUM+ENALAPRILUM)
215 C09BB04 COMBINATII (PERINDOPRILUM+AMLODIPINUM)
223 C09BB10 COMBINATII (VERAPAMILUM+TRANDOLAPRILUM)
226 C09BX01
COMBINATII (PERINDOPRILUM+AMLODIPINUM+INDAPAMIDUM)
227 C09BX01
228 C09BX01
229 C09BX01
230 C09BX01
COMBINATII (PERINDOPRILUM+INDAPAMIDUM+AMLODIPINUM)
231 C09BX01
232 C09BX01
233 C09BX01
234 C09CA03
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
VALSARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
235 C09CA03
236 C09CA03
237 C09CA03
238 C09CA03
239 C09CA03
240 C09CA03
241 C09CA03
242 C09CA03
243 C09CA03
244 C09CA03
245 C09CA03
246 C09CA03
247 C09CA03
248 C09CA03
249 C09CA03
250 C09CA03
251 C09CA03
252 C09CA03
253 C09CA03
254 C09CA03
255 C09CA03
256 C09CA03
257 C09CA03
258 C09CA04
259 C09CA04
260 C09CA04
261 C09CA04
262 C09CA04
263 C09CA04
264 C09CA04
265 C09CA04
ACCUZIDE
ACCUZIDE FORTE
ENEAS
BEATIL 4 mg/ 10 mg
AMLESSA 4 mg/10 mg
AMLESSA 4 mg/5 mg
BEATIL 4 mg/ 5 mg
AMLESSA 8 mg/10 mg
BEATIL 8 mg/ 10 mg
AMLESSA 8 mg/5 mg
BEATIL 8 mg/ 5 mg
TARKA 240 mg/2 mg
TARKA 240 mg/4 mg
TARKA
CO-AMLESSA 4mg/10mg/1,25mg
CO-AMLESSA 4 mg/5mg/1,25 mg
CO-AMLESSA 8 mg/10 mg/2,5 mg
CO-AMLESSA 8 mg/5 mg/2,5 mg
TRIPLIXAM
TRIPLIXAM
TRIPLIXAM
TRIPLIXAM
WENZELL 160 mg
WENZELL 160 mg
DIOVAN 160 mg
VALSACOR 160 mg
AVASSAN 160 mg
VALSARTAN TORRENT 160 mg
VALSARTAN ZENTIVA 160 mg
VAPRESS 160 mg
VAPRESS 160 mg
VALSACOR 320 mg
DIOVAN 40 mg
AVASSAN 40 mg
VAPRESS 40 mg
VAPRESS 40 mg
WENZELL 80 mg
WENZELL 80 mg
DIOVAN 80 mg
VALSACOR 80 mg
AVASSAN 80 mg
VAPRESS 80 mg
VAPRESS 80 mg
DIOVAN 3 mg/ml
IRBESARTAN AUROBINDO 150 mg
IRBESARTAN GALENICA 150 mg
APROVEL 150mg
IRBESARTAN TERAPIA 150 mg
IRBESARTAN SANDOZ 150 mg
IRPRESTAN 150 mg
IFIRMASTA 150 mg
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. CU ELIB. MODIF.
COMPR.FILM.ELIB.MODIF.
Tara det.
concentratie
APP
Detinator APP
Ambalaj
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.
2mg/0,625mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR.
2mg/0,625mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR.
4 mg/1,25 mg TERAPIA S.A.
ROMANIA CUTIE CU BLIST. AL/AL A CATE 30 COMPR.
10mg/2,5mg LES LAB. SERVIER FRANTA

FRANTA
2,5mg/0,625mg LES LABORATOIRES SERVIER
P6L
P6L
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. P-6L
ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L
2,5mg/0,625mg
5mg/1,25mg
5mg/1,25mg
FRANTA
ROMANIA CUTIE CU 1 FLAC. DIN PP X 30 COMPR. FILM. P6L
10mg/12,5mg PFIZER EUROPE MA EEIG

20mg/12,5mg PFIZER EUROPE MA EEIG
20mg+10mg GALENICA S.A.

4mg/10 mg GEDEON RICHTER ROMNIA S.A.
4mg/10mg KRKA D.D., NOVO MESTO
4mg/5mg
4mg/5mg
8mg/10mg KRKA D.D., NOVO MESTO
8mg/10mg GEDEON RICHTER ROMANIA SA
8mg/5mg
8mg/5mg
240mg/2mg ABBOTT GMBH & CO.KG
240mg/4mg ABBOTT GMBH & CO.KG
180mg/2mg ABBOTT GMBH&CO.KG
4mg/10mg/1,25mg KRKA, D.D., NOVO MESTO
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.
10mg/2,5mg/10mg LES LABORATOIRES SERVIER
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
P6L
P-6L
4 mg/1,25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC/PVDC-AL IN AMBALAJ DE AL X 30 (30X1) COMPR. P6L
4mg/1, 25mg SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. P-6L
4mg/1,25mg KRKA POLSKA SP ZO.O. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P-6L
4mg/1,25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L
8mg/2,5mg KRKA-POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L
COMPR.
COMPR.
COMPR.
COMPR.
SOL. ORALA
COMPR.
COMPR.
Prescriptie
Nr. crt
CUTIE X 1 FLAC. DIN PROPILENA X 30 COMPR. FILM. 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
ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. P6L

SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
P6L

P6L

P6L

P6L
GERMANIA
CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF.
GERMANIA
CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. CU ELIB. MODIF.
P6L
GERMANIA
CUTIE X 2 BLIST. AL/PVDC-PVC X 14 COMPR. FILM. CU ELIB. PREL.
P-6L
P6L
4mg/5mg/1,25mg
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
8mg/10mg/2,5mg
P6L
8mg/5mg/2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
10mg/2,5mg/5mg
5mg/1,25mg/10mg LES LABORATOIRES SERVIER
FRANTA
FRANTA
FRANTA
FRANTA
CUTIE CU 1 FLAC. PP CU CAPAC DIN PEJD X 30 COMPR. FILM.
P6L
P6L
P6L
P6L
CUTIE CU BLIST. PVC-PE-PVDC/AL-PVDC X 28 COMPR. FILM.
P-6L
ROMANIA
ROMANIA
P-6L
GERMANIA
P-6L
5mg/1,25mg/5mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
320mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
3mg/ml
150mg
300mg
150 mg
150mg
150mg
150mg
150mg
150mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
TERAPIA S.A.
ROMANIA
P6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 98 COMPR. FILM. P6L
ZENTIVA, K.S.
REPUBLICA CEHA
CUTIE CU BLIST. PVC-PE-PVDC (TRIPLEX)/AL X 28 COMPR. FILM.
P-6L
P6L
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. FILM.
P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM.
P6L
TERAPIA S.A.
ROMANIA
P6L
P6L
P6L
ROMANIA
ROMANIA
P-6L
P-6L
GERMANIA
CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM.
P6L
GERMANIA
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L
TERAPIA S.A.
ROMANIA
P6L
ZENTIVA, K.S.
REPUBLICA CEHA
GERMANIA
P-6L
P6L

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
P-6L
MALTA
MALTA
GRECIA
FRANTA
CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM.
P-6L
TERAPIA S.A.
SANDOZ S.R.L.
ROMANIA
ROMANIA
CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM.
P-6L
ISLANDA
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L

GALENICA S.A.
P6L
P6L
CUTIE CU BLIST. PVC/PVDC/AL A CATE 28 COMPR. FILM.
P6L
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
Pagina 4 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
28
28
28
30
30
30
30
30
30
30
30
28
30
28
28
28
98
28
28
28
30
28
28
28
28
28
30
28
28
28
98
28
28
28
1
28
28
28
28
28
28
30
28
0.559333
0.372333
0.559333
0.761850
0.758000
0.703000
0.694000
0.761850
0.761850
0.761850
0.761850
0.339333
0.761850
0.679666
0.536666
0.761850
2.927000
0.731000
0.732000
0.475103
0.475103
0.950207
0.950207
0.686260
0.686260
1.941963
1.941963
1.829285
0.967000
0.738326
1.252666
1.091706
1.485121
1.100174
1.127506
0.742560
1.070357
1.070333
1.389855
0.534285
1.070357
0.462244
0.561785
0.772142
0.772142
1.129333
0.347463
0.347463
0.347463
0.347463
0.694927
0.694927
0.694927
0.437857
0.694927
0.292755
0.522857
0.385714
0.385714
4.169566
0.368571
0.516071
0.368571
0.694927
0.694927
0.616785
0.299333
0.537500
0.000000
0.000000
0.000000
0.075483
0.000000
0.000000
0.000000
0.033150
0.236483
1.013483
0.567150
0.000000
0.406150
0.000000
0.000000
0.221150
0.000000
0.000000
0.000000
0.189897
0.135563
0.233126
0.143793
0.432740
0.239740
0.112679
0.751608
0.000000
0.000000
0.151674
0.000000
0.050627
0.659212
0.938159
0.301827
0.570773
0.000000
0.000000
0.204073
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
2.220751
1.232179
0.065751
0.065751
0.107930
0.107739
0.500073
0.000000
0.107930
0.000000
0.000000
0.000000
0.000000
37.250434
0.000000
0.000000
0.000000
0.510787
0.088644
0.000000
0.000000
0.000000
0.279666
0.186166
0.279666
0.380925
0.379000
0.351500
0.347000
0.380925
0.380925
0.380925
0.380925
0.169666
0.380925
0.339833
0.268333
0.380925
1.463500
0.365500
0.366000
0.237551
0.237551
0.475103
0.475103
0.343130
0.343130
0.970981
0.970981
0.914642
0.483500
0.369163
0.626333
0.545853
0.742560
0.550087
0.563753
0.371280
0.535178
0.535166
0.694927
0.267142
0.535178
0.231122
0.280892
0.386071
0.386071
0.564666
0.173731
0.173731
0.173731
0.173731
0.347463
0.347463
0.347463
0.218928
0.347463
0.146377
0.261428
0.192857
0.192857
2.084783
0.184285
0.258035
0.184285
0.347463
0.347463
0.308392
0.149666
0.268750
0.279667
0.186167
0.279667
0.456408
0.379000
0.351500
0.347000
0.414075
0.617408
1.394408
0.948075
0.169667
0.787075
0.339833
0.268333
0.602075
1.463500
0.365500
0.366000
0.427449
0.373115
0.708230
0.618897
0.775870
0.582870
1.083661
1.722590
0.914643
0.483500
0.520837
0.626333
0.596480
1.401773
1.488246
0.865580
0.942053
0.535179
0.535167
0.899001
0.267143
0.535179
0.231122
0.280893
0.386071
0.386071
0.564667
2.394483
1.405911
0.239483
0.239483
0.455394
0.455203
0.847537
0.218929
0.455394
0.146378
0.261429
0.192857
0.192857
39.335217
0.184286
0.258036
0.184286
0.858251
0.436108
0.308393
0.149667
0.268750
0.503399
0.335099
0.503399
0.685665
0.682200
0.632700
0.624600
0.685665
0.685665
0.685665
0.685665
0.305399
0.685665
0.611699
0.482999
0.685665
2.634300
0.657900
0.658800
0.427592
0.427592
0.855186
0.855186
0.617634
0.617634
1.747766
1.747766
1.646356
0.870300
0.664493
1.127399
0.982535
1.336608
0.990156
1.014755
0.668304
0.963321
0.963299
1.250869
0.480856
0.963321
0.416019
0.505606
0.694927
0.694927
1.016399
0.312716
0.312716
0.312716
0.312716
0.625434
0.625434
0.625434
0.394071
0.625434
0.263479
0.470571
0.347142
0.347142
3.752609
0.331713
0.464463
0.331713
0.625434
0.625434
0.555106
0.269399
0.483750
0.055934
0.037234
0.055934
0.151668
0.075800
0.070300
0.069400
0.109335
0.312668
1.089668
0.643335
0.033934
0.482335
0.067967
0.053667
0.297335
0.292700
0.073100
0.073200
0.237408
0.183074
0.328147
0.238814
0.501366
0.308366
0.306876
0.945805
0.182929
0.096700
0.225507
0.125267
0.159798
0.807725
1.048177
0.414578
0.645029
0.107036
0.107034
0.343059
0.053429
0.107036
0.046225
0.056179
0.077215
0.077215
0.112934
2.255498
1.266926
0.100498
0.100498
0.177423
0.177232
0.569566
0.043786
0.177423
0.029276
0.052286
0.038572
0.038572
37.667391
0.036858
0.051608
0.036858
0.580280
0.158137
0.061679
0.029934
0.053750
cod ATC
266 C09CA04
267 C09CA04
268 C09CA04
269 C09CA04
270 C09CA04
271 C09CA04
272 C09CA04
273 C09CA04
274 C09CA04
275 C09CA04
276 C09CA04
277 C09CA04
278 C09CA04
279 C09CA04
280 C09CA04
281 C09CA04
282 C09CA04
283 C09CA04
284 C09CA06
285 C09CA06
286 C09CA06
287 C09CA06
288 C09CA06
289 C09CA06
290 C09CA06
291 C09CA06
292 C09CA06
293 C09CA06
294 C09CA06
295 C09CA06
296 C09CA06
297 C09CA06
298 C09CA06
299 C09CA06
300 C09CA06
301 C09CA06
302 C09CA06
303 C09CA06
304 C09CA06
305 C09CA06
306 C09CA06
307 C09CA06
308 C09CA06
309 C09CA06
310 C09CA06
311 C09CA06
312 C09CA06
313 C09CA07
314 C09CA07
315 C09CA07
316 C09CA07
317 C09CA07
318 C09CA07
319 C09CA07
320 C09CA07
321 C09CA07
322 C09CA07
323 C09CA07
324 C09CA07
325 C09CA07
326 C09CA07
327 C09CA07
328 C09CA07
329 C09CA07
330 C09CA07
331 C09CA07
332 C09CA07
333 C09CA07
DCI
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
IRBESARTANUM
CANDESARTANUM CILEXETIL
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
TELMISARTANUM
Denumire Comerciala
IRBESARTAN TEVA 150 mg

ATOKKEN 150 mg
IRBESARTAN ZENTIVA 150mg
IRBESARTAN HF 150 mg
APROVEL 150mg
ATOKKEN 150 mg
APROVEL 300mg
IFIRMASTA 300mg
ATOKKEN 300 mg
APROVEL 300mg
ATOKKEN 300 mg
ATOKKEN 75 mg
ATACAND
TANDESAR 16 mg
CANDESARTAN SANDOZ 16 mg
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
ATACAND 32 mg
CANZENO 32mg
CADEXYL 32 mg
ATACAND
TANDESAR 8 mg
KARBIS 8 mg
ATACAND 8mg
CANZENO 8mg
CADEXYL 8 mg
TELMISARTAN ACTAVIS 40mg
TOLURA 40 mg
TEZEO 40 mg
TELMISARTAN TEVA 40 mg
TELMISARTAN RANBAXY 40 mg
TELMISARTAN TORRENT 40 mg
TELMISARTAN ACTAVIS 80mg
MICARDIS 80 mg
TOLURA 80 mg
TEZEO 80 mg
TELMISARTAN TEVA 80 mg
TELMISARTAN RANBAXY 80 mg
TELMISARTAN TORRENT 80 mg
TELMARK 40 mg
TANYDON 40 mg
TELMISARTAN EGIS 40 mg
TELMOTENS 40mg
TELMARK 80 mg
TANYDON 80 mg
TELMISARTAN EGIS 80 mg
TELMOTENS 80mg
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.
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. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
150mg
150mg
150mg
150mg
150mg
150mg
300 mg
300 mg
300mg
300mg
300mg
300mg
300mg
300mg
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
40mg
80 mg
80mg
80mg
80mg
80mg
80mg
80mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
Detinator APP
Tara det.
APP
TEVA PHARMA B.V. OLANDA
Ambalaj
Prescriptie
Nr. crt
CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.
P-6L
ROMASTRU TRADING SRL
ROMANIA
P6L
SANOFI-AVENTIS GROUPE
FRANTA
P-6L
STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L
SANOFI CLIR SNC
FRANTA
P-6L
P6L

GALENICA S.A.
GRECIA
FRANTA
TERAPIA S.A.
ROMANIA
SANDOZ S.R.L.
ROMANIA
CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM.
P-6L
P6L
P-6L
CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM.
P-6L
ROMANIA
P6L
FRANTA
P-6L
SANOFI CLIR SNC
FRANTA

P-6L
P6L
P6L
ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR.

TERAPIA SA
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR.
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
P-6L
P-6L
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
P6L
ZENTIVA K.S.
REPUBLICA CEHA
CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR.
P-6L
P6L
ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR. P6L
MALTA
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
CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR.
P-6L
P-6L
P6L
ZENTIVA K.S.
REPUBLICA CEHA
P-6L
P6L


TERAPIA SA
SANDOZ SRL
P-6L
P-6L
P-6L
P-6L
P6L
ZENTIVA K.S.
REPUBLICA CEHA
P-6L
P6L
ROMANIA
CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR.
P6L
MALTA
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
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
CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR.
P6L
MAREA BRITANIE
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR.
P6L
ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR. P6L
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
P-6L
CUTIE CU BLIST. AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE 30X1
P6L
P6L
MAREA BRITANIE
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL (OPA-AL-PVC/AL) X 56 COMPR.
P6L
REPUBLICA CEHA
ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L

UNGARIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. P6L
ALVOGEN IPCO S.AR.L.
LUXEMBURG CUTIE CU 3 BLIST. NYLON-AL-PVC/AL X 10 COMPR. FILM.
REPUBLICA CEHA

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
Pagina 5 din 17
P6L
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
28
28
28
30
28
28
28
28
28
28
28
28
28
28
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
56
28
28
28
30
30
28
56
28
30
28
30
28
30
28
30
0.597500
0.694927
0.567500
0.694927
0.694927
0.694927
0.812142
0.576785
1.389855
1.075357
0.802500
0.863571
1.075357
0.887142
1.036000
1.389855
1.075357
0.347463
1.389855
1.062500
0.998928
1.062000
0.700000
1.389855
0.866000
1.062142
1.012333
1.062500
1.062000
2.229285
1.449000
0.603000
2.229285
0.963000
1.357857
1.449000
0.694927
0.531071
0.531071
0.531000
0.531000
0.694927
0.531000
0.531071
0.531000
0.531071
0.531000
0.546428
0.593214
0.594666
0.694927
0.694927
0.694927
0.914642
1.389855
0.861785
0.788000
0.976333
0.976785
0.939464
0.593214
0.694927
0.547500
0.694927
0.914642
0.976333
0.892500
0.976333
0.000000
0.088644
0.000000
0.065073
0.510787
0.088644
0.000000
0.000000
0.210859
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.210859
0.000000
0.508965
0.191930
0.000000
0.000000
0.000000
0.000000
0.191930
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.122215
0.000000
0.000000
0.000000
0.000000
0.122215
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.107739
0.766858
0.115251
0.000000
0.064073
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.397406
0.000000
0.714073
0.000000
0.000000
0.000000
0.000000
0.298750
0.347463
0.283750
0.347463
0.347463
0.347463
0.406071
0.288392
0.694927
0.537678
0.401250
0.431785
0.537678
0.443571
0.518000
0.694927
0.537678
0.173731
0.694927
0.531250
0.499464
0.531000
0.350000
0.694927
0.433000
0.531071
0.506166
0.531250
0.531000
1.114642
0.724500
0.301500
1.114642
0.481500
0.678928
0.724500
0.347463
0.265535
0.265535
0.265500
0.265500
0.347463
0.265500
0.265535
0.265500
0.265535
0.265500
0.273214
0.296607
0.297333
0.347463
0.347463
0.347463
0.457321
0.694927
0.430892
0.394000
0.488166
0.488392
0.469732
0.296607
0.347463
0.273750
0.347463
0.457321
0.488166
0.446250
0.488166
0.298750
0.436108
0.283750
0.412537
0.858251
0.436108
0.406071
0.288393
0.905787
0.537679
0.401250
0.431786
0.537679
0.443571
0.518000
0.905787
0.537679
0.682697
0.886858
0.531250
0.499464
0.531000
0.350000
0.886858
0.433000
0.531071
0.506167
0.531250
0.531000
1.114643
0.724500
0.301500
1.114643
0.481500
0.678929
0.724500
0.469679
0.265536
0.265536
0.265500
0.265500
0.469679
0.265500
0.265536
0.265500
0.265536
0.265500
0.273214
0.296607
0.297333
0.455203
1.114322
0.462715
0.457321
0.759001
0.430893
0.394000
0.488167
0.488393
0.469732
0.296607
0.744870
0.273750
1.061537
0.457321
0.488167
0.446250
0.488167
0.537750
0.625434
0.510750
0.625434
0.625434
0.625434
0.730927
0.519106
1.250869
0.967821
0.722250
0.777213
0.967821
0.798427
0.932400
1.250869
0.967821
0.312716
1.250869
0.956250
0.899035
0.955800
0.630000
1.250869
0.779400
0.955927
0.911099
0.956250
0.955800
2.006356
1.304100
0.542700
2.006356
0.866700
1.222071
1.304100
0.625434
0.477963
0.477963
0.477900
0.477900
0.625434
0.477900
0.477963
0.477900
0.477963
0.477900
0.491785
0.533892
0.535199
0.625434
0.625434
0.625434
0.823177
1.250869
0.775606
0.709200
0.878699
0.879106
0.845517
0.533892
0.625434
0.492750
0.625434
0.823177
0.878699
0.803250
0.878699
0.059750
0.158137
0.056750
0.134566
0.580280
0.158137
0.081215
0.057679
0.349845
0.107536
0.080250
0.086358
0.107536
0.088715
0.103600
0.349845
0.107536
0.543712
0.330916
0.106250
0.099893
0.106200
0.070000
0.330916
0.086600
0.106215
0.101234
0.106250
0.106200
0.222929
0.144900
0.060300
0.222929
0.096300
0.135786
0.144900
0.191708
0.053108
0.053108
0.053100
0.053100
0.191708
0.053100
0.053108
0.053100
0.053108
0.053100
0.054643
0.059322
0.059467
0.177232
0.836351
0.184744
0.091465
0.203059
0.086179
0.078800
0.097634
0.097679
0.093947
0.059322
0.466899
0.054750
0.783566
0.091465
0.097634
0.089250
0.097634
cod ATC
DCI
334 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM)

335 C09DA01 COMBINATII (LOSARTANUM+HYDROCHLOROTHIAZIDUM)
336 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM)
Denumire Comerciala
LORISTA HL 100 mg/12,5 mg

LORISTA H
CO - VALSACOR 160 mg/12,5 mg
CO - VALSACOR 160 mg/25 mg
338 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 160 mg/12,5 mg


CO - VALSACOR 320 mg/25 mg
342 C09DA03 COMBINATII (VALSARTANUM+HYDROCHLOROTHIAZIDUM) VALSARTAN HIDROCLOROTIAZIDA TORRENT 80 mg/12,5 mg
Tara det.
APP
Detinator APP
COMPR.FILM 100mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA
COMPR.FILM 50mg+ 12,50mg KRKA D.D. NOVO MESTO SLOVENIA
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMBINATII (IRBERSARTANUM+HYDROCHLOROTHIAZIDUM)
COAPROVEL 150mg/12,5mg
COMPR.
COMPR.
IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 150mg/12,5mg
IRBESARTAN HYDROCHLOROTHIAZIDE ZENTIVA 300mg/12,5mg
347 C09DA04
IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 150 mg/12,5 mg
348 C09DA04
IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 150 mg/12,5 mg
349 C09DA04
350 C09DA04
351 C09DA04
352 C09DA04
CONVERIDE 150 mg/12,5 mg
353 C09DA04
IRBESARTAN/ HYDROCHLOROTHIAZIDE TEVA 300 mg/12,5 mg
354 C09DA04
355 C09DA04
356 C09DA04
357 C09DA04
358 C09DA04
359 C09DA04
COAPROVEL 300mg/25mg
360 C09DA04
IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg
361 C09DA04
IRBESARTAN HIDROCLOROTIAZIDA RANBAXY 300 mg/25 mg
362 C09DA04
363 C09DA04
364 C09DA04
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.
343 C09DA04
344 C09DA04
345 C09DA04
346 C09DA04
COAPROVEL 300mg/25mg
CONVERIDE 300 mg/25 mg
CONVERIDE 300 mg/25 mg
365 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT) CANDESARTAN HIDROCLOROTIAZIDA TORRENT 16 mg/12,5 mg
370 C09DA07
COMBINATII (TELMISARTANUM+HYDROCHLOROTHIAZIDUM)
371 C09DA07
372 C09DA07
373 C09DA07
374 C09DA07
375 C09DA07
376 C09DA07
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
377 C09DA07
TELMISARTAN/HIDROCLOROTIAZIDA EGIS 80 mg/12,5 mg
378 C09DA07
379 C09DA07
TEZEO HCT 80 mg/12,5 mg

TELMARK PLUS 80mg/12,5mg
380 C09DA07
TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg
381 C09DA07
TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/12,5 mg
382 C09DA07
383 C09DA07
384 C09DA07
TANYDON HCT 80 mg/25 mg

TEZEO HCT 80 mg/25 mg
TELMARK PLUS 80mg/25mg
385 C09DA07
TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg
386 C09DA07
TELMISARTAN/HIDROCLOROTIAZIDA TERAPIA 80 mg/25 mg
366 C09DA06 COMBINATII (CANDESARTANUM CILEXETIL+HCT)

387 C09DB01 COMBINATII ( VALSARTANUM+AMLODIPINUM)

390 C09DB02 COMBINATII(OLMESARTAN MEDOXOMIL+ AMLODIPINA)
393 C09DX01 COMBINATII (AMLODIPINA+VALSARTAN+HCT)
397 C10AA04
398 C10AA04
399 C10AA04
400 C10AA05
401 C10AA05
FLUVASTATINUM
FLUVASTATINUM
FLUVASTATINUM
ATORVASTATINUM
ATORVASTATINUM
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
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.
160 mg/12,5 mg KRKA ,D.D., NOVO MESTO SLOVENIA
Ambalaj

CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM.
P-6L
CUTIE CU BLIST. PVC - PE -PVDC/AL X 30 COMPR. FILM.
P6L
160 mg/25 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM.
160mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
320 mg/12,5 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM.
320 mg/25 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM.
80 mg/12,5 mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC - PE - PVDC/AL X 30 COMPR. FILM.
80mg/12,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
150mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR.
300mg/12,5mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR.
150mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE CU BLIST. PVC/PVDC/AL X 28 COMPR. FILM.
300mg/12,5mg SANOFI-AVENTIS GROUPE FRANTA CUTIE X 2 BLIST. PVC/PVDC/AL X 14 COMPR. FILM.
150mg/12,5mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. AL/AL X 28 COMPR. FILM.
150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
150mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.
150mg/12,5mg SANOFI CLIR SNC
FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.
150mg/12,5mg MEDOCHEMIE LTD CIPRU
CUTIE CU BLIST. OPACE PVC-PVDC/AL X 28 COMPR. FILM.
CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 COMPR. FILM.
300 mg/12,5mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. AL/AL X 28 COMPR. FILM.
300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM.
300mg/12,5mg RANBAXY (U.K.) LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.
300mg/12,5mg SANOFI CLIR SNC
FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
300mg/25mg
16mg/12,5mg
16mg/12,5mg
Prescriptie
Nr. crt
P6L
P6L
P6L
P6L
P6L
P6L
P-6L
P-6L
P-6L
P-6L
P-6L
P6L
P6L
P-6L
P6L
P6L
P-6L
P6L
P6L
P-6L
P6L
P6L
FRANTA
MAREA BRITANIE
P6L
MAREA BRITANIE
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM.
P6L
SANOFI CLIR SNC FRANTA

MEDOCHEMIE LTD CIPRU
MEDOCHEMIE LTD CIPRU
P6L
P6L
CUTIE CU BLIST. AL/AL X 56 COMPR. P6L
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.
8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIT. PVC-PVDC/AL X 30 COMPR.
8mg/12,5mg KRKA D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
8mg/12,5mg ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.
80 mg/12,5 mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN AL/AL X 28 COMPRIMATE
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)
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.
P6L
P6L
P6L
P6L
PRF
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
P6L
REPUBLICA CEHA
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
80mg/25mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/AL X 30 COMPR.

80mg/25mg ZENTIVA, K.S.
REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
80mg/25mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-AL-OPA/AL X 30 COMPRIMATE
80mg/25mg TERAPIA S.A.
ROMANIA CUTIE CU BLIST. AL/AL X 28X1 COMPR.
P-6L
10mg/160mg
CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC )
P-6L
CUTIE X 56 COMPR. FILM. (BLIST. PVC/PVDC )
P-6L
CUTIE X 56 COMPR. FILM.(BLIST.PVC/PVDC )
P-6L
P6L
P6L
P6L
MAREA BRITANIE
5mg/160mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE

5mg/80mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE
ROMANIA
ROMANIA
ROMANIA
P6L
P6L
P6L
P6L
10mg/160mg/12,5 mg
MAREA BRITANIE
CUTIE CU BLIST. DIN PVC/PVDC X 28 COMPR.FILM. PRF
10mg/160mg/25 mg
MAREA BRITANIE
5mg/160mg/12,5 mg
MAREA BRITANIE
5mg/160mg/25 mg NOVARTIS EUROPHARM LTD.
MAREA BRITANIE
20mg
40mg
COMPR. FILM. 10 mg
COMPR. FILM. 10mg
GERMANIA
GERMANIA
CUTIE X 4 BLIST. AL/AL X 7 CAPS.

P-6L

GERMANIA
CUTIE CU BLIST. AL/AL X 28 (4X7) COMPR. ELIB. PREL.
P-6L
ISLANDA
CUTIE CU BLIST. DIN AL/AL X 30 COMPR. FILM.
P-6L
MAREA BRITANIE
P-6L
Pagina 6 din 17
P-6L
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
28
28
30
30
28
30
30
30
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
28
56
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
0.618571
0.455000
0.693963
0.693963
0.693963
0.693963
0.693963
0.489000
0.693963
0.693963
0.693963
0.610714
0.693963
0.659642
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.641250
0.693963
0.441333
0.441333
0.441333
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.690333
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
0.693963
3.194642
3.003750
1.669285
1.669285
3.338570
3.004713
3.125344
3.339410
3.039719
3.167500
0.250593
0.501186
0.967500
0.129333
0.375890
0.000000
0.000000
0.168037
0.028703
2.366037
0.408370
0.413037
0.000000
1.943537
0.492465
0.756037
0.000000
0.279965
0.000000
0.077108
0.077108
0.492465
0.077108
0.077108
0.279965
0.279965
0.279965
0.756037
0.279965
0.279965
0.758179
0.281751
0.281751
0.758179
0.281037
0.281037
0.000000
0.041037
0.000000
0.000000
0.000000
0.400679
0.314370
0.314370
0.403894
0.941037
0.941037
0.314370
0.395679
0.000000
0.402703
0.404251
0.404251
0.314370
0.403037
0.404703
0.404251
0.404251
0.000000
0.000000
1.524643
1.770357
0.431787
0.434929
0.243584
0.029518
0.127781
0.000000
0.341549
0.469528
0.000000
0.000000
0.711443
0.309285
0.227500
0.346981
0.346981
0.346981
0.346981
0.346981
0.244500
0.346981
0.346981
0.346981
0.305357
0.346981
0.329821
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.320625
0.346981
0.220666
0.220666
0.220666
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.345166
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
0.346981
1.597321
1.501875
0.834642
0.834642
1.669285
1.502356
1.562672
1.669705
1.519859
1.583750
0.125296
0.250593
0.483750
0.064666
0.187945
0.309286
0.227500
0.515019
0.375685
2.713019
0.755352
0.760019
0.244500
2.290519
0.839447
1.103019
0.305357
0.626947
0.329821
0.424090
0.424090
0.839447
0.424090
0.424090
0.626947
0.626947
0.626947
1.103019
0.626947
0.626947
1.105161
0.628733
0.628733
1.105161
0.628019
0.628019
0.320625
0.388019
0.220667
0.220667
0.220667
0.747661
0.661352
0.661352
0.750876
1.288019
1.288019
0.661352
0.742661
0.345167
0.749685
0.751233
0.751233
0.661352
0.750019
0.751685
0.751233
0.751233
1.597321
1.501875
2.359286
2.605000
2.101072
1.937286
1.806256
1.699223
1.647641
1.583750
0.466846
0.720121
0.483750
0.064667
0.899388
0.556713
0.409500
0.624566
0.624566
0.624566
0.624566
0.624566
0.440100
0.624566
0.624566
0.624566
0.549642
0.624566
0.593677
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.577125
0.624566
0.397199
0.397199
0.397199
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.621299
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
0.624566
2.875177
2.703375
1.502356
1.502356
3.004713
2.704241
2.812809
3.005469
2.735747
2.850750
0.225533
0.451067
0.870750
0.116399
0.338301
0.061858
0.045500
0.237434
0.098100
2.435434
0.477767
0.482434
0.048900
2.012934
0.561862
0.825434
0.061072
0.349362
0.065965
0.146505
0.146505
0.561862
0.146505
0.146505
0.349362
0.349362
0.349362
0.825434
0.349362
0.349362
0.827576
0.351148
0.351148
0.827576
0.350434
0.350434
0.064125
0.110434
0.044134
0.044134
0.044134
0.470076
0.383767
0.383767
0.473291
1.010434
1.010434
0.383767
0.465076
0.069034
0.472100
0.473648
0.473648
0.383767
0.472434
0.474100
0.473648
0.473648
0.319465
0.300375
1.691572
1.937286
0.765644
0.735401
0.556119
0.363459
0.431753
0.316750
0.366609
0.519647
0.096750
0.012934
0.749032
cod ATC
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 C10AA05
429 C10AA05
430 C10AA05
431 C10AA05
432 C10AA05
433 C10AA05
434 C10AA05
435 C10AA05
436 C10AA05
437 C10AA05
438 C10AA05
439 C10AA05
440 C10AA05
441 C10AA05
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
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
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
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
Denumire Comerciala
ATORIS 10 mg
GLETOR 10 mg
ASCORD 10 mg
TORVAZIN 10 mg
XAMARA 10 mg
ATORVASTATIN RANBAXY 10 mg
STAVRA 10 mg
ATORVASTATINA TORRENT 10 mg
ATORVASTATINA AUROBINDO 10 mg
TORVALIPIN 20 mg
SORTIS 20 mg
ATORIS 20 mg
GLETOR 20 mg
ASCORD 20 mg
TORVAZIN 20 mg
XAMARA 20 mg
STAVRA 20 mg
ATORIS 30 mg
TORVALIPIN 40 mg
SORTIS 40 mg
ATORIS 40 mg
ATORIS 40 mg
GLETOR 40 mg
ASCORD 40 mg
TORVAZIN 40 mg
STAVRA 40 mg
ATORIS 60 mg
SORTIS 80 mg
ASCORD 80 mg
ATORIS 80 mg
STAVRA 80 mg
ROSUVASTATINA RATIOPHARM 10 mg
CRESTOR 10 mg
ROSUCARD 10 mg
ROSUVASTATINA TEVA 10 mg
ROXARDIO 10 mg
ROSWERA 10 mg
ROSTAT 10 mg
TINTAROS 10 mg
ROSUVASTATINA TERAPIA 10 mg
ROSUVASTATINA AUROBINDO 10 mg
ROVASTAMED 10mg
STARCREST 10 mg
ROZUCOR 10 mg
ROSUVASTATINA ATB 10 mg
ROSUVASTATINA RATIOPHARM 20 mg
CRESTOR 20 mg
ROSUCARD 20 mg
ROSUVASTATINA TEVA 20 mg
ROXARDIO 20 mg
ROSWERA 20 mg
ROSTAT 20 mg
TINTAROS 20 mg
ROSUVASTATINA LABORMED 20 mg
ROVASTAMED 20mg
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. 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.
concentratie
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
30mg
40 mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
40mg
60mg
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
Detinator APP
Tara det.
APP
Ambalaj
Prescriptie
Nr. crt
CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM.
REPUBLICA CEHA
TERAPIA SA
ROMANIA
UNGARIA
ROMANIA
CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L
MAREA BRITANIE
P-6L

P6L

CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM.
P6L
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM.
P6L
MALTA
ISLANDA
P-6L
MAREA BRITANIE
P6L
P-6L
P-6L
REPUBLICA CEHA
TERAPIA SA
ROMANIA
UNGARIA
ROMANIA
MAREA BRITANIE
P6L
P6L
P6L


MALTA
SLOVENIA
P6L
ISLANDA
P-6L
MAREA BRITANIE
P-6L
P6L
P-6L
P-6L
REPUBLICA CEHA
TERAPIA SA
ROMANIA
UNGARIA
MAREA BRITANIE
P6L
P6L
P6L
P6L

MALTA
SLOVENIA
P6L
MAREA BRITANIE
P-6L
TERAPIA SA
ROMANIA
SLOVENIA
P6L
MAREA BRITANIE
P6L
P6L
MALTA
RATIOPHARM GMBH GERMANIA

ASTRAZENECA UK LTD.
MAREA BRITANIE
ZENTIVA K.S.
REPUBLICA CEHA
SANDOZ S.R.L.
ROMANIA
ROMANIA
P6L
CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM.
P-6L
P-6L

CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
ROMANIA
ISLANDA
CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM.
P6L
TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
P6L
CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM.
P6L
MALTA
CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. FILM. PRF

P6L
LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. P-6L
ROMANIA
ROMANIA
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM.
P6L
P-6L
ASTRAZENECA UK LTD.
MAREA BRITANIE
P-6L
ZENTIVA K.S.
REPUBLICA CEHA
TORRENT PHARMA SRL
ANTIBIOTICE S.A.
SANDOZ S.R.L.
ROMANIA
ROMANIA
P6L

CUTIE CU BLIST. PVC-PVAC-AL/OPA-AL-PVC X 30 COMPR. FILM.
P-6L
ROMANIA
ISLANDA
P6L
TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
MALTA
P6L
P6L

Pagina 7 din 17
P6L
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
14
14
30
30
30
30
30
30
30
30
30
14
30
30
30
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
0.365666
0.375890
0.375890
0.375890
0.375890
0.222333
0.375890
0.375890
0.236333
0.227000
0.751780
0.501333
0.404333
0.751780
0.334000
0.751780
0.267000
0.751780
0.751780
0.278333
0.608000
0.531000
1.503561
1.102857
0.647000
0.514666
1.102666
1.102666
1.053000
1.102666
1.102666
0.478666
1.001666
1.677142
1.090333
1.017333
1.090333
1.090333
1.090333
0.768000
0.711000
0.751780
0.751780
0.577666
0.311071
0.629333
0.751780
0.680714
0.751780
0.751780
0.751780
0.711071
0.688928
0.751780
0.751780
1.094000
1.503561
0.907666
0.907666
0.621428
0.930666
1.109333
0.907500
0.664642
1.503561
1.503561
1.503561
1.093928
0.000000
0.130443
0.330776
0.273443
0.330776
0.000000
0.330776
0.330776
0.000000
0.000000
0.614553
0.000000
0.000000
0.165886
0.000000
0.165886
0.000000
0.165886
0.165886
0.000000
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0.192153
0.000000
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2.574648
0.081220
0.000000
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0.000000
0.490005
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0.453886
0.000000
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0.813886
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3.361439
0.000000
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0.281081
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0.000000
0.182833
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0.187945
0.111166
0.187945
0.187945
0.118166
0.113500
0.375890
0.250666
0.202166
0.375890
0.167000
0.375890
0.133500
0.375890
0.375890
0.139166
0.304000
0.265500
0.751780
0.551428
0.323500
0.257333
0.551333
0.551333
0.526500
0.551333
0.551333
0.239333
0.500833
0.838571
0.545166
0.508666
0.545166
0.545166
0.545166
0.384000
0.355500
0.375890
0.375890
0.288833
0.155535
0.314666
0.375890
0.340357
0.375890
0.375890
0.375890
0.355535
0.344464
0.375890
0.375890
0.547000
0.751780
0.453833
0.453833
0.310714
0.465333
0.554666
0.453750
0.332321
0.751780
0.751780
0.751780
0.546964
0.182833
0.318388
0.518721
0.461388
0.518721
0.111167
0.518721
0.518721
0.118167
0.113500
0.990443
0.250667
0.202167
0.541776
0.167000
0.541776
0.133500
0.541776
0.541776
0.139167
0.304000
0.265500
0.943934
0.551429
0.323500
0.257333
0.551333
0.551333
0.526500
0.551333
0.551333
0.239333
0.500833
0.838571
0.545167
0.508667
0.545167
0.545167
0.545167
0.384000
0.355500
2.950538
0.457110
0.288833
0.155536
0.314667
0.378110
0.340357
0.865895
0.865895
0.829776
0.355536
0.344464
1.189776
0.471443
0.547000
4.113220
0.453833
0.453833
0.310714
0.465333
0.554667
0.453750
0.332321
1.032862
1.032862
1.033220
0.546964
0.329099
0.338301
0.338301
0.338301
0.338301
0.200099
0.338301
0.338301
0.212699
0.204300
0.676602
0.451199
0.363899
0.676602
0.300600
0.676602
0.240300
0.676602
0.676602
0.250499
0.547200
0.477900
1.353204
0.992571
0.582300
0.463199
0.992399
0.992399
0.947700
0.992399
0.992399
0.430799
0.901499
1.509427
0.981299
0.915599
0.981299
0.981299
0.981299
0.691200
0.639900
0.676602
0.676602
0.519899
0.279963
0.566399
0.676602
0.612642
0.676602
0.676602
0.676602
0.639963
0.620035
0.676602
0.676602
0.984600
1.353204
0.816899
0.816899
0.559285
0.837599
0.998399
0.816750
0.598177
1.353204
1.353204
1.353204
0.984535
0.036567
0.168032
0.368365
0.311032
0.368365
0.022234
0.368365
0.368365
0.023634
0.022700
0.689731
0.050134
0.040434
0.241064
0.033400
0.241064
0.026700
0.241064
0.241064
0.027834
0.060800
0.053100
0.342510
0.110286
0.064700
0.051467
0.110267
0.110267
0.105300
0.110267
0.110267
0.047867
0.100167
0.167715
0.109034
0.101734
0.109034
0.109034
0.109034
0.076800
0.071100
2.649826
0.156398
0.057767
0.031108
0.062934
0.077398
0.068072
0.565183
0.565183
0.529064
0.071108
0.068893
0.889064
0.170731
0.109400
3.511796
0.090767
0.090767
0.062143
0.093067
0.110934
0.090750
0.066465
0.431438
0.431438
0.431796
0.109393
cod ATC
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 C10AA07
484 C10AA07
485 C10AA07
486 C10AA07
487 C10AA07
488 C10AA07
489 C10AA07
490 C10AA07
491 C10AA07
492 C10AA07
493 C10AA07
494 C10AA07
495 C10AA07
496 C10AB02
497 C10AB02
498 C10AB02
499 C10AX09
500 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
501 C10BX03 COMBINATII (ATORVASTATINUM+AMLODIPINUM)

511 D01BA02
512 D01BA02
513 D01BA02
514 D01BA02
515 D01BA02
516 D01BA02
517 D01BA02
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
TERBINAFINUM
518 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM)*

519 D05AX52 COMBINATII (CALCIPOTRIOLUM+BETAMETHASONUM)*
520 D05BB02
521 D06AX01
522 D06AX01
523 D06BA01
524 D06BB04
525 D06BB04
526 D06BB10
527 D07AB02
528 D07AB02
529 D07AB02
530 D07AB02
531 D07AC13
532 D07AC13
533 D07AC13
534 D07AC13
535 D07AC14
536 D07AC14
537 D07AC14
ACITRETINUM**
ACIDUM FUSIDICUM
ACIDUM FUSIDICUM
SULFADIAZINUM
PODOPHYLLOTOXINUM*
PODOPHYLLOTOXINUM*
IMIQUIMODUM*
HYDROCORTISONUM BUTYRATUM
MOMETASONUM
MOMETASONUM
MOMETASONUM
MOMETASONUM
METHYLPREDNISOLONUM ACEPONAT
Denumire Comerciala
STARCREST 20 mg
ROZUCOR 20 mg
ROSUCARD 40 mg
ROSWERA 40 mg
ROSTAT 40 mg
TINTAROS 40 mg
ROVASTAMED 40mg
STARCREST 40 mg
ROZUCOR 40 mg
CRESTOR 5 mg
ROXARDIO 5 mg
ROSWERA 5 mg
ROSTAT 5 mg
TINTAROS 5 mg
ROVASTAMED 5mg
STARCREST 5 mg
ROZUCOR 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
20mg
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
ANTIBIOTICE S.A.
ZENTIVA K.S.
ROMANIA
ROMANIA
P6L
P6L
REPUBLICA CEHA
ROMANIA
ISLANDA
TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
MALTA
P6L
P6L
P6L

P6L

P6L
ANTIBIOTICE S.A.
ROMANIA
ROMANIA
P6L
ASTRAZENECA UK LTD.
MAREA BRITANIE
CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L
SANDOZ S.R.L.
ROMANIA
TORRENT PHARMA SRL
ROMANIA
ISLANDA
P6L
TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
P6L
P6L
MALTA

P6L

TORRENT PHARMA SRL
ROMANIA
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
ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF

ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-PE-PVC/AL X 30 COMPR. PRF
MAREA BRITANIE
CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM.
P-6L
ROMANIA
CUTIE CU BLIST. ALBE, OPACE DIN PA/AL/PVC/AL X 30 COMPR. FILM.
P6L
MERCK SHARP & DOHME
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L
ISLANDA
P6L
MAREA BRITANIE
CUTIE X 3 BLIST. PA-AL-PVC/PVC-AL X 10 COMPR. FILM.
P-6L
ROMANIA
P6L
ISLANDA

RANBAXY UK LIMITED
RANBAXY UK LIMITED
ROMANIA
ROMANIA
P6L
CUTIE X BLISTERE OPA-AL-PVC/AL X 30 COMPRIMATE FILMATE
P6L
P6L
P6L
GERMANIA
P-RF
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. 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
P-RF

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
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 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
CREMA
1mg/g
CREMA
1mg/g
Tara det.
APP
Prescriptie
Nr. crt

MEDA AB
MERCK SHARP & DOHME
DANEMARCA
P-RF
ROMANIA BORCAN X 500 G CREMA

ROMANIA CUTIE X 1 TUB X 5 G CREMA
PRF
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
P-RF
CUTIE X 1 FLACON DIN STICLA BRUNA X 3,5 ML SOL. CUTANATA + 15 DISPOZITIVE DE APLICARE
ANTIBIOTICE SA
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
BAYER PHARMA AG GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF
BAYER PHARMA AG GERMANIA CUTIE CU 1 TUB DIN AL X 50 G CREMA P-RF
Pagina 8 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
28
0.689642
30
1.503561
30
1.001666
30
1.748666
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
0.375890
28
0.375890
30
0.327333
30
0.375890
28
0.375890
28
0.375890
28
0.375890
30
0.375890
28
0.375890
28
0.375890
30
0.375890
30
0.375890
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 21.195000
1 21.195000
1 35.325000
0.000000
0.509439
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
2.260181
0.827681
0.000000
0.396443
0.007681
1.428395
1.428395
0.651776
0.650538
0.312681
1.040776
0.394443
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
3.875000
3.875000
0.595000
0.344821
0.751780
0.500833
0.874333
0.761166
0.548000
0.873392
1.392142
1.392142
1.249500
0.820178
0.667500
1.310000
1.249000
0.187945
0.187945
0.163666
0.187945
0.187945
0.187945
0.187945
0.187945
0.187945
0.187945
0.187945
0.187945
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
10.597500
10.597500
17.662500
0.344821
1.261220
0.500833
0.874333
0.761167
0.548000
0.873393
1.392143
1.392143
1.249500
0.820179
0.667500
1.310000
1.249000
2.448126
1.015626
0.163667
0.584388
0.195626
1.616340
1.616340
0.839721
0.838483
0.500626
1.228721
0.582388
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
14.472500
14.472500
18.257500
0.620677
1.353204
0.901499
1.573799
1.370099
0.986400
1.572106
2.505856
2.505856
2.249100
1.476321
1.201500
2.358000
2.248200
0.338301
0.338301
0.294599
0.338301
0.338301
0.338301
0.338301
0.338301
0.338301
0.338301
0.338301
0.338301
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
19.075500
19.075500
31.792500
0.068965
0.659796
0.100167
0.174867
0.152234
0.109600
0.174679
0.278429
0.278429
0.249900
0.164036
0.133500
0.262000
0.249800
2.297770
0.865270
0.032734
0.434032
0.045270
1.465984
1.465984
0.689365
0.688127
0.350270
1.078365
0.432032
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
5.994500
5.994500
4.127500
cod ATC
538 D07AC14
539 D07AC14
540 D07AC14
541 D07AC14
542 D07AC14
543 D07AC17
544 D07AC17
545 D07AD01
546 D07AD01
547 D07AD01
548 D07AD01
549 D07CA01
550 D07CC01
551 D07XC03
552 D07XC03
553 D10AD54
554 D10AD54
555 D10AX03
556 D10AX03
557 D10AX03
558 D10AX03
559 D10BA01
560 D10BA01
561 D10BA01
562 G01AA51
563 G01AA51
564 G01AA51
565 G01AF12
566 G01AF12
567 G01AF12
568 G01AF15
569 G01AF20
570 G01AF20
571 G01AF20
572 G01AF20
573 G01AF20
574 G01AF20
575 G01AF20
576 G01AF20
577 G01AF20
578 G02BA03
579 G02BA03
580 G02CB03
581 G02CB03
582 G03CA09
583 G03CA09
584 G03CX01
585 G03DA04
586 G03DA04
587 G03DA04
588 G03DA04
589 G03DA04
590 G03DA04
591 G03DA04
592 G03DA04
593 G03DA04
594 G03DB01
595 G03DC03
596 G03FA17
597 G03FB01
598 G03FB08
599 G03FB08
600 G03GA05
601 G03GA05
602 G03GA05
603 G03GA05
604 G03GA05
605 G03GA05
DCI
Denumire Comerciala
ADVANTAN MILK 1mg/g

ADVANTAN MILK 1mg/g
ADVANTAN 1mg/g unguent
ADVANTAN 1 mg/g unguent
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
CLOBETASOLUM*
CLOBETAZOL ATB 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
MECLON
MECLON
MECLON
ZIFEX DUO 500 mg/200 mg
MECLON
LEVONORGESTRELUM***#
DONASERT 20 micrograme/24 ore
LEVONORGESTRELUM***#
MIRENA 20 micrograme/24 ore
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
PROGESTERONUM*
CRINONE 80 mg/g
DYDROGESTERONUM*
DUPHASTON 10 mg
LYNESTRENOLUM*
ORGAMETRIL 5 mg
COMBINATII**
ANGELIQ
COMBINATII**
CYCLO-PROGYNOVA
ESTRADIOL + DIDROGESTERON** FEMOSTON 2/10, comprimate filmate
ESTRADIOL + DIDROGESTERON** FEMOSTON 2/10, comprimate filmate
FOLLITROPINUM ALFA****#
GONAL - f 75 UI (5,5 g)
BEMFOLA 150 UI/0,25 ml
forma farm.
EMULSIE CUT.
EMULSIE CUT.
UNGUENT
UNGUENT
UNGUENT
CREMA
UNGUENT
CREMA
SOL. CUT.
UNGUENT
UNGUENT
CREMA
CREMA
UNGUENT
UNGUENT
GEL
GEL
CREMA
CREMA
GEL
GEL
CAPS. MOI
CAPS. MOI
CAPS. MOI
concentratie
Detinator APP
Tara det.
APP
Ambalaj
Prescriptie
Nr. crt
1mg/g
1mg/g
1mg/g
1mg/g
1mg/g
0,05%
0,005%
0,5mg/g
0,05%
0,5mg/g
0,5mg/g
INTENDIS GMBH
BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG
BAYER PHARMA AG
GERMANIA
P-RF
GERMANIA
CUTIE CU 1 TUB DE AL VERNISAT CU UN STRAT INTERIOR DIN PE X 50 G EMULSIE CUTANATA
PRF
MAREA BRITANIE
MAREA BRITANIE

0,05%/0,2%
STIEFEL LABORATORIES LTD.
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
GERMANIA CUTIE CU 1 TUB DIN AL X 50 G UNGUENT
P-RF

CUTIE X 1 TUB DIN AL X 15 G UNGUENT
P-RF
MAREA BRITANIE
CUTIE CU 1 TUB AL X 25 G CREMA
P-RF
MAREA BRITANIE
CUTIE X 1 FLACON CU PICURATOR DIN PP X 25 ML P-RF
MAREA BRITANIE
CUTIE CU 1 TUB AL X 25 G UNGUENT
P-RF
P-RF
ANTIBIOTICE SA
LEO PHARMA A/S
LEO PHARMA A/S
ROMANIA CUTIE CU 1 TUB DIN AL X 25 G UNGUENT PRF

20mg/g+10mg/g
DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF
20mg/1mg pe gram
DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF
1mg+50mg/gram MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G
P-RF
1mg+50mg/gram MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 45 G
P-RF
0.5mg/g+20mg/g GLAXOSMITHKLINE (GSK) SRL
200mg/g
200mg/g
150mg/g
150mg/g
10mg
10mg
20mg
INTENDIS GMBH
BAYER PHARMA AG
INTENDIS GMBH
BAYER PHARMA AG
CUTIE X 1 TUB DIN AL X 30 G GEL
P-RF
ROMANIA CUTIE X 1 TUB DIN AL X 30 G GEL

GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA
GERMANIA CUTIE X 1 TUB DIN AL X 30 G CREMA
P-RF
MAREA BRITANIE
GERMANIA
GERMANIA
ROCHE ROMANIA SRL ROMANIA

TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
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
CAPS. MOI VAG. 500mg/200000UI
LUXEMBURG CUTIE X 1 BLIST. AL/PVDC-PVC X 12 CAPS. MOI. VAG.
P-RF
CAPS. MOI VAG.
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
P-RF
ITALIA
ITALIA
ITALIA
CUTIE X 1 BLIST. PVC/PVDC-AL X 1 CAPS. VAG. MOALE
P-RF
POLICHEM SA
LAB. INNOTECH INT.
CREMA VAG. 10g/400000UI POLICHEM SA
CAPS. MOI VAG. 1000mg
RECORDATI SPA
CAPS. MOI VAG. 600mg
RECORDATI SPA
CREMA VAG. 2%
RECORDATI SPA
CREMA VAG. 20mg/g
COMPR. VAG. 500mg/200mg ARENA GROUP S.A.
CREMA
FARA CONCENTRATIE
ALFA WASSERMANN SPA
FARA CONCENTRATIE
CUTIE X 1 BLIST. PVC/PVDC-AL X 2 CAPS. VAG. MOI P-RF
ROMANIA
ROMANIA
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 CU 1 FOLIE TERMOSUDATA DIN PVC-PE X 7 OVULE
PRF
CUTIE CU 1 FOLIE TERMOSUDATA DIN PVC X 7 OVULE
PRF
CUTIE CU 2 FOLII TERMOSUDATE DIN PVC-PE X 7 OVULE
PRF
CUTIE CU 2 FOLII TERMOSUDATE DIN PVC X 7 OVULE
PRF
CREMA VAG.
FARA CONCENTRATIE
ALFA WASSERMAN SPA
OVULE
OVULE
OVULE
OVULE
OVULE
500mg/100mg
500mg/200mg
500mg/200mg
500mg/200mg
500mg/200mg
ALFA WASSERMAN SPA
ITALIA
ITALIA
ITALIA
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
SOL. VAGINALA
FARA CONCENTRATIE
ALFA WASSERMAN SPA
ITALIA
CUTIE X 5 FLACOANE PVC-PE X 10 ML + 5 FLACOANE PEJD X 130 ML + 5 CANULE
P-RF
SISTEM CU CEDARE INTRAUTERINA
20micrograme/24ore
ROMANIA
CUTIE CU 1 PUNGA TERMOSUDATA CARE CONTINE UN SISTEM CU ELIBERARE INTRAUTERINA SI UN DISPOZITIV DE INSERTIE
PRF
SISTEM CU CEDARE INTRAUTERINA
20micrograme/24ore
CUTIE CU UN BLISTER CE CONTINE UN SISTEM PENTRU ADMINISTRARE INTRAUTERINA SI UN INSERTOR
P-RF
COMPR.
0,5mg
COMPR.
0,5mg
CAPS. VAG. 10mg
CREMA VAG. 10mg/g
COMPR.
2,5mg
CAPS. MOI 100mg
CAPS. MOI 100mg
CAPS. MOI 100mg
CAPS. MOI 200mg
CAPS. MOI 200mg
CAPS. MOI 200mg
GEL
10mg/g
GEL
10mg/g
GEL VAGINAL 80mg/g
COMPR. FILM. 10mg
COMPR.
5mg
COMPR. FILM. 1mg+2mg
DRAJ.
FARA CONCENTRATIE
COMPR. FILM. 2 mg/10 mg
PULB. + SOLV. PT. SOL. INJ. 75UI
SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT
BAYER OY
FINLANDA
PFIZER EUROPE MA EEG
MAREA BRITANIE
MAREA BRITANIE
LABORATOIRE THERAMEX
MONACO CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. VAG.

MONACO CUTIE CU 1 TUB DIN AL X 15 G CREMA VAGINALA
PRF
OLANDA CUTIE X 1 BLIST. X 28 COMPR.

FRANTA CUTIE X 2 BLIST. X 15 CAPS. MOI
P-RF
MEDICO UNO PHARMA KFT.
UNGARIA
CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L
REPUBLICA CEHA
CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. MOI P-6L
LABORATOIRE THERAMEX
ORGANON NV

P-RF
P-RF
PRF
P-6L
FRANTA CUTIE X 2 BLIST. AL/PVC X 7 CAPS. MOI
MEDICO UNO PHARMA KFT.
UNGARIA
CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L
REPUBLICA CEHA
CUTIE X 2 BLIST. PVC-PVDC/AL X 15 CAPS. MOI P-6L
LABORATOIRES BESINS INTERNATIONAL
FRANTA
CUTIE CU 1 TUB DIN AL X 80 G GEL + DISPOZITIV DE DOZARE
P-6L
PRF
ANTIBIOTICE SA
ROMANIA CUTIE CU 1 TUB DIN AL X 40 G GEL P6L
MERCK ROMANIA SRL ROMANIA
P6L
CUTIE CU 6 APLICATOARE DOZA UNICA DIN PE, CONTINND GEL VAGINAL, PREVAZUTE CU VRF CARE SE DESFACE PRIN RASUCIRE, AMBALATE SEPARAT NTR-O FOLIE DIN HRTIE/AL/RASINA IONOMERICA
OLANDA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. P-RF

ORGANON NV
OLANDA CUTIE X 1 BLIST. X 30 COMPR.
P-6L
BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. CALENDARISTIC PVC/AL X 28 COMPR. FILM. P6L
BAYER PHARMA AG GERMANIA CUTIE CU 1 BLIST. PVC/AL TIP CALENDAR X 21 DRAJ. P-6L
OLANDA
P-RF
BGP PRODUCTS B.V. OLANDA
P-RF
CUTIE X 1 BLISTER TIP CALENDAR X 28 COMPRIMATE FILMATE (14 COMPR. FILM. ROSII-CARAMIZII + 14 COMPR. FILM. GALBENE)
CUTIE X 1 BLIST. TIP CALENDAR X 28 COMPR. FILM. (14 COMPR.FILM. ROSII-CARAMIZII + 14 COMPR.FILM. GALBENE)
MERCK SERONO EUROPE LIMITED
MAREA BRITANIE
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV.
P-RF/R
150UI/0,25ml FINOX BIOTECH AG
LIECHTENSTEIN.
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE
PR/PRF
LIECHTENSTEIN.
PR/PRF
LIECHTENSTEIN.
PR/PRF
LIECHTENSTEIN.
PR/PRF
LIECHTENSTEIN.
PR/PRF

Pagina 9 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
1
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
7
7
14
14
5
1
1
2
8
10
1
28
30
30
30
14
30
30
1
1
6
20
30
28
21
28
28
1
1
1
1
1
1
33.540000
33.540000
21.195000
21.195000
35.325000
10.080000
10.080000
5.860000
5.410000
5.860000
5.860000
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
1.386642
9.980000
13.340000
1.386642
1.386642
1.386642
1.386642
1.386642
1.386642
306.750000
343.540000
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
12.005000
1.113000
0.258333
2.062500
0.383809
0.690118
0.690118
103.550000
207.100000
310.650000
414.200000
584.410000
103.550000
0.000000
0.000000
3.875000
3.875000
0.595000
0.000000
0.000000
6.610000
0.000000
3.380000
0.150000
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
0.171358
0.000000
0.000000
2.448358
0.154786
0.154786
0.154072
0.154072
3.177358
0.000000
110.370000
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
0.000000
0.306310
0.306310
28.980000
4.400000
6.610000
0.000000
0.000000
8.790000
16.770000
16.770000
10.597500
10.597500
17.662500
5.040000
5.040000
2.930000
2.705000
2.930000
2.930000
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
0.693321
4.990000
6.670000
0.693321
0.693321
0.693321
0.693321
0.693321
0.693321
153.375000
171.770000
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
6.002500
0.556500
0.129166
1.031250
0.191904
0.345059
0.345059
51.775000
103.550000
155.325000
207.100000
292.205000
51.775000
16.770000
16.770000
14.472500
14.472500
18.257500
5.040000
5.040000
9.540000
2.705000
6.310000
3.080000
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
0.864679
4.990000
6.670000
3.141679
0.848107
0.848107
0.847393
0.847393
3.870679
153.375000
282.140000
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
6.002500
0.556500
0.129167
1.031250
0.191905
0.651369
0.651369
80.755000
107.950000
161.935000
207.100000
292.205000
60.565000
30.186000
30.186000
19.075500
19.075500
31.792500
9.072000
9.072000
5.274000
4.869000
5.274000
5.274000
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
1.247977
8.982000
12.006000
1.247977
1.247977
1.247977
1.247977
1.247977
1.247977
276.075000
309.186000
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
10.804500
1.001700
0.232499
1.856250
0.345428
0.621106
0.621106
93.195000
186.390000
279.585000
372.780000
525.969000
93.195000
3.354000
3.354000
5.994500
5.994500
4.127500
1.008000
1.008000
7.196000
0.541000
3.966000
0.736000
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
0.310023
0.998000
1.334000
2.587023
0.293451
0.293451
0.292737
0.292737
3.316023
30.675000
144.724000
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
1.200500
0.111300
0.025834
0.206250
0.038381
0.375322
0.375322
39.335000
25.110000
37.675000
41.420000
58.441000
19.145000
cod ATC
606 G03GA05
607 G03GA05
608 G03GA05
609 G03GA06
610 G03GA06
611 G03GA06
612 G03GA06
613 G03GA07
614 G03GB02
615 G03XC01
616 G04BD04
617 G04BD07
618 G04BD07
619 G04BD08
620 G04BD08
621 G04BD08
622 G04BD08
623 G04BD08
624 G04BD08
625 G04BD08
626 G04BD09
627 G04BD09
628 G04CA01
629 G04CA01
630 G04CA01
631 G04CA01
632 G04CA02
633 G04CA02
634 G04CA02
635 G04CA02
636 G04CA02
637 G04CA02
638 G04CB01
639 G04CB01
640 G04CB02
641 H01AC01
642 H01AC01
643 H01AC01
644 H01AC01
645 H01AC01
646 H01AC01
647 H01CC01
648 H01CC01
649 H01CC02
650 H02AA02
651 H02AB01
652 H03BB02
653 H03BB02
654 H03BB02
655 J01CR01
656 J01CR04
657 J01CR04
658 J01FA02
659 J01FA02
660 J01FA02
661 J01FA10
662 J01FA10
663 J01FA10
664 J01FA10
665 J01FA10
666 J01FA10
667 J01FA10
668 J01FA10
669 J01FA10
670 J01FA10
671 J01FA10
672 J01FA10
673 J01FA10
DCI
Denumire Comerciala
FOLLITROPINUM BETA****#
LUTROPINUM ALFA****#
CLOMIFENUM
RALOXIFENUM
OXYBUTYNINUM
TOLTERODINUM**#
TOLTERODINUM**#
SOLIFENACINUM SUCCINATE**#
TROSPIUM
TROSPIUM
ALFUZOSINUM
ALFUZOSINUM
ALFUZOSINUM
ALFUZOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
TAMSULOSINUM
FINASTERIDUM*
FINASTERIDUM*
DUTASTERIDUM*
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
GONAL-f 300 UI/0,5 ml ( 22 g/0,5 ml)

GONAL-f 450 UI/0,75 ml (33 g/0,75 ml)
GONAL-f 900 UI/1,5ml (66 g/1,5 ml)
PUREGON 300UI/0,36 ml
LUVERIS 75UI
CLOSTILBEGYT
EVISTA 60mg
DRIPTANE ( R ) 5 mg
UROFLOW 1
UROFLOW 2
ZEVESIN 10 mg
VESICARE 10 mg
SOLIFENACIN ACTAVIS 10 mg
ZEVESIN 5 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
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
forma farm.
SOL. INJ. IN STILOU INJECTOR PREUMPLUT
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
concentratie
Detinator APP
Tara det.
APP
Ambalaj
Prescriptie
Nr. crt
300UI/0,5ml
MAREA BRITANIE
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM.
P-RF/R
450UI/0,75ml
MAREA BRITANIE
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA
P-RF/R
900UI/1,5ml
MAREA BRITANIE
CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1,5 ML SOL. INJ. + 20 ACE PT. ADM. SUBCUTANATA
P-RF/R
300UI/0,36ml N. V. ORGANON
OLANDA CUTIE X 1 CARTUS + 6 ACE
300UI/0,36ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS + 6 ACE
900UI/1,08ml N. V. ORGANON
OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE
900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE
PR/PRF
PR/PRF
PR/PRF
PR/PRF
75UI
50mg
SERONO EUROPE LTD.
MAREA BRITANIE
CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ.+ 1 FLAC. A 2 ML SAU 3 ML X 1 ML SOLV.
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
LAB. FOURNIER SA FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR.

ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM.
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM.
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM.
ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM.
ZENTIVA K.S.
REPUBLICA CEHA CUTIE CU BLIST. OPA/AL/PVC/AL X 30 COMPR. FILM.
ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.
P-6L
PULB+SOLV.PT.SOL.INJ
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. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
CAPS. ELIB. MODIF.

CAPS. ELIB. MODIF.
CAPS. ELIB. PREL.
5mg
1mg
2mg
10 mg
10mg
10mg
5 mg
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
PULB. + SOLV. PT. SOL. INJ.

SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ. IN CARTUS
SOL. INJ.
SOL. INJ.
COMPR. FILM.
AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM.
AZITROMICINA TERAPIA 250 mg
COMPR. FILM.
COMPR. FILM.
AZIBIOT 250 mg
COMPR. FILM.
SUMAMED 500 mg
COMPR. FILM.
AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM.
AZIBIOT 500 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
AZITROX (R) 500
COMPR. FILM.

P6L
SLOVENIA
ISLANDA
AUSTRIA
AUSTRIA
CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM.
P6L
P-6L
P-6L
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
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
P6L
CUTIE CU 1 BLIST. PVC/AL CU 30 COMPR. ELIB. PREL.
P-6L
P-6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. CU ELIB. PREL.
P-6L
ZENTIVA KS
RANBAXY UK LTD.
CEHIA
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. MODIF.
P-6L
MAREA BRITANIE
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. ELIB. PREL.
P-6L
MALTA
CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 CAPS. ELIB. PREL.
P6L
ROMANIA
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. CU ELIB. PRELUNG.
P6L
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. P-6L
P-6L
CUTIE X 3 BLIST.PVC-PVDC/AL X 10 CAPS. MOI
P-6L
P-RF
4mg (12ui)
10mg/2ml
3,3mg/ml
6,7mg/ml
10mg/1,5ml
GERMANIA
CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FIOLA X 3,5 ML SOLV.
PR/PRF
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
0,25mg/0,5ml MERCK SHARP & DOHME
MAREA BRITANIE
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC ATASAT
P-RF/R
FERRING GMBH
IPSEN PHARMA
SANDOZ GMBH
SANDOZ GMBH
NOVO NORDISK A/S
0,25mg/0,5ml N. V. ORGANON
1000mg/500mg
CAPS.
CAPS.
TERAPIA SA
P6L
P-6L
CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ.
COMPR. FILM. 375mg

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H.
P6L
P-6L
MAREA BRITANIE
PHARMAZEUTISCHE FABRIK MONTAVIT GES.M.B.H.
P6L
16UI/ml (5,3mg/ml) PFIZER EUROPE MA EEIG
SUSP. INJ. I.M.

COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
P6L
ROMANIA
0,25mg
0,1mg
7mg/ml
10mg
20mg
5mg
PULB+SOLV. PT. SOL. INJ.
KRKA, TOVARNA ZDRAVIL, D.D. NOVO MESTO
P-RF/R
250mg/5ml
1,5 M ui
3M ui
3MilU.I.
250mg
250mg
125mg
250mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
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
SERONO EUROPE LTD.
MAREA BRITANIE
MERCK KGAA
GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR.
P-RF
MERCK SHARP & DOHME
P-RF
MERCK KGAA
MERCK KGAA
MERCK KGAA
ANTIBIOTICE S.A.
GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM.
P-6L
GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM.
P-6L
MAREA BRITANIE
CUTIE X 2 BLIST. AL/PVC/PVDC X 6 COMPR. P-RF
MAREA BRITANIE
CUTIE X 1 FLAC. DIN PEID CU PULBERE PT. 60 ML SUSP. ORALA
LAB. AVENTIS
LAB. AVENTIS
CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF
LABORATOIRES AVENTIS
FRANTA
FRANTA
FRANTA
BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS.
CUTIE CU UN SUPORT CONTINAND: 7 FLAC.PULB. + 7 SERINGI PRE-UMPLUTE X 1 ML SOLV. + 7 ACE PT. INJECTII + 7 ACE PT. INJECTII SUBCUTANATE + 14 TAMPOANE IMBIBATE IN ALCOOL
P-RF
GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P6L
ROMANIA
CUTIE CU 50 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF.
PR, PRF
P-RF

CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM.
PRF
P-RF
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
PLIVA LJUBLIJANA D.O.O.

ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM.
P-RF
P-RF
P-RF
KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR.FILM. PRF
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF
SANDOZ S.R.L.
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF
TERAPIA SA
TERAPIA SA
ZENTIVA K.S.
ROMANIA
ROMANIA
CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF
CEHIA
CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF
Pagina 10 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
1
1
1
1
1
1
1
1
10
28
60
28
28
30
30
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
7
50
5
50
50
100
50
12
1
16
10
10
6
6
6
6
6
6
6
3
3
3
3
3
3
414.200000
621.300000
1,242.600000
403.900000
403.900000
1,242.102960
1,242.102960
131.710000
1.770000
2.345357
0.357500
0.380189
0.760379
3.041516
3.041516
3.041516
1.520758
1.520758
1.520758
1.520758
0.570284
1.140568
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
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
0.638750
1.294926
1.294926
3.237318
3.237318
1.618657
3.237318
3.237318
3.237318
3.237318
6.474636
4.063333
5.316666
5.576666
5.576666
5.576666
91.450000
114.480000
141.820000
0.000000
0.000000
38.157040
38.157040
0.000000
0.000000
0.000000
0.000000
0.435882
0.098192
0.173484
1.648817
0.173484
1.370908
3.054575
1.370908
1.369242
0.747716
0.983098
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
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
0.000000
1.318074
1.318074
0.054348
1.829348
2.528009
0.054348
0.054348
0.054348
0.054348
2.108697
0.000000
0.000000
0.000000
0.000000
0.000000
207.100000
310.650000
621.300000
201.950000
201.950000
621.051480
621.051480
65.855000
0.885000
1.172678
0.178750
0.190094
0.380189
1.520758
1.520758
1.520758
0.760379
0.760379
0.760379
0.760379
0.285142
0.570284
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
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
0.319375
0.647463
0.647463
1.618659
1.618659
0.809328
1.618659
1.618659
1.618659
1.618659
3.237318
2.031666
2.658333
2.788333
2.788333
2.788333
298.550000
425.130000
763.120000
201.950000
201.950000
659.208520
659.208520
65.855000
0.885000
1.172679
0.178750
0.625977
0.478382
1.694242
3.169575
1.694242
2.131287
3.814954
2.131287
2.129621
1.032858
1.553382
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
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
0.319375
1.965537
1.965537
1.673007
3.448007
3.337338
1.673007
1.673007
1.673007
1.673007
5.346015
2.031667
2.658333
2.788333
2.788333
2.788333
372.780000
559.170000
1,118.340000
363.510000
363.510000
1,117.892664
1,117.892664
118.539000
1.593000
2.110821
0.321750
0.342170
0.684341
2.737364
2.737364
2.737364
1.368682
1.368682
1.368682
1.368682
0.513255
1.026511
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
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
0.574875
1.165433
1.165433
2.913586
2.913586
1.456791
2.913586
2.913586
2.913586
2.913586
5.827172
3.656999
4.784999
5.018999
5.018999
5.018999
132.870000
176.610000
266.080000
40.390000
40.390000
162.367336
162.367336
13.171000
0.177000
0.234536
0.035750
0.473901
0.174230
0.477636
1.952969
0.477636
1.522984
3.206651
1.522984
1.521318
0.804745
1.097155
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
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
0.063875
1.447567
1.447567
0.378080
2.153080
2.689875
0.378080
0.378080
0.378080
0.378080
2.756161
0.406334
0.531667
0.557667
0.557667
0.557667
cod ATC
674 J01FA10
675 J01FA10
676 J01FA10
677 J01FA10
678 J01FA10
679 J01FA10
680 J01FA10
681 J01FA10
682 J01FA10
683 J01FA10
684 J01FF01
685 J01FF01
686 J01FF01
687 J01FF01
688 J01FF01
689 J01FF01
690 J01MA12
691 J01MA12
692 J01MA12
693 J01MA12
694 J01MA12
695 J01MA12
696 J01MA12
697 J01MA12
698 J01MA12
699 J01MA14
700 J01MA14
701 J01MA14
702 J01MA14
703 J01MA14
704 J02AC02
705 J02AC02
706 J02AC02
707 J02AC02
708 J02AC02
709 J02AC02
710 J05AB11
711 J05AB11
712 J05AB15
713 L01AA01
714 L02AE03
715 L02AE04
716 L02AE04
717 L02AE04
718 L02AE04
719 L04AX01
720 L04AX01
721 M01AC05
722 M01AC05
723 M01AC05
724 M01AC05
725 M01AE17
726 M01AE17
727 M01AE17
728 M01AE17
729 M01AE17
DCI
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
CLINDAMYCINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
LEVOFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
MOXIFLOXACINUM
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
ITRACONAZOLUM*
VALACYCLOVIRUM*
VALACYCLOVIRUM*
BRIVUDINUM*#
CYCLOPHOSPHAMIDUM*
GOSERELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
TRIPTORELINUM***#
AZATHIOPRINUM*
AZATHIOPRINUM*
LORNOXICAMUM
LORNOXICAMUM
LORNOXICAMUM
LORNOXICAMUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
DEXKETOPROFENUM
730 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)

731 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)
732 M01AH01
733 M01AH01
734 M01AH01
735 M01AH01
736 M01AH01
737 M01AH01
738 M01AH01
739 M01AH01
740 M01AH01
741 M01AH01
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
Denumire Comerciala
AZATRIL 500 mg
AZITROMICINA ARENA 500 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
CLINDAMYCIN - MIP 300 mg
LEVOFLOXACINA ACTAVIS 250 mg
TAVANIC 250 mg
LEVOTOR 250 mg
LEVALOX 250 mg
FLERADAY 500 mg
LEVOFLOXACINA ACTAVIS 500 mg
TAVANIC 500 mg
LEVOTOR 500 mg
LEVALOX 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
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 RAPID 8 mg
XEFO 8 mg/ 2 ml
XEFO 8 mg/ 2 ml
TADOR 25 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PULB. + SOLV. SUSP. ORALA

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.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
COMPR.
DRAJ.
IMPLANT
PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.
SOL. INJ.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
DEXKETOPROFEN TROMETAMOL SANDOZ 25mg COMPR. FILM.
TADOR INJECT
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
SOL. INJ./CONC. PT. SOL. PERF.
concentratie
Detinator APP
Tara det.
APP
500mg
500mg
600mg
600mg
200mg/5ml
100mg/5ml
200 mg/5 ml
200mg/5ml
200mg/5ml
200mg/5ml
150mg
300mg
300mg
300mg
600mg
600mg
250mg
250mg
250mg
250mg
500 mg
500mg
500mg
500mg
500mg
400mg
400mg
400mg
400mg
400mg
100mg
100mg
100mg
100mg
100mg
100mg
500 mg
500mg
125mg
50mg
3,6mg
0,1mg
11,25mg
3,75mg
0,1mg/ml
50mg
50mg
8mg
8mg
8mg/2ml
8mg/2ml
25mg
25mg
50mg/2ml
50mg/2ml
50mg/2ml
ISLANDA
ARENA GROUP S.A.

TERAPIA SA
TERAPIA SA
ZENTIVA S.A.
SANDOZ SRL
SANDOZ SRL
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
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
SLOVENIA
SLOVENIA
PLIVA LJUBLIJANA D.O.O. SLOVENIA
MAREA BRITANIE
MAREA BRITANIE
MIP PHARMA GMBH

MIP PHARMA GMBH
MIP PHARMA GMBH
MIP PHARMA GMBH
GERMANIA
ISLANDA
GERMANIA
GERMANIA
GERMANIA
TERAPIA S.A.
ROMANIA
ROMANIA
ISLANDA
TERAPIA S.A.
ROMANIA
BAYER PHARMA AG GERMANIA

MALTA
LUXEMBURG
ISLANDA
BELGIA
JANSSEN PHARMACEUTICA N.V.
ROMANIA
ROMANIA

REPUBLICA CEHA
THE WELLCOME FOUNDATION LTD.
MAREA BRITANIE

GERMANIA
BAXTER ONCOLOGY GMBH
GERMANIA
ASTRAZENECA UK LTD.
MAREA BRITANIE
IPSEN PHARMA
IPSEN PHARMA
IPSEN PHARMA
FERRING GMBH
FRANTA
FRANTA
FRANTA
GERMANIA
ASPEN EUROPE GMBH GERMANIA
IRLANDA
AUSTRIA
AUSTRIA
NYCOMED AUSTRIA GMBH AUSTRIA
TAKEDA AUSTRIA GMBH AUSTRIA
NYCOMED AUSTRIA GMBH
TAKEDA AUSTRIA GMBH
BERLIN CHEMIE AG (MENARINI GROUP)
GERMANIA
SANDOZ S.R.L.
ROMANIA
MENARINI INTERNATIONAL OPERATIONS S.A.
LUXEMBOURG
COMPR. ELIB. MODIF.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
100mg
100mg
100mg
100mg
100mg
100mg
100mg
200mg
200mg
200mg
COMPR. ELIB. MODIF.

MAREA BRITANIE
ZENTIVA K.S.
REPUBLICA CEHA

ISLANDA
TORRENT PHARMA SRL
TERAPIA SA
ROMANIA
UNGARIA
ROMANIA
MAREA BRITANIE
MAREA BRITANIE
ZENTIVA K.S.
REPUBLICA CEHA
3
5.130000
3
5.576666
3
7.769566
3
7.769566
1 14.470000
1 12.722396
1 19.290000
P-RF
1 19.083600
P-RF
1 38.167200
P-RF
1 47.709000
CUTIE X 2 BLIST. AL/PVC X 8 CAPS. P-RF
16
0.497046
16
0.994093
CUTIE X 2 BLIST. PVC/AL X 8 COMPR. FILM. P-RF
16
0.883750
30
0.884000
16
1.988187
30
1.988187
7
1.555714
CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF
7
2.453400
CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-RF
7
1.555714
7
2.453400
CUTIE CU BLIST. PVC/PVDC - AL X 7 COMPR. FILM. PRF
7
4.427142
7
3.280000
CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF
7
4.906800
7
3.228571
7
4.274285
CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM. P-RF
5
4.906800
5
4.906800
CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM PRF
5
4.906800
CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR. FILM. PRF
5
4.906800
CUTIE CU BLISTERE DIN OPA-AL-PVC/AL CONAINND 5 COMPRIMATE FILMATE
PRF
5
4.906800
CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS. P-RF
15
3.194000
15
2.144666
CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF
15
2.144666
CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF
15
2.144666
15
2.144666
CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-RF
15
2.144666
CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM.
PRF
10
4.661000
CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM.
PRF
10
3.131000
CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-RF
7 48.002857
CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-RF
50
0.542400
CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG S/P-RF
1 298.459994
CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7 FIOLE X 1 ML SOLV. S/P-RF
7 13.681428
S/P-RF
1 886.880000
S/P-RF
1 371.770000
CUTIE X 28 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ S/P-RF
28
2.097156
CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100
0.614116
CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM. S/P-RF 100
0.614116
CUTIE CU BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L
10
0.431999
CUTIE CU BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L
10
0.431999
PRF
10
1.310332
PRF
10
1.310332
CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L
10
0.475199
CUTIE BLIST. DIN PVC-PVDC/AL X 20 COMPRIMATE FILMATE P6L
20
0.475199
CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF.
P-RF
5
2.276000
PRF
5
2.276000
PRF
10
2.276000
PRF
30
1.611749
PRF
60
1.584666
30
0.586583
CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF
30
0.584000
CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF
30
0.584000
30
0.584000
30
0.584000
30
0.584000
CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF
30
0.584000
10
1.173166
30
1.173166
30
1.173166
MEDICO UNO PHARMACEUTICAL SRL
Ambalaj
CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM.
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
ROMANIA
ROMANIA
500 mg/20 mg ASTRA ZENECA AB SUEDIA
500 mg/20 mg ASTRA ZENECA AB SUEDIA
Prescriptie
Nr. crt
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
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
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 10 FLAC. DIN STICLA BRUNA CU PULB. PT. SOL. INJ. + 10 FIOLE DIN STICLA INCOLORA X 2 ML SOLV. PT. SOL. INJ.
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 17
PRF
0.000000
0.000000
7.657100
7.657100
0.000000
6.617604
0.000000
3.176400
1.512800
12.651000
0.290454
0.365907
0.000000
0.000000
0.660563
0.747146
0.000000
1.398028
0.000000
0.050885
0.000000
0.000000
1.684628
0.000000
0.000000
6.177200
2.299200
2.299200
2.299200
2.299200
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
4.700006
0.000000
0.000000
0.000000
20.075701
0.088184
0.088184
0.540001
0.540001
7.789668
7.789668
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
2.565000
2.788333
3.884783
3.884783
7.235000
6.361198
9.645000
9.541800
19.083600
23.854500
0.248523
0.497046
0.441875
0.442000
0.994093
0.994093
0.777857
1.226700
0.777857
1.226700
2.213571
1.640000
2.453400
1.614285
2.137142
2.453400
2.453400
2.453400
2.453400
2.453400
1.597000
1.072333
1.072333
1.072333
1.072333
1.072333
2.330500
1.565500
24.001428
0.271200
149.229997
6.840714
443.440000
185.885000
1.048578
0.307058
0.307058
0.215999
0.215999
0.655166
0.655166
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
2.565000
2.788333
11.541883
11.541883
7.235000
12.978802
9.645000
12.718200
20.596400
36.505500
0.538977
0.862954
0.441875
0.442000
1.654657
1.741240
0.777857
2.624728
0.777857
1.277585
2.213571
1.640000
4.138028
1.614286
2.137143
8.630600
4.752600
4.752600
4.752600
4.752600
1.597000
1.072333
1.072333
1.072333
1.072333
1.072333
2.330500
1.565500
24.001429
0.271200
153.930003
6.840714
443.440000
185.885000
21.124279
0.395242
0.395242
0.756001
0.756001
8.444834
8.444834
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
4.617000
5.018999
6.992609
6.992609
13.023000
11.450156
17.361000
17.175240
34.350480
42.938100
0.447341
0.894683
0.795375
0.795600
1.789368
1.789368
1.400142
2.208060
1.400142
2.208060
3.984427
2.952000
4.416120
2.905713
3.846856
4.416120
4.416120
4.416120
4.416120
4.416120
2.874600
1.930199
1.930199
1.930199
1.930199
1.930199
4.194900
2.817900
43.202571
0.488160
268.613994
12.313285
798.192000
334.593000
1.887440
0.552704
0.552704
0.388799
0.388799
1.179298
1.179298
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
0.513000
0.557667
8.434057
8.434057
1.447000
7.889844
1.929000
5.084760
5.329520
17.421900
0.340159
0.465317
0.088375
0.088400
0.859382
0.945965
0.155572
1.643368
0.155572
0.296225
0.442715
0.328000
2.175308
0.322858
0.427429
6.667880
2.789880
2.789880
2.789880
2.789880
0.319400
0.214467
0.214467
0.214467
0.214467
0.214467
0.466100
0.313100
4.800286
0.054240
34.546006
1.368143
88.688000
37.177000
20.285417
0.149596
0.149596
0.583201
0.583201
7.920702
7.920702
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
cod ATC
DCI
769 M05BA07
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
CELECOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
ETORICOXIBUM
BACLOFENUM
BACLOFENUM
ACIDUM ALENDRONICUM*
ACIDUM RISEDRONICUM*
770 M05BB03
COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)*
771 M05BB03
772 M05BB03
773 M05BB03
774 N02AA05
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
OXYCODONUM*#
DIHYDROCODEINUM*
DIHYDROCODEINUM*
DIHYDROCODEINUM*
742 M01AH01
743 M01AH01
744 M01AH01
745 M01AH01
746 M01AH01
747 M01AH01
748 M01AH05
749 M01AH05
750 M01AH05
751 M01AH05
752 M01AH05
753 M01AH05
754 M01AH05
755 M03BX01
756 M03BX01
757 M05BA04
758 M05BA04
759 M05BA04
760 M05BA04
761 M05BA04
762 M05BA04
763 M05BA04
764 M05BA07
765 M05BA07
766 M05BA07
767 M05BA07
768 M05BA07
775 N02AA05
776 N02AA05
777 N02AA05
778 N02AA05
779 N02AA05
780 N02AA05
781 N02AA05
782 N02AA05
783 N02AA05
784 N02AA05
785 N02AA05
786 N02AA05
787 N02AA05
788 N02AA05
789 N02AA05
790 N02AA05
791 N02AA05
792 N02AA08
793 N02AA08
794 N02AA08
795 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM

796 N02AX52 COMBINATII (TRAMADOLUM+PARACETAMOLUM)
Denumire Comerciala
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
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
LORINE 35mg
OSODENS 35 mg
RISEDRONAT SODIC ZENTIVA 35mg
RISEDRONAT AUROBINDO 35 mg
ACTONEL SAPTAMANAL 35 mg
ACTONEL 75 mg
FOSAVANCE 70mg/2800UI
DA-BONE 70 mg/5600 UI
OXYCONTIN 10 mg
OXYCONTIN 20 mg
OXYCONTIN 40 mg
OXYCONTIN 80 mg
RELTEBON 10 mg
RELTEBON 20 mg
forma farm.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
Tara det.
APP
PRF
PRF
Detinator APP
Ambalaj
CUTIE CU BLIST. PVC/AL X 30 CAPS.
ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS.
ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS.
UNGARIA CUTIE CU BLIST. PVC/AL X 10 CAPS.
UNGARIA CUTIE CU BLIST. PVC/AL X 30 CAPS.
ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS.
ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL, X 14 COMPR. FILM.
GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR.
ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR.
MALTA
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
200mg
200mg
200mg
200mg
200mg
200mg
120mg
120mg
30mg
60mg
60mg
90mg
90mg
10mg
25mg
70 mg
70mg
70mg
70mg
70mg
70mg
70mg
35mg
35mg
35mg
35mg
35mg
75mg
COMPR.
COMPR.
COMPR.
COMPR.
70mg/2800UI MERCK SHARP & DOHME MAREA BRITANIE

70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.


CLORHIDRAT DE OXICODONA TORRENT 20 mg
RELTEBON 40 mg
RELTEBON 80 mg
OXIDOLOR 10 mg
OXIDOLOR 20 mg
OXIDOLOR 40 mg
OXICODONA SANDOZ 40 mg
OXIDOLOR 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
PADOLTEN 37,5 mg/325 mg
PADOLTEN 37,5 mg/325 mg
LINEROL 37,5 mg/325 mg
DORETA 75 mg/650 mg
DORETA 75 mg/650 mg
PALGOTAL 75 mg/650 mg
concentratie
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.
10 mg
20 mg
40 mg
80mg
10mg
20mg
20mg
40mg
40mg
80mg
80mg
10mg
20mg
40mg
40mg
60mg
80mg
80mg
120mg
60mg
90mg
COMPR. FILM. 37,5mg+325mg

CAPS.
37,5mg/325mg
CAPS.
37,5mg/325mg
COMPR. FILM. 37,5mg/325mg
COMPR. FILM. 75mg/650mg
TORRENT PHARMA SRL

TERAPIA SA
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MERCK SHARP & DOHME
MERCK SHARP & DOHME
CUTIE CU BLIST. TRANSPARENTE PVC-ACLAR/AL X 4 COMPR.
PRF
PRF
PRF
PRF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-RF
P-6L
P-6L
P-6L
P6L
ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L

SANDOZ S.R.L.
ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM P-6L
ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L
ANTIBIOTICE S.A.
ROMANIA CUTIE X 1BLIST. PVC- PVDC/AL X 4 COMPR. FILM. P-6L
TERAPIA SA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM. P-6L
MERCK SHARP & DOHME
ZENTIVA KS

REPUBLICA CEHA
MALTA
ISLANDA
ISLANDA
CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE
P-6L
CUTIE CU BLIST. PVC/PE/PVDC-AL X 4 COMPR. FILM.
P6L
CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM.
P-6L
CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM.
P6L
CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.)
P-6L
P-6L
P-6L
CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR., AMBALAJ TIP CALENDAR
P6L
CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
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
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
ISLANDA
ISLANDA
PR, PS
TORRENT PHARMA SRL
ROMANIA
CUTIE CU BLIST. PVC/PVDC/AL/PET/HARTIE X 60 COMPR. CU ELIB. PREL.
PR, PS
ISLANDA
PR, PS
TORRENT PHARMA SRL
ROMANIA
PR, PS
ISLANDA
PR, PS
TORRENT PHARMA SRL
ROMANIA
PR, PS
P-TS
P-TS
P-TS
MUNDIPHARMA GES.M.B.H
AUSTRIA
AUSTRIA
AUSTRIA
SANDOZ S.R.L.
SANDOZ S.R.L.
ROMANIA
ROMANIA


CUTIE CU BLIST. PVC-PE-PVDC/AL X 20 COMPR. ELIB. PREL.
PS
PS
AUSTRIA
P-TS
SANDOZ S.R.L.
ROMANIA
AUSTRIA
AUSTRIA
AUSTRIA
CUTIE X 1 FLAC. DIN PP X 56 COMPR. ELIB. PREL.

PS
PS
PS
PS
GRUNENTHAL GMBH GERMANIA

ROMPHARM COMPANY SRL ROMANIA
ROMPHARM COMPANY SRL ROMANIA
CUTIE X 1 BLIST. PVC OPAC/AL X 10 COMPR. FILM. P-RF
STADA ARZNEIMITTEL AG GERMANIA
CUTIE CU 1 BLIST.DIN HRTIE-PET-AL/PVC OPAC X 10 COMPR. FILM.
P-RF
P-RF
P-RF
P-RF
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
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. FILM. P-RF
S.C.TEVA PHARMACEUTICALS S.R.L.
S.C.TEVA PHARMACEUTICALS S.R.L.
ROMANIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM.

POLONIA CUTIE CU BLIST. PVC/AL X 20 COMPR. FILM.
P-RF
P-RF
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
Pagina 12 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
30
30
30
10
30
30
7
14
28
14
14
14
14
50
50
4
4
2
2
12
2
4
4
4
4
4
4
2
4
2
4
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
10
20
20
10
20
30
1.173166
1.173166
1.173166
1.173166
1.173166
1.173166
2.346333
2.346333
0.586583
1.173166
1.173166
1.759749
1.759749
0.333959
0.666000
2.705000
2.487500
6.572249
4.890000
6.572249
6.572249
6.572249
6.572249
6.572249
3.712500
3.712500
6.572249
14.083392
6.572249
6.572249
6.572249
6.572249
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
0.272875
0.272875
0.272875
0.272875
0.272875
0.272875
0.272875
0.272875
0.272500
0.272875
0.272875
0.272875
0.545000
0.545500
0.537333
0.005167
0.005167
0.005167
0.220834
0.005167
0.005167
2.212238
2.065095
2.234488
2.023262
2.023262
1.757393
1.757393
0.079241
0.000000
0.000000
0.000000
7.047751
0.000000
1.563584
2.277751
1.995251
0.650251
0.650251
0.000000
0.000000
4.177751
19.111608
11.917751
11.102751
10.515251
0.730251
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
0.534125
0.240791
0.253125
0.534125
0.533625
0.517125
0.387325
0.000125
0.000000
0.252125
0.251625
0.251625
0.000000
0.000000
0.000000
0.586583
0.586583
0.586583
0.586583
0.586583
0.586583
1.173166
1.173166
0.293291
0.586583
0.586583
0.879874
0.879874
0.166979
0.333000
1.352500
1.243750
3.286124
2.445000
3.286124
3.286124
3.286124
3.286124
3.286124
1.856250
1.856250
3.286124
7.041696
3.286124
3.286124
3.286124
3.286124
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
0.136437
0.136437
0.136437
0.136437
0.136437
0.136437
0.136437
0.136437
0.136250
0.136437
0.136437
0.136437
0.272500
0.272750
0.268666
0.591750
0.591750
0.591750
0.807417
0.591750
0.591750
3.385405
3.238262
2.527780
2.609845
2.609845
2.637268
2.637268
0.246221
0.333000
1.352500
1.243750
10.333876
2.445000
4.849709
5.563876
5.281376
3.936376
3.936376
1.856250
1.856250
7.463876
26.153304
15.203876
14.388876
13.801376
4.016376
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
0.670563
0.377229
0.389563
0.670563
0.670063
0.653563
0.523763
0.136563
0.136250
0.388563
0.388063
0.388063
0.272500
0.272750
0.268667
1.055849
1.055849
1.055849
1.055849
1.055849
1.055849
2.111699
2.111699
0.527924
1.055849
1.055849
1.583774
1.583774
0.300563
0.599400
2.434500
2.238750
5.915024
4.401000
5.915024
5.915024
5.915024
5.915024
5.915024
3.341250
3.341250
5.915024
12.675052
5.915024
5.915024
5.915024
5.915024
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
0.245587
0.245587
0.245587
0.245587
0.245587
0.245587
0.245587
0.245587
0.245250
0.245587
0.245587
0.245587
0.490500
0.490950
0.483599
0.122484
0.122484
0.122484
0.338151
0.122484
0.122484
2.446872
2.299729
2.293147
2.140579
2.140579
1.933368
1.933368
0.112637
0.066600
0.270500
0.248750
7.704976
0.489000
2.220809
2.934976
2.652476
1.307476
1.307476
0.371250
0.371250
4.834976
20.519948
12.574976
11.759976
11.172476
1.387476
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
0.561413
0.268079
0.280413
0.561413
0.560913
0.544413
0.414613
0.027413
0.027250
0.279413
0.278913
0.278913
0.054500
0.054550
0.053734
cod ATC
810 N03AX16
811 N03AX16
812 N03AX16
813 N03AX16
814 N03AX16
815 N03AX16
816 N04BC05
817 N04BC05
818 N04BC05
819 N04BC05
820 N04BC05
821 N04BC05
822 N04BC05
823 N04BC05
824 N04BC05
825 N04BC05
826 N04BC05
827 N04BC05
828 N04BC05
829 N04BC05
830 N04BC05
831 N04BC05
832 N04BC05
833 N04BC05
834 N04BC05
835 N04BC05
836 N04BC05
837 N04BC05
838 N04BC05
839 N04BC05
840 N04BC05
841 N04BC05
842 N04BC05
843 N04BC05
844 N04BC05
845 N04BC05
846 N04BC05
847 N04BC05
848 N04BC05
849 N04BC05
850 N04BC05
851 N04BC05
852 N04BC08
853 N05AL03
854 N05BE01
855 N05BE01
856 N06AB10
857 N06AB10
858 N06AB10
859 N06AB10
860 N06AB10
861 N06AB10
862 N06AB10
863 N06AB10
864 N06AB10
865 N06AB10
866 N06AB10
867 N06AB10
868 N06AB10
869 N06AB10
870 N06AB10
871 N06AB10
872 N06AB10
873 N06AB10
874 N06AB10
875 N06AB10
876 N06AB10
877 N06AB10
DCI
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PREGABALINUM**#
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
PRAMIPEXOLUM*
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**
Denumire Comerciala
LYRICA 150 mg
LYRICA 150 mg
LYRICA 300 mg
LYRICA 300 mg
LYRICA 75 mg
LYRICA 75 mg
PRAMIPEXOLE ACCORD 0,088 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
OPRYMEA 0,7mg
MEDOPEXOL 0,7 mg
GLEPARK 0,7 mg
PRAMIPEXOLE ACCORD 0,7mg
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
OPRYMEA 2,62 mg
MIRAPEXIN 3,15 mg
OPRYMEA 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
ELICEA 15 mg
SERODEPS 20mg
ESCITALOPRAM ACTAVIS 20 mg
ELICEA 20 mg
ELICEA Q-TAB 10 mg
forma farm.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
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.
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.
concentratie
150mg
150mg
300mg
300mg
75mg
75mg
0,088 mg
0,088mg
0,18 mg
0,18 mg
0,18 mg
0,18mg
0,18mg
0,18mg
0,18mg
0,18mg
0,18mg
0,7 mg
0,7 mg
0,7mg
0,7mg
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
2,62mg
3,15mg
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
Detinator APP
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
ACCORD HEALTHCARE LIMITED
Tara det.
APP
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
KRKA D.D.
SLOVENIA
MAREA BRITANIE
MAREA BRITANIE
ZENTIVA, K.S.
REPUBLICA CEHA
KRKA D.D.
SLOVENIA
REPUBLICA CEHA

MALTA
MALTA
ZENTIVA, K.S.
REPUBLICA CEHA
KRKA D.D.
SLOVENIA
REPUBLICA CEHA
MAREA BRITANIE

MAREA BRITANIE

GERMANIA
KRKA D.D.
SLOVENIA
GERMANIA
KRKA D.D.
SLOVENIA
GERMANIA
KRKA D.D.
KRKA D.D.
KRKA D.D.
SLOVENIA
SLOVENIA
SLOVENIA
GERMANIA

GERMANIA

SANOFI-SYNTHELABO FRANCE
FRANTA
FRANTA
UNGARIA
UNGARIA
AUSTRIA
H. LUNDBECK A/S
DANEMARCA
UNGARIA
ROMANIA
ROMANIA

ZENTIVA K.S.
TERAPIA SA
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
CEHIA
ROMANIA
CIPRU
CIPRU
ISLANDA

MAREA BRITANIE
ANTIBIOTICE S.A.
ROMANIA
ROMANIA
ROMANIA
TORRENT PHARMA SRL

TORRENT PHARMA SRL
ROMANIA
ROMANIA
ROMANIA
ISLANDA
TERAPIA SA

Ambalaj
Prescriptie
Nr. crt
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
14
56
P-RF
56
P-RF
14
P-RF
14
P-RF
56
CUTIE CU 3 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF
30
CUTIE X 30 COMPR. (BLIST. AL/AL) P-RF
30
30
CUTIE CU 10 BLIST. AL-PVC/AL A CATE 10 COMPR. PRF 100
CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. PRF
30
30
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
30
CUTIE CU BLIST. AL/AL X 30 COMPR. P-RF
30
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-RF
30
CUTIE CU BLIST. PA/AL/PVC-AL X 30 COMPR. PRF
30
30
30
30
30
30
30
30
30
CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR. P-RF
30
30
CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR.
P-RF
10
P-RF
30
CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL.
PRF
10
P-RF
30
P-RF
30
PRF
30
P-RF
30
P-RF
30
P-RF
30
P-RF
30
P-RF
30
PRF
30
CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL.
PRF
30
P-RF
30
CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL.
PRF
30
CUTIE X 2 BLIST. AL/PVC X 15 DRAJ. CU ELIB. PREL. P-RF
30
20
CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF
60
CUTIE X 6 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-RF
60
30
CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF
28
28
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-RF
30
28
30
CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM.
P-RF
28
CUTIE CU BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. PRF
14
28
CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF
28
30
CUTIE CU BLIST. PVC-ACLAR/AL X 28 COMPR. FILM. PRF
28
28
CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM.
PRF
28
30
30
30
CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM.
P-RF
28
PRF
28
CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM. PRF
28
30
CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE PRF
28
CUTIE X 14 CAPS., (BLIST. PVC/AL)
CUTIE X 56 CAPS. (BLIST. PVC/AL)
CUTIE CU BLISTERE (OPA/AL/DES/PE-AL) X 30 COMPRIMATE CU ELIBERARE PRELUNGITA

Pagina 13 din 17
P-RF
P-RF
2.957051
2.957051
5.731785
5.914103
1.478525
1.478525
0.087075
0.087075
0.178109
0.178109
0.178109
0.178109
0.178109
0.178109
0.178109
0.178109
0.178109
0.692649
0.692649
0.692649
0.692649
0.692649
0.692649
0.692649
0.692649
0.692649
0.692649
0.257269
0.257269
0.257269
0.514539
0.514539
0.514539
1.038974
1.038974
1.553513
2.077948
2.077948
2.077948
2.592487
3.116922
3.116922
0.618436
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
1.423663
0.939199
0.000000
0.130897
1.154332
0.935403
0.436258
0.442925
0.144557
0.144391
0.208557
0.248557
0.473224
0.144557
0.412557
0.345224
0.335891
1.196684
1.416351
1.335351
1.341684
1.564017
1.196684
1.745351
1.334684
1.008751
1.755017
1.261731
0.378731
0.378731
1.638794
0.885127
0.885127
3.063026
1.086026
3.495820
2.644385
5.187052
2.644385
5.834179
8.833078
4.650411
0.316897
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
1.478525
1.478525
2.865892
2.957051
0.739262
0.739262
0.043537
0.043537
0.089054
0.089054
0.089054
0.089054
0.089054
0.089054
0.089054
0.089054
0.089054
0.346324
0.346324
0.346324
0.346324
0.346324
0.346324
0.346324
0.346324
0.346324
0.346324
0.128634
0.128634
0.128634
0.257269
0.257269
0.257269
0.519487
0.519487
0.776756
1.038974
1.038974
1.038974
1.296243
1.558461
1.558461
0.309218
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
2.902189
2.417725
2.865893
3.087949
1.893595
1.674666
0.479796
0.486463
0.233612
0.233446
0.297612
0.337612
0.562279
0.233612
0.501612
0.434279
0.424946
1.543009
1.762676
1.681676
1.688009
1.910342
1.543009
2.091676
1.681009
1.355076
2.101342
1.390366
0.507366
0.507366
1.896064
1.142397
1.142397
3.582513
1.605513
4.272577
3.683359
6.226026
3.683359
7.130423
10.391539
6.208872
0.626115
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
2.661345
2.661345
5.158606
5.322692
1.330672
1.330672
0.078367
0.078367
0.160298
0.160298
0.160298
0.160298
0.160298
0.160298
0.160298
0.160298
0.160298
0.623384
0.623384
0.623384
0.623384
0.623384
0.623384
0.623384
0.623384
0.623384
0.623384
0.231542
0.231542
0.231542
0.463085
0.463085
0.463085
0.935076
0.935076
1.398161
1.870153
1.870153
1.870153
2.333238
2.805229
2.805229
0.556592
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
1.719369
1.234905
0.573179
0.722308
1.302185
1.083256
0.444966
0.451633
0.162368
0.162202
0.226368
0.266368
0.491035
0.162368
0.430368
0.363035
0.353702
1.265949
1.485616
1.404616
1.410949
1.633282
1.265949
1.814616
1.403949
1.078016
1.824282
1.287458
0.404458
0.404458
1.690248
0.936581
0.936581
3.166924
1.189924
3.651172
2.852180
5.394847
2.852180
6.093428
9.144771
4.962104
0.378741
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
cod ATC
878 N06AB10
879 N06AB10
880 N06AB10
881 N06AB10
882 N06AB10
883 N06AB10
884 N06AB10
885 N06AX05
886 N06AX05
887 N06AX05
888 N06AX05
889 N06AX05
890 N06AX05
891 N06AX12
892 N06AX14
893 N06AX14
894 N06AX14
895 N06AX14
896 N06AX14
897 N06AX21
898 N06AX21
899 N06AX21
900 N06AX21
901 N06AX21
902 N06AX21
903 N06AX21
904 N06AX21
905 N06AX21
906 N06AX21
907 N06AX21
908 N06BX16
909 N06BX18
910 N06BX18
911 N06BX18
912 N07CA01
913 N07CA01
914 N07CA01
915 N07CA01
916 N07CA01
917 N07CA01
918 N07CA01
919 N07CA01
920 N07CA01
921 N07CA01
922 N07CA01
923 N07CA01
924 N07CA01
925 N07CA01
926 N07CA01
927 N07CA01
928 N07CA01
929 N07CA01
930 N07CA01
931 N07CA01
932 N07CA01
933 N07CA01
934 N07CA01
935 N07CA01
936 N07CA01
937 N07CA01
DCI
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
TRAZODONUM**
BUPROPIONUM**#
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
TIANEPTINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
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
938 N07CA52 COMBINATII (CINARIZINUM +DIMENHIDRINATUM)

939 N07XN03 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#
940 N07XN03 ACIDUM TIOCTICUM (ALFA-LIPOICUM)**#
941 N07XXN3 HIDROLIZAT DE PROTEINA DIN CREIER DE PORCINA**
944 P01BA02
945 P01BA02
HYDROXYCHLOROQUINUM
HYDROXYCHLOROQUINUM
Denumire Comerciala
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
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
NOBIXAL 12,5 mg
COAXIL (R)
CYMBALTA 30mg
DULSEVIA 30 mg
ZATINEX 30 mg
ZATINEX 30 mg
DULOXETINA DR. REDDY'S 30 mg
CYMBALTA 60mg
DULSEVIA 60 mg
ZATINEX 60 mg
ZATINEX 60 mg
DULOXETINA DR. REDDY'S 60 mg
DULOXETINE ZENTIVA 60 mg
PRAMISTAR
VINPOCETINA VIM SPECTRUM 5 mg
CAVINTON(R) FORTE
CAVINTON(R)
VERTIMED 16 mg
BETAHISTINA LPH 16 mg
BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg
EMPERIN 24 mg
BETAHISTIN MCC 24 mg
BETASERC 24 mg
VERTIMED 24 mg
VERTIMED 24 mg
VESTIBO 24 mg
MARBETA 24 mg
MARBETA 24 mg
BETASERC 24 mg
BETAHISTIN MCC 8 mg
BETASERC 8 mg
BETAHISTIN MCC 8 mg
MARBETA 8 mg
MARBETA 8 mg
ACUVER 8 mg/doza
ACUVER 8 mg/doza
ARLEVERT
THIOCTACID (R) 600 HR (vezi A16AX01)
THIOCTACID (R) 600 HR (vezi A16AX01)
CEREBROLYSIN 215,2 mg/ml
PLAQUENIL
PLAQUENIL 200 mg
forma farm.
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.
COMPR. FILM.
DRAJ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
COMPR. FILM.
CAPS.
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.
SOL. ORALA
SOL. ORALA
COMPR.
concentratie
10mg
10mg
15mg
15mg
20mg
20mg
20mg
150mg
150mg
150mg
150mg
75mg
75mg
150mg
12,5 mg
12,5 mg
12,5mg
12,5mg
12,5mg
30mg
30mg
30mg
30mg
30mg
60mg
60mg
60mg
60mg
60mg
60mg
600mg
5mg
10mg
5mg
16mg
16mg
16mg
24 mg
24 mg
24mg
24mg
24mg
24mg
24mg
24mg
24mg
24mg
24mg
24mg
24mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg/doza
8mg/doza
FARA CONCENTRATIE
Detinator APP
Ambalaj
CUTIE CU BLIST. OPA-AL-PVC/AL-PET-HARTIE X 28 COMPR. ORODIPSERSABILE
PRF
ROMANIA
CUTIE CU BLIST. HARTIE-PET-AL/PVC-AL-OPA X 30 COMPR. ORODISPERSABILE
PRF
PRF
CUTIE CU BLIST. OPA-AL-PVC/AL-PET X 28 COMPR. ORODIPSERSABILE
PRF
PRF
PRF
PRF
ROMANIA
ANGELINI FRANCESCO SPA
ITALIA
ITALIA
ITALIA
ITALIA
ITALIA
ITALIA

ARENA GROUP S.A.

ARENA GROUP S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
LES LAB. SERVIER IND.
ELI LILLY NEDERLAND BV
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
CUTIE X 1 BLIST. AL/PVC X 20 COMPR. ELIB. PREL. P-RF

ROMANIA
ROMANIA
ROMANIA
OLANDA
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
PRF
CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM. PRF

CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM.
FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ.

OLANDA CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL)
PRF
P-RF
P-RF
CUTIE CU BLIST. OPA-AL[PEID-PE-DESICANT-PEID-AL-PE X 30 CAPS. GASTROREZ.
PRF
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 CAPS. GASTROREZ.
PRF
CUTIE CU BLIST. PVC-PVDC/AL X 28 CAPS. GASTROREZ.
PRF
CUTIE CU BLIST. PVC-PE-ACLAR/AL X 28 CAPS. GASTROREZ.
PRF
CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL)
P-RF
PRF
PRF
PRF
ROMANIA
ROMANIA
ROMANIA
PRF
ZENTIVA, K.S.
REPUBLICA CEHA
CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ.
PRF
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
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. X PVC/AL X10 CAPS. P6L
P-6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-6L
CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR.
P6L
ROMANIA
P-6L
MALTA
P6L
UNGARIA
CUTIE CU BLIST. DIN PVC-PVDC/AL X 60 COMPR. P6L
LABORMED PHARMA SA ROMANIA CUTIE CU 6 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L

OLANDA
ACTAVIS GROUP PTC EHF. ISLANDA
MEDREG S.R.O.
REPUBLICA CEHA
MALTA
CUTIE CU 2 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR.
P-6L
P-6L
P-6L
P6L
P6L
P6L
P6L
P-6L
P6L
P6L
REPUBLICA CEHA
OLANDA
P6L
P-6L
P-6L
P-6L
P-6L

OLANDA
ROMANIA

MEDREG S.R.O.
REPUBLICA CEHA
P6L
ROMANIA
P-6L
MALTA
P6L
REPUBLICA CEHA
P6L
CUTIE X 1 FLAC. STICLA BRUNA X 60 ML SOL. ORALA
P-6L
CUTIE X 1 FLAC. STICLA BRUNA X 120 ML SOL. ORALA
P-6L
CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH
AUSTRIA
AUSTRIA
HENNIG ARZNEIMITTEL GMBH & CO.KG
GERMANIA CUTIE X 1 FLAC. X 30 COMPR. FILM. P-6L
GERMANIA CUTIE X 1 FLAC. X 100 COMPR. FILM.
EVER NEURO PHARMA GMBH
AUSTRIA
AUSTRIA
AUSTRIA
CYATHUS EXQUIRERE PHARMAFORSCHUNGS GMBH
COMPR. FILM. 600mg

COMPR. FILM. 600mg
215,2mg/ml
215,2mg/ml
215,2mg/ml
COMPR. FILM. 200mg
COMPR. FILM. 200mg
Tara det.
APP
Prescriptie
Nr. crt
P-RF
P-6L
CUTIE CU 5 FIOLE DIN STICLA BRUNA CU PUNCT DE RUPERE X 10 ML SOL. INJ./CONC. PT. SOL. PERF.
PR/PRF
PR/PRF
PR/PRF

SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM.
Pagina 14 din 17
P-6L
P-6L
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
28
30
28
28
28
28
30
20
60
60
20
30
30
30
30
90
30
30
30
28
30
28
28
28
28
30
28
28
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
60
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
0.460333
0.460333
1.529196
1.529196
1.529196
1.529196
1.529196
3.058392
2.929333
3.044642
3.044642
3.058392
3.058392
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
0.542833
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
0.000000
0.247333
1.410804
0.482804
0.409375
0.409375
0.482589
1.504465
0.000000
0.000000
0.000000
0.013750
0.013750
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
0.390178
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
0.230166
0.230166
0.764598
0.764598
0.764598
0.764598
0.764598
1.529196
1.464666
1.522321
1.522321
1.529196
1.529196
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
0.271416
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
0.230167
0.477500
2.175402
1.247402
1.173973
1.173973
1.247187
3.033661
1.464667
1.522321
1.522321
1.542946
1.542946
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
0.271417
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
0.414299
0.414299
1.376276
1.376276
1.376276
1.376276
1.376276
2.752552
2.636399
2.740177
2.740177
2.752552
2.752552
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
0.488549
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
0.046034
0.293367
1.563724
0.635724
0.562295
0.562295
0.635509
1.810305
0.292934
0.304465
0.304465
0.319590
0.319590
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
0.054284
cod ATC
946 R01AD05
947 R01AD08
948 R01AD09
949 R01AD09
950 R01AD09
951 R01AD09
952 R03AC04
953 R03AC18
954 R03AC18
955 R03AK03
956 R03AK06
957 R03AK06
958 R03AK06
959 R03AK06
960 R03AK06
961 R03AK06
962 R03AK06
963 R03AK06
964 R03AK06
965 R03AK06
DCI
BUDESONIDUM*
FLUTICASONUM*
MOMETASONUM*
MOMETASONUM*
MOMETASONUM*
MOMETASONUM*
FENOTEROLUM
INDACATEROLUM**
INDACATEROLUM**
Denumire Comerciala
forma farm.
concentratie
RHINOCORT AQUA 32 micrograme/doza

FLIXONASE 0,05g/100g
SPRAY NAZAL SUSP. 32micrograme/doza

SPRAY NAZAL SUSP.
0,05g/100g
MOMETAZONA FUROAT CIPLA 50 micrograme/doza
SPRAY NAZ., SUSP.
KALMENTE 50 micrograme/doza
SPRAY NAZ., SUSP.
MOMETAZONA FUROAT SANDOZ 50 micrograme/doza
SPRAY NAZ.,SUSP.
50micrograme/doza
NASONEX 50mcg/doza
BEROTEC N - 100 mcg
ONBREZ BREEZHALER 150 g
ONBREZ BREEZHALER 300 g
COMBINATII (FENOTEROLUM + IPRATROPIUM)* BERODUAL (R) N
SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50/100
SPRAY NAZAL SUSP.

Tara det.
APP
Ambalaj
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
PRF
MAREA BRITANIE
CUTIE X 1 FLACON X 120 DOZE, PREVAZUT CU POMPA DOZATOARE
P-RF
50micrograme/doza
CIPLA (EU) LIMITED
MAREA BRITANIE
CUTIE CU UN FLAC. DIN PEID, PREVAZUT CU POMPA DOZATOARE MANUALA DIN PP CARE CONTINE 18 G SUSPENSIE, ECHIVALENT CU 140 DOZE
PRF
50micrograme/doza
LUXEMBURG
CUTIE CU 1 FLAC. PEID PREVAZUT CU POMPA DOZATOARE SI APLICATOR NAZAL CARE CONTINE SPRAY NAZAL, SUSP. PT. 140 PULVERIZARI
PRF
SANDOZ S.R.L.
ROMANIA
50mcg/doza MERCK SHARP & DOHME ROMANIA
100mcg/doza BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA
CAPS. CU PULB.INHAL.
150 g
300 g
AEROSOL SOL. INHAL.
0,020mg+0,050mg
CAPS. CU PULB.INHAL.
Detinator APP
Prescriptie
Nr. crt
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 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
PRF
P-RF
CUTIE X 1 FLACON PRESURIZAT X 200 DOZE SOL. DE INHALAT PRESURIZATA
P-6L
MAREA BRITANIE
CUTIECU BLIST. DIN PA/AL/PVC X 30 CAPSULE (3 BIST X10)+ UN INHALATOR
PRF
MAREA BRITANIE
CUTIE CU BLIST. DIN PA/AL/PVC X 30 CAPSULE (1 BLIST. X10)+ UN INHALATOR
PRF
GERMANIA
CUTIE X 1 FLACON PRESURIZAT DIN OTEL X 200 DOZE SOLUTIE DE INHALAT PRESURIZATA
P-6L
CUTIE X 1DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL.
P-6L
CUTIE X 1, DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL.
P-6L
CUTIE X 1 DISPOZITIV DE INHALAT X 60 DOZE PULB. DE INHAL.
P-6L
PULB. INHAL. 50mg/100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE

PULB. INHAL. 50mg/250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE
PULB. INHAL. 50mg/500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE
SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50 micrograme/100 micrograme PULB. INHAL. 50micrograme/100micrograme GLAXO WELLCOME UK LIMITED MAREA BRITANIE
SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50 micrograme/250 micrograme PULB. INHAL. 50micrograme/250micrograme GLAXOWELLCOME UK LTD. MAREA BRITANIE
SALMETEROLUM+FLUTICASONUM* SERETIDE DISKUS 50 micrograme/500 micrograme PULB. INHAL. 50micrograme/500micrograme GLAXOWELLCOME UK LTD. MAREA BRITANIE
SALMETEROLUM+FLUTICASONUM* SERETIDE 25 mcg/125 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/125mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE
SALMETEROLUM+FLUTICASONUM* SERETIDE 25 mcg/50 mcg INHALER CFC FREE SUSP. INHAL. PRESURIZATA 25mcg/50mcg GLAXOWELLCOME UK LTD. MAREA BRITANIE
SALMETEROLUM+FLUTICASONUM* SERROFLO 25 micrograme/125 micrograme/doza SUSP. INHAL. PRESURIZATA
CIPLA EUROPE NV BELGIA
SALMETEROLUM+FLUTICASONUM* SERROFLO 25 micrograme/250 micrograme/doza SUSP. INHAL. PRESURIZATA
CIPLA EUROPE NV BELGIA
CUTIE CU 1 DISPOZITIV DE INHALAT DIN PLASTIC PREVAZUT CU INDICATOR CE ARATA NR. DOZELOR RAMASE X 60 DOZE PULB. DE INHAL.
P6L
P6L
P6L
CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA
P-6L
CUTIE X 1 FLACON PRESURIZAT AL X 120 DOZE SUSP. DE INHALAT PRESURIZATA
P-6L
25micrograme/125micrograme/doz
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
25micrograme/250micrograme/doz
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
PRF
PRF
969 R03AK08 COMBINATII (BECLOMETASONUM+FORMOTEROLUM)
FOSTER 100/6 micrograme pe doza
100/6micrograme pe doza
CHIESI PHARMACEUTICALS GMBH AUSTRIA
970 R03AL04 COMBINATII (INDACATEROLUM+GLICOPIRONIUM)
ULTIBRO BREEZHALER 85 micrograme/43 micrograme
CAPS. CU PULB. DE INHAL.
85micrograme/43micrograme
MAREA BRITANIE
CUTIE X 30 BLISTERE PERFORATE PA-AL-PVC/AL PENTRU ELIBERAREA UNEI UNITATI DOZATE X 1 CAPSULA CU PULBERE DE INHALAT + 1 INHALATOR
PR/PRF
FLIXOTIDE DISKUS 100 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 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
MONKASTA 4 mg
MONTELUKAST ALVOGEN 4 mg
STANGEN 4 mg
SOLOK 4 mg
MONART 4 mg
SINGULAIR 4 mg
PULB. INHAL. 100mcg/doza

125mcg/doza
MAREA BRITANIE
CUTIE X 1 DISPOZITIV INHALATOR DIN PLASTIC SUB FORMA DE DISC X 1 BLIST. PVC/AL X 60 DOZE
P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
966 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM)* SYMBICORT TURBUHALER 160 micrograme/4,5 micrograme/inhalatie PULB. DE INHAL.
160micrograme/4,5micrograme/in
967 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM)* SYMBICORT TURBUHALER 320 micrograme/9 micrograme/inhalatie
PULB. DE INHAL.
320micrograme/9micrograme/inha
968 R03AK07 COMBINATII (BUDESONIDUM + FORMOTEROLUM)* SYMBICORT TURBUHALER 80 micrograme/4,5 micrograme/inhalatie
PULB. DE INHAL.
80micrograme/4,5micrograme/inh
971 R03BA05
972 R03BA05
973 R03BA05
974 R03BA05
975 R03BA05
976 R03BA05
977 R03BA05
978 R03BA07
979 R03BA07
980 R03BA08
981 R03BA08
982 R03BB04
983 R03BB04
984 R03BB06
985 R03DA05
986 R03DA05
987 R03DA05
988 R03DA05
989 R03DA05
990 R03DC03
991 R03DC03
992 R03DC03
993 R03DC03
994 R03DC03
995 R03DC03
996 R03DC03
997 R03DC03
998 R03DC03
999 R03DC03
1,000
R03DC03
1,001
R03DC03
1,002
R03DC03
1,003
R03DC03
1,004
R03DC03
1,005
R03DC03
1,006
R03DC03
1,007
R03DC03
1,008
R03DC03
1,009
R03DC03
1,010
R03DC03
1,011
R03DC03
1,012
R03DC03
1,013
R03DC03
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*
CUTIE CU 1 INHALATOR DIN MATERIAL PLASTIC CU 60 DOZE PULB. DE INHAL.
P6L
P6L

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
P6L
PRF
CUTIE X 1 FLACON PRESURIZAT DIN AL X 60 DOZE SUSP. DE INHALAT PRESURIZATA
P-RF
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
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
CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L

CUTIE X 1 DISPOZITIV DE ADM. X 30 DOZE P-6L
CUTIE X 1 FLAC. DIN AL CU VALVA DOZATOARE X 60 DOZE SOL. DE INHALAT PRESURIZATA
P-RF
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
CUTIE CU 1 AMBALAJ UNIC CU UN INHALATOR RESPIMAT SI UN CARTUS CARE FURNIZEAZA 60 PUFURI (30 DOZE MEDICINALE) SOL. PT. INHALAT
PRF
CUTIE CU BLIST. PERFORATE PA-AL-PVC/AL CE CONTINE 30 X 1 CAPSULA CU PULBERE PENTRU INHALAT INSOTITE DE UN INHALATOR
PRF
18micrograme
SOL. DE INHALAT 2,5micrograme
CAPS. CU PULB. INHAL.
44 micrograme
CAPS. CU PULB. INHAL.
CAPS.
COMPR.
COMPR.
COMPR.
SOL. INJ.
COMPR.
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.
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
GERMANIA
GERMANIA
MAREA BRITANIE
ZENTIVA SA
BIO EEL SRL
ARENA GROUP SA
ARENA GROUP SA
ZENTIVA S.A.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
MERCK SHARP & DOHME ROMANIA

P-RF
CUTIE X 5 FIOLE PREVAZUTE CU INEL DE RUPERE X 10 ML SOL.INJ.
S/P-RF
P-RF
P-RF
P-RF

CUTIE X 2 BLIST. OPA-AL-PVC X 14 COMPR. FILM. P6L
P6L
P6L
P6L
SLOVENIA
CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. FILM.
P6L
P6L
CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. FILM.
P6L
TERAPIA S.A.
ROMANIA
ROMANIA
ROMANIA
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST.
P6L
REPUBLICA CEHA
CUTIE CU 1 FLAC. PEID X 28 COMPR. FILM. P6L
MALTA
P6L
MAREA BRITANIE
P6L
ISLANDA
SANDOZ S.R.L.
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L
ROMANIA
ROMANIA
ROMANIA
CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST.
ISLANDA
P6L
SLOVENIA
CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST.
P6L
LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE
P6L
ROMANIA
ROMANIA
CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST.
P6L
TERAPIA S.A.
CUTIE CU BLIST. PAPVC/AL X 28 COMPR. MAST.
P6L
REPUBLICA CEHA
CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST. P6L
MALTA
CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST.
P6L
MERCK SHARP & DOHME
ROMANIA
P6L
MERCK SHARP & DOHME

P-RF
CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST. P6L

CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST. P6L
Pagina 15 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
1
1
1
1
1
1
1
30
30
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
30
1
1
1
1
1
10
10
1
1
1
1
30
1
30
20
50
40
20
5
28
28
28
30
30
28
28
28
28
28
28
28
28
28
28
30
30
28
28
28
28
28
28
28
26.220000
28.340000
22.707500
22.700000
22.707500
22.707500
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
8.954333
24.317999
60.795000
118.180000
30.397500
24.317999
0.810599
3.242399
33.613750
62.550000
89.330000
51.371249
5.127666
153.829999
4.986000
0.172934
0.140800
0.172934
0.345870
2.452000
0.913189
0.913189
0.720714
0.721000
0.826333
0.913189
0.913189
0.913189
0.913189
0.913189
0.913189
0.913189
0.528214
0.528214
0.527857
0.527333
0.434000
0.528214
0.528214
0.528214
0.528214
0.528214
0.528214
0.528214
0.000000
0.000000
0.002500
0.000000
0.002500
11.092500
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
0.000000
10.812001
6.285000
0.000000
3.612500
10.902001
1.995401
4.963601
7.016250
0.000000
0.000000
20.118751
0.236334
4.250001
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
1.060000
1.833571
0.000000
0.000000
0.000000
0.220357
1.059286
1.058928
1.040000
1.040000
1.060000
1.833571
13.110000
14.170000
11.353750
11.350000
11.353750
11.353750
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
4.477166
12.158999
30.397500
59.090000
15.198750
12.158999
0.405299
1.621199
16.806875
31.275000
44.665000
25.685624
2.563833
76.914999
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
0.264107
0.264107
0.263928
0.263666
0.217000
0.264107
0.264107
0.264107
0.264107
0.264107
0.264107
0.264107
13.110000
14.170000
11.356250
11.350000
11.356250
22.446250
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
4.477167
22.971001
36.682500
59.090000
18.811250
23.061001
2.400701
6.584801
23.823125
31.275000
44.665000
45.804376
2.800167
81.165001
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
1.324107
2.097678
0.263929
0.263667
0.217000
0.484464
1.323393
1.323035
1.304107
1.304107
1.324107
2.097678
23.598000
25.506000
20.436750
20.430000
20.436750
20.436750
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
8.058899
21.886199
54.715500
106.362000
27.357750
21.886199
0.729539
2.918159
30.252375
56.295000
80.397000
46.234124
4.614899
138.446999
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
0.475392
0.475392
0.475071
0.474599
0.390600
0.475392
0.475392
0.475392
0.475392
0.475392
0.475392
0.475392
2.622000
2.834000
2.273250
2.270000
2.273250
13.363250
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
0.895434
13.243801
12.364500
11.818000
6.652250
13.333801
2.076461
5.287841
10.377625
6.255000
8.933000
25.255876
0.749101
19.633001
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
1.112822
1.886393
0.052786
0.052734
0.043400
0.273179
1.112108
1.111750
1.092822
1.092822
1.112822
1.886393
cod ATC
DCI
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
MONTELUKASTUM*
FENSPIRIDUM
FENSPIRIDUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
DEXTROMETHORPHANUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
LEVOCETIRIZINUM
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
1,014
R03DC03
1,015
R03DC03
1,016
R03DC03
1,017
R03DC03
1,018
R03DC03
1,019
R03DC03
1,020
R03DC03
1,021
R03DC03
1,022
R03DC03
1,023
R03DC03
1,024
R03DC03
1,025
R03DC03
1,026
R03DC03
1,027
R03DC03
1,028
R03DC03
1,029
R03DC03
1,030
R03DC03
1,031
R03DX03
1,032
R03DX03
1,033
R05DA09
1,034
R05DA09
1,035
R05DA09
1,036
R05DA09
1,037
R05DA09
1,038
R05DA09
1,039
R05DA09
1,040
R06AE09
1,041
R06AE09
1,042
R06AE09
1,043
R06AE09
1,044
R06AE09
1,045
R06AE09
1,046
R06AE09
1,047
R06AX27
1,048
R06AX27
1,049
R06AX27
1,050
R06AX27
1,051
R06AX27
1,052
R06AX27
1,053
R06AX27
1,054
R06AX27
1,055
R06AX27
1,056
R06AX27
1,057
R06AX27
1,058
R06AX27
1,059
R06AX27
1,060
R06AX27
1,061
R06AX27
1,062
R06AX27
1,063
S01AA11
1,064
S01AA12
1,065
S01AA12
1,066
S01AA12
1,067
S01AA12
1,068
S01AA23
1,069
S01AA23
1,070
S01AA23
1,071
S01AX11
1,072
S01AX11
1,073
S01BA01
1,074
S01BA01
1,075
S01BA01
1,076
S01BA06
1,077
S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM)
1,078
S01CA01 COMBINATII ( NETILMICINUM + DEXAMETHASONUM)
1,079
S01CA01 COMBINATII (CLORAMPHENICOLUM+DEXAMETHASONUM)
1,080
S01CA01 COMBINATII (TOBRAMYCINUM +DEXAMETAZONUM)
1,081
Denumire Comerciala
forma farm.
concentratie
ASTMASAN 4 mg
ASTHATOR 5 mg
SINGULAIR (R)
MONKASTA 5 mg
MONTELUKAST ALVOGEN 5 mg
STANGEN 5 mg
SOLOK 5 mg
MONART 5 mg
ASTMASAN 5 mg
ASTMASAN 4 mg
SINGULAIR 4 mg
EURESPAL 80 mg
EURESPAL 2 mg/ml
TUSSIN FORTE 20 mg
ROFEDEX
HUMISEC pentru adulti 20mg/15 ml
HUMISEC pentru copii 5mg/5ml
TUSSIN 6,5mg/5ml
ROBITUSSIN JUNIOR
ROBITUSSIN ANTITUSSICUM
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
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
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
NETILDEX
NETILDEX
SPERSADEX COMP
DEXATOBROM 3 mg+1 mg/ml
TOBRADEX ( R )
COMPR. MAST.
PIC. OFT./AURIC./NAZALE SOL.
4mg
4mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
4mg
4mg
80mg
2mg/ml
20mg
15mg/5ml
20mg/15 ml
5mg/5ml
6,5mg/5ml
3,75mg/5ml
7,5mg/5ml
5mg
5mg
5mg
5mg
5mg
5mg/ml
0,5mg/ml
5mg
5 mg
5 mg
5 mg
5mg
5mg
5mg
5mg
5mg
2,5mg
5mg
0,5 mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,5mg/ml
0,3%
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
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
GRANULE
SIROP
COMPR.
SIROP
SIROP
SIROP
SIROP
SOL. ORALA
SOL. ORALA
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PIC. ORALE, SOL.
SIROP
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
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.
Detinator APP
Tara det.
APP
MAREA BRITANIE
SANDOZ SRL
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST.

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST.
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST.
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 28 COMPR. MAST.
TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. DIN AL/AL X 30 COMPR. MAST.
P6L
P6L
P6L
P6L
P6L
P6L
ISLANDA
P6L
SLOVENIA
CUTIE CU BLIST. OPA-AL-PVC//AL X 28 COMPR. MAST.
P6L
LUXEMBURG CUTIE CU BLIST. PA-ALL-PVC/AL X 28 COMPR. MASTICABILE
P6L
CUTIE CU BLIST. AL/PE-PEID/PE SI DESICANT/AL/OPA X 28 COMPR. MAST.
P6L
TERAPIA S.A.
ROMANIA
ROMANIA
CUTIE CU BLIST. PA/PVC/AL X 28 COMPR. MAST.
P6L
REPUBLICA CEHA
CUTIE CU 1 FLAC. PEID X 28 COMPR. MAST. P6L
MALTA
CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST.
P6L
MAREA BRITANIE
P6L
SANDOZ SRL
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. MAST. P6L

ROMANIA CUTIE CU 28 PLICURI PET/AL/PE CONTINAND GRANULE P6L
MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L
LES LAB. SERVIER IND.

BIOFARM SA
LAB. URGO SA
LAB. URGO 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
FRANTA
FRANTA
ROMANIA
AUSTRIA
AUSTRIA
CUTIE X 1 FLACON X 200 ML + O MASURA DOZATOARE DIN POLIPROPILENA
P-RF
CUTIE X 1 FLACON X 125 ML SIROP + O MASURA DOZATOARE PENTRU MASURAREA VOLUMELOR 2,5ML; 5ML; 7,5ML; 15ML
P-RF
CUTIE X 1 FLAC. X 115ML SIROP + O LINGURITA DOZATOARE GRADATA LA 1,25ML; 2,5ML SI 5 ML
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
CUTIE X 1 FL. DIN STICLA BRUNA CU CAPAC SECURIZAT X 100 ML SOL. ORALA + MASURA DOZATOARE PT.2,5ML;5M
P-RF
U.C.B. GMBH
SANDOZ S.R.L.
GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM.
REPUBLICA CEHA
ROMANIA
P-6L

ISLANDA
ZENTIVA, K.S.
REPUBLICA CEHA
CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 20 COMPR. FILM.
P6L
CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML PIC. ORALE, SOL., PREVAZUT CU PICURATOR
P-6L
UCB PHARMA GMBH GERMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
REPUBLICA CEHA

ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 10

ISLANDA CUTIE CU BLIST. DIN OPA/AL/PVC-AL X30
SANDOZ S.R.L.
ROMANIA
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

PRF
PRF
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
TERAPIA SA
CUTIE CU BLIST. PCTFE-PVC/AL X 30 COMPR. FILM.
P6L
ROMANIA
ROMANIA
P6L
MERCK SHARP&DOHME LTD.
MAREA BRITANIE
CUTIE X 10 COMPR. FILM. ( PCTFE/ PVC/AL) P-RF
MAREA BRITANIE
CUTIE X 30COMPR. FILM. ( PCTFE/ PVC/AL)
P-RF
MAREA BRITANIE
CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL)
P-RF
MAREA BRITANIE
CUTIE X 30 COMPR. ORODISPERSABILE (PVC/OPA/AL)
P-RF
SANDOZ S.R.L.
ROMANIA
LUXEMBURG
REPUBLICA CEHA
MAREA BRITANIE
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 X 120 ML SOL. ORALA + LIGURITA DOZATOARE DE 2,5 ML SI 5 ML
ROMANIA
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 10ML
ROMPHARM COMPANY SRL ROMANIA CUTIE C 1 FLAC. PEJD X 5 ML PIC. OFT. SOL
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

ALCON COUVREUR NV
ALCON COUVREUR NV
ALCON COUVREUR NV
P6L
P6L
P6L
P-RF
P6L
P-RF
P-RF
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 FLACON DIN PEJD X 5 ML PICATURI OFT., SOL.
P-RF
GERMANIA
CUTIE X 1 TUB DIN AL PREVAZUT CU APLICATOR X 3 G
P-RF
ROMANIA
ROMANIA
CUTIE X 1 FLAC. DIN PEID X 10 ML PIC. OFT., SUSPENSIE
P-RF
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
CUTIE CU 1 FLAC. PEJD, PREVAZUT CU APLICATOR PT. PICURARE DIN PEJD A 10 ML PIC. OFT., AURICULARE, NAZALE SOL.
S.I.F.I. SPA
S.I.F.I. SPA
ITALIA
ITALIA
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
PIC. OFT. SUSP.
3mg+1mg/ml ROMPHARM COMPANY S.R.L. ROMANIA

3mg+1mg/ml ALCON COUVREUR NV BELGIA
PICATURI OFT.-SUSP.
Ambalaj
Prescriptie
Nr. crt
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
CUTIE CU 1 FLAC. PEJD A 5 ML + PICURATOR
P-RF
CUTIE X 1 FLACON PICURATOR PEJD X 5 ML
P-RF
Pagina 16 din 17
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
28
28
28
28
28
30
30
28
28
28
28
28
28
28
28
28
28
30
1
20
1
1
1
1
1
1
30
10
10
10
20
1
1
30
10
30
30
30
30
30
10
30
30
30
1
1
1
1
1
1
1
1
1
1
1
15
1
1
1
1
1
1
1
1
20
1
1
1
0.528214
0.528214
0.660267
0.660267
0.542500
0.542333
0.483666
0.660267
0.660267
0.660267
0.660267
0.660267
0.660267
0.660267
0.560357
0.528214
0.528214
0.952666
20.370000
0.352000
5.470000
4.850066
8.460000
2.725883
6.042000
2.734999
0.863333
0.561000
0.561000
0.362000
0.561000
20.196000
20.196000
0.356666
0.322000
0.322666
0.350333
0.356666
0.356666
0.356666
0.356666
0.356666
0.178333
0.356666
10.627500
10.620000
10.627500
10.627500
10.627500
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
1.059286
0.000000
1.056161
1.892590
0.000000
0.000000
0.000000
0.120090
1.056161
1.056161
1.056161
1.056161
1.056161
1.056161
0.000000
1.060000
1.833571
0.000000
0.000000
0.000000
0.000000
5.969934
0.000000
5.444117
2.898000
6.205001
0.000000
0.000000
0.000000
0.000000
0.000000
5.534000
3.644000
0.165667
0.000000
0.000000
0.000000
0.006334
0.196334
0.182667
0.490334
0.494334
0.809333
0.631000
0.002500
0.000000
0.002500
5.722500
0.002500
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
0.264107
0.264107
0.330133
0.330133
0.271250
0.271166
0.241833
0.330133
0.330133
0.330133
0.330133
0.330133
0.330133
0.330133
0.280178
0.264107
0.264107
0.476333
10.185000
0.176000
2.735000
2.425033
4.230000
1.362941
3.021000
1.367499
0.431666
0.280500
0.280500
0.181000
0.280500
10.098000
10.098000
0.178333
0.161000
0.161333
0.175166
0.178333
0.178333
0.178333
0.178333
0.178333
0.089166
0.178333
5.313750
5.310000
5.313750
5.313750
5.313750
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
1.323393
0.264107
1.386295
2.222724
0.271250
0.271167
0.241833
0.450224
1.386295
1.386295
1.386295
1.386295
1.386295
1.386295
0.280179
1.324107
2.097678
0.476333
10.185000
0.176000
2.735000
8.394967
4.230000
6.807059
5.919000
7.572501
0.431667
0.280500
0.280500
0.181000
0.280500
15.632000
13.742000
0.344000
0.161000
0.161333
0.175167
0.184667
0.374667
0.361000
0.668667
0.672667
0.898500
0.809333
5.316250
5.310000
5.316250
11.036250
5.316250
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
0.475392
0.475392
0.594240
0.594240
0.488250
0.488099
0.435299
0.594240
0.594240
0.594240
0.594240
0.594240
0.594240
0.594240
0.504321
0.475392
0.475392
0.857399
18.333000
0.316800
4.923000
4.365059
7.614000
2.453294
5.437800
2.461499
0.776999
0.504900
0.504900
0.325800
0.504900
18.176400
18.176400
0.320999
0.289800
0.290399
0.315299
0.320999
0.320999
0.320999
0.320999
0.320999
0.160499
0.320999
9.564750
9.558000
9.564750
9.564750
9.564750
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
1.112108
0.052822
1.122188
1.958617
0.054250
0.054234
0.048367
0.186117
1.122188
1.122188
1.122188
1.122188
1.122188
1.122188
0.056036
1.112822
1.886393
0.095267
2.037000
0.035200
0.547000
6.454941
0.846000
5.716706
3.502200
6.478501
0.086334
0.056100
0.056100
0.036200
0.056100
7.553600
5.663600
0.201334
0.032200
0.032267
0.035034
0.042001
0.232001
0.218334
0.526001
0.530001
0.827167
0.666667
1.065250
1.062000
1.065250
6.785250
1.065250
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
cod ATC
DCI
1,082
1,083
S01GX09
OLOPATADINUM
Denumire Comerciala
TOBRADEX (R)
OPATANOL 1mg/ml
forma farm.
UNG. OFT.
PIC. OFT., SOL.
concentratie
Detinator APP
Tara det.
APP
Ambalaj
3 mg/1 mg/g ALCON COUVREUR NV BELGIA CUTIE X 1 TUB AL, PREVAZUT CU APLICATOR PEID X 3,5 G
1mg/ml
ALCON LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 FLACON X 5 ML
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 17 din 17
Prescriptie
Nr. crt
P-RF
P-RF
Co-plata maxima a
asiguratii care
cant.
beneficiaza de
asiguratii care
asiguratii care
UT/
Pret de
compensare 100%
beneficiaza de
beneficiaza de
beneficiaza de
beneficiaza de
amba referinta / UT
din pretul de
laj
(RON)
referinta)
1
1
5.712525
28.000000
7.357475
0.000000
2.856262
14.000000
10.213738
14.000000
5.141272
25.200000
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 IANUARIE 2016
Val. maxima suportata de Co-plata maxima a

asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
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
39
40
41
B01AA07
B01AA07
C01AA05
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
C07AB02
C07AB02
ACENOCUMAROLUM
ACENOCUMAROLUM
DIGOXINUM
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
METOPROLOLUM
METOPROLOLUM
TROMBOSTOP 2 mg
SINTROM 4 mg
DIGOXIN SOPHARMA 0,25 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 LPH 40 mg
VEROSPIRON
SPIRONOLACTONA ARENA 25 mg
SPIRONOLACTONA LPH 25 mg
VEROSPIRON
SPIRONOLACTONA ARENA 50 mg
SPIRONOLACTONA BIOEEL 25 mg
SPIRONOLACTONA TERAPIA 25 mg
ALSPIRON 25 mg
ALSPIRON 50 mg
BLOXAN
BETAPROL 100 mg
EGILOK 100 mg
METOPROLOL LPH 100 mg
METOPROLOL LAROPHARM 100 mg
METOPROLOL 100 mg
METOPROLOL TERAPIA 100 mg
METOPROLOL VIM SPECTRUM 100 mg
METOPROLOL ARENA 100 MG
METOPROLOL 100 mg
METOPROLOL AL 100
METOPROLOL ZENTIVA 100 mg
EGILOK 25 mg
METOPROLOL 25 mg
METOPROLOL ARENA 25 MG
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
SOL. INJ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
2mg
4mg
0,25 mg
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
25mg
25mg
TERAPIA SA
P-RF
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF
CN UNIFARM S.A.
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
ARENA GROUP S.A.

ARENA GROUP S.A.

BIO EEL SRL
TERAPIA SA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

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 20 COMPRIMATE
PRF
P-RF
CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ.
S/P-RF
CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ROSU SI PORTOCALIU)X 2 ML SOL. INJ.
S/P-RF

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

P-RF
P-6L

P-6L

P-6L
P-6L

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

CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L

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

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
UNGARIA
LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L

LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR.
Pagina 1 din 39
P-6L
P-6L
P-6L
30
20
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
30
60
0.226000
0.350000
0.166560
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
0.098666
0.098333
0.226000
0.350000
0.166560
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
0.098666
0.098333
0.000000
0.000000
0.033940
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
0.000000
0.000000
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
88
89
90
91
92
93
COD ATC
C07AB02
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
C07AG02
C07AG02
DCI
METOPROLOLUM
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
CARVEDILOLUM
CARVEDILOLUM
Denumire Comerciala
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
METOPROLOL 50 mg
COMPR.
METOPROLOL AL 50
COMPR.
METOPROLOL LAROPHARM 50 mg
BETAPROL 50 mg
EGILOK 50 mg
METOPROLOL 50 mg
METOSUCCINAT SANDOZ 190 mg

METOSUCCINAT SANDOZ 47,5 mg
METOPROLOL RETARD 100 mg
METOPROLOL TARTRAT AUROBINDO 100 mg
METOPROLOL TARTRAT AUROBINDO 50 mg

METOSUCCINAT SANDOZ 47,5 mg
BETALOC
BOREZ 10 mg
CONCOR COR 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 COR 5 mg
CONCOR COR 5 mg
SOBYC 5 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

CORYOL 12,5 mg
TALLITON (R) 12,5 mg
CARVEDILOL VIM SPECTRUM 12,5mg
GLADYCOR 12,5 mg
MIOCARVIL 12,5 mg
concentratie
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
50mg
COMPR. ELIB. MODIF. 47,5mg
COMPR. FILM. 100mg
COMPR. FILM. 50mg
COMPR.FILM.ELIB.MOD. 190mg
COMPR.FILM.ELIB.MOD. 47,5mg
COMPR.FILM.ELIB.MOD. 95mg
SOL. INJ./PERF. 5mg/5ml
COMPR. FILM. 10 mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 2,5 mg
COMPR. FILM. 2,5mg
COMPR. FILM. 2,5mg
COMPR. FILM. 2,5mg
COMPR. FILM. 5mg
COMPR. FILM. 5mg
COMPR. FILM. 5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
5mg
COMPR.
12,5 mg
COMPR.
12,5mg
COMPR.
12,5mg
COMPR.
12,5mg
COMPR.
12,5mg
COMPR.
12,5mg
COMPR.
12,5mg
COMPR.
12,5mg
TARA
DET. APP
AMBALAJ
LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
DETINATOR APP
UNGARIA
Prescriptie
NR.CRT
P-6L
P-6L
P-6L
MAGISTRA C & C SRL ROMANIA

TERAPIA SA
ROMANIA
SLAVIA PHARMA S.R.L. ROMANIA
ALIUD PHARMA GMBH GERMANIA
ZENTIVA S.A.
ROMANIA
HEXAL AG
HEXAL AG
HEXAL AG
TERAPIA SA
ASTRAZENECA AB
ASTRAZENECA AB
HEXAL AG
HEXAL AG
HEXAL AG
ASTRAZENECA AB
P-6L
P-6L
P-6L
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
MALTA
MALTA
SUEDIA
SUEDIA
P6L
P6L
GERMANIA
P-6L
GERMANIA
P-6L
GERMANIA
P-6L
SUEDIA
CUTIE X 5 FIOLE X 5 ML SOL.INJ. I.V./PERF.
P6L


GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L
P6L
P6L

KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM.
MERCK KGAA
MERCK KGAA
P-6L
CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L
MERCK KGAA
MERCK KGAA
P-6L
MERCK KGAA
MERCK KGAA

P6L
GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L

P6L
ACTAVIS S.R.L.
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.

REPUBLICA CEHA
P-6L
P-6L
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

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

UNGARIA
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 3 BLIST. PVC/AL X 10 COMPR.
P-6L
Pagina 2 din 39
P-6L

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
20
30
20
30
30
30
20
30
20
30
30
30
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
30
30
0.181999
0.181999
0.181999
0.164333
0.181999
0.181999
0.172500
0.181999
0.181999
0.151666
0.181999
0.504000
0.215666
0.358333
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
0.308570
0.308570
0.181999
0.181999
0.181999
0.164333
0.181999
0.181999
0.172500
0.181999
0.181999
0.151666
0.181999
0.504000
0.215666
0.358333
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
0.308570
0.308570
0.000501
0.000334
0.000501
0.000000
0.000334
0.062001
0.000000
0.000334
0.000501
0.000000
0.000334
0.000000
0.000000
0.000000
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
0.076763
0.153763
94
95
96
97
98
99
DCI
COD ATC
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 C07AG02
111 C07AG02
112 C07AG02
113 C07AG02
114 C09AA01
115 C09AA01
116 C09AA01
117 C09AA01
118 C09AA01
119 C09AA01
120 C09AA01
121 C09AA01
122 C09AA01
123 C09AA01
124 C09AA01
125 C09AA01
126 C09AA01
127 C09AA01
128 C09AA02
129 C09AA02
130 C09AA02
131 C09AA02
132 C09AA02
133 C09AA02
134 C09AA02
135 C09AA02
136 C09AA02
137 C09AA02
138 C09AA02
139 C09AA02
140 C09AA02
141 C09AA02
142 C09AA02
143 C09AA02
144 C09AA02
145 C09AA02
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
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
ENALAPRILUM
Denumire Comerciala
forma farm.
CARVEDILOL HELCOR 12,2 mg COMPR.
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

CORYOL (R)
TALLITON 6,25 mg
CARVEDILOL VIM SPECTRUM 6,25 mg
GLADYCOR 6,25 mg
MIOCARVIL 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 MCC 25 mg
CAPTOPRIL LPH 25 mg
CAPTOPRIL SINTOFARM 25 mg
CAPTOPRIL 50 mg
CAPTOPRIL 50 EEL
CAPTOPRIL MCC 50 mg
CAPTOPRIL LPH 50 mg
ENALAPRIL 10 mg
ENALAPRIL LPH 10 mg
ENALAPRIL LPH 10 mg
ENAP 10 mg
RENITEC 10 mg
ENALAPRIL VIM SPECTRUM 10 mg

ENALAPRIL 20 mg
ENALAPRIL LPH 20 mg
ENALAPRIL LPH 20 mg
ENAP 20 mg
RENITEC 20 mg
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.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
concentratie
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
10mg
20mg
20mg
20mg
20mg
20mg
TARA
DET. APP
AMBALAJ
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR.
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR.
DETINATOR APP
UNGARIA
ANTIBIOTICE S.A.
ROMANIA
P-6L
P-6L
P-6L
P-6L

P-6L
P6L
HEXAL AG
Prescriptie
NR.CRT
P-6L
P-6L
P-6L
KRKA D.D.
UNGARIA
P-6L

ANTIBIOTICE S.A.
P-6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR.
P-6L
HEXAL AG
P6L
P6L
P6L
P6L

MAGISTRA C & C
TERAPIA SA
BIO EEL SRL
MAGISTRA C & C
LABORMED PHARMA SA
SINTOFARM SA
ARENA GROUP SA
ARENA GROUP SA
TERAPIA SA
BIO EEL SRL
MAGISTRA C & C
LABORMED PHARMA SA
MAGISTRA C & C
LABORMED PHARMA SA
LABORMED PHARMA SA
P-6L
MALTA
MALTA
MALTA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

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
SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR.
P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L
TERAPIA SA
ARENA GROUP SA
ARENA GROUP SA
ARENA GROUP SA
VIM SPECTRUM SRL
LAROPHARM SRL
TERAPIA SA
MAGISTRA C & C
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
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 2 BLIST. OPA-AL-PVC/AL X 10 COMPR.
P-6L

CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI) P6L
P-6L

P-6L
P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L
Pagina 3 din 39

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
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
20
20
30
20
28
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
0.185000
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
0.199500
0.330500
0.330500
0.330666
0.330500
0.396600
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
0.185000
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
0.199500
0.330500
0.330500
0.330666
0.330500
0.396600
0.143430
0.583929
0.012144
0.180477
0.259144
0.181144
0.258144
0.259644
0.000000
0.173642
0.000000
0.000000
0.022333
0.012000
0.000000
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
0.000000
0.000000
0.000000
0.000000
0.112328
DCI
COD ATC
146 C09AA02
147 C09AA02
148 C09AA02
149 C09AA02
150 C09AA02
151 C09AA02
152 C09AA02
153 C09AA02
154 C09AA02
155 C09AA02
156 C09AA02
157 C09AA02
158 C09AA02
159 C09AA02
160 C09AA02
161 C09AA02
162 C09AA02
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 C09AA03
178 C09AA03
179 C09AA03
180 C09AA03
181 C09AA03
182 C09AA03
183 C09AA05
184 C09AA05
185 C09AA05
186 C09AA05
187 C09AA05
188 C09AA05
189 C09AA05
190 C09AA05
191 C09AA05
192 C09AA05
193 C09AA05
194 C09AA05
195 C09AA05
196 C09AA05
197 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
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
RAMIPRILUM
Denumire Comerciala
forma farm.
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.
COMPR.
COMPR.
COMPR.

ENALAPRIL 5 mg
ENAP 5 mg
RENITEC 5 mg

ENAP 1,25 mg/ml
RANOLIP
LISIREN 10 mg
LISINOPRIL SANDOZ 10 mg
LISINOPRIL 10 MEDO
LISINOPRIL ACTAVIS 10 mg
TONOLYSIN 10 mg
TONOLYSIN 2,5 mg
RANOLIP
LISIREN 20 mg
LISINOPRIL SANDOZ 20 mg
TONOLYSIN 20 mg
LISINOPRIL 20 MEDO
RANOLIP
LISINOPRIL 5 MEDO
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
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
concentratie
20mg
20mg
20mg
20mg
20mg
20mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
1,25mg/ml
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
40mg
5mg
5mg
5mg
5mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
2,5 mg
2,5mg
2,5mg
2,5mg
2,5mg
Prescriptie
NR.CRT
KRKA, D.D., NOVO MESTO
TARA
DET. APP
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
SLOVENIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
SLOVENIA
CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
PR/PRF
MAREA BRITANIE
P-6L
DETINATOR APP
TERAPIA SA
ARENA GROUP SA
ARENA GROUP SA
SLAVIA PHARM S.R.L.
LAROPHARM SRL
TERAPIA SA
MAGISTRA C & C
KRKA D.D. NOVO MESTO
MERCK SHARP & DOHME
LABORMED PHARMA SA
LABORMED PHARMA SA
TERAPIA SA
ARENA GROUP S.A.
SLAVIA PHARM S.R.L.
LAROPHARM SRL
TERAPIA SA
AC HELCOR SRL
HEXAL AG
AMBALAJ

CUTIE CU 2 BLIST. AL/PVC X 10 COMPR.
CUTIE X 2 BLISTERE AL/PVC X 10 COMPRIMATE (2 ANI)
P-6L
CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR.
P-6L

P-6L
MAREA BRITANIE
AC HELCOR SRL
HEXAL AG
ANTIBIOTICE SA

ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR.
ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR.
MAREA BRITANIE
ANTIBIOTICE SA
P-6L

CUTIE X 2 BLISTERE AL/PVC- X 10 COMPRIMATE (2 ANI) P6L
ANTIBIOTICE SA
P-6L
P-6L
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

P-6L
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR.

SANDOZ SRL
P-6L
P-6L

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

P-6L
ZENTIVA S.A.
MALTA
P-6L
P-6L

TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR.

SANDOZ SRL
P-6L
P-6L
P-6L
ZENTIVA S.A.
Pagina 4 din 39
P-6L

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
20
30
50
20
20
20
20
20
28
30
20
20
30
20
20
20
5
30
20
30
30
30
30
28
28
30
20
30
30
30
28
20
30
30
30
30
28
28
28
30
30
28
28
28
30
30
30
28
28
30
30
28
0.330500
0.330666
0.330600
0.330500
0.330500
0.330500
0.093000
0.094000
0.108000
0.093333
0.093000
0.093000
0.093333
0.090000
0.090000
0.093000
3.204000
0.305199
0.305199
0.270000
0.254333
0.270000
0.305199
0.305199
0.311071
0.454800
0.454800
0.379000
0.379000
0.454800
0.454800
0.428500
1.359333
0.231199
0.192666
0.193000
0.231199
0.238214
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.149642
0.172142
0.168333
0.172000
0.166071
0.330500
0.330666
0.330600
0.330500
0.330500
0.330500
0.093000
0.094000
0.108000
0.093333
0.093000
0.093000
0.093333
0.090000
0.090000
0.093000
3.204000
0.305199
0.305199
0.270000
0.254333
0.270000
0.305199
0.305199
0.311071
0.454800
0.454800
0.379000
0.379000
0.454800
0.454800
0.428500
1.359333
0.231199
0.192666
0.193000
0.231199
0.238214
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.285856
0.149642
0.172142
0.168333
0.172000
0.166071
0.000000
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
0.000000
0.000000
0.213134
0.231801
0.000000
0.000000
0.000000
0.108134
0.081229
0.000000
0.344533
0.327700
0.000000
0.000000
0.357200
0.194128
0.000000
0.000000
0.033467
0.000000
0.000000
0.032015
0.000000
0.016286
0.016144
0.016144
0.016286
0.178429
0.016286
0.016144
0.016144
0.016144
0.000000
0.000000
0.000000
0.000000
0.000000
COD ATC
198 C09AA05
199 C09AA05
200 C09AA05
201 C09AA05
202 C09AA05
203 C09AA05
204 C09AA05
205 C09AA05
206 C09AA05
207 C09AA05
208 C09AA05
209 C09AA05
210 C09AA05
211 C09AA05
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 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
DCI
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**
CANDESARTANUM CILEXETIL**
Denumire Comerciala
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
RAMIRAN 5 mg
RAMIRAN 5 mg
WENZELL 160 mg
WENZELL 160 mg
DIOVAN 160 mg
VALSACOR 160 mg
AVASSAN 160 mg
VAPRESS 160 mg
VAPRESS 160 mg
VALSACOR 320 mg
DIOVAN 40 mg
AVASSAN 40 mg
VAPRESS 40 mg
VAPRESS 40 mg
WENZELL 80 mg
WENZELL 80 mg
DIOVAN 80 mg
VALSACOR 80 mg
AVASSAN 80 mg
VAPRESS 80 mg
VAPRESS 80 mg
DIOVAN 3 mg/ml
ATACAND
TANDESAR 16 mg
KARBIS 16 mg
ATACAND 16mg
CANZENO 16mg
CADEXYL 16 mg
ATACAND 32 mg
KARBIS 32 mg
forma farm.
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.
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.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
concentratie
2,5mg
2,5mg
2,5mg
2,5mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
160mg
320mg
40mg
40mg
40mg
40mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
80mg
3mg/ml
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
16mg
32mg
32mg
32mg
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT
P-6L

TERAPIA SA
TERAPIA SA
ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR.

SANDOZ SRL
P-6L
P-6L
P-6L

P-6L
ZENTIVA S.A.
MALTA
P-6L
P-6L

TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
P-6L
P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L
TERAPIA S.A.
ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
P6L
P6L
P6L
P-6L
P6L
P6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P-6L
TERAPIA S.A.
ROMANIA
P6L
P6L
P6L
P6L
ROMANIA
ROMANIA
P-6L
P-6L
NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28COMPR. FILM.

NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X28COMPR. FILM. P6L
TERAPIA S.A.
ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
P6L
P6L
P6L
P-6L
P6L
P6L

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 )

TERAPIA SA
SANDOZ SRL
P-6L
P-6L
P-6L
P-6L
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L
ASTRAZENECA AB
ZENTIVA K.S.
P6L
SUEDIA
CUTIE CU BLIST. PVC/PVDC/AL CE CONTINE 28 COMPR. P-6L
REPUBLICA CEHA
LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14COMPR. P6L

MALTA

ASTRAZENECA AB
SUEDIA
CUTIE X 2 BLIST. AL-PVC/PVDC X 14 COMPR. P-6L
Pagina 5 din 39
P6L

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
28
30
30
30
28
28
30
30
28
28
28
30
30
30
28
30
28
28
28
98
28
28
28
30
28
28
28
28
28
30
28
28
28
98
28
28
28
1
28
28
28
30
30
28
30
28
30
28
30
28
30
30
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
0.554692
0.554692
0.554692
0.534285
0.554692
0.462244
0.554692
0.554692
0.554692
1.129333
0.495856
0.495856
0.413214
0.413214
0.351306
0.351306
0.351306
0.351306
0.351306
0.292755
0.351306
0.351306
0.351306
41.420000
0.840000
0.840000
0.840000
0.840000
0.700000
0.840000
0.840000
0.840000
0.840000
0.840000
0.840000
0.723600
0.723600
0.603000
0.179570
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
0.554692
0.554692
0.554692
0.534285
0.554692
0.462244
0.554692
0.554692
0.554692
1.129333
0.495856
0.495856
0.413214
0.413214
0.351306
0.351306
0.351306
0.351306
0.351306
0.292755
0.351306
0.351306
0.351306
41.420000
0.840000
0.840000
0.840000
0.840000
0.700000
0.840000
0.840000
0.840000
0.840000
0.840000
0.840000
0.723600
0.723600
0.603000
0.085072
0.000000
0.000000
0.000000
0.000000
0.041644
0.041430
0.041430
0.032715
0.175215
0.041644
0.041430
0.041430
0.041430
0.515665
0.515641
1.039236
0.000000
0.515665
0.000000
0.007093
0.217450
0.217450
0.000000
2.072358
1.083786
0.000000
0.000000
0.451551
0.451360
0.843694
0.086551
0.451551
0.000000
0.171551
0.034408
0.034408
0.000000
0.741785
0.222500
0.158928
0.222000
0.000000
0.741785
0.026000
0.222142
0.172333
0.222500
0.222000
1.505685
0.725400
0.000000
COD ATC
250 C09CA06
251 C09CA06
252 C09CA06
253 C09CA06
254 C09CA06
255 C09CA06
256 C09CA06
257 C09CA06
258 C09CA06
259 C09CA06
260 C09CA06
261 C09CA06
262 C09CA06
263 C09CA06
264 C09CA06
DCI
Denumire Comerciala
forma farm.
ATACAND 32 mg
CANZENO 32mg
CADEXYL 32 mg
COMPR.
COMPR.
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.
concentratie
32mg
32mg
32mg
32mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
8mg
DETINATOR APP
ASTRAZENECA AB
ZENTIVA K.S.
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT
SUEDIA
REPUBLICA CEHA


TERAPIA SA
SANDOZ SRL
P-6L
P-6L
P-6L
ASTRAZENECA AB
ZENTIVA K.S.
REPUBLICA CEHA
LABORMED PHARMA S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR.

P6L
SUEDIA
MALTA
P6L


asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
28
30
28
30
28
28
28
30
30
28
30
28
30
28
30
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
0.723600
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
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
30
30
30
30
30
90
28
28
9.342333
9.342333
0.460714
0.506570
0.506570
0.506570
0.506570
0.422142
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
9.342333
9.342333
0.460714
0.506570
0.506570
0.506570
0.506570
0.422142
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
0.506570
0.000000
0.000000
0.000000
1.141287
0.039144
0.600215
0.112358
0.000000
0.600215
0.182096
0.599763
0.599763
0.412763
0.074430
0.055430
0.087358
1.141287
56 113.407142
56 1,190.124285
113.407142
1,190.124285
0.000000
0.000000
2. BOLNAVI CU PROTEZE VALVULARE SI VASCULARE - G2

1
2
B01AA07
B01AA07
ACENOCUMAROLUM
ACENOCUMAROLUM
TROMBOSTOP 2 mg
SINTROM 4 mg
COMPR.
COMPR.
2mg
4mg
TERAPIA SA
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
11
12
13
14
15
16
17
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
B01AC04
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
CLOPIDOGRELUM***
PLAVIX 300mg
PLAVIX 300mg
ZYLLT
PLAVIX 75mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CLOPIDOGREL MYLAN 75mg COMPR. FILM.
TROGRAN 75 mg
COMPR. FILM.
PLAVOCORIN 75 mg
COMPR. FILM.
CLOPIDOGREL ACTAVIS 75 mg COMPR. FILM.
DEFROZYP 75 mg
COMPR. FILM.
TESSYRON 75 mg
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.
300mg
300mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
SANOFI CLIR SNC
FRANTA
FRANTA
P-RF
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.
REPUBLICA CEHA
P-RF
SANDOZ S.R.L.
ROMANIA
P-RF
ISLANDA
CUTIE CU BLIST. AL/AL X 28 COMPR. FILM.
P-RF
CUTIE CU BLIST. DIN OPA/AL/PVC-AL X 28 COMPR.FILM. P-RF
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVDC/AL X 28 COMPR. FILM. P-RF
ROMANIA
ROMANIA
TERAPIA S.A.
ROMANIA
CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 30 COMPR. FILM.
P-RF
P-RF
ZENTIVA K.S.
ZENTIVA K.S.
SANOFI CLIR SNC
CEHIA
CEHIA
MALTA
FRANTA
CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. PRF

PRF
P-RF
P-RF
CUTIE X 28 COMPR. FILM. ( BLIST. PVC-PVDC/AL) P-RF
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 FARA DASABUVIRUM****
EXVIERA 250mg
2 FARA OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM**** VIEKIRAX
COMPR. FILM.
COMPR. FILM.
250 mg
12,5 mg+75 mg+50 mg
ABBVIE LTD.
ABBVIE LTD.
Pagina 6 din 39
MAREA BRITANIE
CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE)
MAREA BRITANIE
CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE(AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE)
PR
PR
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
COD ATC
J05AB04
J05AB04
J05AB04
J05AB04
J05AB04
J05AF05
J05AF05
J05AF07
DCI
Denumire Comerciala
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

J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE**** TENOFOVIR DISOPROXIL TEVA 245 mg
J05AF08
J05AF10
J05AF10
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AB04
L03AB05
L03AB05
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB11
N04BB01
ADEFOVIRUM DIPIVOXILUM****
ENTECAVIRUM****
ENTECAVIRUM****
FILGRASTIMUM (G-CSF)**
INTERFERONUM ALFA 2A****
INTERFERONUM ALFA 2B****
PEGINTERFERON ALFA-2B****
PEGINTERFERON ALFA-2A****
AMANTADINUM**
HEPSERA
BARACLUDE 0,5mg
BARACLUDE 1mg
ZARZIO 30MU/0,5ml
ZARZIO 48MU/0,5ml
ACCOFIL 30 MU/0,5 ml
NIVESTIM 30 MU/0,5 ml
TEVAGRASTIM 30MUI/0,5ml
ROFERON A
INTRON A 18 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
forma farm.
concentratie
DETINATOR APP
MERCK SHARP & DOHME
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ.
200mg
200mg
200mg
400mg
600mg
100 mg
100mg
245mg
245mg
245mg
10mg
0,5mg
1mg
60MU/ml
96MU/ml
30MU/0,5 ml
30MU/0,5 ml
48MU/0,5 ml
48MU/0,5 ml
300g/0,5ml
300g/0,5ml
480g/0,5ml
480g/0,8ml
9Mui/0,5ml
SOL. INJ. PEN MULTIDOZA
18 milioane U.I. MERCK SHARP & DOHME
CAPS.
COMPR. FILM.
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. SAU PERF. IN SERINGA PREUMPLUTA
TARA
DET. APP
MAREA BRITANIE
AMBALAJ
CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )
Prescriptie
NR.CRT
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.
ABBVIE LIMITED
MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 56 COMPR.
TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM.
GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL)
GILEAD SCIENCE INTERNATIONAL LIMITED
MAREA BRITANIE
CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM
PRF
PRF
P-RF/R
P-RF/R
P-RF/R
PR
PR
ROMANIA
ROMANIA
MAREA BRITANIE
P-RF/R
BRISTOL-MYERS SQUIBB PHARMA EEIG
MAREA BRITANIE
CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA)
P-RF/R
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
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.
CUTIE CU 1 FLAC. DIN PED CU PERETII NGROSATI CU CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM.
ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 5 SERINGI PREUMPLUTE CU 0,5 ML SOL. INJ.
PR
PR
PR
PR
HOSPIRA UK LIMITED
MAREA BRITANIE
CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.
P-RF
TEVA GMBH
GERMANIA
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. SAU PERF. CU APARATOARE DE SIG.PT.AC
PR
HOSPIRA UK LIMITED
MAREA BRITANIE
P-RF
TEVA GMBH
GERMANIA
ACCORD HEALTHCARE LIMITED MAREA BRITANIE AMBALAJ CU 1 SERINGA PREUMPLUTA CU 0,5 ML SOL. INJ.
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL
PR
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
ROCHE ROMANIA S.R.L. ROMANIA
MERCK SHARP & DOHME
MAREA BRITANIE
CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FIOLA SOLV. + 1 SERINGA + 2 ACE + 1 TAMPON DEZINFECTANT
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
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
100g
100g
120g
120g
150g
150g
50g
50g
MERCK SHARP & DOHME
MAREA BRITANIE
PR
PR
PR
PR
PR
PR
PR
PR
180mcg/0,5ml
MAREA BRITANIE
CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML + 1 AC
P-RF/R
CAPS.
100mg
UNGARIA CUTIE X 1 FLAC. X 50 CAPS.

P-6L

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
140
168
168
56
56
30
28
30
30
30
30
30
30
1
1
1
5
1
5
5
1
5
1
1
1
1
1
1
1
1
1
1
1
1
1
50
2.333071
1.949464
2.339356
10.544464
13.558214
2.836666
3.403999
32.970399
27.475333
27.475333
41.273333
57.113666
61.447000
110.870000
163.380000
101.990000
92.674000
150.280000
136.150000
106.198000
111.208800
162.800000
163.380000
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
2.339356
10.544464
13.558214
2.836666
3.403999
32.970399
27.475333
27.475333
41.273333
57.113666
61.447000
110.870000
163.380000
101.990000
92.674000
150.280000
136.150000
106.198000
111.208800
162.800000
163.380000
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
2.867489
0.000000
0.000000
0.000000
0.959572
8.027267
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
7.000000
0.000000
0.000000
0.000000
0.000000
0.000000
8.351200
0.000000
7.460000
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
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
Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie / boli infectioase si nefrologie (doar pentru pacientii cu afectare renala consecutiva infectiei cu virusuri hepatitice)
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
LEMOD SOLU 125 mg

LEMOD SOLU 500 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
16mg
32mg
250mg/4ml
125mg
500mg
50mg
50mg
75mg
MAREA BRITANIE
CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR.
MAREA BRITANIE
CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-RF
MAREA BRITANIE
P-RF
P-RF
STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML
S/P-RF
STADA HEMOFARM S.R.L. ROMANIA 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.
S/P-RF

EBEWE PHARMA GES.M.B.H. NFG KG
Tratamentul se initiaz de ctre medicul n specialitatea gastroenterologie

Pagina 7 din 39
IRLANDA
AUSTRIA
S/P-RF
CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
PR
DCI
COD ATC
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
6. CIROZA BILIARA PRIMARA, COLANGITA SCLEROZANTA PRIMITIVA, HEPATITA CRONICA SI CIROZE DE ALTE ETIOLOGII CU COLESTAZA - G6
1
2
3
4
5
A05AA02
A05AA02
A05AA02
A05AA02
A05AA02
ACIDUM URSODEOXYCHOLICUM
URSOFALK (R)
URSOFALK (R)
URSOROM 250 mg
URSOFALK 500 mg
URSOFALK 250 mg/5 ml
CAPS.
CAPS.
CAPS.
COMPR. FILM.
SUSP. ORALA
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
25mg
50mg
50mg
25mg
25mg
25mg
50mg
250 mg
100
50
ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L
60
GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100
GERMANIA
P6L
1
OLANDA

0.946200
0.946200
0.788500
2.681700
97.490000
0.946200
0.946200
0.788500
2.681700
97.490000
0.206200
0.267200
0.000000
0.000000
0.000000
1 10.750000
1 10.800000
P-6L
1
3.590000
P-6L
1 17.230000
P-6L
1 33.340000
CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L
1
6.730000
12
2.625833
CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM. P-RF
36
2.413333
P-RF
1 19.810000
20
0.156500
20
0.156500
CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L
20
0.187800
20
0.157000
20
0.187800
P-6L
20
0.187800
30
0.157666
P-RF
5
1.260000
30
0.753000
50
0.258000
60
0.258000
30
0.441666
30
0.529999
20
0.222500
50
0.258000
20
0.215000
20
0.529999
PR
56 113.407142
PR
56 1,190.124285
CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140
6.248214
CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168
6.248214
CUTIE CU 1 FLAC. PEID X 168 COMPR. PRF 168
5.206845
CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF
56 10.544464
CUTIE CU 1 FLAC. PEID X 56 COMPR. PRF
56 13.558214
CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R
30
2.836666
CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL) P-RF/R
28
3.403999
CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF/R
30 41.273333
CUTIE X 30 X 1 COMPR. FILM. (BLIST. AL/AL UNIDOZA) P-RF/R
30 57.113666
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
0.258000
0.441666
0.529999
0.222500
0.258000
0.215000
0.529999
113.407142
1,190.124285
6.248214
6.248214
5.206845
10.544464
13.558214
2.836666
3.403999
41.273333
57.113666
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
0.078333
0.000000
0.032001
0.000000
0.111800
0.000000
0.157001
0.000000
0.000000
1.633857
1.549643
0.000000
0.000000
0.000000
0.000000
0.959572
0.000000
0.000000
CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L

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 A06AD11 LACTULOSUM
7 A07AA11 RIFAXIMINUM
10 C03CA01 FUROSEMIDUM
18 C03DA01 SPIRONOLACTONUM
27 FARA DASABUVIRUM****
28 FARA OMBITASVIRUM+PARITAPREVIRUM+RITONAVIRUM****
29 J05AB04 RIBAVIRINUM****
34 J05AF05 LAMIVUDINUM****
35 J05AF05 LAMIVUDINUM****
36 J05AF08 ADEFOVIRUM DIPIVOXILUM****
37 J05AF10 ENTECAVIRUM****
DUPHALAC (R)
LACTULOSE
LACTULOSE
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 LPH 40 mg
VEROSPIRON
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
SOL. INJ.
CAPS.
SPIRONOLACTONA LPH 25 mg CAPS.
VEROSPIRON
CAPS.
SPIRONOLACTONA BIOEEL 25 mg COMPR.
SPIRONOLACTONA TERAPIA 25 mg COMPR. FILM.
ALSPIRON 25 mg
COMPR. FILM.
ALSPIRON 50 mg
COMPR. FILM.
EXVIERA 250mg
COMPR. FILM.
VIEKIRAX
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.
12,5 mg+75 mg+50 mg
200mg
200mg
200mg
400mg
600mg
100 mg
100mg
10mg
0,5mg
FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML

MIP PHARMA GMBH

MIP PHARMA GMBH
GERMANIA
GERMANIA
ROMANIA
ALFA WASSERMANN SPA
ITALIA
ITALIA
ITALIA
ALFA WASSERMANN SPA

ALFA WASSERMANN SPA

ZENTIVA SA
ROMANIA
BIO EEL SRL
ROMANIA
ZENTIVA SA
ROMANIA
BIO EEL SRL
ROMANIA
TERAPIA SA
ROMANIA
ABBVIE LTD.
ABBVIE LTD.
MERCK SHARP & DOHME
MAREA BRITANIE
CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE (AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE)
MAREA BRITANIE
CUTIE X BLISTERE PVC-PE-PCTFE/FOLIE DIN AL X 56 COMPRIMATE FILMATE(AMBALAJ MULTIPLU CARE CONTINE 4 CUTII INTERIOARE X 14 COMPRIMATE FILMATE)
MAREA BRITANIE
ROCHE ROMANIA SRL ROMANIA
ABBVIE LIMITED
MAREA BRITANIE
ABBVIE LIMITED
MAREA BRITANIE
ABBVIE LIMITED
MAREA BRITANIE
GLAXO GROUP LTD. MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
Pagina 8 din 39
CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML
P6L
P-6L
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
J05AF10
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AA02
L03AB04
L03AB05
L03AB05
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB10
L03AB11
N04BB01
DCI
ENTECAVIRUM****
INTERFERONUM ALFA 2A****
PEGINTERFERON ALFA-2A****
AMANTADINUM**
Denumire Comerciala
BARACLUDE 1mg
ZARZIO 30MU/0,5ml
ZARZIO 48MU/0,5ml
ROFERON A
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
forma farm.
COMPR. FILM.
concentratie
DETINATOR APP
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ./PERF.
SOL. INJ.
1mg
60MU/ml
96MU/ml
30MU/0,5 ml
30MU/0,5 ml
48MU/0,5 ml
48MU/0,5 ml
300g/0,5ml
300g/0,5ml
480g/0,5ml
480g/0,8ml
9Mui/0,5ml

TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT
MAREA BRITANIE
CUTIE X 30 X 1 COMPR. FILM.(BLIST. AL/AL UNIDOZA)
P-RF/R
SANDOZ GMBH
SANDOZ GMBH
AUSTRIA
AUSTRIA
P-RF/R
P-RF/R
PR
PR
PR
PR
HOSPIRA UK LIMITED
MAREA BRITANIE
P-RF
TEVA GMBH
GERMANIA
PR
HOSPIRA UK LIMITED
MAREA BRITANIE
P-RF
TEVA GMBH
GERMANIA
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL
PR
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
ROCHE ROMANIA S.R.L. ROMANIA
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
MERCK SHARP & DOHME
MAREA BRITANIE
100g
100g
120g
120g
150g
150g
50g
50g
MERCK SHARP & DOHME
MAREA BRITANIE
PR
PR
PR
PR
PR
PR
PR
PR
180mcg/0,5ml
MAREA BRITANIE
P-RF/R
CAPS.
100mg

P-6L

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
30
1
1
1
5
1
5
5
1
5
1
1
1
1
1
1
1
1
1
1
1
1
1
50
61.447000
110.870000
163.380000
101.990000
92.674000
150.280000
136.150000
106.198000
111.208800
162.800000
163.380000
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
61.447000
110.870000
163.380000
101.990000
92.674000
150.280000
136.150000
106.198000
111.208800
162.800000
163.380000
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
7.000000
0.000000
0.000000
0.000000
0.000000
0.000000
8.351200
0.000000
7.460000
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
10
10
10
10
10
10
5
5
5
1
1
6
6
1
6
1
1.975000
3.345000
9.078000
4.936000
9.074000
4.936000
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
1.975000
3.345000
9.078000
4.936000
9.074000
4.936000
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
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
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
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
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
A04AA01
A04AA01
A04AA01
A04AA01
A04AA01
A04AA01
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA02
A04AA05
A04AA05
B03XA01
B03XA01
B03XA01
B03XA01
B03XA01
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
ONDANSETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
GRANISETRONUM**
PALONOSETRONUM**
PALONOSETRONUM**
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
EPOETINUM ALFA***
OSETRON 4 mg
OSETRON 8 mg
COMPR. FILM.
COMPR. FILM.
OSETRON 8 mg SOLUTIE INJECTABILA SOL. INJ.
OSETRON 4 mg SOLUTIE INJECTABILA SOL. INJ.
EMESET 8 mg/4 ml
SOL. INJ./PERF.
EMESET 4 mg/2 ml
SOL. INJ./PERF.
GRANISETRON ACTAVIS 1 mg COMPR. FILM.
GRANEGIS 1 mg
COMPR. FILM.
GRANORED 1 mg
COMPR. FILM.
SETROGEN 1 mg
COMPR. FILM.
GRANISETRON ACTAVIS 2 mg COMPR. FILM.
GRANORED 2 mg
COMPR. FILM.
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.
ALOXI 500mcg
ALOXI
BINOCRIT 1000UI/0,5ml
EPREX 40000 UI/ml
CAPS. MOI
SOL. INJ.
4mg
8mg
2mg/ml
2mg/ml
2mg/ml
2mg/ml
1mg
1mg
1mg
1mg
2mg
2mg
1mg/1ml
3mg/3ml
1mg/ml
500mcg
250 mcg/5ml
1000UI/0,5ml
2000UI/1,0ml
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
ISLANDA
UNGARIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P-RF

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

CIPLA (UK) LIMITED

CIPLA (UK) LIMITED
ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. FILM. PRF
ISLANDA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

FRESENIUS KABI ROMANIA SRL

HELSINN BIREX PHARMACEUTICALS LTD.
HELSINN BIREX PHARMACEUTICALS LTD.
IRLANDA
IRLANDA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
SANDOZ GMBH
SANDOZ GMBH
30000UI/0,75ml SANDOZ GMBH
40 000UI/ml JOHNSON & JOHNSON D.O.O. SLOVENIA
Pagina 9 din 39
S
S
PR
CUTIE X BLISTER DIN POLIAMIDA/AL/PVC X 1 CAPSULA MOALE
PRF
CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF./INJ.

CUTIE X 5 FIOLE DIN STICLA INCOLORA X 3 ML CONC. PT. SOL. PERF./INJ.
CUTIE X 1 FLAC. DIN STICLA X 5 ML SOL. INJ. P-RF

CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML SOL. INJ.
S/P-RF/R
CUTIE X 6 SERINGI PREUMPLUTE X 1ML SOL. INJ.
S/P-RF/R
CUTIE X 1 SERINGA PREUMPLUTA X 0,75ML SOL. INJ.
P-RF/R
S/P-RF/R
CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ.
S/P-RF
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
65
66
67
68
69
70
71
72
73
74
COD ATC
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
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC02
J02AC03
J02AC03
J02AC03
J02AC03
J02AC04
J02AC04
J02AX04
DCI
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***
CYPROTERONUM**
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
ITRACONAZOLUM
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
POSACONAZOLUM**
POSACONAZOLUM**
CASPOFUNGINUM**
Denumire Comerciala
BINOCRIT 40000 UI/1 ml

NEORECORMON 10000UI/0,6ml
RETACRIT 10000UI/1,0ml
ARANESP 100mcg/0,5ml
ARANESP 10mcg/0,4ml
ARANESP 20mcg/0,5ml
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
forma farm.
concentratie
DETINATOR APP
40000 UI/1 ml SANDOZ GMBH
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT
CUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ.
P-RF/R
S/P-RF/R

AUSTRIA
AUSTRIA
AUSTRIA
S/P-RF/R
10000UI/0,6ml
MAREA BRITANIE
CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE
S/P-RF/R
2000UI/0,3ml
MAREA BRITANIE
CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE
S/P-RF/R
30000 UI/0,6ml ROCHE REGISTRATION LTD.
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
10000UI/1,0ml HOSPIRA UK LIMITED MAREA BRITANIE

100mcg/0,5ml AMGEN EUROPE BV OLANDA
10mcg/0,4ml AMGEN EUROPE BV

500mcg/ml AMGEN EUROPE BV
50mg
BAYER PHARMA AG
0,5mg
CN UNIFARM S.A.
4mg/ml
4mg/ml
4mg/ml
4mg/ml
4mg/ml
4mg/ml
8mg
8mg
8mg/2ml
MEDOCHEMIE LTD.
100mg
100mg
SLAVIA PHARM SRL
100mg
MEDICO UNO PHARMACEUTICAL SRL
100mg
100mg
ARENA GROUP S.A.
100mg
200mg
PFIZER LIMITED
50mg
PFIZER LIMITED
200mg
PFIZER LIMITED
40mg/ml
PFIZER LIMITED
100mg
MERCK SHARP & DOHME LTD.
40mg/ml
MERCK SHARP & DOHME
50mg
MERCK SHARP & DOHME


COMPR.
COMPR.
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
VFEND 40 mg/ml
NOXAFIL 100mg
CAPS. GASTROREZ.
NOXAFIL 40mg/ml
SUSP. ORALA
CANCIDAS 50 mg
PULB. PT. CONC. PT. SOL. PERF.
4000UI/0,3ml
5000UI/0,3ml
Pagina 10 din 39
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
PR
PR
PR
PR
PR
PR
PR
PR
PR
CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X 0,5 ML
P-RF/R
P-RF/R
CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X 0,3 ML
P-RF/R
P-RF/R
CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML
P-RF/R
P-RF/R
P-RF/R
CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML
P-RF/R
P-RF/R
P-RF/R
P-RF/R


GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-RF
ROMANIA CUTIE CU 10 BLISTERE X 10 COMPRIMATE

ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ.
ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ.
ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.
PRF
PRF
PRF
PRF
PRF
PRF
PRF
P-RF
P-RF
CIPRU
BELGIA
CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF
CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5 CAPS.
P-RF
ROMANIA
ROMANIA
ROMANIA
ROMANIA

P-RF
P-RF
CUTIE CU BLISTERE PVC/AL X 15 CAPSULE P-RF

P-RF
P-RF
MAREA BRITANIE
CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL)

CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL)
MAREA BRITANIE
CUTIE X 1 FLAC. UNIDOZA X 30ML
P-RF
REPUBLICA CEHA
MAREA BRITANIE
P-RF
P-RF
P-RF
MAREA BRITANIE
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
MAREA BRITANIE
CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE
PR
MAREA BRITANIE
CUTIE X 1 FLAC. X 105ML SUSP. ORALA
P-RF/R
MAREA BRITANIE
CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF.

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
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
10
25
100
100
5
10
15
15
15
15
15
15
28
28
1
1
24
1
1
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
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
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
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
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
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
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
J02AX04
L01XX35
L04AD01
L04AD01
L04AD01
L04AD01
L04AD01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA01
N02AA05
N02AA05
N02AA05
N02AA05
N02AA05
N02AA05
N02AA05
100 N02AA05
101 N02AA05
102 N02AA05
103 N02AA05
104 N02AA05
105 N02AA05
106 N02AA05
107 N02AA05
108 N02AA05
109 N02AA05
110 N02AA05
111 N02AA08
112 N02AA08
113 N02AA08
114 N02AB02
115 N02AB03
116 N02AB03
117 N02AB03
118 N02AB03
119 N02AB03
120 N02AB03
121 N02AB03
122 N02AB03
123 N02AB03
124 N02AB03
125 N02AB03
126 N02AB03
DCI
CASPOFUNGINUM**
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
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
OXYCODONUM
DIHYDROCODEINUM
DIHYDROCODEINUM
DIHYDROCODEINUM
PETHIDINUM
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
FENTANYLUM**
Denumire Comerciala
CANCIDAS 70 mg
THROMBOREDUCTIN 0,5 mg
EQUORAL 100 mg
SANDIMMUN NEORAL (R)
EQUORAL 25 mg
EQUORAL 50 mg
MST CONTINUS 100 mg
MST CONTINUS 10 mg
MST CONTINUS 200 mg
MST CONTINUS 30 mg
MST CONTINUS 60 mg
SEVREDOL 10 mg
SEVREDOL 20 mg
VENDAL (R) RETARD 100 mg
forma farm.
CAPS.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
COMPR. ELIB. MODIF.
COMPR. ELIB. MODIF.
COMPR. ELIB. MODIF.
COMPR. ELIB. MODIF.
COMPR. ELIB. MODIF.
COMPR. FILM.
COMPR. FILM.
MORFINA ZENTIVA 20 mg/ml SOL. INJ.
concentratie
70mg
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
10mg
20mg
40mg
40mg
60mg
80mg
80mg
120mg
60mg
90mg
50mg/ml
DETINATOR APP
MERCK SHARP & DOHME
AOP ORPHAN PHARMACEUTICALS AG
TEVA CZECH INDUSTRIES S.R.O.


ZENTIVA S.A.
OXYCONTIN 10 mg
OXYCONTIN 20 mg
OXYCONTIN 40 mg
OXYCONTIN 80 mg
RELTEBON 10 mg
RELTEBON 20 mg
RELTEBON 40 mg
RELTEBON 80 mg
OXIDOLOR 10 mg
OXIDOLOR 20 mg
OXIDOLOR 40 mg
OXIDOLOR 80 mg
DHC CONTINUS 120 mg
DHC CONTINUS 60 mg
DHC CONTINUS 90 mg
MIALGIN (R) 100 mg/2 ml
LUNALDIN 100 micrograme
COMPR. ELIB. PREL.
COMPR. SUBLING.
COMPR. SUBLING.
COMPR. SUBLING.
COMPR. SUBLING.
COMPR. SUBLING.
COMPR. SUBLING.
100micrograme GEDEON RICHTER PLC.
FENTANYL TTS SANDOZ 100 mcg/h
PLASTURE TRANSDERMIC
100mcg/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.
AMBALAJ
CUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF.
AUSTRIA CUTIE CU 1 FLAC. DIN PE X 100 CAPS.

CEHIA
CUTIE X 5 BLIST. X 10 CAPS. MOI
GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
CEHIA
GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
CEHIA
AUSTRIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. CU ELIB. MOD.
AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM.
AUSTRIA CUTIE CU BLIST. AL/PVC-PVDC X 60 COMPR. FILM.
AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
AUSTRIA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.
ISLANDA
ISLANDA
S
PR
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
PR, PS
PR, PS
PR, PS
PR, PS
PR, PS
PR, PS
PR, PS
P-TS
P-TS
AUSTRIA
AUSTRIA
AUSTRIA
P-TS
SANDOZ S.R.L.
SANDOZ S.R.L.
ROMANIA
ROMANIA

PS
PS
AUSTRIA
P-TS
SANDOZ S.R.L.
ROMANIA
AUSTRIA
AUSTRIA
AUSTRIA
TORRENT PHARMA SRL ROMANIA

ISLANDA

ISLANDA

ZENTIVA SA

SANDOZ S.R.L.
FENTANYL ACTAVIS 100micrograme/h PLASTURE TRANSDERMIC 100micrograme/h ACTAVIS GROUP PTC EHF.
PLASTURE TRANSDERMIC 100micrograme/ora
MAREA BRITANIE
ALGOGESIC 100 micrograme/ora
TARA
DET. APP
Prescriptie
NR.CRT
ZENTIVA K.S.
DOLFORIN 100 g/ORA
100g/ora
25mcg/h
FENTANYL ACTAVIS 25micrograme/h
25micrograme/h ACTAVIS GROUP PTC EHF.
SANDOZ S.R.L.
Pagina 11 din 39

PS
PS
PS
PS
ROMANIA CUTIE X 5 FIOLE DIN STICLA X 2 ML

UNGARIA
UNGARIA
UNGARIA
UNGARIA
UNGARIA
UNGARIA
ROMANIA CUTIE X 5 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC
P-TS
ISLANDA
CUTIE X 5 PLICURI MULTISTRAT DIN HARTIE -PEJD- AL- SURLYN X 1 PLASTURE TRANSDERMIC
REPUBLICA CEHA
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 PLIC DIN HARTIE/PE/AL/PE X 1 PLASTURE TRANSDERMIC
P-TS
PS
CUTIE CU BLIST. SECURIZATE PT. COPII OPA/AL/PVC-HARTIE/POLIESTER/AL X 10 COMPR. SUBLINGUALE
PRF
PRF
PRF
PRF
PRF
ROMANIA
ROMANIA
ISLANDA
PRF
P-TS

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
1 1,801.340000
100 14.483900
50
6.232400
50
1.784400
50
1.487000
50
3.040560
50
2.533800
60
2.910799
60
0.626333
60
6.769666
60
0.925599
60
1.944000
60
0.751599
60
1.219500
30
2.425666
30
0.771333
30
1.620000
5
1.720000
60
0.815599
60
1.440199
60
2.331999
60
3.964399
60
0.679666
60
1.200166
60
1.200166
60
1.943333
60
1.943333
60
3.303666
60
3.304000
60
0.679666
60
1.200166
60
1.943333
20
2.046000
20
7.230000
60
3.303666
20
3.546500
56
2.159107
56
0.543750
56
1.462142
5
1.942000
10 29.404000
10 27.380000
10 27.968000
10 27.968000
10 27.968000
10 27.968000
5 31.884000
5 26.570000
5 31.884000
5 31.884000
5 10.538400
5
8.782000
1,801.340000
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
0.679666
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
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
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
DCI
COD ATC
127 N02AB03
128 N02AB03
129 N02AB03
130 N02AB03
131 N02AB03
132 N02AB03
133 N02AB03
134 N02AB03
135 N02AB03
136 N02AX02
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
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 N07BC02
171 N07BC02
172 N07BC02
173 N07BC02
174 R05DA04
175 R05DA04
176 R05DA04
177 R05DA04
178 R05DA04
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
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
TRAMADOLUM
METHADONUM
METHADONUM
METHADONUM
METHADONUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
CODEINUM
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
ZENTIVA K.S.
DOLFORIN 25 g/ORA
25g/ora
50mcg/h
FENTANYL ACTAVIS 50micrograme/h
50micrograme/h ACTAVIS GROUP PTC EHF.
DOLFORIN 50 g/ORA
DOLFORIN 75 g/ORA
TRAMADOL
K-ALMA (R)
TRAMADOL ARENA
TRAMACALM
TRAMAG 50
TRAMADOL EEL
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
COMPR.
COMPR.
COMPR. ELIB. PREL.
TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL.

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.

TRADOLAN RETARD 200 mg
TRADOLAN 50 mg
MABRON
MABRON
TRAMADOL
TRAMADOL
TRAMADOL
SINTALGON 2,5 mg
METADON BIOEEL 5 mg
MISYO 10 mg/ml
MISYO 10 mg/ml
FOSFAT DE CODEINA 15 mg
CODEINA FOSFORICA
FARMACOD
CODEINA FOSFAT
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.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SUPOZ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
CODEINA FOSFAT LPH 15 mg COMPR.
50g/ora
75mcg/h
75g/ora
50mg
50mg
50mg
50mg
50mg
50mg
50mg
100mg
100mg
100mg
100mg
100mg
100mg
150mg
150mg
150mg
150mg
150mg
150mg
200mg
200mg
200mg
200mg
200mg
50mg
150mg
200mg
50mg
50mg
100mg
100mg
50mg/ml
50mg/ml
100mg
2,5mg
5mg
10mg/ml
10mg/ml
15mg
15mg
15mg
15mg
15mg
SANDOZ S.R.L.
ZENTIVA K.S.
TARA
DET. APP
REPUBLICA CEHA
ROMANIA
ROMANIA
AMBALAJ
Prescriptie
NR.CRT
PS
P-TS
P-TS
ISLANDA
REPUBLICA CEHA
PS
PS
P-TS
P-TS
ROMANIA
ROMANIA
SANDOZ S.R.L.
ZENTIVA K.S.
REPUBLICA CEHA
PS
ROMANIA
P-TS
KRKA D.D.
SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
ANTIBIOTICE SA
P-RF

SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS.
P-RF
ZENTIVA A.S.
MAGISTRA C & C
BIO EEL SRL
P-RF
P-RF
P-RF
P-RF
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.
ZENTIVA AS
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
SLOVACIA
CIPRU
CIPRU
CIPRU
CIPRU
AUSTRIA
SLOVACIA
CIPRU
CIPRU
CIPRU
CIPRU
AUSTRIA
CIPRU
CIPRU
CIPRU
CIPRU
AUSTRIA
CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF

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

PRF
PRF
PRF
PRF
PRF
PRF
PRF
PRF
PRF
CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF
CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL.
P-RF
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
REPUBLICA SLOVACA
CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE
PRF
S/P-RF
S/P-RF
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
INN-FARM D.O.O.
INN-FARM D.O.O.
SINTOFARM SA
BIO EEL SRL
FARMACOM SA
SLAVIA PHARM SRL
CIPRU
CIPRU

SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ.
S/P-RF
P-RF
P-TS
ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR.
P-TS
SLOVENIA
SLOVENIA
PS
PS
ROMANIA
ROMANIA
ROMANIA
ROMANIA
Pagina 12 din 39
S/P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 CU SIGILIU DIN PE A 1000 ML CONC. PT. SOL. ORAL
CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPAC DIN PP 28 PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII, A 1000 ML CONC. PT. SOL. ORALA

P-RF
P-RF

P-RF
P-RF
P-RF

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
5 10.538400
5 10.538400
5 16.424000
5 15.444000
5 18.532800
5 18.532800
5 30.532000
5 32.076000
5 32.076000
20
0.299500
20
0.341400
20
0.341400
10
0.341400
20
0.284500
20
0.341400
20
0.341400
30
0.632400
30
0.630333
10
0.527000
30
0.528000
10
0.527000
30
0.528000
30
0.949599
30
0.904333
10
0.792000
30
0.791333
10
0.792000
30
0.791333
30
1.170666
10
1.055000
30
1.055333
10
1.055000
30
1.055333
30
0.330333
30
0.949599
30
1.266000
10
0.341400
10
0.341400
5
1.675320
100
1.396100
5
1.024000
5
1.675320
5
1.158000
50
0.506400
50
0.326000
1 387.080000
1 387.080000
30
0.181200
25
0.181200
20
0.151000
20
0.173500
20
0.165500
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
0.792000
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
387.080000
387.080000
0.181200
0.181200
0.151000
0.173500
0.165500
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
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
0.000000
0.000000
0.019133
0.024000
0.000000
0.000000
0.000000
DCI
COD ATC
179 R05DA04
180 V03AC01
181 V03AC03
182 V03AC03
183 V03AC03
CODEINUM
DEFEROXAMINUM**3)
DEFERASIROXUM***
DEFERASIROXUM***
DEFERASIROXUM***
Denumire Comerciala
forma farm.
CODEINA FOSFAT MCC 15 mg COMPR.
DESFERAL
EXJADE 125mg
EXJADE 250mg
EXJADE 500mg
COMPR. DISP.
COMPR. DISP.
COMPR. DISP.
concentratie
15mg
500mg
125mg
250mg
500mg
TARA
DET. APP
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT
P-RF
CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF. S/P-RF
MAREA BRITANIE
CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL)
MAREA BRITANIE
CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL)
MAREA BRITANIE
CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL)
PR
PR
PR

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
20
10
28
28
28
0.181200
13.266000
27.555357
52.592500
95.897142
0.181200
13.266000
27.555357
52.592500
95.897142
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
50
50
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
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
0.141800
0.141800
0.392200
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
0.142800
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
0.141800
0.141800
0.392200
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
0.039600
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
0.000000
0.000000
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
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
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
N03AA02
N03AA02
N03AA02
N03AA02
N03AB02
N03AB02
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
N03AF01
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
PHENOBARBITALUM
PHENOBARBITALUM
PHENOBARBITALUM
PHENOBARBITALUM
PHENYTOINUM
PHENYTOINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
CARBAMAZEPINUM
OXCARBAZEPINUM
OXCARBAZEPINUM
ACIDUM VALPROICUM + SARURI
LAMOTRIGINUM**
FENOBARBITAL ZENTIVA 100 mg
COMPR.
100 mg
100mg
100mg
SOL. INJ.
100 mg/ml
COMPR.
100mg
SOL. INJ.
250mg/5ml
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
200mg
COMPR.
400mg
COMPR.
400mg
COMPR. CU ELIB. PRELUNGITA 150mg
300mg
600mg
SUSP. ORALA
100mg/5ml
COMPR. FILM. 300mg
COMPR. FILM. 600mg
CAPS. MOI GASTROREZ. 150mg
MINICOMPR. ELIB. PREL. 1000mg
SIROP
57,64mg/ml
SIROP
57,64mg/ml
COMPR.
100mg
FENOBARBITAL ARENA 100mg COMPR.

FENOBARBITAL ARENA 100mg COMPR.
FENOBARBITAL ZENTIVA 100 mg/ml
FENITOINA RICHTER 100 mg

PHENHYDAN 250 mg/5 ml
TEGRETOL (R) 200
CARBAMAZEPINA LPH (R) 200 mg
CARBAMAZEPINA LPH 200 mg
CARBAVIM
CARBEPSIL 200mg
CARBAMAZEPIN
CARBAMAZEPIN EEL
CARBAMAZEPINA SLAVIA 200 mg
CARBAMAZEPINA TERAPIA 200 mg
CARBEPSIL 400mg

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
ZENTIVA SA
SC ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 10 COMPR.
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
P-6L
GERMANIA
P-RF
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L
CUTIE X 6 BLISTERE PVC-PVDC/AL X 10 COMPRIMATE
P-6L/S

SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
BIO EEL SRL
TERAPIA S.A.
AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR.
ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR.
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
PRF
P-6L
P-6L
GERMANIA
CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA
GERMANIA
GERMANIA
P6L
P6L
P6L
AUSTRIA
AUSTRIA
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
P-6L
P-6L
GERMANIA
CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE
P-6L
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
GERMANIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
FRANTA
FRANTA
FRANTA
GERMANIA


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
P-6L
P6L
CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ.
P-6L
P6L
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.
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
SANOFI - AVENTIS FRANCE
Pagina 13 din 39
P-6L
P-6L
P-6L
P-6L
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
88
89
90
91
92
93
94
COD ATC
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
N03AX11
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
DCI
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
TOPIRAMATUM**
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***
Denumire Comerciala
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
forma farm.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. DISP.
COMPR. DISP.
COMPR. DISP./MAST.
COMPR. DISP./MAST.
COMPR. FILM.
TOPIRAMAT ACTAVIS 100 mg COMPR. FILM.
LUSITRAX 100mg
TORLEPTA 100 mg
NEXTOP 100 mg
TOPAMAX 100 mg
TOPAMAX 100 mg
TOPILEX 100 mg
NEXTOP 200 mg
TOPRAN 25 mg
TOPIRAMAT ACTAVIS 25 mg
LUSITRAX 25 mg
TORLEPTA 25 mg
NEXTOP 25 mg
TOPAMAX 25 mg
TOPILEX 25 mg
TOPRAN 50 mg
TOPIRAMAT ACTAVIS 50 mg
LUSITRAX 50 mg
TORLEPTA 50 mg
NEXTOP 50 mg
TOPAMAX 50 mg
TOPAMAX 50 mg
TOPILEX 50 mg
GABAGAMMA 100 mg
GRIMODIN 100 mg

GABAGAMMA 300 mg
GABARAN 300 mg
GABALEPT 300 mg
GRIMODIN 300 mg

GABAGAMMA 400 mg
GABARAN 400 mg
GABALEPT 400 mg
GRIMODIN 400 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.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
concentratie
100mg
100mg
200mg
25mg
50mg
100mg
50mg
2mg
5mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg
200mg
25mg
25mg
25mg
25mg
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
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT
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
CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST. P-6L
GERMANIA

TERAPIA SA
ACTAVIS S.R.L.

ROMANIA CUTIE X 6 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM.
ROMANIA CUTIE CU BLIST. PVC-PCTFE-PVC/AL-PVDC X 30 COMPR. FILM.
REPUBLICA CEHA
P-6L
P-6L
P-6L
P-6L
P-RF
P-RF
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

SLOVENIA CUTIE CU 1 FLAC. PEID X 60 COMPR. FILM. P6L
AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L
TERAPIA SA
ACTAVIS S.R.L.

REPUBLICA CEHA
P-6L
P-RF
P-RF
P-RF
SLOVENIA
AUSTRIA
TERAPIA SA
ACTAVIS S.R.L.

REPUBLICA CEHA
P6L
P6L
P-6L
P-RF
P-RF
P-RF
SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L

SLOVENIA CUTIE CU 1 FLAC. PEID X 60 COMPR. FILM. P6L
AUSTRIA CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L
MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L
GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L

MAREA BRITANIE
MAREA BRITANIE
CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS.
MAREA BRITANIE
P-6L
P6L
P6L
RANBAXY UK LTD.
MAREA BRITANIE
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L

MAREA BRITANIE
MAREA BRITANIE
CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS.
MAREA BRITANIE
P-6L
P6L
P6L
RANBAXY UK LTD.
MAREA BRITANIE
PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L

Pagina 14 din 39
P-6L

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
30
28
30
28
30
30
30
30
30
60
60
30
30
30
28
60
30
30
60
60
30
30
30
28
30
60
60
30
30
30
28
60
30
50
100
60
50
100
60
50
100
50
100
60
50
100
60
50
100
50
100
60
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
0.527000
0.632400
0.632400
0.632400
5.168333
0.242799
0.242799
0.242799
0.242799
0.202333
0.242799
0.242799
0.413599
0.413599
0.413599
0.413599
0.344666
0.413599
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
0.692500
0.692520
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
0.527000
0.632400
0.632400
0.632400
5.168333
0.242799
0.242799
0.242799
0.242799
0.202333
0.242799
0.242799
0.413599
0.413599
0.413599
0.413599
0.344666
0.413599
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
0.692500
0.692520
0.000000
0.501757
0.000000
0.000000
0.086667
0.000000
0.000000
0.000000
0.000000
0.350266
0.347433
0.382933
0.382933
0.000000
0.879385
0.865100
0.381933
0.000000
0.147534
0.147367
0.148201
0.147534
0.000000
0.358272
0.146867
0.229067
0.212401
0.250401
0.233067
0.000000
0.608186
0.618067
0.233401
0.000000
0.015060
0.397460
0.288760
0.273660
0.228293
0.000000
0.236500
0.827000
0.000100
0.055900
0.000000
0.000000
0.377733
0.000000
0.500580
0.816480
0.000000
0.336813
95
96
97
98
99
COD ATC
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
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
DCI
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
GABAPENTINUM***
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**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
LEVETIRACETAMUM**
PREGABALINUM***
Denumire Comerciala
forma farm.

GABAPENTIN ARENA 400 mg CAPS.
GABARAN 600 mg
GRIMODIN 600 mg
GABARAN 800 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
LEVETIRACETAM TORRENT 1000 mg COMPR. FILM.
LEVETIRACETAM TERAPIA 1000 mg COMPR. FILM.
KEPPRA 1000 mg
COMPR. FILM.
LEVETIRACETAM ACTAVIS 1000mg COMPR. FILM.
LEVETIRACETAM TEVA 1000mg COMPR. FILM.
TRUND 1000 mg
COMPR. FILM.
EPILETAM 1000 mg
COMPR. FILM.
LEVETIRACETAM AUROBINDO 1000 mg COMPR. FILM.
MYAKELL 1000 mg
COMPR. FILM.
NORMEG 1000 mg
COMPR. FILM.
LEVELANZ 1000 mg
COMPR. FILM.
LEVELANZ 1000 mg
COMPR. FILM.
LEVETIRACETAM TEVA 250 mg COMPR. FILM.
KEPPRA 250 mg
COMPR. FILM.
TRUND 250 mg
COMPR. FILM.
EPILETAM 250 mg
COMPR. FILM.
MYAKELL 250 mg
COMPR. FILM.
LEVELANZ 250 mg
COMPR. FILM.
LEVELANZ 250 mg
COMPR. FILM.
KEPPRA 500 mg
COMPR. FILM.
LEVETIRACETAM TEVA 500 mg COMPR. FILM.
TRUND 500 mg
COMPR. FILM.
EPILETAM 500 mg
COMPR. FILM.
MYAKELL 500 mg
COMPR. FILM.
NORMEG 500 mg
COMPR. FILM.
LEVELANZ 500 mg
COMPR. FILM.
LEVELANZ 500 mg
COMPR. FILM.
MYAKELL 750 mg
COMPR. FILM.
LEVETIRACETAM DESITIN 1000 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
SOL. ORALA
SOL. ORALA
SOL. ORALA
SOL. ORALA
CAPS.
concentratie
400mg
400mg
400mg
600mg
600mg
800mg
1000 mg
1000 mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
1000mg
250 mg
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
DETINATOR APP
TARA
DET. APP
MAREA BRITANIE
MAREA BRITANIE

RANBAXY UK LTD. MAREA BRITANIE
UNGARIA
RANBAXY UK LTD.
MAREA BRITANIE
TERAPIA S.A.
UCB PHARMA SA
ROMANIA
TEVA PHARMA
BELGIA
ISLANDA
OLANDA
REPUBLICA CEHA
UNGARIA
MALTA
ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
MAREA BRITANIE
MAREA BRITANIE
TEVA PHARMA
OLANDA
TERAPIA S.A.
UCB PHARMA SA
ROMANIA
BELGIA
ISLANDA
REPUBLICA CEHA
UNGARIA
MALTA
ROMANIA
MAREA BRITANIE
MAREA BRITANIE
TERAPIA S.A.
UCB PHARMA SA
ROMANIA
TEVA PHARMA
BELGIA
ISLANDA
OLANDA
REPUBLICA CEHA
UNGARIA
MALTA
ROMANIA
ZENTIVA, K.S.
REPUBLICA CEHA
MAREA BRITANIE
MAREA BRITANIE

ROMANIA
GERMANIA
GERMANIA
GERMANIA
GERMANIA
UCB PHARMA SA
ISLANDA
BELGIA
REPUBLICA CEHA

PFIZER LIMITED
MAREA BRITANIE
Pagina 15 din 39
AMBALAJ
Prescriptie
NR.CRT

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
50
100
CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L
60
CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
30
60
CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L
30
CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. P-RF
30
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMP.FILM. PRF
30
CUTIE X 30 COMPR. FILM.1 (BLIST. AL/PVC) P-RF
30
CUTIE CU BLIST. DIN AL/PVC X 30 COMPR. FILM. PRF
30
CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR.FILM. PRF
30
CUTIE CU 6 BLIST. AL/PVC-PE-PVDC X 10 COMPR. FILM. PRF
60
30
CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. PRF
30
CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF
30
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM. PRF
30
28
28
30
CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF
30
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF
30
CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF
30
30
60
30
30
30
28
28
30
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.FILM. PRF
30
CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC) P-RF
30
30
30
60
30
30
30
CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.FILM. PRF
30
28
28
30
30
PRF
30
PRF
30
PRF
30
PRF
60
PRF
1
CUTIE X 1 FLACON X 300 ML SOL. ORALA + SERINGA PT. ADMIN. ORALA
P-RF
1
PRF
1
PRF
1
CUTIE X 14 CAPS., (BLIST. PVC/AL) P-RF
14
CUTIE CU 30 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE

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 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
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
0.525999
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
3.029570
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
0.525999
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
3.029570
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
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
1.351144
COD ATC
147 N03AX16
148 N03AX16
149 N03AX16
150 N03AX16
151 N03AX16
152 N03AX16
153 N03AX16
154 N03AX16
155 N03AX16
156 N03AX17
157 N03AX17
158 N03AX17
159 N03AX17
DCI
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
PREGABALINUM***
STIRIPENTOLUM**
STIRIPENTOLUM**
STIRIPENTOLUM**
STIRIPENTOLUM**
forma farm.
Denumire Comerciala
LYRICA 150 mg
CAPS.
PREGABALIN ZENTIVA 150 mg CAPS.
LYRICA 300 mg
CAPS.
LYRICA 300 mg
CAPS.
LYRICA 75 mg
CAPS.
LYRICA 75 mg
CAPS.
PREGLENIX 75 mg
CAPS.
PREGLENIX 75 mg
CAPS.
PREGABALIN ZENTIVA 75 mg CAPS.
DIACOMIT 250mg
CAPS.
DIACOMIT 500mg
CAPS.
DIACOMIT 250mg
DIACOMIT 500mg
concentratie
150mg
150mg
300mg
300mg
75mg
75mg
75mg
75mg
75mg
250mg
500mg
250mg
500mg
DETINATOR APP
PFIZER LIMITED
ZENTIVA, K.S.
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
TARA
DET. APP
MAREA BRITANIE
REPUBLICA CEHA
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
REPUBLICA CEHA
REPUBLICA CEHA
ZENTIVA, K.S.
BIOCODEX
BIOCODEX
BIOCODEX
BIOCODEX
REPUBLICA CEHA
FRANTA
FRANTA
FRANTA
FRANTA
AMBALAJ

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
Prescriptie
NR.CRT
P-RF
PRF
P-RF
P-RF
P-RF
P-RF
PRF
PRF
PRF
P-RF/R
P-RF/R
P-RF/R
P-RF/R

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
56
56
56
14
14
56
14
56
56
60
60
60
60
3.029570
2.524642
5.731785
6.045000
1.597285
1.597285
1.597285
1.597285
1.331071
12.749333
25.643166
12.749333
25.643166
3.029570
2.524642
5.731785
6.045000
1.597285
1.597285
1.597285
1.597285
1.331071
12.749333
25.643166
12.749333
25.643166
0.866680
0.000000
0.000000
0.000000
1.035572
0.816643
0.170572
0.027715
0.000000
0.000000
0.000000
0.000000
0.000000
50
0.562400
100
0.773600
7 452.308571
100
1.782700
100
2.139000
100
1.782500
100
2.139000
100
1.782500
100
1.851000
100
2.221200
100
1.851000
100
1.994800
100
2.393760
100
1.995000
100
1.646200
100
1.975440
100
1.646200
100
1.515120
100
1.262600
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
0.562400
0.773600
452.308571
1.782700
2.139000
1.782500
2.139000
1.782500
1.851000
2.221200
1.851000
1.994800
2.393760
1.995000
1.646200
1.975440
1.646200
1.515120
1.262600
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
0.000000
0.000000
0.000000
0.000000
0.603400
0.000000
0.603400
0.000000
0.000000
0.626500
0.000000
0.000000
0.675440
0.000000
0.000000
0.557260
0.000000
1.325480
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
Tratamentul se iniiaz de ctre medicul n specialitatea neurologie i neurologie pediatric.
10. BOALA PARKINSON - G12

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
N04AA01
TRIHEXYPHENIDYLUM
ROMPARKIN (R) 2 mg
ISICOM 250 mg/25 mg
COMBINATII (LEVODOPUM+CARBIDOPUM)** DUODOPA
N04BA02 COMBINATII (LEVODOPUM+CARBIDOPUM)**

N04BA02
N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** TADOGLEN 100 mg/25 mg/200 mg

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)***
STALEVO 100 mg/25 mg/200 mg
LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 100 mg/25 mg/200 mg
N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** STALEVO 125 mg/31,25 mg/200 mg

LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 125 mg/31,25 mg/200 mg
N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** TADOGLEN 150 mg/37,5 mg/200 mg

N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** TADOGLEN 200 mg/50 mg/200 mg

STALEVO 200 mg/50 mg/200 mg
LEVODOPA/CARBIDOPA/ENTACAPONA TEVA 200 mg/50 mg/200 mg
N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** TADOGLEN 50 mg/12,5 mg/200 mg


N04BB01
N04BC01
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
N04BC04
AMANTADINUM**
BROMOCRIPTINUM
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
ROPINIROLUM**
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
COMPR.
COMPR.
GEL INT.
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.
DRAJ.
ROPINIROL AUROBINDO 2 mg COMPR. ELIB. PREL.
ROPINIROL ACTAVIS 2 mg
COMPR. ELIB. PREL.
2mg
TERAPIA SA
250mg/25mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 10 BLIST. PP/AL X 10 COMPR.
FARA CONCENTRATIE
ABBVIE DEUTSCHLAND GMBH & CO. KG
GERMANIA
100mg/25mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA
100mg/25mg/200mg
ROMANIA
P-6L
S/P-RF
CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. PRF
ORION CORPORATION FINLANDA CUTIE X 1 FLAC. PEID X 100 COMPR. FILM.
100mg/25mg/200mg TEVA PHARMACEUTICALS S.R.L.

125mg/31,25mg/200mg
CUTIE X 7 CASETE BRUNE TRANSPARENTE X 100 GEL INT. IN PUNGA PVC
P-6L
P-RF
CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF
ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF
125mg/31,25mg/200mg TEVA PHARMACEUTICALS S.R.L.
ROMANIA
150mg/37,5mg/200 mg
REPUBLICA CEHA
150mg/37,5mg/200mg
150mg/37,5mg/200mg
P-RF
ROMANIA
200mg/50mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA
200mg/50mg/200mg
P-RF
200mg/50mg/200mg TEVA PHARMACEUTICALS S.R.L.
ROMANIA
50mg/12,5 mg/200 mg
REPUBLICA CEHA
50mg/12,5mg/200mg
50mg/12,5mg/200mg TEVA PHARMACEUTICALS S.R.L.
ROMANIA
P-RF
75mg/18,75mg/200mg
ORION CORPORATION FINLANDA CUTIE X 1 FLAC. HDPE X 100 COMPR. FILM. PRF
75mg/18,75mg/200mg
100mg
2,5mg
2mg
2mg
4mg
4mg
8mg
8mg
2 mg
4 mg
8 mg
2 mg
2mg
ROMANIA CUTIE CU 1 FLAC. ALB DIN PEID X 100 COMPR. FILM. PRF
P-6L
ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 DRAJ. P-RF
ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG. PRF
BIOFARM SA
SMITHKLINE BEECHAM PLC
MAREA BRITANIE
CUTIE CU BLIST. PVC-PCTFE-PVC/AL X 28 COMPR. CU ELIB. PREL.
ROMANIA
CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG.
PRF
MAREA BRITANIE
P-RF
ROMANIA
CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. ELIB. PRELUNG.
PRF
MAREA BRITANIE
P-RF
KRKA ,D.D., NOVO MESTO SLOVENIA
CUTIE CU BLIST. OPA - AL - PVC/AL X 28 COMPR. ELIB. PREL.
PRF
PRF
PRF
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ELIB. PREL.
PRF
Pagina 16 din 39
MALTA
ISLANDA
P-RF
CUTIE CU BLIST. AL/AL X 28 COMPR. ELIB. PREL. PRF
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
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
COD ATC
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
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC05
N04BC09
N04BC09
N04BC09
N04BC09
N04BD01
N04BD01
N04BD02
N04BX02
N04BX02
DCI
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**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
PRAMIPEXOLUM**
ROTIGOTINUM***
ROTIGOTINUM***
ROTIGOTINUM***
ROTIGOTINUM***
SELEGILINUM
SELEGILINUM
RASAGILINUM***
ENTACAPONUM***
ENTACAPONUM***
Denumire Comerciala
NERVAMAT 2 mg
forma farm.
COMPR. ELIB. PREL.
NERVAMAT 4 mg
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
NERVAMAT 8 mg
COMPR. ELIB. PREL.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
OPRYMEA 0,088mg
OPRYMEA 0,18mg
MEDOPEXOL 0,18 mg
GLEPARK 0,18 mg
MIGLASEN 0,18 mg
OPRYMEA 0,7mg
MEDOPEXOL 0,7 mg
GLEPARK 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
OPRYMEA 2,62 mg
MIRAPEXIN 3,15 mg
OPRYMEA 3,15 mg
NEUPRO 2mg/24h
NEUPRO 4mg/24h
NEUPRO 6mg/24h
NEUPRO 8mg/24h
SELEGOS
SELEGOS
AZILECT 1mg
COMTAN 200mg
ENTACAPONE TEVA
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.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
concentratie
2mg
4 mg
4mg
4mg
8 mg
8mg
8mg
0,088 mg
0,088mg
0,18 mg
0,18 mg
0,18 mg
0,18mg
0,18mg
0,18mg
0,18mg
0,18mg
0,18mg
0,7 mg
0,7 mg
0,7mg
0,7mg
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
2,62mg
3,15mg
3,15mg
2mg/24h
4mg/24h
6mg/24h
8mg/24h
5mg
5mg
1mg
200mg
200mg
Prescriptie
NR.CRT
DETINATOR APP
TARA
DET. APP
UNGARIA
CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL.
PRF
MALTA
PRF
UNGARIA

ISLANDA
MALTA
UNGARIA
ISLANDA
ACCORD HEALTHCARE LIMITED MAREA BRITANIE
KRKA D.D.
SLOVENIA

ZENTIVA, K.S.
REPUBLICA CEHA
KRKA D.D.
SLOVENIA
REPUBLICA CEHA

MALTA
MALTA
ZENTIVA, K.S.
REPUBLICA CEHA
KRKA D.D.
SLOVENIA
REPUBLICA CEHA


GERMANIA
KRKA D.D.
SLOVENIA
GERMANIA
KRKA D.D.
SLOVENIA
GERMANIA
KRKA D.D.
KRKA D.D.
KRKA D.D.
SLOVENIA
SLOVENIA
SLOVENIA
GERMANIA

GERMANIA
IRLANDA
IRLANDA
UCB MANUFACTURING IRELAND LTD. IRLANDA
UCB MANUFACTURING IRELAND LTD. IRLANDA
UCB MANUFACTURING IRELAND LTD.
UCB MANUFACTURING IRELAND LTD.
TEVA PHARMA GMBH GERMANIA

MAREA BRITANIE

Pagina 17 din 39
AMBALAJ

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
28
28
CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF
28
28
PRF
28
CUTIE CU 4 BLIST. PVC-PCTFE/AL X 7 COMPR. ELIB. PREL. PRF
28
28
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
CUTIE X 3 BLIST. OPA-AL -PVC/AL X 10 COMPR. P-RF
30
30
CUTIE CU 1 BLIST.OPA-AL-PVC/AL X 10 COMPR. P-RF
10
P-RF
30
CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF
10
30
P-RF
30
30
30
P-RF
30
P-RF
30
P-RF
30
30
30
CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF
30
30
CUTIE X BLIST. OPA-AL/DESICANT/PE/AL X 30 COMPR. ELIB. PREL. PRF
30
CUTIE X 28 PLASTURI TRANSDERMICI P-RF
28
28
28
28
CUTIE X 5 BLIST. DIN AL/PVC X 10 COMPR. P-6L
50
CUTIE X 10 BLIST. DIN AL/PVC X 10 COMPR. P-6L 100
CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF
30
P-RF
100
CUTIE X 1 FLAC. DIN PEID X 100 COMPR. FILM PRF 100

CUTIE X 1 FLAC. DIN STICLA BRUNA CU SISTEM DE INCHIDERE SECURIZAT X 100 COMPR. FILM.
0.916071
1.772857
1.772857
1.772857
3.044642
3.044642
3.044642
0.523333
0.530000
0.322666
0.322500
0.386666
0.387000
0.387000
0.322666
0.387000
0.387000
0.387000
1.889333
2.041680
2.028000
2.034333
2.041680
1.889333
2.041680
2.027333
1.701400
2.041680
0.763200
0.636000
0.636000
1.679599
1.399666
1.399666
2.550000
2.125000
5.049333
4.722333
5.666799
4.722333
8.426666
9.320799
7.767333
7.975714
11.431428
14.614285
17.376071
0.725200
0.701100
14.349333
1.922280
1.601900
0.916071
1.772857
1.772857
1.772857
3.044642
3.044642
3.044642
0.523333
0.530000
0.322666
0.322500
0.386666
0.387000
0.387000
0.322666
0.387000
0.387000
0.387000
1.889333
2.041680
2.028000
2.034333
2.041680
1.889333
2.041680
2.027333
1.701400
2.041680
0.763200
0.636000
0.636000
1.679599
1.399666
1.399666
2.550000
2.125000
5.049333
4.722333
5.666799
4.722333
8.426666
9.320799
7.767333
7.975714
11.431428
14.614285
17.376071
0.725200
0.701100
14.349333
1.922280
1.601900
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.039666
0.264333
0.000000
0.203666
0.136333
0.127000
0.000000
0.067320
0.000000
0.000000
0.214986
0.000000
0.396320
0.000000
0.000000
0.405986
0.755800
0.000000
0.000000
0.473734
0.000000
0.000000
1.552000
0.000000
0.000000
0.000000
1.598201
0.000000
0.000000
2.629201
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.542220
0.000000
85
86
87
88
89
COD ATC
N04BX02
N04BX02
N04BX02
N05AH02
N05AH02
DCI
ENTACAPONUM***
ENTACAPONUM***
ENTACAPONUM***
CLOZAPINUM**
CLOZAPINUM**
Denumire Comerciala
ENCAPIA 200 mg
ENCAPIA 200 mg
ENCAPIA 200 mg
LEPONEX (R) 100 mg
LEPONEX (R) 25 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
concentratie
200mg
200mg
200mg
100mg
25mg
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT


P-RF

SINTOFARM SA
ROMANIA

P-RF

P-RF

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
30
60
100
50
50
1.779000
1.689166
1.601900
1.274200
0.386200
1.779000
1.689166
1.601900
1.274200
0.386200
0.000000
0.000000
0.000000
0.000000
0.000000
20
0.108399
30
0.090333
30
0.108399
20
0.108399
1 374.090000
1 82.990000
1 64.090000
1 61.880000
1 118.008000
1 46.730000
1 79.700000
1 98.340000
1 56.076000
1 110.680000
1 74.880000
100
0.702300
100
0.702300
100
0.788900
20
0.712000
60
0.688833
20
0.618500
0.108399
0.090333
0.108399
0.108399
374.090000
82.990000
64.090000
61.880000
118.008000
46.730000
79.700000
98.340000
56.076000
110.680000
74.880000
0.702300
0.702300
0.788900
0.712000
0.688833
0.618500
0.028601
0.000000
0.015267
0.025101
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
0.000000
0.000000
50
0.543200
20
1.234000
1 20.480000
1
8.810000
1 31.020000
20
0.108399
30
0.090333
30
0.108399
20
0.108399
1 374.090000
1 82.990000
1 64.090000
1 61.880000
1 118.008000
0.543200
1.234000
20.480000
8.810000
31.020000
0.108399
0.090333
0.108399
0.108399
374.090000
82.990000
64.090000
61.880000
118.008000
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
9.082000
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
21
H02AB07
H02AB07
H02AB07
H02AB07
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L04AX01
L04AX01
L04AX01
N07AA01
N07AA01
N07AA02
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
PYRIDOSTIGMINI BROMIDUM
PREDNISON MCC 5 mg
PREDNISON 5 mg
COMPR.
COMPR.
COMPR.
METHOTREXAT "EBEWE" 5000 mg
CONC. PT. SOL. INJ./PERF.
BENDATREXAT
METOTREXAT EBEWE 10 mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
IMURAN
IMURAN
IMMUNOPRIN 75 mg
MESTINON 60 mg
SOL INJ.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR.
COMPR.
DRAJ.
5mg
5mg
5mg
5mg
100mg/ml
100mg/ml
25mg/ml
10mg/ml
10mg/ml
10mg/ml
10mg/ml
50mg/ml
50mg/ml
50mg/ml
50mg/ml
50mg
50mg
75mg
15mg
15mg
60mg
P-RF
P-RF
P-RF
AUSTRIA CUTIE X 1 FLACON X 50 ML

AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML
ROMANIA CUTIE CU 1 FLAC. X 2 ML
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE
S
S
PR
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
P-RF
GERMANIA
P-RF
GERMANIA
P-RF
GERMANIA
CUTIE X 1 SERINGA PREUMPLUTA X 0.30ML SOLUTIA INJECTABILA PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

CN UNIFARM S.A.
CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ

IRLANDA
AUSTRIA
P-RF
S/P-RF
S/P-RF
PR

LABORMED PHARMA SA ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR.
P-6L
MEDA AB
SUEDIA
CUTIE X 1 FLAC. X 20 DRAJ.
S/P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
MAREA BRITANIE
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
H02AB04
H02AB04
H02AB04
H02AB04
H02AB04
H02AB07
H02AB07
H02AB07
H02AB07
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
MEDROL A 16
MEDROL 32
LEMOD SOLU 125 mg

LEMOD SOLU 500 mg
PREDNISON MCC 5 mg
PREDNISON 5 mg
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
BENDATREXAT
SOL INJ.
16mg
32mg
250mg/4ml
125mg
500mg
5mg
5mg
5mg
5mg
100mg/ml
100mg/ml
25mg/ml
10mg/ml
10mg/ml
P-RF
S/P-RF
S/P-RF

SINTOFARM SA
ROMANIA
CN UNIFARM S.A.
Pagina 18 din 39


AUSTRIA
AUSTRIA
P-RF
P-RF
P-RF
P-RF
S
S
PR
PR
PR
15
16
17
18
19
20
21
22
23
24
COD ATC
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01DB07
L04AX01
L04AX01
L04AX01
DCI
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
MITOXANTRONUM***
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
Denumire Comerciala

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
ONKOTRONE
IMURAN
IMURAN
IMMUNOPRIN 75 mg
forma farm.
CONC. PT. SOL. INJ.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
10mg/ml
10mg/ml
50mg/ml
50mg/ml
50mg/ml
50mg/ml
2mg/ml
50mg
50mg
75mg
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT
PR
PR
GERMANIA
P-RF
GERMANIA
P-RF
GERMANIA
P-RF
GERMANIA
P-RF
AUSTRIA
AUSTRIA
BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ.
S/P-RF

IRLANDA
AUSTRIA
S/P-RF
PR

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
1 46.730000
1 79.700000
1 98.340000
1 56.076000
1 110.680000
1 74.880000
1 555.760000
100
0.702300
100
0.702300
100
0.788900
46.730000
79.700000
98.340000
56.076000
110.680000
74.880000
555.760000
0.702300
0.702300
0.788900
0.000000
0.000000
0.000000
13.944000
0.000000
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
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
2.787333
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
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.432000
0.000000
0.000000
0.000000
0.000000
0.000000
Tratamentul se iniiaz de ctre medicul din specialitatea neurologie.
13. BOLI PSIHICE (SCHIZOFRENIE, TULBURRI SCHIZOTIPALE I DELIRANTE, TULBURRI AFECTIVE MAJORE, TULBURRI PSIHOTICE ACUTE I BOLI PSIHICE COPII, AUTISM, TULBURRI CU
DEFICIT DE ATENIE/HIPERREACTIVITATE) - G15
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
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AG01
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N03AX09
N04AA01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AD01
N05AE03
N05AE03
N05AE04

LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
LAMOTRIGINUM**
TRIHEXYPHENIDYLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
HALOPERIDOLUM
SERTINDOL**
SERTINDOL**
ZIPRASIDONUM**
ORFIRIL LONG 150 mg

CAPS. ELIB. PREL.
CONVULEX (R) 150 mg
CAPS. MOI GASTROREZ.
CONVULEX 150 mg
CONVULEX (R) 300 mg
CONVULEX 300 mg
CONVULEX (R) 500 mg
CONVULEX 500 mg
DEPAKINE CHRONO 300 mg COMPR. ELIB. PREL.
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
ROMPARKIN (R) 2 mg
HALOPERIDOL LAROPHARM 0,5 mg
HALOPERIDOL ARENA 1 mg
HALOPERIDOL ARENA 2 mg
HALDOL
HALOPERIDOL ROMPHARM 2 mg/ml
HALOPERIDOL 2 mg/ml
HALOPERIDOL DECANOAT
HALOPERIDOL RICHTER 5 mg/ml
SERDOLECT 16 mg
SERDOLECT 4 mg
ZYPSILA 40 mg
150mg
150mg
150mg
300mg
300mg
500mg
500mg
300mg
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.
2mg
COMPR.
0,5mg
COMPR.
1mg
COMPR.
2mg
COMPR.
5mg
PIC. ORALE, SOL. 2 mg/ml
SOL. INJ.
50mg/ml
SOL. INJ.
5mg/ml
COMPR. FILM. 16mg
COMPR. FILM. 4mg
CAPS.
40mg
50
100
CUTIE CU 5 BLIST. PVDC-PVC/AL X 20 CAPS. MOI GASTROREZ. P6L
100
CUTIE X 10 BLIST. AL/PVDC-PVC X 10 CAPS. MOI GASTROREZ. P-6L
100
100
CUTIE X 10 BLIST. AL/PVDC-PVCX 10 CAPS. MOI GASTROREZ. P-6L
100
100
CUTIE X 2 FLAC. DIN PP X 50 COMPR. ELIB. PREL. P-6L 100
CUTIE X 1 FLAC. PP X 30 COMPR. FILM. ELIB. PREL. P-RF
30
CUTIE X 1 FLAC. DIN PP X 40 COMPR. GASTROREZ. P-6L
40
DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 50 MINIPLICURI. DIN PET/AL/PE CU MINICOMPR. CU ELIB. PRELUNG.
P-6L
50
SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 SERINGA PT. ADMIN. ORALA P-6L
1
SANOFI - AVENTIS FRANCE FRANTA CUTIE X 1 FLACON X 150 ML + 1 LINGURITA DOZATOARE P-6L
1
30
DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 3 BLIST. X 10 COMPR.
P-6L
30
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L
28
30
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 28 COMPR. P-6L
28
30
ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L
30
ACTAVIS GROUP HF. ISLANDA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. DISPERSABILE P-6L
30
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 COMPR. DISP./MAST. P-6L
30
THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. DISP./MAST. P-6L
30
TERAPIA SA
50
LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
20
ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF
30
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF
30
25
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF
1
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF
1
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML
P-RF
5
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.
P-RF
5
H. LUNDBECK A/S DANEMARCA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-RF
28
H. LUNDBECK A/S DANEMARCA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF
30
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF
60
GERMANIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
FRANTA
FRANTA
FRANTA
Pagina 19 din 39
CUTIE X 1 FLAC. DIN PP X 50 CAPS. CU MINICOMPR. CU ELIB. PRELUNG.
P-6L
P-6L
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
0.562400
0.168000
0.267000
0.373333
0.299600
5.390000
6.468000
8.452000
2.206000
14.899285
3.767000
2.787333
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
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
COD ATC
N05AE04
N05AE04
N05AF01
N05AF05
N05AF05
N05AF05
N05AF05
N05AF05
N05AH02
N05AH02
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
N05AH03
N05AH03
N05AH03
N05AH03
DCI
ZIPRASIDONUM**
ZIPRASIDONUM**
FLUPENTIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
ZUCLOPENTHIXOLUM**
CLOZAPINUM**
CLOZAPINUM**
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
ZYPSILA 60 mg
ZYPSILA 80 mg
FLUANXOL DEPOT
CLOPIXOL 10 mg
CLOPIXOL 25 mg
CLOPIXOL 20 mg/ml
CLOPIXOL (R) DEPOT
CLOPIXOL ACUPHASE (R)
LEPONEX (R) 100 mg
LEPONEX (R) 25 mg
ZALASTA 10mg
OLAZAX 10 mg
ZALASTA 5mg
OLAZAX 5 mg
ZYPREXA 10 mg
LAPOZAN 10 mg
LAPOZAN 10 mg
OLANZAPINA ACTAVIS 10 mg
BLOONIS 10 mg
LAPOZAN 15 mg
EGOLANZA 15 mg
EGOLANZA 20 mg
ZYPREXA 5 mg
LAPOZAN 5 mg
LAPOZAN 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
IRROPIA 10 mg
OLANZAPINA TORRENT 10 mg
WRANELON 10 mg
OLANZAPINA AUROBINDO 10 mg
ZALASTA 15mg
LAPOZAN 15 mg
BLOONIS 15 mg
IRROPIA 15 mg
WRANELON 15 mg
forma farm.
CAPS.
CAPS.
SOL. INJ.
COMPR. FILM.
COMPR. FILM.
concentratie
60mg
80mg
20mg/ml
10mg
25mg
SOL. INJ.
200mg/ml
SOL. INJ.
50mg/ml
COMPR.
100mg
COMPR.
25mg
COMPR.
10mg
COMPR.
10mg
COMPR.
5mg
COMPR.
5mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 10mg
COMPR. FILM. 15mg
COMPR. FILM. 15mg
COMPR. FILM. 20mg
COMPR. FILM. 5mg
COMPR. FILM. 5mg
COMPR. FILM. 5mg
COMPR. FILM. 5mg
COMPR. FILM. 5mg
COMPR. ORODISPERSABILE 10mg
TARA
DET. APP
AMBALAJ
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC-PVDC/AL X 10 CAPS.
DETINATOR APP
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
H. LUNDBECK A/S
Prescriptie
NR.CRT
P-RF
P-RF
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
DANEMARCA
DANEMARCA

P-RF
P-RF
P-RF
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)
P-RF
CUTIE CU BLIST. AL/AL X 28 COMPR.
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 28 COMPR., (BLISTER OPA/AL/PVC/AL)
P-RF
CUTIE CU BLIST. AL/AL X 28 COMPR.
P-RF
CUTIE X 28 COMPR. FILM. ( BLIST.AL ABUTISATE LA RECE)
P-RF
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
P-RF
P-RF
P-RF
P-RF
CUTIE X 28 COMPR.ORODISPERSABILE. (BLISTER OPA/AL/PVC/AL)
P-RF
REPUBLICA CEHA
REPUBLICA CEHA
OLANDA
ROMANIA

UNGARIA
UNGARIA
OLANDA
ROMANIA
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. ORODISP.
P-RF
ROMANIA
CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE
P-RF
REPUBLICA CEHA
CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE
P-RF
P-RF
P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. ORODISPERSABILE
P-RF
P-RF
P-RF

ROMANIA
ROMANIA
ISLANDA
ROMANIA
GALENICA S.A.
GRECIA
MALTA
CUTIE CU 4 BLIST. AL/AL X 7 COMPR. ORODISPERSABILE
PRF
P-RF
CUTIE CU BLIST. OPA-AL-PVC/AL X 28 (4X7) COMPR. ORODISPERSABILE
PRF
CUTIE CU BLISTERE DIN PA/AL+EAA-PE+DESICANT-PED//AL-PE X 28 COMPR. ORODISPERSABILE
PRF
P-RF
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
P-RF
ROMANIA
P-RF
REPUBLICA CEHA
P-RF
P-RF
P-RF
P-RF
P-RF

ROMANIA
ROMANIA
ISLANDA
ROMANIA
GALENICA S.A.
Pagina 20 din 39
GRECIA
MALTA
PRF
P-RF
PRF
PRF

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
60
60
10
50
50
1
10
5
50
50
28
28
28
28
28
28
30
30
28
28
28
28
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
4.212166
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
2.440713
2.440713
2.764285
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
4.212166
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
2.440713
2.440713
2.764285
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
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
4.871787
5.162501
6.115000
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
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
100 N05AH03
101 N05AH03
102 N05AH03
103 N05AH03
104 N05AH03
105 N05AH03
106 N05AH03
107 N05AH03
108 N05AH03
109 N05AH03
110 N05AH03
111 N05AH03
112 N05AH03
113 N05AH03
114 N05AH03
115 N05AH03
116 N05AH03
117 N05AH04
118 N05AH04
119 N05AH04
120 N05AH04
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
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**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
Denumire Comerciala
OLANZAPINA POLPHARMA 20 mg
ZALASTA 20mg
BLOONIS 20 mg
IRROPIA 20 mg
WRANELON 20 mg
ZALASTA 5mg
OLANZAPINE TEVA 5mg
LAPOZAN 5 mg
LAPOZAN 5 mg
IRROPIA 5 mg
WRANELON 5 mg
OLANZAPINA TORRENT 7,5 mg
ZYPADHERA 210mg
ZYPADHERA 300mg
ZYPADHERA 405mg
ZYPREXA 10 mg
SEROQUEL XR 150 mg
QUETIAPINA TEVA 150 mg
KETILEPT 100 mg
QUETIAPINE TEVA 100 mg
KVENTIAX 100 mg
QUETROP 100 mg
Q MIND 100 mg
KATHIRA 100 mg
KATHIRA 150 mg
KETILEPT 200 mg
KVENTIAX 200 mg
QUETROP 200 mg
Q MIND 200 mg
KATHIRA 200 mg
KATHIRA 25 mg
KETILEPT 300 mg
KVENTIAX 300 mg
forma farm.
concentratie
20 mg
COMPR. ORODISPERSABILE 7,5mg
210mg
300mg
405mg
COMPR. FILM. 100mg
COMPR. FILM. 100mg
COMPR. FILM. 100mg
COMPR. FILM. 100mg
COMPR. FILM. 100mg
COMPR. FILM. 100mg
COMPR. FILM. 150mg
COMPR. FILM. 200mg
COMPR. FILM. 200mg
COMPR. FILM. 200mg
COMPR. FILM. 200mg
COMPR. FILM. 200mg
COMPR. FILM. 200mg
COMPR. FILM. 25mg
COMPR. FILM. 300mg
COMPR. FILM. 300mg
COMPR. FILM. 300mg
DETINATOR APP
TARA
DET. APP
POLONIA
AMBALAJ
Prescriptie
NR.CRT
CUTIE CU BLIST. DIN AL/OPA-AL-PVC X 28 COMPR. ORODISP.
PRF
P-RF
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
P-RF
ROMANIA
P-RF
REPUBLICA CEHA
P-RF
P-RF
P-RF
P-RF
ROMANIA
ROMANIA
ISLANDA
ROMANIA
GALENICA S.A.
GRECIA
MALTA
PRF
P-RF
PRF
PRF
P-RF
TEVA PHARMA BV
TERAPIA S.A.
OLANDA
CUTIE X 30 COMPR. FILM. (BLIST. OPA-AL-PVC/AL) P-RF
ROMANIA
P-RF
REPUBLICA CEHA
P-RF
P-RF
P-RF

ROMANIA
P-RF
ISLANDA
P-RF
ROMANIA
GALENICA S.A.
GRECIA
MALTA
PRF
P-RF
PRF
PRF
P-RF
CUTIE X 1 FLAC X 210MG PULB. + 1 FLAC. X 3ML SOLVENT
P-RF/R
P-RF/R
P-RF/R
OLANDA
OLANDA
OLANDA
OLANDA
ASTRAZENECA UK LIMITED
MAREA BRITANIE
CUTIE CU 6 BLIST. PVC-PCTFE/AL X 10 COMPR. ELIB. PREL.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
UNGARIA
ROMANIA
CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. FILM. PRF

TEVA PHARMACEUTICAL S.R.L.
CUTIE X 1 FLAC. X 10 MG PULB.PT.SOL.INJ. P-RF

P-RF
CUTIE CU BLIST. PVC/ACLAR-AL X 60 COMPR. CU ELIB. PREL.
PRF
PRF
PRF
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
REPUBLICA CEHA
CUTIE CU 6 BLIST. PVC/AL X 10 COMPR. FILM. P-RF
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF

UNGARIA
ROMANIA
CUTIE CU 6 BLIST. OPACE DIN PVC/AL X 10 COMPR. FILM.
PRF
PRF

P-RF/S
REPUBLICA CEHA

UNGARIA
ROMANIA
PRF
PRF

P-RF/S
Pagina 21 din 39

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
28
2.764285
28
2.303571
30
2.304000
28
2.764285
28
2.764285
28
2.764285
35
2.764285
28
2.749642
28
2.764285
28
2.764285
28
2.764285
28
2.764285
28
0.440357
30
0.443666
28
0.446400
28
0.446400
30
0.446400
50
0.446400
35
0.446400
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
1.770199
60
1.475166
60
1.953500
60
2.752000
60
3.405166
60
0.742500
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
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
0.446400
0.446400
0.446400
0.446400
0.446400
3.313571
650.040000
916.710000
1,223.460000
20.710000
1.770199
1.475166
1.953500
2.752000
3.405166
0.742500
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
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
0.015742
0.107885
1.598600
0.107885
0.107885
0.000000
0.000000
0.000000
0.000000
0.000000
1.316134
0.000000
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
COD ATC
140 N05AH04
141 N05AH04
142 N05AH04
143 N05AH04
144 N05AH04
145 N05AH04
146 N05AH04
147 N05AL01
148 N05AL01
149 N05AL01
150 N05AL05
151 N05AL05
152 N05AL05
153 N05AL05
154 N05AX08
155 N05AX08
156 N05AX08
157 N05AX08
158 N05AX08
159 N05AX08
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
DCI
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
QUETIAPINUM**
SULPIRIDUM
SULPIRIDUM
SULPIRIDUM
AMISULPRIDUM**
AMISULPRIDUM**
AMISULPRIDUM**
AMISULPRIDUM**
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**
RISPERIDONUM**
RISPERIDONUM**
Denumire Comerciala
QUETROP 300 mg
Q MIND 300 mg
KATHIRA 300 mg
SEROQUEL XR 200 mg
SEROQUEL XR 300 mg
SEROQUEL XR 400 mg
SEROQUEL XR 50 mg
EGLONYL (R) 50 mg
EGLONYL 50 mg
EGLONYL (R) 200 mg
AMISULPRIDA LPH 200 mg
MIDORA 200 mg
SOLIAN 200 mg
SOLIAN 400 mg
RISPERIDONE TEVA 1 mg
SPRING 1 mg
RONYDAL 1 mg
RISPEN 1
RISPERIDONA ARENA 1 mg
RONYDAL 1 mg
RISPEN 2
RISON 2 mg
SPRING 2 mg
RONYDAL 2 mg
RONYDAL 2 mg
TORENDO 3 mg
RISON 3 mg
SPRING 3 mg
RONYDAL 3 mg
RISPEN 3
RONYDAL 3 mg
RISPEN 4
TORENDO 4 mg
RISON 4 mg
SPRING 4 mg
RONYDAL 4 mg
forma farm.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
CAPS.
CAPS.
COMPR.
COMPR.
COMPR.
COMPR. DIVIZ.
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.
RISPERIDONA MEDOCHEMIE 4 mg COMPR. FILM.
RISPERIDONA ARENA 4 mg COMPR. FILM.
RONYDAL 4 mg
COMPR. FILM.
TORENDO Q-TAB 1 mg
ESSENS OD 1 mg
TORENDO Q-TAB 2 mg
ESSENS OD 2 mg
ESSENS OD 3 mg
RISPOLEPT CONSTA 25 mg
RISPOLEPT CONSTA 37,5 mg
RISPOLEPT CONSTA 50 mg
concentratie
300mg
300mg
300mg
200mg
300mg
400mg
50mg
50mg
50mg
200mg
200mg
200mg
200mg
400mg
1mg
1mg
1mg
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
DETINATOR APP
TARA
DET. APP
REPUBLICA CEHA
AMBALAJ
Prescriptie
NR.CRT
PRF
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 CUTIE X 2 BLIST. X 15 CAPS.

FRANTA CUTIE CU 1 BLIST. PVC/AL X 30 CAPS.
FRANTA CUTIE X 1 BLIST. X 12 COMPR.
P-RF
LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR.
P-RF
TERAPIA S.A.
P-RF
FRANTA
FRANTA
ROMANIA
ANTIBIOTICE S.A.
ROMANIA
ROMASTRU TRADING SRL ROMANIA
PRF
P-RF
CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. 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
ZENTIVA KS
CEHIA
CUTIE X 2 BLIST. PVC-PE-PVDC/AL-PVDC X 10 COMPR. FILM. P-RF
ZENTIVA KS
CEHIA
ROMANIA

ANTIBIOTICE S.A.
ROMANIA

ROMANIA

ANTIBIOTICE S.A.
ROMANIA

ZENTIVA KS
CEHIA
ZENTIVA KS
CEHIA
ROMANIA

ANTIBIOTICE S.A.
ROMANIA


PRF
CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE
P-RF
TERAPIA SA
ROMANIA
P-RF
P-RF
P-RF
TERAPIA SA
TERAPIA SA
ROMANIA
ROMANIA
BELGIA
BELGIA
BELGIA

Pagina 22 din 39
P-RF
CUTIE CU 1 FLACON PULBERE PT SUSP. INJ. CU ELIB. PREL., O SERINGA PRE-UMPLUTA CU 2 ML SOLVENT + 2 ACE
S/P-RF
S/P-RF
S/P-RF

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
60
1.256799
60
1.256799
60
1.256799
60
2.344200
60
3.302400
60
4.086199
60
0.891000
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
50
0.359600
20
0.364599
60
0.364599
50
0.309000
60
0.309000
20
0.257500
30
0.309000
60
0.309000
20
0.309000
60
0.309000
30
0.507600
60
0.507600
20
0.423000
30
0.507600
60
0.507600
50
0.507600
20
0.507600
60
0.507600
50
0.309000
30
0.309000
60
0.309000
20
0.257500
30
0.309000
60
0.309000
20
0.309000
20
0.309000
60
0.309000
30
0.364599
30
0.364599
30
0.309000
30
0.309000
30
0.507600
1 374.930000
1 530.080000
1 635.690000
1.256799
1.256799
1.256799
2.344200
3.302400
4.086199
0.891000
0.274333
0.274333
0.698333
1.522000
1.522000
1.826400
3.672000
0.303833
0.364599
0.364599
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
1.445534
0.489701
0.700034
1.771133
2.844766
3.775301
0.213333
0.000000
0.000000
0.000000
0.000000
0.000000
0.437266
0.000000
0.000000
0.150401
0.050901
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
COD ATC
192 N05AX08
193 N05AX12
194 N05AX12
195 N05AX12
196 N05AX12
197 N05AX12
198 N05AX12
199 N05AX12
200 N05AX12
201 N05AX12
202 N05AX12
203 N05AX12
204 N05AX12
205 N05AX12
206 N05AX12
207 N05AX12
208 N05AX12
209 N05AX12
210 N05AX12
211 N05AX12
212 N05AX12
213 N05AX12
214 N05AX12
215 N05AX12
216 N05AX12
217 N05AX13
218 N05AX13
219 N05AX13
220 N05AX13
221 N05AX13
222 N05AX13
223 N05AX13
224 N06AB04
225 N06AB04
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 N06AB10
241 N06AB10
242 N06AB10
243 N06AB10
DCI
RISPERIDONUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
ARIPIPRAZOLUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
PALIPERIDONUM**
CITALOPRAMUM**
CITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
ESCITALOPRAMUM**
Denumire Comerciala
RISPOLEPT
ABILIFY 10mg
ARYZALERA 10mg
ARIPIPRAZOL GLENMARK 10 mg
ARIPIPRAZOL TEVA 10 mg
ARIPIPRAZOL AUROBINDO 10 mg
ARIPIPRAZOL SANDOZ 10 mg
ARIPIPRAZOLE ZENTIVA 10 mg
RESTIGULIN 10 mg
ABILIFY 15mg
ARYZALERA 15mg
ARIPIPRAZOL GLENMARK 15 mg
ARIPIPRAZOL AUROBINDO 15 mg
ARIPIPRAZOL SANDOZ 15 mg
forma farm.
SOL. ORALA
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
RESTIGULIN 15 mg
ASTORET 10 mg
ASTORET 15 mg
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
XEPLION
XEPLION
LINISAN 10 mg
COMPR. FILM.
LINISAN 20 mg
COMPR. FILM.
DEPRESINAL 10 mg
COMPR. FILM.
CIPRALEX 10 mg
COMPR. FILM.
ESCITIL 10 mg
COMPR. FILM.
ESCITALOPRAM-TEVA 10 mg COMPR. FILM.
LENUXIN 10 mg
COMPR. FILM.
ESLOREX 10 mg
COMPR. FILM.
SERODEPS 10mg
COMPR. FILM.
ESTAN 10 mg
COMPR. FILM.
ESTAN 10 mg
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.
ELICEA 15 mg
COMPR. FILM.
SERODEPS 20mg
COMPR. FILM.
concentratie
1mg/ml
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
15mg
20mg
30mg
10mg
10mg
15mg
15mg
400mg
7,5mg/ml
3mg
6mg
9mg
100mg
150mg
50mg
75mg
10mg
20mg
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
15mg
15mg
20mg
20mg
DETINATOR APP
TARA
DET. APP
BELGIA
AMBALAJ
Prescriptie
NR.CRT
CUTIE X 1 FLACON DIN STICLA BRUNA X 30 ML SOL. ORALA + 1 PIPETA
P-RF
CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR.
P-RF
PRF
OTSUKA PHARMACEUTICAL EUROPE LTD. MAREA BRITANIE
CUTIE CU 1 BLSIT. OPA-AL-PVC/AL X 28 COMPR. PRF
REPUBLICA CEHA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR.

AUSTRIA CUTIE CU BLIST. ALU/ALU X 28 COMPR.
PRF
CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR.
PRF
SANDOZ GMBH
ZENTIVA, K.S.
REPUBLICA CEHA
GEDEON RICHTER ROMANIA S.A.
ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. PRF
PRF
CUTIE X 1BLIST. AL/AL PERFORAT UNIDOZA X 28 (X1) COMPR.
P-RF
PRF
CUTIE CU 1 BLSIT. OPA-AL-PVC/AL X 28 COMPR. PRF
REPUBLICA CEHA
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF
SANDOZ GMBH
ZENTIVA, K.S.
GEDEON RICHTER ROMANIA S.A.

TERAPIA S.A.
ZENTIVA, K.S.
TERAPIA S.A.
ZENTIVA, K.S.
MALTA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR.

AUSTRIA CUTIE CU BLIST. ALU/ALU X 28 COMPR.
PRF
CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR.
PRF
ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR.

ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR.
ROMANIA
PRF
CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE
PRF
REPUBLICA CEHA
CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. ORODISPERSABILE
PRF
ROMANIA
CUTIE CU BLIST. DETASABIL (PEEL-OF) DIN PA/AL/PVC-AL X 28 COMPR. ORODISPERSABILE
PRF
REPUBLICA CEHA
CUTIE CU BLIST. OPA/AL/PVC/AL (BLISTER AL-AL) X 28 COMPR. ORODISPERSABILE
PRF
REPUBLICA CEHA

JANSSEN-CILAG INTERNATIONAL NV
JANSSEN CILAG INTERNATIONALL NV
BELGIA
BELGIA
BELGIA
BELGIA
BELGIA
BELGIA
BELGIA
CUT IE 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 JET ABILA DE 3 ML CU VRF LUER-LOCK, UN ADAPT OR PENT RU FLACON, UN AC HIPODERMIC SECURIZAT SI UN AC HIPODERMIC SECURIZAT PT OBEZI
PRF
PRF
PRF
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


P-RF
AUSTRIA
P-RF
H. LUNDBECK A/S
DANEMARCA
CUTIE X 2 BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 14 COMPR. FILM.
P-RF
UNGARIA
ROMANIA
ROMANIA
P-RF
P-RF
CEHIA
PRF
ROMANIA
CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF
CIPRU
CIPRU
ISLANDA
PRF
PRF
CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
PRF

ZENTIVA K.S.
TERAPIA SA
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
P-RF
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. PRF
MAREA BRITANIE
ANTIBIOTICE S.A.
ROMANIA

PRF
TERAPIA SA
Pagina 23 din 39
ROMANIA
ROMANIA

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

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
1
28
30
28
30
30
28
28
28
28
30
28
30
30
28
28
28
30
30
28
28
28
28
1
1
30
30
30
1
1
1
1
30
30
30
28
28
30
28
30
28
14
28
28
30
28
28
28
30
30
30
28
17.330000
5.626713
5.626713
5.626713
5.626713
5.511666
5.626713
5.626713
4.688928
6.889599
6.889599
6.889599
6.889599
5.741333
6.889599
6.889599
6.889599
12.270000
12.270000
5.626713
5.626713
6.889599
6.889599
1,163.560000
19.950000
15.777333
16.040000
17.477333
1,463.340000
2,055.980000
944.130000
1,202.120000
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
17.330000
5.626713
5.626713
5.626713
5.626713
5.511666
5.626713
5.626713
4.688928
6.889599
6.889599
6.889599
6.889599
5.741333
6.889599
6.889599
6.889599
12.270000
12.270000
5.626713
5.626713
6.889599
6.889599
1,163.560000
19.950000
15.777333
16.040000
17.477333
1,463.340000
2,055.980000
944.130000
1,202.120000
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
0.000000
5.855787
1.665287
1.836858
1.836953
0.000000
1.836858
1.665072
0.000000
4.592901
0.574067
0.573972
0.574067
0.000000
0.573972
0.573972
0.017543
0.000000
0.000000
1.836858
1.665072
0.573972
0.573972
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.346285
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
COD ATC
244 N06AB10
245 N06AB10
246 N06AB10
247 N06AB10
248 N06AB10
249 N06AB10
250 N06AB10
251 N06AB10
252 N06AB10
253 N06AB10
254 N06AB10
255 N06AX05
256 N06AX05
257 N06AX05
258 N06AX05
259 N06AX05
260 N06AX05
261 N06AX14
262 N06AX14
263 N06AX14
264 N06AX14
265 N06AX14
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 N06AX16
279 N06AX16
280 N06AX16
281 N06AX16
282 N06AX16
283 N06AX16
284 N06AX16
285 N06AX16
286 N06AX16
287 N06AX16
288 N06AX16
289 N06AX16
290 N06AX16
291 N06AX16
292 N06AX16
293 N06AX21
294 N06AX21
295 N06AX21
DCI
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**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
VENLAFAXINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
Denumire Comerciala
forma farm.
COMPR. FILM.
ESCITALOPRAM ACTAVIS 20 mg COMPR. FILM.
ELICEA 20 mg
COMPR. FILM.
ELICEA Q-TAB 10 mg
ELICEA Q-TAB 10 mg
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 15 mg
ELICEA Q-TAB 20 mg
ELICEA Q-TAB 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
LYXIT 12,5 mg
LYXIT 12,5 mg
NOBIXAL 12,5 mg
NOBIXAL 12,5 mg
COAXIL (R)
EFECTIN EP 150 mg
ELIFY EP 150 mg
IVRYX 150mg
VELAXIN 150 mg
ALVENTA 150mg

FOBILESS 37,5 mg
VENLAFAXINA ARENA EP 37,5 mg
EFECTIN EP 75 mg
ELIFY EP 75 mg
IVRYX 75mg
IVRYX 75mg
VELAXIN 75 mg
ALVENTA 75 mg
FOBILESS 75 mg
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
DRAJ.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
VENLAFAXINA ARENA 37,5 mg COMPR.
VENLAFAXINA ARENA 50 mg
VENLAFAXINA ARENA 75 mg
ARGOFAN 150 SR
ARGOFAN 75 SR
CYMBALTA 30mg
DULSEVIA 30 mg
ZATINEX 30 mg
COMPR.
COMPR.
COMPR. ELIB. PREL.
COMPR. ELIB. PREL.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
concentratie
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
150mg
150mg
150mg
150mg
37,5mg
37,5mg
75 mg
75 mg
75 mg
75 mg
75mg
75mg
75mg
75mg
75mg
75mg
75mg
37,5mg
50mg
75mg
150mg
75mg
30mg
30mg
30mg
Prescriptie
NR.CRT
TARA
DET. APP
PRF
ISLANDA
CUTIE CU BLIST. PVDC/PVDC/AL X 28 COMPR. FILM.
PRF
DETINATOR APP
AMBALAJ
PRF
PRF
ROMANIA
PRF
PRF
PRF
PRF
PRF
PRF
ROMANIA
ITALIA
ITALIA
ITALIA
ITALIA
ITALIA
ITALIA
ARENA GROUP S.A.

ARENA GROUP S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
PRF
PRF


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

CUTIE CU BLIST. PVC/ACLAR-AL X 30 COMPR. FILM. PRF
LES LAB. SERVIER IND. FRANTA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ.

MAREA BRITANIE
P-RF
P-RF
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF
CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL.
PRF
P-RF
UNGARIA
P-RF
ISLANDA
TERAPIA S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
MAREA BRITANIE
CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF
CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL.
P-RF
P-RF
PRF
PRF

P-RF
CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF
PRF

P-RF
P-RF
CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL
P-RF
UNGARIA
CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. P-RF
AUSTRIA
ISLANDA

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.
ZENTIVA A.S.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
P-RF
PRF
PRF
SLOVACIA
SLOVACIA
P-RF
P-RF
OLANDA
CUTIE X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL)
P-RF
PRF
ANTIBIOTICE S.A.
PRF
Pagina 24 din 39
ROMANIA
CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF


asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
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
30
30
30
30
28
30
28
28
28
30
30
28
30
30
30
30
30
30
30
30
28
30
28
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
0.665599
0.665599
0.596333
0.715599
0.391200
0.391200
0.391200
0.391200
0.391200
0.326000
0.391200
0.391200
0.391200
0.391200
0.391200
0.715599
0.847333
0.391200
0.665000
0.391000
2.326285
2.012000
1.938571
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
0.665599
0.665599
0.596333
0.715599
0.391200
0.391200
0.391200
0.391200
0.391200
0.326000
0.391200
0.391200
0.391200
0.391200
0.391200
0.715599
0.847333
0.391200
0.665000
0.391000
2.326285
2.012000
1.938571
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
0.643067
0.643067
0.000000
0.116067
0.927014
0.358133
0.272014
0.272014
0.493800
0.000000
0.271466
0.265228
0.488133
0.494133
0.494133
0.116067
0.000000
0.488133
0.000000
0.000000
0.613715
0.000000
0.000000
DCI
COD ATC
296 N06AX21
297 N06AX21
298 N06AX21
299 N06AX21
300 N06AX21
301 N06AX21
302 N06AX21
303 N06AX21
304 N06BA09
305 N06BA09
306 N06BA09
307 N06BA09
308 N06BA09
309 N06BA09
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
DULOXETINUM**
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
ATOMOXETINUM***
Denumire Comerciala
ZATINEX 30 mg
forma farm.
CAPS. GASTROREZ.
DULOXETINA DR. REDDY'S 30 mg CAPS. GASTROREZ.
CYMBALTA 60mg
DULSEVIA 60 mg
ZATINEX 60 mg
ZATINEX 60 mg
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
CAPS. GASTROREZ.
DULOXETINA DR. REDDY'S 60 mg CAPS. GASTROREZ.
DULOXETINE ZENTIVA 60 mg CAPS. GASTROREZ.
STRATTERA 10 mg
STRATTERA 18 mg
STRATTERA 25 mg
STRATTERA 40 mg
STRATTERA 60 mg
STRATTERA 80 mg
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
CAPS.
concentratie
30mg
30mg
60mg
60mg
60mg
60mg
60mg
60mg
10mg
18mg
25mg
40mg
60mg
80mg
TARA
DET. APP
ROMANIA
ROMANIA
OLANDA
DETINATOR APP
ANTIBIOTICE S.A.
AMBALAJ
Prescriptie
NR.CRT
PRF
PRF
CUTIE, X 28 CAPS. GASTROREZ.( BLIST. PVC/PE/PCTFE/AL)
P-RF
PRF
PRF
PRF
ROMANIA
ROMANIA
ROMANIA
PRF
ZENTIVA, K.S.
REPUBLICA CEHA
CUTIE CU BLIST. PVC/PCTFE/AL X 28 CAPS. GASTROREZ.
PRF
ELI LILLY AND COMPANY LTD.
MAREA BRITANIE
CUTIE X 1 BLIST. PVC-PE-PCTFE/AL X 7 CAPS.
P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
P-RF
MAREA BRITANIE
CUTIE X 4 BLIST. PCTFE-PE-PVC/AL X 7 CAPS.
P-RF/R
CUTIE CU, BLIST., DIN OPA-AL-PVC/AL CU 28 COMPR. FILM.
P-RF
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
28
28
28
30
28
28
28
28
7
7
28
28
28
28
1.938571
2.011785
3.515199
2.929333
3.044642
3.044642
3.072142
3.072142
13.407142
13.491428
12.654285
12.654285
12.654285
15.916785
1.938571
2.011785
3.515199
2.929333
3.044642
3.044642
3.072142
3.072142
13.407142
13.491428
12.654285
12.654285
12.654285
15.916785
0.000000
0.000000
1.047658
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
28
30
30
30
28
28
28
28
50
56
60
98
100
30
28
28
28
30
30
30
28
28
28
50
56
60
98
100
30
28
28
28
1.251428
1.256570
1.256570
1.237666
1.256570
1.047142
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
0.985000
1.158856
1.158856
1.158856
1.158856
0.965714
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.251428
1.256570
1.251428
1.256570
1.256570
1.237666
1.256570
1.047142
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
1.256570
0.985000
1.158856
1.158856
1.158856
1.158856
0.965714
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.158856
1.251428
1.256570
0.000000
0.896763
0.896763
0.000000
1.063787
0.000000
0.477001
0.862001
0.755230
0.755037
0.755096
0.650981
0.651030
0.564096
1.059858
0.000000
0.552215
0.383810
0.383810
0.347144
0.000000
0.127215
0.371144
0.293744
0.294179
0.293810
0.218797
0.218944
0.100477
0.553286
0.000000
4.127001
Tratamentul se iniiaz de ctre medicul n specialitatea psihiatrie i psihiatrie pediatric/neuropsihiatrie infantil.
14. DEMENTE(DEGENERATIVE, VASCULARE, MIXTE) - G 16

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
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
YASNAL 10 mg
DAVIA 10 mg
DAVIA 10 mg
TUADIN 10 mg
PRIDIA 10 mg
DONECEPT 10 MG
COGNEZIL 10 mg
DOSPELIN 10 mg
DOSPELIN 10 mg
DOSPELIN 10 mg
DOSPELIN 10 mg
DOSPELIN 10 mg
DOSPELIN 10 mg
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
DONEPEZIL TORRENT 10 mg COMPR. FILM.
XALINAT 10 mg
COMPR. FILM.
YASNAL 5 mg
COMPR. FILM.
ZILDON 5 mg
COMPR. FILM.
DAVIA 5 mg
COMPR. FILM.
DAVIA 5 mg
COMPR. FILM.
TUADIN 5 mg
COMPR. FILM.
DONECEPT 5 MG
COMPR. FILM.
COGNEZIL 5 mg
COMPR. FILM.
DOSPELIN 5 mg
COMPR. FILM.
DOSPELIN 5 mg
COMPR. FILM.
DOSPELIN 5 mg
COMPR. FILM.
DOSPELIN 5 mg
COMPR. FILM.
DOSPELIN 5 mg
COMPR. FILM.
DOSPELIN 5 mg
COMPR. FILM.
DONEPEZIL TORRENT 5 mg COMPR. FILM.
XALINAT 5 mg
COMPR. FILM.
YASNAL 10 mg
ARICEPT EVESS
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
10 mg
10mg
TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.

ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.
LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.
P-RF
P-RF
P-RF
P-RF
ISLANDA
CUTIE X BLIST. PVC/AL X 28 COMPR. FILM.
REPUBLICA CEHA
CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
CIPRU
CIPRU
CIPRU
CIPRU
CIPRU
CIPRU
P-RF

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF
GALENICA S.A.
GRECIA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM.
P-RF
SANDOZ S.R.L.
TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.

ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.
P-RF
ISLANDA
CUTIE X BLIST. PVC/AL X 28 COMPR. FILM.
P-RF
REPUBLICA CEHA
CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
CIPRU
CIPRU
CIPRU
CIPRU
CIPRU
CIPRU
P-RF
P-RF
P-RF

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF
GALENICA S.A.
KRKA D.D.
GRECIA
SLOVENIA
CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL TIP "PEEL-OPEN" A CATE 28 COMPR. ORODISP.
PRF
MAREA BRITANIE
CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE
P-RF
Pagina 25 din 39
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
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
COD ATC
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA02
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA03
N06DA04
N06DA04
N06DA04
N06DA04
N06DA04
N06DA04
N06DA04
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
DCI
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
DONEPEZILUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
RIVASTIGMINUM***
GALANTAMINUM***
GALANTAMINUM***
GALANTAMINUM***
GALANTAMINUM***
GALANTAMINUM***
GALANTAMINUM***
GALANTAMINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
Denumire Comerciala
DONEPEZIL TEVA 10 mg
DARIZOL 10 mg
forma farm.
DONEPEZIL STADA HEMOFARM 10 mg
DARIZOL 10 mg
ARICEPT EVESS
YASNAL 5 mg
ARICEPT EVESS
DONEPEZIL TEVA 5 mg
DARIZOL 5 mg
DARIZOL 5 mg
ARICEPT EVESS
RIDAXIN 1,5 mg
CAPS.
RIVASTIGMINA TORRENT 1,5 mg CAPS.
RIDAXIN 1,5 mg
CAPS.
NIMVASTID 1.5mg
CAPS.
NIMVASTID 3mg
CAPS.
RIVASTIGMINE SANDOZ 3mg CAPS.
RIDAXIN 3 mg
CAPS.
RIVASTIGMINA TORRENT 3 mg CAPS.
RIDAXIN 3 mg
CAPS.
RIDAXIN 4,5 mg
CAPS.
RIDAXIN 4,5 mg
CAPS.
RIDAXIN 6 mg
CAPS.
NIMVASTID 1.5 mg
NIMVASTID 3mg
NIMVASTID 4.5 mg
NIMVASTID 6mg
EXELON 13,3mg/24h
EXELON 4,6mg/24h
EVERTAS 4,6 mg/24 h
EXELON 9,5mg/24h
EVERTAS 9,5 mg/24 h
RIVASTIGMINA DR. REDDY'S 4,6 mg/24 ore PLASTURI TRANSDERMICI
RIVASTIGMINA DR. REDDY'S 9,5 mg/24 ore PLASTURI TRANSDERMICI
RIVASTIGMINA TEVA 2 mg/ml SOL. ORALA
GALSYA 16 mg
CAPS. ELIB. PREL.
GALANTAMINA ZENTIVA 16 mg CAPS. ELIB. PREL.
GALSYA 24 mg
CAPS. ELIB. PREL.
GALSYA 8 mg
CAPS. ELIB. PREL.
REMINYL (R) 4 mg/ml
MEMANTINA RATIOPHARM 10 mg
EBIXA 10 mg
MEMANTINA TORRENT 10 mg
NEMDATINE 10mg
MEMANTINA DR. REDDY'S 10 mg
MIRVEDOL 10 mg
MEMANTINA AUROBINDO 10 mg
SOL. ORALA
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
10mg
10mg
10mg
10mg
10mg
10mg
5 mg
5mg
5mg
5mg
5mg
5mg
5mg
5mg
1,5mg
1,5mg
1,5mg
1.5mg
3mg
3mg
3mg
3mg
3mg
4,5mg
4,5mg
6mg
1.5mg
3mg
4.5mg
6mg
13,3/24h
4,6mg/24h
4,6mg/24h
9,5mg/24h
9,5mg/24h
4,6mg/24ore
9,5mg/24ore
2mg/ml
16mg
16mg
24mg
24mg
8mg
8mg
4mg/ml
10 mg
10mg
10mg
10mg
10mg
10mg
10mg
Prescriptie
NR.CRT
TARA
DET. APP
ROMASTRU TRADING S.R.L. ROMANIA
STADA HEMOFARM SRL ROMANIA
CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.
P-RF
CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE
PRF
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE
PRF
PRF
PRF
MAREA BRITANIE
CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. ORODISPERSABILE
PRF
KRKA D.D.
SLOVENIA
CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL "PEEL-OPEN" A CATE 28 COMPR. ORODISP.
PRF
MAREA BRITANIE
CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE
P-RF
CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP.
P-RF
PRF
CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE
PRF
PRF
PRF
DETINATOR APP
ROMANIA
ROMANIA
MAREA BRITANIE
AMBALAJ
CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. ORODISPERSABILE

TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS.
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS.
PRF
P-RF/R
P-RF/R
P-RF/R
KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE
P-RF/R
KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE
P-RF/R
SANDOZ S.R.L.
CUTIE CU BLIST.PVC/AL X 56 CAPS.
P-RF/R
P-RF/R
CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS.
P-RF/R
TORRENT PHARMA S.R.L.
NEOLA PHARMA S.R.L.

NEOLA PHARMA S.R.L.

NEOLA PHARMA S.R.L.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA

P-RF/R
P-RF/R
P-RF/R
P-RF/R
CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE
P-RF/R
P-RF/R
P-RF/R
P-RF/R
MAREA BRITANIE
CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC
MAREA BRITANIE
ZENTIVA, K.S.
REPUBLICA CEHA
CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC
MAREA BRITANIE
ZENTIVA, K.S.
REPUBLICA CEHA
CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC

ROMANIA
ROMANIA
ROMANIA
CUT IE CU 30 PLICURI DIN MAT ERIAL MULT ILAMINAT DIN HRT IE/POLIET ILENT EREFT ALAT /AL/POLIACRILONIT RIL CU CU SIST EM DE NCHIDERE SECURIZAT PENT RU COPII, A CT E 1 PLAST URE T RANSDERMIC PROT EJ. DE O FOLIE DIN FILM DIN T EREFT ALAT DE POLIET ILENA SILICONAT A
CUT IE CU 30 PLICURI DIN MAT ERIAL MULT ILAMINAT DIN HRT IE/POLIET ILENT EREFT ALAT /AL/POLIACRILONIT RIL CU CU SIST EM DE NCHIDERE SECURIZAT PENT RU COPII, A CT E 1 PLAST URE T RANSDERMIC PROT EJ. DE O FOLIE DIN FILM DIN T EREFT ALAT DE POLIET ILENA SILICONAT A
PR
PR
PRF
PR
PRF
PRF
PRF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 125 ML SOL. ORALA + 1 SERINGA DOZATOARE
P-RF/R
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL.
PRF
ZENTIVA, K.S.
CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL.
PRF
PRF
ZENTIVA, K.S.
PRF
PRF
ZENTIVA, K.S.
REPUBLICA CEHA
PRF
JANSSEN-PHARMACEUTICA NV
BELGIA
CUTIE X 1 FLACON X 100 ML + 1 PIPETA DOZATOARE
P-RF
REPUBLICA CEHA
REPUBLICA CEHA
RATIOPHARM GMBH GERMANIA CUTIE CU BLISTERE DIN FOLIE PVC/PVDC-AL X 56 COMPRIMATE FILMATE PR
H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. PR
ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR
DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR
CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR
Pagina 26 din 39

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
28
1.187142
28
1.256570
28
1.256570
28
1.256570
28
1.256570
28
1.256570
28
1.158856
28
1.158856
28
1.158856
28
1.158856
28
1.055357
28
1.158856
28
1.158856
28
1.158856
56
1.178570
56
1.178570
56
1.178570
28
0.982142
28
1.174285
56
1.409142
56
1.409142
56
1.409142
56
1.409142
56
2.080285
56
2.080285
56
2.724428
28
0.982142
28
1.174285
28
1.733571
28
2.270357
30 11.130666
30
3.568800
30
2.974000
30
6.295999
30
5.246666
30
3.568800
30
5.246666
1 433.380000
30
1.815666
28
1.513571
30
1.815666
28
1.513571
30
1.815666
28
1.513571
1 124.860000
56
0.650785
56
0.650785
56
0.650785
28
0.647857
56
0.570892
56
0.650785
56
0.542321
1.187142
1.256570
1.256570
1.256570
1.256570
1.256570
1.158856
1.158856
1.158856
1.158856
1.055357
1.158856
1.158856
1.158856
1.178570
1.178570
1.178570
0.982142
1.174285
1.409142
1.409142
1.409142
1.409142
2.080285
2.080285
2.724428
0.982142
1.174285
1.733571
2.270357
11.130666
3.568800
2.974000
6.295999
5.246666
3.568800
5.246666
433.380000
1.815666
1.513571
1.815666
1.513571
1.815666
1.513571
124.860000
0.650785
0.650785
0.650785
0.647857
0.570892
0.650785
0.542321
0.000000
1.063787
0.854858
2.433430
1.063787
4.127001
0.023286
2.940786
0.028286
0.498286
0.000000
1.506144
0.498286
2.940786
0.005715
0.114108
0.005715
0.000000
0.000000
0.983358
1.005143
0.554429
1.005143
0.156857
0.156857
0.128250
0.000000
0.000000
0.000000
0.000000
0.000000
4.503200
0.000000
1.776001
0.000000
1.677866
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.221715
1.572250
0.009572
0.000000
0.000000
0.396179
0.000000
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
DCI
COD ATC
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
N06DX01
100 N06DX01
101 N06DX01
102 N06DX01
103 N06DX01
104 N06DX01
105 N06DX01
106 N06DX01
107 N06DX01
108 N06DX01
109 N06DX01
110 N06DX01
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
MEMANTINUM***
forma farm.
Denumire Comerciala
MEMANTINA TERAPIA 10 mg
MEMANTINA ATB 10 mg
MARIXINO 10mg
COGNOMEM 10 mg
MEMANTINA LANNACHER HEILMITTEL 10 mg
MANTOMED 10 mg
MANTOMED 10 mg
MEMANTINE ACCORD 10 mg
MEMANTINA RATIOPHARM 20 mg
MEMANTINA TORRENT 20 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.
NEMDATINE 20mg
MEMANTINA ATB 20 mg
COGNOMEM 20 mg
MANTOMED 20 mg
MANTOMED 20 mg
MEMANTINA TEVA 10 mg
MEMANTINA TEVA 20 mg
EBIXA 5mg/doza
PICATURI ORALE - SOL.
MEMANTINA TEVA 10 mg/ml SOL. ORALA
MEMANTINA TORRENT 10 mg/ml SOL. ORALA
concentratie
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
10mg
20 mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg
10mg
20mg
5mg/doza
10 mg/ml
10mg/ml
DETINATOR APP
TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.
Prescriptie
NR.CRT
TARA
DET. APP
AMBALAJ
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR
ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR
ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR
CONSILIENT HEALTH LTD.
IRLANDA
CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE
ZENTIVA K.S.
REPUBLICA CEHA

PR
PR
PR
CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM.
PRF
PRF
ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 14 COMPR. FILM.
AUSTRIA
PR
PR
PR
PR
PR
PR
PR
PR
PR
CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM.
PRF
PRF
PRF
PRF
CUTIE X BLISTERE DIN FOLIE PVC/PVDC-AL X 28 COMPRIMATE FILMATE
TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM.

ISLANDA
TERAPIA SA
TERAPIA SA
ANTIBIOTICE S.A.
ZENTIVA K.S.
MEDOCHEMIE LTD.
MEDOCHEMIE LTD.
ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM.
REPUBLICA CEHA
CIPRU
CIPRU
ROMANIA
ROMANIA
H LUNDBECK A/S
DANEMARCA
ROMANIA
CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE
CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 28X1 COMPR. ORODISPERSABILE
PR
PR
CUTIE X 1 FLACON DIN STICLA BRUNA CU POMPA DOZATOARE X 50 ML SOLUTIE
P-RF/R
CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. ORODISPERSABILE
CUTIE CU 1 FLAC. A 100 ML SOL. SOL. ORALA SI O POMPA DOZATOARE
PR
PR
P-RF
CUTIE CU 1 FLAC. DIN STICLA + SERINGA DOZATOARE A 50 ML SOL. ORALA

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
56
0.650785
56
0.650785
56
0.650785
56
0.619821
56
0.650785
70
0.628428
56
0.650785
56
0.650785
14
0.648571
28
0.647857
28
1.644428
56
1.644428
28
1.552500
28
1.644428
28
1.644428
28
1.491071
56
1.644285
56
1.644428
56
1.644428
14
1.540714
28
1.491071
56
0.650785
28
1.370357
1 115.980000
1 96.650000
1 183.300000
0.650785
0.650785
0.650785
0.619821
0.650785
0.628428
0.650785
0.650785
0.648571
0.647857
1.644428
1.644428
1.552500
1.644428
1.644428
1.491071
1.644285
1.644428
1.644428
1.540714
1.491071
0.650785
1.370357
115.980000
96.650000
183.300000
0.034393
0.034393
0.005286
0.000000
0.034393
0.000000
0.032965
0.032965
0.000000
0.000000
0.100572
0.373786
0.000000
0.449500
0.449500
0.000000
0.000000
0.419857
0.419857
0.000000
0.000000
0.034393
0.000000
25.020000
0.000000
0.000000
Tratamentul se initiaza de catre medicul in specialitatea psihiatrie, neurologie sau geriatrie
15. COLAGENOZE MAJORE (LUPUS ERITEMATOS SISTEMIC, SCLERODERMIE, POLI/DERMATOMIOZITA, VASCULITE SISTEMICE) - G 17
1
2
3
4
5
6
7
8
9
H02AB04
H02AB04
L01AA01
L01AA01
L04AX01
L04AX01
L04AX01
P01BA02
P01BA02
METHYLPREDNISOLONUM5)
CYCLOPHOSPHAMIDUM
CYCLOPHOSPHAMIDUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
HYDROXYCHLOROQUINUM
HYDROXYCHLOROQUINUM
MEDROL A 16
MEDROL 32
ENDOXAN (R) 50 mg
ENDOXAN 200 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
PLAQUENIL
PLAQUENIL 200 mg
COMPR.
COMPR.
DRAJ.
PULB. PT. SOL. PERF./INJ. I.V.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
16mg
32mg
50mg
200mg
50mg
50mg
75mg
200mg
200mg
MAREA BRITANIE
MAREA BRITANIE
BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ.
ACTAVIS S.R.L.
ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ

IRLANDA
AUSTRIA
P-RF
S
S/P-RF
S/P-RF
PR

SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM.
P-6L
P-6L
P-6L
50
20
50
1
100
100
100
60
60
0.543200
1.234000
0.542400
15.890000
0.702300
0.702300
0.788900
0.542833
0.542833
0.543200
1.234000
0.542400
15.890000
0.702300
0.702300
0.788900
0.542833
0.542833
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
50
50
5
50
20
0.584200
0.585200
5.366000
0.543200
1.234000
0.584200
0.585200
5.366000
0.543200
1.234000
0.000000
0.000000
0.000000
0.000000
0.000000
Tratamentul se initiaza si se monitorizeaza de catre medicul in specialitatea reumatologie, nefrologie si boli infectioase.
16. POLIARTRITA REUMATOIDA , ARTROPATIA PSORIAZICA SI ARTRITA JUVENILA - G 18

1
2
3
4
5
A07EC01
A07EC01
H02AB01
H02AB04
H02AB04
SULFASALAZINUM
SULFASALAZINUM
BETAMETHASONUM
SULFASALAZIN EN
SALAZIDIN GR 500 mg
DIPROPHOS
MEDROL A 16
MEDROL 32
COMPR. GASTROREZ.
SUSP. INJ. I.M.

COMPR.
COMPR.
500mg
500mg
7mg/ml
16mg
32mg
ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L

MERCK SHARP & DOHME ROMANIA CUTIE X 5 FIOLE X 1 ML
P-RF
MAREA BRITANIE
MAREA BRITANIE
Pagina 27 din 39
P-RF
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
COD ATC
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L04AA13
L04AA13
L04AA13
L04AA13
L04AA13
L04AA13
L04AD01
L04AD01
L04AD01
L04AD01
L04AD01
L04AX01
L04AX01
L04AX01
L04AX03
L04AX03
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
P01BA02
DCI
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
LEFLUNOMIDUM**
LEFLUNOMIDUM**
LEFLUNOMIDUM**
LEFLUNOMIDUM**
LEFLUNOMIDUM**
LEFLUNOMIDUM**
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
METHOTREXATUM
METHOTREXATUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
HYDROXYCHLOROQUINUM
Denumire Comerciala
forma farm.
concentratie
100mg/ml
METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml
BENDATREXAT
SOL INJ.
25mg/ml
METOTREXAT EBEWE 10 mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 10mg/ml
METOJECT 50mg/ml
SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
LEFLUNOMIDA SANDOZ 10 mg COMPR. FILM.
10 mg
LEFLUNOMIDE WINTHROP 10mg COMPR. FILM.
10mg
LEFLON 10 mg
COMPR. FILM. 10mg
LEFLUNOMIDA SANDOZ 20 mg COMPR. FILM.
20 mg
LEFLUNOMIDE WINTHROP 20mg COMPR. FILM.
20mg
LEFLON 20 mg
COMPR. FILM. 20mg
EQUORAL 100 mg
CAPS. MOI
100mg
CAPS. MOI
25mg
EQUORAL 25 mg
CAPS. MOI
25mg
CAPS. MOI
50mg
EQUORAL 50 mg
CAPS. MOI
50mg
IMURAN
COMPR. FILM. 50mg
IMURAN
COMPR. FILM. 50mg
IMMUNOPRIN 75 mg
COMPR. FILM. 75mg
METHOTREXATE PCH 10mg COMPR.
10mg
METHOTREXATE PCH 2,5mg COMPR.
2,5mg
DICLOREUM 150 mg
DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg
DICLOTARD 100 mg
COMPR. CU ELIB. PREL. 100mg
DICLAC (R) 75 ID
VOLTAREN (R) RETARD
REFEN (R) RETARD
VOLTAREN (R) 50
DICLOFENAC 50 mg
DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg
VOLTAREN RAPID (R)
DRAJ.
50mg
DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg
VOLTAREN (R)
SOL. INJ.
25mg/ml
TRATUL (R)
SOL. INJ.
30mg/ml
DICLOFENAC 75 mg
SOL. INJ.
75mg/3ml
REFEN 75 mg
SOL. INJ./PERF. 25mg/ml
CLAFEN 100 mg
SUPOZ.
100mg
VOLTAREN (R)
SUPOZ.
100mg
DICLOFENAC 100 mg
SUPOZ.
100mg
DICLOFENAC SODIC 100 mg SUPOZ.
100mg
DICLOFENAC SINTOFARM 12,5 mg SUPOZ.
12,5 mg
12,5 mg
VOLTAREN (R)
SUPOZ.
50mg
PLAQUENIL
COMPR. FILM. 200mg
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT

AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
S
S
PR
PR
PR
PR
PR
GERMANIA
P-RF
GERMANIA
P-RF
GERMANIA
P-RF
GERMANIA
P-RF

CN UNIFARM S.A.
SANDOZ S.R.L.
ROMANIA
SANOFI- AVENTIS DEUTSCHLAND GMBH
GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM.
PR
PR
NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR
SANDOZ S.R.L.
ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP DESICANT X 30 COMPR. FILM. PR
SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PR
NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR
TEVA CZECH INDUSTRIES S.R.O. CEHIA
CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-RF
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
S/P-RF
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI
S/P-RF
CUTIE CU 1 FLACON PEID CU CAPAC PP CU DESICANT X 30 COMPR. FILM.

IRLANDA
AUSTRIA

S/P-RF
S/P-RF
PR
ROMANIA CUTIE X 10COMPR.

ROMANIA CUTIE X30 COMPRIMATE
P6L
P6L
ITALIA
CEHIA
P-6L
TERAPIA SA
HEXAL AG
ROMANIA

ALFA WASSERMANN SPA
CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L
P-6L
P-6L
STADA HEMOFARM S.R.L. ROMANIA
P-6L
P-6L
TERAPIA SA
P-6L
P-6L
ROMANIA
ROMANIA
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
ROMANIA
ROMANIA
CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L


TERAPIA SA
AUSTRIA
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML

STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF.
ANTIBIOTICE SA
ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ.
P-RF
P-RF
P-RF
P-6L
SINTOFARM SA
MAGISTRA C & C
SINTOFARM S.A.
SINTOFARM S.A.
ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L
SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 6 BLIST. X 10 COMPR. FILM. P-6L
Pagina 28 din 39

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
1 374.090000
1 82.990000
1 64.090000
1 61.880000
1 118.008000
1 46.730000
1 79.700000
1 98.340000
1 56.076000
1 110.680000
1 74.880000
30
1.899666
30
1.899666
30
1.899666
30
3.149333
30
3.608333
30
3.608333
50
6.232400
50
1.784400
50
1.487000
50
3.040560
50
2.533800
100
0.702300
100
0.702300
100
0.788900
10
2.989000
30
0.747666
20
2.474500
30
0.195600
20
0.354500
10
0.163000
10
0.425400
20
0.354500
20
0.140400
20
0.117000
20
0.117000
10
0.140400
30
0.197666
20
0.117000
30
0.117000
5
1.010400
5
1.010400
5
1.010400
5
0.842000
6
0.570000
5
0.684000
10
0.570000
10
0.572000
6
0.606666
10
0.601000
10
0.960000
60
0.542833
374.090000
82.990000
64.090000
61.880000
118.008000
46.730000
79.700000
98.340000
56.076000
110.680000
74.880000
1.899666
1.899666
1.899666
3.149333
3.608333
3.608333
6.232400
1.784400
1.487000
3.040560
2.533800
0.702300
0.702300
0.788900
2.989000
0.747666
2.474500
0.195600
0.354500
0.163000
0.425400
0.354500
0.140400
0.117000
0.117000
0.140400
0.197666
0.117000
0.117000
1.010400
1.010400
1.010400
0.842000
0.570000
0.684000
0.570000
0.572000
0.606666
0.601000
0.960000
0.542833
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
0.000000
0.000000
0.000000
0.574000
0.000000
0.788040
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.385400
0.000000
0.000000
0.119600
0.000000
0.040100
0.000000
0.000000
0.102600
0.000000
0.000000
0.000000
0.671600
0.083600
0.083600
0.000000
0.000000
0.194000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
COD ATC
58
P01BA02
DCI
HYDROXYCHLOROQUINUM
Denumire Comerciala
PLAQUENIL 200 mg
forma farm.
COMPR. FILM.
concentratie
200mg
TARA
DET. APP
SANOFI ROMANIA S.R.L. ROMANIA
DETINATOR APP
AMBALAJ
Prescriptie
NR.CRT

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
CUTIE CU 4 BLISTERE DIN PVC/AL X 15 COMPR. FILM.
P-6L
60
0.542833
0.542833
0.000000
P-6L
50
50
5
20
30
20
10
10
20
20
20
20
10
30
20
30
5
5
5
5
6
5
10
10
6
10
10
0.584200
0.585200
5.366000
2.474500
0.195600
0.354500
0.163000
0.425400
0.354500
0.140400
0.117000
0.117000
0.140400
0.197666
0.117000
0.117000
1.010400
1.010400
1.010400
0.842000
0.570000
0.684000
0.570000
0.572000
0.606666
0.601000
0.960000
0.584200
0.585200
5.366000
2.474500
0.195600
0.354500
0.163000
0.425400
0.354500
0.140400
0.117000
0.117000
0.140400
0.197666
0.117000
0.117000
1.010400
1.010400
1.010400
0.842000
0.570000
0.684000
0.570000
0.572000
0.606666
0.601000
0.960000
0.000000
0.000000
0.000000
0.000000
0.385400
0.000000
0.000000
0.119600
0.000000
0.040100
0.000000
0.000000
0.102600
0.000000
0.000000
0.000000
0.671600
0.083600
0.083600
0.000000
0.000000
0.194000
0.000000
0.000000
0.000000
0.000000
0.000000
10.795000
9.912500
270.534666
539.183333
2.499333
2.999199
6.047000
3.337000
0.000000
0.000000
0.000000
0.000000
0.000000
0.846134
0.000000
0.000000
Tratamentul se iniiaz de ctre medicul din specialitatea reumatologie, nefrologie, medicin intern, pediatrie i reabilitare medical.
17. SPONDILITA ANKILOZANTA - G 19

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
A07EC01
A07EC01
H02AB01
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
M01AB05
SULFASALAZINUM
SULFASALAZINUM
BETAMETHASONUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
DICLOFENACUM
SULFASALAZIN EN
SALAZIDIN GR 500 mg
DIPROPHOS
DICLOREUM 150 mg
500mg
500mg
SUSP. INJ. I.M. 7mg/ml
DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg
DICLOTARD 100 mg
COMPR. CU ELIB. PREL. 100mg
DICLAC (R) 75 ID
VOLTAREN (R) RETARD
REFEN (R) RETARD
VOLTAREN (R) 50
DICLOFENAC 50 mg
DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg
VOLTAREN RAPID (R)
DRAJ.
50mg
VOLTAREN (R)
SOL. INJ.
25mg/ml
TRATUL (R)
SOL. INJ.
30mg/ml
DICLOFENAC 75 mg
SOL. INJ.
75mg/3ml
REFEN 75 mg
CLAFEN 100 mg
SUPOZ.
100mg
VOLTAREN (R)
SUPOZ.
100mg
DICLOFENAC 100 mg
SUPOZ.
100mg
DICLOFENAC SODIC 100 mg SUPOZ.
100mg
12,5 mg
12,5 mg
VOLTAREN (R)
SUPOZ.
50mg
COMPR. GASTROREZ.
ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L

MERCK SHARP & DOHME ROMANIA CUTIE X 5 FIOLE X 1 ML
P-RF
ITALIA
CEHIA
TERAPIA SA
HEXAL AG
ROMANIA
ALFA WASSERMANN SPA
P-6L
CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L
P-6L
P-6L
P-6L
P-6L
TERAPIA SA
P-6L
P-6L
ROMANIA
ROMANIA
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
ROMANIA
ROMANIA


AUSTRIA
TERAPIA SA
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 ML

STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF.
ANTIBIOTICE SA
ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ.
P-RF
P-RF
P-RF
P-6L
SINTOFARM SA
MAGISTRA C & C
SINTOFARM S.A.
SINTOFARM S.A.
ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L

NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L
Tratamentul se iniiaz de ctre medicul din specialitatea reumatologie sau reabilitare medical.
18. BOLI ENDOCRINE (GUSA ENDEMICA, INSUFICIENTA SUPRARENALA CRONICA, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARA SI TUMORI
1
2
3
4
5
6
7
8
G02CB03
G02CB03
H01AX01
H01AX01
H01BA02
H01BA02
H01BA02
H01BA02
CABERGOLINUM**
CABERGOLINUM**
PEGVISOMANTUM****
PEGVISOMANTUM****
DESMOPRESSINUM
DESMOPRESSINUM
DESMOPRESSINUM
DESMOPRESSINUM
DOSTINEX
DOSTINEX
SOMAVERT 10 mg
SOMAVERT 20 mg
COMPR.
COMPR.
DESMOPRESINA TEVA 0,2mg COMPR.
MINIRIN 0,2 mg
MINIRIN MELT 120 mcg
MINIRIN MELT 60 mcg
COMPR.
LIOF. ORAL
LIOF. ORAL
0,5mg
0,5mg
10mg
20mg
0,2mg
0,2mg
120mcg
60mcg
MAREA BRITANIE
MAREA BRITANIE

MAREA BRITANIE
CUTIE X 30 FLAC. CU PULB., INSOTITE DE 30 FLAC. X 8 ML SOLV. PT. RECONSTITUIRE
P-RF/R
MAREA BRITANIE
CUTIE X 30 FLAC. CU LIOF., INSOTITE DE 30 FLAC. A 8 ML SOLV. PT. RECONSTITUIRE
P-RF/R
ROMANIA
CUTIE CU BLIST. OPA-AL- PVC/AL X 30 COMPR.
P-RF
FERRING GMBH
FERRING GMBH
FERRING GMBH
GERMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF
PFIZER LIMITED
PFIZER LIMITED
Pagina 29 din 39
P-RF
P-RF
GERMANIA
CUTIE X 3 BLIST. AL/AL X 10 UNITATI DOZATE LIOF. ORAL
P-RF
GERMANIA
CUTIE X 1 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL
P-RF
2 10.795000
8
9.912500
30 270.534666
30 539.183333
30
2.499333
30
2.999199
30
6.047000
10
3.337000
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
COD ATC
H01BA02
H01CB02
H01CB02
H01CB02
H01CB02
H01CB02
H01CB02
H01CB02
H01CB03
H01CB03
H01CB03
H01CB05
H01CB05
H01CB05
H02AA02
H02AB07
H02AB07
H02AB07
H02AB07
H02AB09
H02AB09
H02AB09
H02AB09
H02AB09
H03AA01
H03AA01
H03AA01
H03AA01
H03AA01
H03AA01
H03AA01
H03AA01
H03CA01
H03CA01
N04BC01
DCI
DESMOPRESSINUM
OCTREOTIDUM****
OCTREOTIDUM****
OCTREOTIDUM****
OCTREOTIDUM****
OCTREOTIDUM****
OCTREOTIDUM****
OCTREOTIDUM****
LANREOTIDUM****
LANREOTIDUM****
LANREOTIDUM****
PASIREOTIDUM**
PASIREOTIDUM**
PASIREOTIDUM**
FLUDROCORTISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
HYDROCORTISONUM
HYDROCORTISONUM
HYDROCORTISONUM
HYDROCORTISONUM
HYDROCORTISONUM
LEVOTHYROXINUM
LEVOTHYROXINUM
LEVOTHYROXINUM
LEVOTHYROXINUM
LEVOTHYROXINUM
LEVOTHYROXINUM
LEVOTHYROXINUM
LEVOTHYROXINUM
KALII IODIDUM
KALII IODIDUM
BROMOCRIPTINUM
Denumire Comerciala
MINIRIN MELT 60 mcg

SANDOSTATIN LAR 20 mg
SANDOSTATIN 0,1 mg/ml
SOMATULINE PR 30 mg
SOMATULINE AUTOGEL 120 mg
SOMATULINE AUTOGEL 120 mg
forma farm.
LIOF. ORAL
PULB. + SOLV. PT. SUSP. INJ. (I.M.) CU ELIB. PRELU
PULB.+SOLV. PT. SOL. INJ.

PULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG.
PULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG.
SOL. INJ.
LIOF. PT. SOL. INJ. + SOLV.
SOL. INJ. CU ELIB. PREL.

SIGNIFOR 0,3 mg
SIGNIFOR 0,6 mg
SIGNIFOR 0,9 mg
ASTONIN H
PREDNISON MCC 5 mg
PREDNISON 5 mg
SOL INJ.
SOL INJ.
SOL INJ.
COMPR.
COMPR.
COMPR.
COMPR.
HYDROCORTISONE ROUSSEL COMPR.
HYDROCORTISONE SUCCINAT SODIC LIOF. + SOLV. PT. SOL. INJ.
HIDROCORTIZON HEMISUCCINAT
EUTHYROX 100mcg
EUTHYROX 100g
EUTHYROX 200mcg
EUTHYROX 200g
EUTHYROX 25mcg
EUTHYROX 25g
EUTHYROX 50mcg
EUTHYROX 50g
JODID 100
JODID 100
BROCRIPTIN (N04BC01)
PULB. + SOLV. PT. SOL. INJ./PERF.

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

COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
DRAJ.
concentratie
60mcg
20mg
10mg
20mg
30mg
10mg
30mg
0,1mg/ml
30mg
120mg
120mg
0,3mg
0,6mg
0,9mg
0,1mg
5mg
5mg
5mg
5mg
10mg
100mg
500mg
100mg
25mg/5ml
100mcg
100g
200mcg
200g
25mcg
25g
50mcg
50g
100mcg
100mcg
2,5mg
DETINATOR APP
FERRING GMBH
TARA
DET. APP
GERMANIA
AMBALAJ
CUTIE X 3 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL
P-RF
CUTIE X 1 FLACON LIOF. + 1 FIOLA X 2 ML SOLV. + 1 SERINGA X 3 ML + 2 ACE
PR
PR
PR
PR
PR
PR
PR
S
CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. CU ELIB. PREL., IN PUNGA AL/NYLON/PE + AC
S/P-RF
CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE
CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2 ML SOLVENT + ADAPTOR PT FLACON+1 AC
CUTIE X 1 FLAC. PULBERE + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE
CUTIE X 1 FLAC. PULB. + 1 SERINGA PREUMPLUTA X 2,5 ML SOLVENT + 2 ACE
Prescriptie
NR.CRT
IPSEN PHARMA
IPSEN PHARMA
IPSEN PHARMA
FRANTA
FRANTA
FRANTA
MAREA BRITANIE
CUTIE CU 30 FIOLE DIN STICLA A 1ML X 0,3 MG
MAREA BRITANIE
MAREA BRITANIE
MERCK KGAA
GERMANIA CUTIE X 1 FLAC. DIN PP X 50 COMPR. P-RF

SINTOFARM SA
ROMANIA
CN UNIFARM
ROMANIA
ZENTIVA S.A.
ROMANIA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
MERCK KGAA
BIOFARM SA
Tratamentul se initiaza de catre medicul in specialitatea endocrinologie sau oncologie
Pagina 30 din 39
CUTIE CU 1 SERINGA PREUMPLUTA PE TEREFTALAT/AL/PE LAMINATA X 0,5 ML PREVAZUTA CU SIST. DE SIGURANTA AUTOMAT SI 1 AC DIN OTEL (1,2MMX20MM), TEACA DIN PLASTIC PT. AC (PEID) SI 1 OPRITOR PT. PISTON (BROMOBUTIL CAUCIUC)

PR
PR
PR
PR
P-RF
P-RF
P-RF
P-RF
CUTIE X 1 FLAC. 25 COMPR.
PRF
CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML
S/P-RF
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV.
PR/PRF
CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV.
PR/PRF
CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B
S/P-RF
GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L

GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L
GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L
GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF
GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF
P-RF

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
30
1
1
1
1
1
1
5
1
1
1
30
30
30
50
20
30
30
20
25
1
1
1
5
100
100
100
100
100
100
100
100
100
100
40
3.169333
2,919.710000
1,495.280000
2,919.710000
4,251.210000
1,519.360000
4,344.140000
8.830000
1,611.250000
4,667.070000
4,667.070000
223.166333
262.131666
295.473666
0.403000
0.108399
0.090333
0.108399
0.108399
0.506800
3.910000
11.910000
4.692000
4.426000
0.121400
0.121400
0.250500
0.250500
0.085800
0.085800
0.085800
0.085800
0.127300
0.127300
0.549000
3.169333
2,919.710000
1,495.280000
2,919.710000
4,251.210000
1,519.360000
4,344.140000
8.830000
1,611.250000
4,667.070000
4,667.070000
223.166333
262.131666
295.473666
0.403000
0.108399
0.090333
0.108399
0.108399
0.506800
3.910000
11.910000
4.692000
4.426000
0.121400
0.121400
0.250500
0.250500
0.085800
0.085800
0.085800
0.085800
0.127300
0.127300
0.549000
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
0.028601
0.000000
0.015267
0.025101
0.000000
0.000000
0.000000
2.398000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
DCI
COD ATC
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
19. BOALA WILSON - G23

1
M01CC01
PENICILLAMINUM**4)
CUPRIPEN 250mg
CAPS.
250mg
CN UNIFARM S.A.
ROMANIA FLACON X 30 CAPSULE
PRF
30
1.362000
1.362000
0.000000
5
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
1
1
1
1
1
1
1
1
1
31.080000
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
31.080000
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
778.610000
930.390000
1,132.460000
1,486.320000
1,861.580000
264.720000
2,768.720000
424.740000
601.690000
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
0.000000
0.000000
0.000000
0.000000
Tratamentul se iniiaz de ctre medicul din specialitatea endocrinologie, neurologie sau neurologie pediatric.
20. BOALA CRONICA DE RINICHI - faza predializa - G 25

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
B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA**

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
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**
B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA**

VENOFER (R)
EPREX 40000 UI/ml
BINOCRIT 40000 UI/1 ml
ARANESP 10mcg/0,4ml
ARANESP 20mcg/0,5ml
ARANESP 30mcg/0,3ml
ARANESP 40mcg/0,4ml
ARANESP 500mcg/ml
ARANESP 50mcg/0,5ml
ARANESP 60mcg/0,3ml
ARANESP 80mcg/0,4ml
MIRCERA 100mcg/0,3ml
MIRCERA 30mcg/0,3ml
MIRCERA 50 mcg/0,3ml
MIRCERA 75mcg/0,3ml

VIFOR FRANCE S.A.
SOL. INJ. IN SERINGA PREUMPLUTA 2000UI/1,0ml SANDOZ GMBH
SOL. INJ. IN SERINGA PREUMPLUTA 40 000UI/ml
SOL. INJ. IN SERINGA PREUMPLUTA 40000 UI/1 ml SANDOZ GMBH
FRANTA CUTIE X 5 FIOLE X 5 ML

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.
AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML SOL. INJ.
S/P-RF
S/P-RF/R
S/P-RF/R
P-RF/R
S/P-RF/R
SLOVENIA
CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML SOL. INJ.
AUSTRIA
AUSTRIA
AUSTRIA
P-RF/R
S/P-RF/R
S/P-RF
S/P-RF/R
10000UI/0,6ml
MAREA BRITANIE
S/P-RF/R
2000UI/0,3ml
MAREA BRITANIE
CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE
S/P-RF/R
30000 UI/0,6ml ROCHE REGISTRATION LTD.
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
S/P-RF/R

100mcg/0,5ml AMGEN EUROPE BV OLANDA

500mcg/ml AMGEN EUROPE BV
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA
OLANDA

4000UI/0,3ml
5000UI/0,3ml
PR
PR
PR
PR
PR
PR
PR
PR
PR
P-RF/R
P-RF/R
CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X 0,3 ML
P-RF/R
P-RF/R
CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML
P-RF/R
P-RF/R
P-RF/R
CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML
P-RF/R
P-RF/R
P-RF/R


P-RF/R
MAREA BRITANIE
CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 ML SOL. INJ.
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
S/P-RF/R
100mcg/0,3ml
120mcg/0,3ml
150mcg/0,3ml
200mcg/0,3ml
250mcg/0,3ml
MAREA BRITANIE
S/P-RF/R
30mcg/0,3ml
MAREA BRITANIE
S/P-RF/R
MAREA BRITANIE
CUTIE X 1 SERINGA PREUMPLUTA, X 0,6ML SOL. INJ.
S/P-RF/R
360mcg/0,6ml
50 mcg/0,3ml
MAREA BRITANIE
S/P-RF/R
75mcg/0,3ml
MAREA BRITANIE
S/P-RF/R

Pagina 31 din 39
1,960.260000
206.655000
269.612500
3,219.860000
321.740000
395.560000
521.557500
778.610000
930.390000
1,132.460000
1,486.320000
1,861.580000
264.720000
2,768.720000
424.740000
601.690000
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
88
DCI
COD ATC
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
C09CA04
H02AB07
H02AB07
H02AB07
H02AB07
H05BX02
H05BX02
H05BX02
H05BX02
H05BX02
L01AA01
L04AD01
L04AD01
L04AD01
L04AD01
L04AD01
L04AX01
L04AX01
L04AX01
V06DDN1
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
IRBESARTANUM**
PREDNISONUM
PREDNISONUM
PREDNISONUM
PREDNISONUM
PARICALCITOLUM**
PARICALCITOLUM**
PARICALCITOLUM**
PARICALCITOLUM**
PARICALCITOLUM**
CYCLOPHOSPHAMIDUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
COMBINATII (AMINOACIZI)**
Denumire Comerciala
APROVEL 150mg
IRPRESTAN 150 mg
IFIRMASTA 150 mg
ATOKKEN 150 mg
APROVEL 150mg
ATOKKEN 150 mg
APROVEL 300mg
IFIRMASTA 300mg
ATOKKEN 300 mg
APROVEL 300mg
ATOKKEN 300 mg
ATOKKEN 75 mg
PREDNISON MCC 5 mg
PREDNISON 5 mg
PREDNISON - RICHTER 5 mg
ZEMPLAR 1g
ZEMPLAR 2g
PARICALCITOL FRESENIUS 2 micrograme/ml
PARICALCITOL FRESENIUS 5 micrograme/ml
ZEMPLAR
ENDOXAN (R) 50 mg
EQUORAL 100 mg
EQUORAL 25 mg
EQUORAL 50 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
KETOSTERIL
forma farm.
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.
COMPR.
COMPR.
COMPR.
CAPS. MOI
CAPS. MOI
SOL INJ.
SOL INJ.
SOL. INJ.
DRAJ.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PIC. OFT., SOL
concentratie
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
300mg
300mg
300mg
75mg
5mg
5mg
5mg
5mg
1g
2g
DETINATOR APP
TARA
DET. APP
AMBALAJ
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
ISLANDA

GALENICA S.A.

P6L
CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L
P-6L
CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L
ROMANIA
FRANTA
CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L
P6L
SANOFI CLIR SNC
FRANTA

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

P6L
P6L

CUTIE CU BLIST. PVC-PE-PVDC/AL, X 28 COMPR. FILM. P-6L
P-6L
ROMANIA
FRANTA
CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L
P6L
SANOFI CLIR SNC
FRANTA
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L
NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P6L
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF
ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF
SINTOFARM SA
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF
ABBVIE FARMACEUTICA S.L.U.
SPANIA
SPANIA
2micrograme/ml
FRESENIUS MEDICAL CARE DEUTSCHLAND GMBH
GERMANIA
CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU CAPACITATEA DE 2 ML X 1 ML SOL. INJ.
5micrograme/ml
FRESENIUS MEDICAL CARE DEUTSCHLAND GMBH
GERMANIA
CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU CAPACITATEA DE 2 ML X 1 ML SOL. INJ.
SPANIA
CUTIE X 5 FIOLE X 1 ML SOL. INJ.
5 g/ml
50mg
100mg
25mg
25mg
50mg
50mg
50mg
50mg
75mg
Prescriptie
NR.CRT
CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS. MOI
P-RF
CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL X 7 CAPS.
P-RF

CEHIA

CEHIA

CEHIA

PR
PR
S
P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
IRLANDA
AUSTRIA
FARA CONCENTRATIE
FRESENIUS KABI DEUTSCHLAND GMBH
GERMANIA CUTIE X 5 BLIST. DIN PVC/AL X 20 COMPR. FILM. P-RF
20mg/ml
ROMANIA CUTIE X 1 FLAC. PEJD X 5 ML PIC. OFT., SOL
S/P-RF
PR

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
28
28
28
28
28
28
30
28
28
28
28
30
28
28
28
28
28
28
28
28
28
28
30
28
28
28
20
30
30
20
28
28
5
5
5
50
50
50
50
50
50
100
100
100
100
0.359199
0.516071
0.359199
0.359199
0.359199
0.359199
0.299333
0.359199
0.359199
0.359199
0.359199
0.359199
0.359199
0.359199
0.619285
0.576785
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.856428
0.108399
0.090333
0.108399
0.108399
10.363571
17.300357
13.302000
26.916000
32.299200
0.542400
6.232400
1.784400
1.487000
3.040560
2.533800
0.702300
0.702300
0.788900
2.272200
0.359199
0.516071
0.359199
0.359199
0.359199
0.359199
0.299333
0.359199
0.359199
0.359199
0.359199
0.359199
0.359199
0.359199
0.619285
0.576785
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.619285
0.856428
0.108399
0.090333
0.108399
0.108399
10.363571
17.300357
13.302000
26.916000
32.299200
0.542400
6.232400
1.784400
1.487000
3.040560
2.533800
0.702300
0.702300
0.788900
2.272200
0.009372
0.000000
0.009372
0.846515
0.424372
0.257586
0.000000
0.178301
0.238301
0.424372
0.208301
0.400801
0.846515
0.424372
0.192857
0.000000
0.981429
0.456072
0.183215
0.244286
0.456072
0.267857
0.416715
0.981429
0.456072
0.000000
0.028601
0.000000
0.015267
0.025101
0.000000
0.000000
0.000000
0.000000
15.386800
0.000000
0.000000
0.574000
0.000000
0.788040
0.000000
0.000000
0.000000
0.000000
0.000000
14.530000
14.530000
0.000000
Tratamentul se initiaza de catre medicul in specialitatea nefrologie.
21. GLAUCOM - G 26
1
S01EC03
DORZOLAMIDUM
DORZOPT 20 mg/ml
Pagina 32 din 39
P-RF
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
DCI
COD ATC
S01EC03
S01EC04
S01ED01
S01ED01
S01ED01
S01ED01
S01ED02
S01ED02
S01ED02
S01ED05
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01ED51
S01EE01
S01EE01
S01EE01
S01EE01
S01EE01
S01EE03
S01EE03
S01EE03
S01EE04
S01EE04
S01EE04
S01EE04
Denumire Comerciala
DORZOLAMIDUM
BRINZOLAMIDUM
TIMOLOLUM
TIMOLOLUM
TIMOLOLUM
TIMOLOLUM
BETAXOLOLUM
BETAXOLOLUM
BETAXOLOLUM
CARTEOLOLUM
TRUSOPT
AZOPT 10mg/ml
TIMOLOL ROMPHARM 0,25%
TIMOLOL ROMPHARM 0,5%
TIMOLOL 0,25%
TIMOLOL 0,5%
BETAX
BETOPTIC
BETOPTIC - S
FORTINOL EP 2%
COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM) AZARGA
COMBINATII (BIMATOPROSTUM + TIMOLOLUM) GANFORT
COMBINATII (DORZOLAMIDUM+TIMOLOLUM) SIFIOPT 20 mg/5 mg/ml
COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT
forma farm.
concentratie
SOL. OFT.
20mg/ml
PICATURI OFT.-SUSP. 10mg/ml
PIC. OFT., SOL. 2,5mg/ml
PIC. OFT.,SOL. 5mg/ml
PIC. OFT.-SOL. 5mg/ml
PIC.OFTALMICE,SOL. 5mg/ml
PICATURI OFT.-SUSP. 0,25%
PIC. OFTALMICE CU ELIB. PREL. 20mg/ml
PIC. OFT. SUSP. 10mg/ml+5mg/ml
PIC. OFT.,SOL. 300mcg/ml+5mg/ml
PIC. OFT., SOL. 20mg/5mg/ml
PIC. OFT.-SOL. 20mg/ml+5mg/ml
COMBINATII (LATANOPROSTUM+TIMOLOLUM) GLAUTAN PLUS 50 micrograme/ml + 5 mg/ml PIC. OFT., SOL 50 micrograme/ml + 5 mg/ml
COMBINATII (LATANOPROSTUM+TIMOLOLUM)
PIC. OFT., SOL 50micrograme/ml+5mg/ml
COMBINATII (LATANOPROSTUM+TIMOLOLUM) XALCOM (R)
SOL. OFT.
50mcg/ml+5mg/ml
COMBINATII (TRAVOPROSTUM+TIMOLOLUM) DUOTRAV 40mcg/ml + 5mg/ml PIC. OFT.-SOL. 40mcg/ml + 5mg/ml
LATANOPROSTUM
SIFITAN 50 micrograme/ml
PIC. OFT., SOL 50micrograme/ml
LATANOPROSTUM
LATANOPROST STADA HF 50 micrograme/ml PIC. OFT., SOL. 50 micrograme/ml
LATANOPROSTUM
MONOPOST 50 micrograme/ml
50micrograme/ml
LATANOPROSTUM
GLAUTAN 0,05 mg/ml
PIC. OFT.,SOL. 0,05mg/ml
LATANOPROSTUM
XALATAN (R)
PICATURI OFT.-SOL. 50mcg/ml
BIMATOPROSTUM
BIMAGAN 0,3 mg/ml
PIC. OFT., SOL 0,3 mg/ml
BIMATOPROSTUM
BIMAGAN 0,1 mg/ml
PIC. OFT., SOL. 0,1mg/ml
BIMATOPROSTUM
LUMIGAN 0,1mg/ml
PIC. OFT.,SOL. 0,1mg/ml
TRAVOPROSTUM
IZBA
PIC. OFT., SOL 30mcg/ml
TRAVOPROSTUM
BONDULC 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml
TRAVOPROSTUM
TRAVOPROST ZENTIVA 40 micrograme/ml PIC. OFT., SOL. 40micrograme/ml
TRAVOPROSTUM
TRAVATAN 40mcg/ml
PICATURI OFT.SOL. 40mcg/ml
LATANOPROST/TIMOLOL STADA HEMOFARM 50 micrograme/ml si 5 mg/ml
PIC. OFT., SOL., IN RECIPIENT UNIDOZA
Prescriptie
NR.CRT
TARA
DET. APP
CUTIE X 1 FLACON TIP OCULOMETER PLUS X 5 ML SOL. OFT.
P-6L
ALCON LABORATORIES LTD.
CUTIE X 1 FLACON, PEJD X 5 ML
P-6L
DETINATOR APP
MAREA BRITANIE
AMBALAJ
ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL.

ROMANIA CUTIE X 1 FLAC. PICURATOR DIN PEID X 5 ML PIC. OFTALMICE, SOL.
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON PEID, PREVAZUT CU PICURATOR X 5 ML
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON CU PICURATOR X 5 ML
ROMPHARM SRL
ROMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PIC. OFTALMICE, SOL.
P-6L
P-6L
ALCON COUVREUR NV BELGIA

ALCON COUVREUR NV BELGIA
P-6L
CUTIE X 1 FLACON DIN PEJD PREV. CU PICURATOR X 5 ML PIC.OFTALMICE, SOL.
P-6L
P-6L
P-6L
CUTIE X 1 FLACON DIN PEJD X 5ML PIC. OFT.SUSP. P-6L
GERMANIA
CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFTALMICE CU ELIB. PREL.
P-6L
ALCON LABORATORIES (UK) LTD.
MAREA BRITANIE
CUTIE X 1 FLAC. X 5 ML SUSP. OFT.
P-RF
ALLERGAN PHARMACEUTICALS IRELAND
IRLANDA
CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC.OFT.SOL. P-RF
OFTAFARMA ROMNIA S.R.L.
ROMANIA
CUTIE CU 1 FLAC. PE ALB, OPAC +PICURATOR PEID A 5 ML PIC. OFT. SOL.
PRF
CUTIE X 1 FLACON DE TIP OCUMETER PLUS X 5ML PIC. OFT., SOL.
P-6L

ROMANIA
CUTIE CU 1 FLAC. TRANSPARENT PEJD + PICURATOR TRANSPARENT PEJD X 2,5 ML PIC. OFT., SOL.
P6L
P6L
CUTIE X 1 FLACON DIN PEJD CU PICURATOR DIN PEJD INCHIS CU CAPAC DIN PEID X 2.5ML PICATURI OFTALMICE-
MAREA BRITANIE
CUTIE X 1 FLACON X 2,5 ML
P-6L
MAREA BRITANIE
CUTIE X 1 FLAC. DIN PP X 2,5 ML PIC. OFTALMICE,SOLUTIE
P-RF
NTC S.R.L.
ITALIA
CUTIE CU 1 FLAC. PEJD X 2,5 ML PIC. OFT., SOL.
P6L
P6L
P6L
P6L

ROMANIA
MAREA BRITANIE

ROMANIA
ROMANIA
ALLERGAN PHARMACEUTICALS IRELAND
IRLANDA
MAREA BRITANIE
ISLANDA
ZENTIVA, K.S.
REPUBLICA CEHA
ALCON LABORATORIES LTD.
MAREA BRITANIE
CUTIE CU 1 FLAC. DIN PEJD CU CAPAC DIN PEID X 2,5 ML PIC. OFT. PT. APROX. 80 PIC. SOL.
CUTIE CU 30 (6X5) RECIPIENTE UNIDOZA DIN PEID AMBALATE CATE 5 IN 6 PLICURI LAMINATE DIN PE-AL-COPOLIMER A CATE 0,2 MILILITRI PIC. OFT., SOL.
CUTIE CU 1 FLAC. PEJD CU CAPACITATEA DE 5 ML+PICURATOR DIN PEJD, CU CAPAC DE SIGURANTA DIN PEJD X 2,5 ML PIC. OFT., SOL.
CUTIE X 1 FLACON PICURATOR PE X 2,5 ML P-6L

CUTIE X 1 FLACON ALB DIN PEJD CU PICURATOR DIN PEJD SI CAPAC CU INEL DE SIGURANTA DIN PEID X 3ML PICATURI OFTALMICE , SOLUTIE
PRF
CUTIE CU UN FLACON DIN PEJD CU PICURATOR DIN PEJD SI CAPAC VERDE- ALBASTRUI DIN PED A 3 ML PICATURI OFTALMICE, SOLUTIE
PRF
CUTIE X 1 FLAC. DIN PEJD X 3 ML PIC. OFT. SOL. P-RF

CUTIE X 1 FLACON X 4ML PICATURI OFTALMICE, SOLUTIE
CUTIE CU 1 FLAC. TRANSLUCID DIN PP CU CAPACITATEA DE 5 ML, PREVAZUT CU DOP PICURATOR TRANSPARENT DIN PEJD SI CAPAC DIN PEID A 2,5 ML PIC. OFT., SOL.
CUTIE CU 1 FLAC. TRANSLUCID DIN PP CU CAPACITATEA DE 5 ML, CU PICURATOR TRANSPARENT DIN PEJD A 2 ,5 ML PIC. OFT. SOL.
CUTIE X 1 FLACON X 2,5 ML
PRF
P6L
P6L
P-6L

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
30
1
1
1
1
1
1
1
1
1
17.436000
44.870000
3.110000
4.980000
3.130000
5.300000
5.320000
6.384000
15.330000
10.890000
58.030000
69.360000
26.430000
31.716000
29.000000
29.000000
34.800000
62.810000
25.150000
25.150000
1.874000
25.150000
30.180000
42.800000
50.970000
61.164000
87.630000
33.440000
36.290000
40.128000
17.436000
44.870000
3.110000
4.980000
3.130000
5.300000
5.320000
6.384000
15.330000
10.890000
58.030000
69.360000
26.430000
31.716000
29.000000
29.000000
34.800000
62.810000
25.150000
25.150000
1.874000
25.150000
30.180000
42.800000
50.970000
61.164000
87.630000
33.440000
36.290000
40.128000
4.904000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
6.436000
0.000000
0.000000
0.000000
0.000000
0.000000
7.634000
0.000000
0.000000
8.370000
0.000000
0.000000
0.000000
0.000000
0.000000
7.260000
0.000000
0.000000
13.296000
0.000000
0.000000
0.000000
15.712000
100
10
25
100
10
25
100
100
5
10
50
20
1
1
1
20
0.190800
0.832000
0.816800
0.736400
1.387000
1.327200
1.246200
1.256100
1.380000
1.425000
0.543200
1.234000
20.480000
8.810000
31.020000
0.108399
0.190800
0.832000
0.816800
0.736400
1.387000
1.327200
1.246200
1.256100
1.380000
1.425000
0.543200
1.234000
20.480000
8.810000
31.020000
0.108399
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
0.028601
Tratamentul se iniiaz de ctre medicul n specialitatea oftalmologie.
22. PEMFIGUS - G 27
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB02
H02AB04
H02AB04
H02AB04
H02AB04
H02AB04
H02AB07
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
DEXAMETHASONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
METHYLPREDNISOLONUM
PREDNISONUM
DEXAMED
DEXAMETAZONA ROMPHARM 4 mg/ml
DEXAMETHASONE SODIUM PHOSPHATE
DEXAMETHASONE SODIUM PHOSPHATE
DEXAMED
MEDROL A 16
MEDROL 32
LEMOD SOLU 125 mg

LEMOD SOLU 500 mg
PREDNISON MCC 5 mg
COMPR.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
SOL. INJ.
COMPR.
COMPR.
COMPR.
0,5mg
4mg/ml
4mg/ml
4mg/ml
4mg/ml
4mg/ml
4mg/ml
8mg
8mg
8mg/2ml
16mg
32mg
250mg/4ml
125mg
500mg
5mg
CN UNIFARM S.A.
PRF
PRF
ROMANIA CUTIE CU 10 BLISTERE X 10 COMPRIMATE

ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 25 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ.
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 100 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ.
ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU UN SUPORT CU 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.
E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.
PRF
PRF
PRF
PRF
PRF
P-RF
P-RF
CUTIE X 10 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. P-RF
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
P-RF
P-RF
S/P-RF
S/P-RF
MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
P-RF
Pagina 33 din 39
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
DCI
COD ATC
H02AB07
H02AB07
H02AB07
J04BA02
L01AA01
L01AA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L01BA01
L04AD01
L04AD01
L04AD01
L04AD01
L04AD01
L04AX01
L04AX01
L04AX01
PREDNISONUM
PREDNISONUM
PREDNISONUM
DAPSONUM 4)
CYCLOPHOSPHAMIDUM
CYCLOPHOSPHAMIDUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
METHOTREXATUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
CICLOSPORINUM
AZATHIOPRINUM
AZATHIOPRINUM
AZATHIOPRINUM
Denumire Comerciala
forma farm.
PREDNISON 5 mg
COMPR.
COMPR.
DISULONE
COMPR.
ENDOXAN (R) 50 mg
DRAJ.
ENDOXAN 200 mg
PULB. PT. SOL. PERF./INJ. I.V.
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
CAPS. MOI
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
5mg
5mg
5mg
100mg
50mg
200mg
100mg/ml
100mg/ml
25mg/ml
10mg/ml
10mg/ml
10mg/ml
10mg/ml
50mg/ml
50mg/ml
50mg/ml
50mg/ml
100mg
25mg
25mg
50mg
50mg
50mg
50mg
75mg
PULB. PT.CONC. PT.SOL. PERF.
400U
BENDATREXAT
SOL INJ.

METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
METOJECT 50mg/ml
EQUORAL 100 mg
EQUORAL 25 mg
EQUORAL 50 mg
IMURAN
IMURAN
IMMUNOPRIN 75 mg
concentratie

DETINATOR APP
ARENA GROUP SA
SINTOFARM SA
CN UNIFARM
TARA
DET. APP
ROMANIA
ROMANIA
ROMANIA
ROMANIA
AMBALAJ
Prescriptie
NR.CRT
S/P-RF
PR
30
0.090333
30
0.108399
20
0.108399
100
0.489700
50
0.542400
1 15.890000
1 374.090000
1 82.990000
1 64.090000
1 61.880000
1 118.008000
1 46.730000
1 79.700000
1 98.340000
1 56.076000
1 110.680000
1 74.880000
50
6.232400
50
1.784400
50
1.487000
50
3.040560
50
2.533800
100
0.702300
100
0.702300
100
0.788900
CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF.
PR
1 6,149.520000

P-RF
CUTIE X 100 COMPR.
P-RF
P-RF
P-RF
P-RF
ACTAVIS S.R.L.

AUSTRIA
AUSTRIA
AUSTRIA
AUSTRIA
S
S
S
PR
PR
PR
PR
PR
GERMANIA
P-RF
GERMANIA
P-RF
GERMANIA
P-RF
GERMANIA
CEHIA

CN UNIFARM S.A.
ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ

CEHIA

CEHIA


IRLANDA
AUSTRIA

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
S/P-RF
0.090333
0.108399
0.108399
0.489700
0.542400
15.890000
374.090000
82.990000
64.090000
61.880000
118.008000
46.730000
79.700000
98.340000
56.076000
110.680000
74.880000
6.232400
1.784400
1.487000
3.040560
2.533800
0.702300
0.702300
0.788900
0.000000
0.015267
0.025101
0.000000
0.000000
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
0.574000
0.000000
0.788040
0.000000
0.000000
0.000000
0.000000
6,149.520000
0.000000
0.416000
0.363000
0.361000
0.155000
0.186000
4.141700
4.850000
4.840000
4.141700
2.848000
3.270000
0.299166
0.527500
0.000000
0.000000
0.000000
0.000000
0.150000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
Tratamentul se iniiaz de ctre medicul n specialitatea dermatologie.
23. BOALA GAUCHER - G 29

1
A16AB02
IMIGLUCERASUM****
CEREZYME 400U
GENZYME EUROPE BV OLANDA
Dup precizarea diagnosticului de ctre laboratoarele de specialitate, tratamentul se iniiaz de ctre medicul din specialitatea gastroenterologie, hematologie, neurologie, neurologie pediatric i pediatrie.
24. BOLI VENERICE (SIFILIS, GONOREE, INFECTIA CU CHLAMIDIA) - G 30

1
2
3
4
5
6
7
8
9
10
11
12
13
J01AA02
J01AA02
J01AA02
J01AA07
J01AA07
J01CE01
J01CE01
J01CE01
J01CE01
J01CE01
J01CE01
J01CE02
J01CE02
DOXYCYCLINUM
DOXYCYCLINUM
DOXYCYCLINUM
TETRACYCLINUM
TETRACYCLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
BENZYLPENICILLINUM
PHENOXYMETHYLPENICILLINUM
DOXICICLINA ATB 100 mg

DOXICICLINA ARENA
CAPS.
CAPS.
DOXICICLINA SANDOZ 100 mg CAPS.
TETRACICLINA ARENA 250 mg CAPS.
TETRACICLINA ATB 250 mg CAPS.
PENICILINA G SODICA
PULB. PT. SOL. INJ.
PENICILINA G SODICA
PULB. PT. SOL. INJ.
PENICILINA G POTASICA
PULB. PT. SOL. INJ.
PENICILINA G POTASICA
PULB. PT. SOL. INJ.
PENICILINA G SODICA
PULB. PT. SOL. INJ.
PENICILINA G SODICA
PULB. PT. SOL. INJ.
OSPEN (R) 1000
COMPR. FILM.
OSPEN 1500
COMPR. FILM.
100 mg
100mg
100mg
250mg
250mg
1 000 000ui
1 000 000ui
1000000ui
1000000ui
400 000ui
400 000ui
1000000ui
1500000ui
ANTIBIOTICE S.A.
ARENA GROUP SA
SANDOZ SRL
ARENA GROUP SA
ANTIBIOTICE S.A.
ANTIBIOTICE SA
ANTIBIOTICE SA
ANTIBIOTICE SA
ANTIBIOTICE SA
ANTIBIOTICE SA
ANTIBIOTICE SA
SANDOZ GMBH
SANDOZ GMBH
Pagina 34 din 39
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
AUSTRIA
AUSTRIA
CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF

CUTIE X 2 BLIST., AL/PVC X 10 CAPS.
P-RF
P-RF
P-RF
CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF

CUTIE X 100 FLAC. DIN STICLA CU PULB. PT. SOL. INJ.
P-RF/S
CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ. P-RF

P-RF/S
P-RF/S
10
20
10
20
20
100
1
1
100
100
1
12
12
0.416000
0.363000
0.361000
0.155000
0.186000
4.141700
4.850000
4.840000
4.141700
2.848000
3.270000
0.299166
0.527500
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
62
63
64
65
COD ATC
J01CE02
J01CE02
J01CE08
J01CE08
J01DD08
J01DD08
J01DD08
J01DD08
J01FA01
J01FA01
J01FA01
J01FA01
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01FA10
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
DCI
BENZATHINI BENZYLPENICILLINUM
BENZATHINI BENZYLPENICILLINUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM
CEFIXIMUM
ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
ERYTHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
AZITHROMYCINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
Denumire Comerciala
OSPEN (R) 500

OSPEN 400.000 U.I./5 ml
MOLDAMIN 1200000 UI
MOLDAMIN 1200000 UI
EFICEF 100 mg
EFICEF (R) 200 mg
XIFIA 400mg
XIFIA 400mg
ERITROMAGIS 200 mg
ERITROMICINA 200 mg
forma farm.
COMPR. FILM.
SUSP. ORALA
PULB. PT. SUSP. INJ.
PULB. PT. SUSP. INJ.
AZITROMICINA ARENA 500 mg

CAPS.
CAPS.
COMPR. FILM.
COMPR. FILM.
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.
AZITROX 200 mg/5 ml
PULB. + SOLV. SUSP. ORALA
ERITROMICINA SANDOZ 200 mg COMPRIMATE
ERITROMICINA ATB 200 mg

AZATRIL 250 mg
SUMAMED 250 mg
SUMAMED 125 mg
AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE

AZIBIOT 250 mg
SUMAMED 500 mg
AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE
AZIBIOT 500 mg
AZITROX (R) 500

AZATRIL 500 mg
AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA

AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA
SUMAMED FORTE
SUMAMED FORTE
SUMAMED FORTE

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.
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.
concentratie
500000ui
400.000U.I./5ml
1200000UI
1200000UI
100mg
200mg
400mg
400mg
200mg
200mg
200mg
200mg
250mg
250mg
125mg
250mg
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
100mg
100mg
250mg
250mg
250mg
250mg
250mg
250mg
250mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
500mg
DETINATOR APP
SANDOZ GMBH
SANDOZ GMBH
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
ANTIBIOTICE SA
INN-FARM D.O.O.
INN-FARM D.O.O.
ARENA GROUP SA
ANTIBIOTICE SA
SANDOZ S.R.L.
ANTIBIOTICE SA
TARA
DET. APP
AUSTRIA
AUSTRIA
AMBALAJ
Prescriptie
NR.CRT

CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE
P-RF
ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. P-RF
ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. S/P-RF
ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF
ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF
SLOVENIA
SLOVENIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE

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

PRF
PRF
P-RF
P-RF
P-RF
CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF
BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS.
P-RF
PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF
SANDOZ S.R.L.
TERAPIA SA
TERAPIA SA

ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM.
P-RF
P-RF
P-RF
KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR.FILM. PRF
SANDOZ S.R.L.
P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF
TERAPIA SA
TERAPIA SA
ZENTIVA K.S.
ROMANIA
ROMANIA
CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF
CEHIA
ISLANDA
ARENA GROUP S.A.

TERAPIA SA
TERAPIA SA
ZENTIVA S.A.
SANDOZ SRL
SANDOZ SRL
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
CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM.
CUTIE CU BLIST. OPA-PVC-AL/AL X 3 COMPR. FILM.
P-RF
PRF
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 X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE
P-RF

AC HELCOR SRL

RANBAXY UK LIMITED
MAREA BRITANIE

P-RF
P-RF


AC HELCOR SRL
ROMANIA
RANBAXY UK LIMITED MAREA BRITANIE
ANTIBIOTICE SA
ROMANIA
Pagina 35 din 39
P-RF



asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
12
1
1
100
10
10
5
10
20
20
20
20
6
6
6
6
6
6
6
3
3
3
3
3
3
3
3
3
3
1
1
1
1
1
1
10
20
10
10
10
10
10
10
20
10
10
10
10
10
10
10
20
0.225833
8.920000
5.590000
4.662700
2.237000
3.609000
10.020000
9.516000
0.367500
0.441000
0.422000
0.441000
3.291666
3.949999
4.146666
3.291666
3.291666
3.291666
3.291666
4.875999
4.063333
4.875999
4.875999
4.875999
4.875999
4.875999
4.875999
15.426666
15.426666
14.470000
19.340000
19.290000
17.364000
39.680000
60.360000
3.871000
3.404000
0.683000
0.707000
0.683000
0.709000
0.720000
0.681000
0.638000
1.022400
0.920000
1.022400
1.022400
0.911000
1.022400
0.957000
0.852000
0.225833
8.920000
5.590000
4.662700
2.237000
3.609000
10.020000
9.516000
0.367500
0.441000
0.422000
0.441000
3.291666
3.949999
4.146666
3.291666
3.291666
3.291666
3.291666
4.875999
4.063333
4.875999
4.875999
4.875999
4.875999
4.875999
4.875999
15.426666
15.426666
14.470000
19.340000
19.290000
17.364000
39.680000
60.360000
3.871000
3.404000
0.683000
0.707000
0.683000
0.709000
0.720000
0.681000
0.638000
1.022400
0.920000
1.022400
1.022400
0.911000
1.022400
0.957000
0.852000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.056500
0.000000
0.056500
0.000000
1.116667
0.000000
0.000000
0.000000
0.000000
0.000000
3.707334
0.000000
0.440667
0.700667
0.700667
0.700667
0.254001
0.700667
0.000000
0.000000
0.000000
0.000000
0.000000
4.896000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.160600
0.000000
0.299600
0.348600
0.000000
0.348600
0.000000
0.000000
66
67
68
69
70
71
72
73
74
COD ATC
DCI
J01MA02
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
CIPROFLOXACINUM
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
J01MA02
Denumire Comerciala
CIPRINOL 750 mg
CIPROBAY XR 1000 mg
CIPROBAY XR 500 mg
CIPRINOL (R)
CIPRINOL (R)
forma farm.
COMPR. FILM.
COMPR. FILM.

CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF.
CIPROFLOXACINA INFOMED 2 mg/ml

CIPROFLOXACINA INFOMED 2 mg/ml
SOL. PERF.
SOL. PERF.
concentratie
750mg
750mg
1000 mg
500 mg
100mg/10ml
100mg/10ml
100mg/10ml
2mg/ml
2mg/ml
TARA
DET. APP
AMBALAJ
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.
DETINATOR APP
BAYER PHARMA AG
BAYER PHARMA AG
KRKA D.D.
KRKA D.D.
ZENTIVA S.A.
Prescriptie
NR.CRT
P-RF
P-RF
GERMANIA
CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL.
P-RF
GERMANIA
CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL.
P-RF

S
S/P-RF
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA PREVAZUTE CU INEL DE RUPERE X 10 ML S/P-RF
INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 100ML S
INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
10
10
7
3
50
5
5
10
10
1.031000
1.237200
12.554285
1.022400
2.833800
3.400560
3.400560
8.815000
16.023000
1.031000
1.237200
12.554285
1.022400
2.833800
3.400560
3.400560
8.815000
16.023000
0.000000
2.633800
0.000000
8.530933
0.000000
0.073440
0.085440
0.000000
0.000000
3
3
1
2
1,902.410000
1,628.203333
1,593.040000
1,956.550000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
0.000000
0.000000
0.000000
0.000000
Tratamentul se iniiaz de ctre medicul n specialitatea dermatologie i obstetric-ginecologie (pentru gonoree i infecia cu Chlamidia).
IMUNOSUPRESOARE SELECTIVE - G31

25. BOALA CRONICA INFLAMATORIE INTESTINALA - G31a
1
2
3
4
L04AB02
L04AB02
L04AB02
L04AB04
INFLIXIMABUM****
INFLIXIMABUM****
INFLIXIMABUM****
ADALIMUMABUM****
REMICADE 100 mg
INFLECTRA 100 mg
REMSIMA 100mg
HUMIRA 40 mg

100mg
100mg
100mg
40mg
JANSSEN BIOLOGICS B.V.
OLANDA
CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF.
HOSPIRA UK LIMITED
MAREA BRITANIE
CELLTRION HEALTHCARE HUNGARY KFT.
UNGARIA
PR
PR
PR
ABBVIE LTD.
MAREA BRITANIE
CUTIE X 2 BLIST. X 1 SERINGA PREUMPLUTA X 0,8 ML + 1 TAMPON CU ALCOOL
P-RF/R
Tratamentul se iniiaz de ctre medicul n specialitatea gastro-enterologie i medicin intern.
Pagina 36 din 39
COD ATC
DCI
Denumire Comerciala
forma farm.
MABTHERA 100 mg
MABTHERA 500 mg
ORENCIA
ORENCIA
ENBREL 10mg de uz pediatric
ENBREL 25mg
ENBREL 25mg
ENBREL 50mg
ENBREL 50mg
REMICADE 100 mg
INFLECTRA 100 mg
REMSIMA 100mg
HUMIRA 40 mg
CIMZIA
SIMPONI 50 mg
SIMPONI 50 mg
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
concentratie
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
26. POLIARTITRITA REUMATOIDA - G31b

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
L01XC02
L01XC02
L04AA24
L04AA24
L04AB01
L04AB01
L04AB01
L04AB01
L04AB01
L04AB02
L04AB02
L04AB02
L04AB04
L04AB05
L04AB06
L04AB06
L04AC07
L04AC07
L04AC07
L04AC07
L04AC07
L04AC07
RITUXIMABUM****
RITUXIMABUM****
ABATACEPTUM****
ABATACEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
INFLIXIMABUM****
INFLIXIMABUM****
INFLIXIMABUM****
ADALIMUMABUM****
CERTOLIZUMAB PEGOL****
GOLIMUMAB****
GOLIMUMAB****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****

SOL INJ. IN SERINGA PRE-UMPLUTA

SOL. INJ. (INSERINGA PREUMPLUTA)

SOL. INJ. IN PEN PRE-UMPLUT


10mg/ml
10mg/ml
250mg
125mg/ml
10mg
25mg
25mg
50mg
50mg
100mg
100mg
100mg
40mg
200 mg
50mg/0,5ml
50mg/0,5ml
20mg/ml
20mg/ml
20mg/ml
20mg/ml
20mg/ml
20mg/ml
MAREA BRITANIE
CUTIE X 2 FLACOANE X 10 ML
MAREA BRITANIE
CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML)
MAREA BRITANIE
CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA
MAREA BRITANIE
CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA CU AC CU GARDA X 125 MG/ML SOL INJ.
MAREA BRITANIE
CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL
MAREA BRITANIE
CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL
P-RF/R
MAREA BRITANIE
CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL
P-RF/R
OLANDA
HOSPIRA UK LIMITED
MAREA BRITANIE
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
ABBVIE LTD.
UCB PHARMA SA
UNGARIA
PR
PR
PR
MAREA BRITANIE
P-RF/R
CUTIE X 2 SERINGI PREUMPLUTE DIN STICLA CU PISTON A 1 ML + 2 TAMPOANE CU ALCOOL
P-RF/R
BELGIA
OLANDA
OLANDA
MAREA BRITANIE
CUTIE X 1 FLAC X 4 ML CONC. PT. SOL. PERF.
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
S
S
S
PR
PR
CUTIE X 1 STILOU INJECTOR PREUMPLUT (PEN) X 0,5ML
CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML
PR
PR
S
S
S
S
S
S
2
1
1
4
4
4
4
4
4
3
3
1
2
2
1
1
1
4
1
4
1
4
1,032.520000
5,088.050000
1,434.080000
1,032.520000
5,088.050000
1,434.080000
983.055000
209.250000
496.610000
496.277500
975.780000
975.780000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
1,859.470000
3,988.470000
3,988.470000
648.750000
610.770000
2,908.050000
3,383.597500
1,508.960000
1,700.557500
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
4
4
4
4
4
3
3
1
2
1
1
209.250000
496.610000
496.277500
975.780000
975.780000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
3,988.470000
3,988.470000
209.250000
496.610000
496.277500
975.780000
975.780000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
3,988.470000
3,988.470000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
4 209.250000
4 496.610000
209.250000
496.610000
0.000000
0.000000
983.055000
209.250000
496.610000
496.277500
975.780000
975.780000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
1,859.470000
3,988.470000
3,988.470000
648.750000
610.770000
2,908.050000
3,383.597500
1,508.960000
1,700.557500
Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie, medicin intern, nefrologie (pentru pacienii cu afectare renal) i reabilitarea medical.
27. ARTROPATIA PSORIAZICA - G31c

1
2
3
4
5
6
7
8
9
10
11
L04AB01
L04AB01
L04AB01
L04AB01
L04AB01
L04AB02
L04AB02
L04AB02
L04AB04
L04AB06
L04AB06
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
INFLIXIMABUM****
INFLIXIMABUM****
INFLIXIMABUM****
ADALIMUMABUM****
GOLIMUMAB****
GOLIMUMAB****

ENBREL 25mg
ENBREL 25mg
ENBREL 50mg
ENBREL 50mg
REMICADE 100 mg
INFLECTRA 100 mg
REMSIMA 100mg
HUMIRA 40 mg
SIMPONI 50 mg
SIMPONI 50 mg



10mg
25mg
25mg
50mg
50mg
100mg
100mg
100mg
40mg
50mg/0,5ml
50mg/0,5ml
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PR
MAREA BRITANIE
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
OLANDA
HOSPIRA UK LIMITED
MAREA BRITANIE
UNGARIA
PR
PR
PR
ABBVIE LTD.
MAREA BRITANIE
P-RF/R

OLANDA
OLANDA
PR
PR
Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie i reabilitare medical.
28. SPONDILITA ANKILOZANTA - G 31d

1
2
L04AB01
L04AB01
ETANERCEPTUM****
ETANERCEPTUM****

ENBREL 25mg

10mg
25mg
PFIZER LIMITED
PFIZER LIMITED
Pagina 37 din 39
MAREA BRITANIE
MAREA BRITANIE
PR
P-RF/R
3
4
5
6
7
8
9
10
11
COD ATC
DCI
L04AB01
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
INFLIXIMABUM****
INFLIXIMABUM****
INFLIXIMABUM****
ADALIMUMABUM****
GOLIMUMAB****
GOLIMUMAB****
L04AB01
L04AB01
L04AB02
L04AB02
L04AB02
L04AB04
L04AB06
L04AB06
Denumire Comerciala
ENBREL 25mg
ENBREL 50mg
ENBREL 50mg
REMICADE 100 mg
INFLECTRA 100 mg
REMSIMA 100mg
HUMIRA 40 mg
SIMPONI 50 mg
SIMPONI 50 mg
forma farm.


concentratie
25mg
50mg
50mg
100mg
100mg
100mg
40mg
50mg/0,5ml
50mg/0,5ml
DETINATOR APP
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
P-RF/R
MAREA BRITANIE
OLANDA
HOSPIRA UK LIMITED
MAREA BRITANIE
UNGARIA
PR
PR
PR
ABBVIE LTD.
MAREA BRITANIE
P-RF/R

Tratamentul se iniiaz de ctre medicul n specialitatea reumatologie, medicin intern i reabilitare medical.
Pagina 38 din 39
OLANDA
OLANDA
PR
PR

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
4
4
4
3
3
1
2
1
1
496.277500
975.780000
975.780000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
3,988.470000
3,988.470000
496.277500
975.780000
975.780000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
3,988.470000
3,988.470000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
COD ATC
DCI
Denumire Comerciala
forma farm.
concentratie
DETINATOR APP
TARA
DET. APP
AMBALAJ
Prescriptie
NR.CRT

asiguratului / UT
cant.
beneficiaza de
UT/
Pret de
beneficiaza de
compensare 100%
amba referinta / UT
compensare 100% din
din pretul de
laj
(RON)
referinta)
29. ARTRITA JUVENILA - G 31e

1
2
3
4
5
6
7
8
9
10
11
12
13
L04AA24
L04AB01
L04AB01
L04AB01
L04AB01
L04AB01
L04AB04
L04AC07
L04AC07
L04AC07
L04AC07
L04AC07
L04AC07
ABATACEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ADALIMUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
TOCILIZUMABUM****
ORENCIA
ENBREL 25mg
ENBREL 25mg
ENBREL 50mg
ENBREL 50mg
HUMIRA 40 mg
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml
ROACTEMRA 20mg/ml


250mg
10mg
25mg
25mg
50mg
50mg
40mg
20mg/ml
20mg/ml
20mg/ml
20mg/ml
20mg/ml
20mg/ml
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
ABBVIE LTD.
MAREA BRITANIE
CUTIE X 1 FLAC. X 250 MG PULB. + 1 SERINGA
S
PR
MAREA BRITANIE
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
S
S
S
S
S
S
MAREA BRITANIE
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
MAREA BRITANIE
P-RF/R
OLANDA
HOSPIRA UK LIMITED
MAREA BRITANIE
1
4
4
4
4
4
2
1
4
1
4
1
4
1,434.080000
4
4
4
4
4
3
3
1
2
209.250000
496.610000
496.277500
975.780000
975.780000
209.250000
496.610000
496.277500
975.780000
975.780000
1,956.550000
648.750000
610.770000
2,908.050000
3,383.597500
1,508.960000
1,700.557500
1,434.080000
209.250000
496.610000
496.277500
975.780000
975.780000
1,956.550000
648.750000
610.770000
2,908.050000
3,383.597500
1,508.960000
1,700.557500
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
209.250000
496.610000
496.277500
975.780000
975.780000
1,902.410000
1,628.203333
1,593.040000
1,956.550000
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 reumatologie, pediatrie i reabilitare medical.
30. PSORIAZIS CRONIC SEVER - G 31f

1
2
3
4
5
6
7
8
9
L04AB01
L04AB01
L04AB01
L04AB01
L04AB01
L04AB02
L04AB02
L04AB02
L04AB04
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
ETANERCEPTUM****
INFLIXIMABUM****
INFLIXIMABUM****
INFLIXIMABUM****
ADALIMUMABUM****

ENBREL 25mg
ENBREL 25mg
ENBREL 50mg
ENBREL 50mg
REMICADE 100 mg
INFLECTRA 100 mg
REMSIMA 100mg
HUMIRA 40 mg


10mg
25mg
25mg
50mg
50mg
100mg
100mg
100mg
40mg
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
PR
UNGARIA
PR
PR
PR
ABBVIE LTD.
MAREA BRITANIE
P-RF/R
Tratamentul se iniiaz de ctre medicul n specialitatea dermatologie.

NOTA:
- Pentru medicamentele corespunztoare acestei seciuni iniierea tratamentului se face de ctre medicul de specialitate, altul dect medicul de familie, excepie fcnd medicamentele din G1 - Insuficien
cardiac cronic (clasa III sau IV Nyha) poziiile 2, 3, 4, 5, 6, 7 i 9, (conf. HG 720/2008, cu modificarile si completarile ulterioare) pentru care iniierea tratamentului poate fi efectuat i de ctre medicul de
familie.
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul
Caselor Judetene de Asigurari de Sanatate;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul
Casei Nationale de Asigurari de Sanatate;
- Medicamentul corespunzator DCI-ului notat cu (3) se livreaza impreuna cu solventul;
- Medicamentele corespunztoare DCI-urilor notate cu (4) se import cu avizul Ageniei Naionale a Medicamentului i a Dispozitivelor Medicale.
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu ( 5) se utilizeaza numai pentru cazurile fara raspuns terapeutic la prednisonum.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu () se efectueaz n baza contractelor cost-volum-rezultat ncheiate.
Pagina 39 din 39
1,902.410000
1,628.203333
1,593.040000
1,956.550000
ANEXA 2d
Nr. crt
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
cod
ATC
A03AD02
A03BA01
A03BB01
A03DA02
A03DA02
A03DA02
A05BAN3
A06AD65
A06AD65
A07AX03
A11CA01
A11CA01
A11CC04
A11CC05
A11CC05
A11CC05
A11CC05
A11CC20
A11CC20
A11DA01
A11DA03
A11DBN1
A11DBN1
A11DBN1
A11DBN1
A11DBN1
A11DBN1
A11DBN2
A11DBN2
A11GA01
A11GA01
A11HA02
A11HA02
A11HA02
A11HA02
A11HA03
A12AA03
A12AA03
A16AA01
A16AXN1
A16AXN1
A16AXN1
DCI
DROTAVERINUM
ATROPINUM
Denumire Comerciala
NO - SPA 40 mg/2 ml
forma farm.
SOL. INJ.
SOL. INJ.
BUTYLSCOPOLAMMONII BROMIDUM SCOBUTIL 10 mg/ml
SOL. INJ.
COMBINATII
PIAFEN
COMPR.
COMBINATII
ALGIFEN COMPRIMATE
COMPR.
COMBINATII
ALGIFEN SOLUTIE INJECTABILA SOL. INJ.
COMBINATII
ASPATOFORT (R)
SOL. INJ.
COMBINATII
ENDOFALK
COMBINATII
FORTRANS
NIFUROXAZIDUM
ERCEFURYL (R) 200 mg
CAPS.
RETINOLUM
VITAMINA A FORTE BIOFARM 50000 UI CAPS. MOI
RETINOLUM
VITAMINA A BIOFARM 20mg/ml PIC. ORALE, SOL.
CALCITRIOLUM
ROCALTROL
CAPS. MOI
COLECALCIFEROLUM
VIGANTOLETTEN 1000
COMPR.
COLECALCIFEROLUM
VIGANTOLETTEN 500
COMPR.
COLECALCIFEROLUM
VITAMINA D3 BIOFARM 18000UI/ml PIC. ORALE, SOL.
COLECALCIFEROLUM
VIGANTOL OIL
PIC. ORALE, SOL.
COMBINATII
FLUOR VIGANTOLETTEN 1000 COMPR.
COMBINATII
FLUOR VIGANTOLETTEN 500 COMPR.
THIAMINUM
VITAMINA B1 ZENTIVA 100 mg/2 ml SOL. INJ.
BENFOTIAMINUM
BENFOGAMMA
DRAJ.
COMBINATII
MILGAMMA (R) N
CAPS. MOI
COMBINATII
MILGAMMA (R) 100+100mg DRAJ.
COMBINATII
MILGAMMA (R) (vezi B03BA51) DRAJ.
COMBINATII
MILGAMMA (R) (vezi B03BA51) DRAJ.
COMBINATII
MILGAMMA (R) N
SOL. INJ.
COMBINATII
MILGAMMA (R) NA
SOL. INJ.
COMBINATII
NEUROMULTIVIT
COMPR. FILM.
COMBINATII
NEUROMULTIVIT
COMPR. FILM.
ACIDUM ASCORBICUM
ACID ASCORBIC ARENA 750 mg SOL INJ.
ACIDUM ASCORBICUM
VITAMINA C ARENA 750 mg SOL. INJ.
PYRIDOXINUM
VITAMINA B6 250 mg
COMPR.
PYRIDOXINUM
VITAMINA B6 ZENTIVA 250 mg COMPR.
PYRIDOXINUM
VITAMINA B6 ZENTIVA 250 mg/5 ml SOL. INJ.
PYRIDOXINUM
VITAMINA B6 ZENTIVA 50 mg/2ml SOL. INJ.
TOCOFEROLUM
VITAMINA E 400 mg
CAPS. MOI
CALCII GLUCONAS
GLUCONAT DE CALCIU 94mg/ml SOL. INJ.
CALCII GLUCONAS
GLUCONAT DE CALCIU ZENTIVA 95 mg/ml SOL. INJ.
LEVOCARNITINUM
CARNIL (R)
SOL. ORALA
DIVERSE
ACTOVEGIN (R)
DRAJ.
DIVERSE
ACTOVEGIN 200 mg
DRAJ.
DIVERSE
ACTOVEGIN (R)
SOL. INJ.
SULFAT DE ATROPINA TAKEDA 1 mg/ml
concentratie
40mg/2ml
1mg/ml
10mg/ml
Detinator APP
Tara det.
APP
Ambalaj
Prescriptie
SECIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% - CONFORM DCI-URILOR DIN CANAMED, ALTELE DECT CELE DIN SUBLISTELE A, B, C1,
C2, INDICATE PENTRU COPII PN LA 18 ANI, TINERI DE LA 18 LA 26 DE ANI DACA SUNT ELEVI, STUDENI SAU UCENICI DAC NU REALIZEAZ VENITURI, PRECUM I
GRAVIDE I LUZE
DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOARE
VALABIL NCEPND CU 01 IANUARIE 2016
CHINOIN PRIVATE CO. LTD.
UNGARIA CUTIE X 25 FIOLE X 2ML SOL. INJ.
P-RF
TAKEDA GMBH
NYCOMED GMBH
ANTIBIOTICE SA
ZENTIVA SA
ZENTIVA SA
TERAPIA SA
GERMANIA
cant.
UT/
Pret de
ambal referinta / UT
aj
(RON)
25
5
GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 1 ML SOL. INJ. P-RF
5
FARA CONCENTRATIE
P-RF
20
FARA CONCENTRATIE
20
FARA CONCENTRATIE
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 5 ML SOL. INJ. P-RF
5
FARA CONCENTRATIE
P-RF
10
FARA CONCENTRATIE DR. FALK PHARMA GMBH GERMANIA CUTIE X 6 PLICURI DE HARTIE/AL/PEJD X 55,318 G PULB. PT. SOL. ORALA
P-RF
6
FARA CONCENTRATIE IPSEN PHARMA
FRANTA CUTIE CU 4 PLICURI DIN HARTIE-AL-PE X 73,69 G PULB. PT. SOL. ORALA P-RF
4
200mg
SANOFI-SYNTHELABO OTC FRANTA CUTIE X 2 BLIST. X 14 CAPS.
P-RF
28
50000ui
BIOFARM SA
ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 CAPS. MOI P6L
30
20mg/ml
BIOFARM SA
ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 10 ML PIC. ORALE, SOL. P-6L
1
0,25mcg
ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 20 CAPS. MOI. P6L 100
1000UI
MERCK KGAA
30
500UI
MERCK KGAA
30
0,45mg/ml BIOFARM S.A.
ROMANIA CUTIE X 1 FLACON X 10 ML PIC. ORALE, SOL. P-6L
1
0,5mg/ml
MERCK KGAA
GERMANIA CUTIE X 1 FLACON DIN STICLA X 10 ML PIC. ORALE SOLUTIE, PREVAZUT CU PICURATOR P-6L
1
1000 UI/0,55 mg MERCK KGAA
30
500 UI/0,55 mg MERCK KGAA
30
100mg/2ml ZENTIVA SA
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF
5
50mg
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-6L
50
FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 CAPS. MOI P-6L
50
100mg+100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. PVC-PVDC/AL X 15 DRAJ. P-6L
60
FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L
50
FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-6L
50
FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML
P-RF
5
FARA CONCENTRATIE WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 1 ML
P-RF
5
FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. FILM. P-6L
20
FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 5 BLIST. PVC/AL X 20 COMPR. FILM. P-6L
100
750mg
ARENA GROUP S.A. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ. PRF
5
750mg
ARENA GROUP S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 5 ML SOL. INJ. P-RF
5
250 mg
ARENA GROUP SA ROMANIA CUTIE X 1 FLACON DIN PE X 20 COMPR. P-6L
20
250mg
ZENTIVA SA
ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR.
P-6L
20
250mg/5ml ZENTIVA SA
5
50mg/2ml
ZENTIVA SA
5
400mg
PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 12 CAPS. MOI P-6L
24
94mg/ml
B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FIOLE DIN PEJD X 10 ML SOL. INJ. P-RF
20
95mg/ml
ZENTIVA SA
ROMANIA CUTIE X 5 FIOLE X 10 ML SOL. INJ.
P-RF
5
100mg/ml
ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA
CUTIE X 10 FLACOANE DIN STICLA BRUNA, ACOPERITE CU UN CAPAC DIN AL. X 10 ML
P-6L
10
200mg
NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P-6L
50
200mg
TAKEDA AUSTRIA GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 50 DRAJ. P6L
50
200mg/5ml NYCOMED AUSTRIA GMBH AUSTRIA CUTIE X 5 FIOLE PUNCT DE RUPERE X 5 ML P-RF
5
Pagina 1 din 5
1.016800
1.606000
0.672000
0.375000
0.375000
2.540000
3.253000
5.656666
6.787999
0.422500
0.190666
3.070000
0.691000
0.286000
0.231666
5.240000
6.010000
0.277000
0.222333
1.448000
0.596000
0.972600
1.555333
0.972600
0.972600
3.842000
3.842000
0.553680
0.461400
2.046000
2.455200
0.472500
0.472500
2.144000
1.448000
0.404583
0.875000
1.050000
1.599000
2.901600
2.901600
21.744000

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
1.016800
1.606000
0.672000
0.375000
0.375000
2.540000
3.253000
5.656666
6.787999
0.422500
0.190666
3.070000
0.691000
0.286000
0.231666
5.240000
6.010000
0.277000
0.222333
1.448000
0.596000
0.972600
1.555333
0.972600
0.972600
3.842000
3.842000
0.553680
0.461400
2.046000
2.455200
0.472500
0.472500
2.144000
1.448000
0.404583
0.875000
1.050000
1.599000
2.901600
2.901600
21.744000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
3.127001
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
0.025820
0.000000
0.000000
2.796800
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
2.254000
0.000000
0.000000
0.000000
0.000000
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
88
89
90
91
92
93
cod
ATC
D07XC01
Denumire Comerciala
DIVERSE
ACTOVEGIN 200 mg/5 ml
ETAMSYLATUM
ETAMSILAT ZENTIVA 250mg
CARBAZOCHROMI SALICYLAS ADRENOSTAZIN
FERROSI GLUCONAS
ASCOFER
COMBINATII
FERRETAB (R)
COMBINATII
FERRETAB (R)
COMBINATII
TARDYFERON FOL (R)
COMBINATII
MALTOFER FOL
COMBINATII
FERRO - FOLGAMMA (R)
COMBINATII
TOT'HEMA
CYANOCOBALAMINUM
VITAMINA B12 ZENTIVA 50g/ml
ALPROSTADILUM**
ALPROSTADIL "REMEDIA" 500 g
COMBINATII
HEMORZON
COMBINATII
HEMORZON
COMBINATII
ULTRAPROCT SUPOZITOARE
COMBINATII
ULTRAPROCT UNGUENT RECTAL
COMBINATII
DOXIPROCT
CALCII DOBESILAS
DOXILEK
TROXERUTINUM (COMBINATII) GINKOR FORT
COMBINATII
DISTONOCALM (R)
NIMODIPINUM
NIMOTOP 30 mg
NIMODIPINUM
NIMOTOP
ISOCONAZOLUM
TRAVOGEN
ISOCONAZOLUM
TRAVOGEN
ISOCONAZOLUM
TRAVOGEN 10mg/g
KETOCONAZOLUM
KETOCONAZOL
KETOCONAZOLUM
KETOCONAZOL CREMA
KETOCONAZOLUM
KETOCONAZOL CREMA
KETOCONAZOLUM
NIZORAL 20 mg/g
COMBINATII
ASORIAN
FLUOCINOLONI ACETONIDUM FLUOCINOLON ACETONID 0,025%
COMBINATII
NIDOFLOR
COMBINATII
FLUOCINOLON N
COMBINATII
FLUOCINOLON N ATB 0,25 mg/5 mg/g
COMBINATII
TRIAMCINOLON S
COMBINATII
DIPROSALIC
COMBINATII
DIPROSALIC
D07XC01
COMBINATII (BETAMETHASONUM+ACIDUM SALICYLICUM)
SAL-EKARZIN 0,50 mg/30 mg pe gram
D07XC04
COMBINATII
COMBINATII
ERYTHROMYCINUM
ERYTHROMYCINUM
COMBINATII
PIMECROLIMUS
METRONIDAZOLUM
CICLOPIROXUM
COMBINATII
NOMEGESTROLUM
TRAVOCORT
TRAVOCORT
ERYFLUID
ERYFLUID
ZINERYT
ELIDEL 1% (10mg/g)
FLAGYL
DAFNEGIN
TERGYNAN
LUTENYL (R)
PREGNYL 5000
MENOPUR
URALYT-U
A16AXN1
B02BX01
B02BX02
B03AA03
B03AD02
B03AD02
B03AD03
B03AD04
B03AE01
B03AE10
B03BA01
C01EA01
C05AA01
C05AA01
C05AA08
C05AA08
C05AD01
C05BX01
C05CA54
C07NAN1
C08CA06
C08CA06
D01AC05
D01AC05
D01AC05
D01AC08
D01AC08
D01AC08
D01AC08
D05AXN1
D07AC04
D07CB01
D07CC02
D07CC02
D07XB02
D07XC01
D07XC04
D10AF02
D10AF02
D10AF52
D11AH02
G01AF01
G01AX12
G01BDN1
G03DB04
DCI
G03GA01 GONADOTROPHINUM CHORIONICUM

G03GA02
G04BCN1
MENOTROPINUM
COMBINATII
forma farm.
concentratie
SOL. INJ.
SOL. INJ.
SOL. INJ.
COMPR.
200mg/5ml
250mg/2ml
0,3mg/ml
FARA CONCENTRATIE
CAPS. ELIB. PREL.
FARA CONCENTRATIE
CAPS. ELIB. PREL.
FARA CONCENTRATIE
DRAJ. ELIB. PREL.
FARA CONCENTRATIE
COMPR. MAST.
FARA CONCENTRATIE
Detinator APP
Tara det.
APP
TAKEDA AUSTRIA GMBH
AUSTRIA
Ambalaj
CUTIE CU 5 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE X 5 ML SOL. INJ.
ZENTIVA S.A
ROMANIA CUTIE X 5 FIOLE X 2 ML SOL. INJ.
TERAPIA SA
ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 20 COMPR.
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. AL/PVC X 20 CAPS. ELIB. PREL.
LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. ELIB. PREL.
LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL.
VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MAST.
WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. X 10 CAPS. MOI
LABORATOIRE INNOTECH INTERNATIONAL FRANTA
ZENTIVA SA
ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 1 ML SOL. INJ.
CAPS. MOI FARA CONCENTRATIE

SOL. ORALA FARA CONCENTRATIE
SOL. INJ.
50g/ml
CONC. PT. SOL. PERF. 500g
FARMACEUTICA REMEDIA S.A.
SUPOZ.
FARA CONCENTRATIE ANTIBIOTICE SA
UNGUENT FARA CONCENTRATIE ANTIBIOTICE SA
SUPOZ.
FARA CONCENTRATIE INTENDIS GMBH
UNGUENT RECTAL FARA CONCENTRATIE INTENDIS GMBH
UNGUENT RECTAL FARA CONCENTRATIE OM PHARMA S.A.
CAPS.
500mg
CAPS.
FARA CONCENTRATIE IPSEN PHARMA
COMPR. FILM. FARA CONCENTRATIE ZENTIVA S.A.
COMPR. FILM. 30mg
BAYER PHARMA AG
SOL. PERF. 10mg/50ml BAYER PHARMA AG
CREMA
10mg/1g
BAYER PHARMA AG
CREMA
10mg/1g
INTENDIS GMBH
CREMA
10mg/g
BAYER PHARMA AG
CREMA
2%
TIS FARMACEUTIC SA
CREMA
20mg/g
SC HYPERION SA
CREMA
20mg/g
SC HYPERION SA
CREMA
20mg/g
SOL. CUT.
FARA CONCENTRATIE BIOFARM SA
UNGUENT 0,025%
LAROPHARM SRL
CREMA
UNGUENT 0,25mg/5mg/g ANTIBIOTICE SA
UNGUENT 0,25mg/5mg/g ANTIBIOTICE SA
CREMA
SOL. CUT.
FARA CONCENTRATIE MERCK SHARP & DOHME
UNGUENT FARA CONCENTRATIE MERCK SHARP & DOHME
UNGUENT 0,50mg/30mg pe gram ANTIBIOTICE S.A.
CREMA
10mg/1mg/1g INTENDIS GMBH
CREMA
10mg/1mg/1g BAYER PHARMA AG
SOL. CUT.
4g/30ml
PIERRE FABRE DERMATOLOGIE
SOL. CUT.
4g/30ml
PIERRE FABRE DERMATOLOGIE
PULB. + SOLV. SOL. CUT.
40mg/12mg/ml
CREMA
OVULE
OVULE
10mg/g
500mg
100mg
COMPR. VAG.
ROMANIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF.

ROMANIA CUTIE CU 2 FOLII TERMOFORMATE PVC X 3 SUPOZ.
ROMANIA CUTIE X 1 TUB X 18 G
GERMANIA
CUTIE X 2 FOLII X 5 SUPOZ.
GERMANIA CUTIE X 1 TUB AL X 30 G + 1 CANULA PEJD

PORTUGALIA CUTIE X 1 TUB DIN AL X 30 G UNGUENT RECTAL + CANULA APLICATOARE
SLOVENIA CUTIE X 3 BLIST. AL/PVC. X 10 CAPS.
FRANTA CUTIE X 3 BLIST. AL/PVC X 10 CAPS.

GERMANIA CUTIE CU 10 BLIST. AL/PP X 10 COMPR. FILM.
GERMANIA
GERMANIA
GERMANIA
GERMANIA
ROMANIA
ROMANIA
ROMANIA
BELGIA
CUTIE X 5 CUTII X 1 FLACON DIN STICLA DE CULOARE BRUNA X 50 ML + 1 PERFUZOR DIN POLIETILENA

CUTIE X 1 TUB, DIN AL X 20 G CREMA
CUTIE X 1 TUB PEJD X 15 G
CUTIE CU 1 TUB DIN AL X 15 G CREMA
CUTIE X 1 FLACON X 100 ML
CUTIE X 1 TUB AL X 20 G
CUTIE CU 1 TUB DIN AL X 18 G UNG.
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA
ROMANIA CUTIE X 1 FLACON DIN PEID X 30 ML SOL. CUT., PREVAZUT CU PICURATOR
ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT
ROMANIA CUTIE CU 1 TUB AL X 15 G UNGUENT

FRANTA CUTIE X 1 FLACON X 100 ML SOL. CUT.
FRANTA CUTIE X 1 FLACON X 30 ML SOL. CUT.
OLANDA
GERMANIA CUTIE X 1 TUB AL X 30 G CREMA
FRANTA CUTIE X 2 BLIST. X 5 OVULE
GERMANIA
GERMANIA
CUTIE X 1 FLAC. DIN PEID PULB. PT. SOL. CUTANATA + APLICATOR DIN PP CU SOLV. PT 30 ML SOL. CUTANATA
LAB. AVENTIS
POLICHEM SA
LUXEMBURG
CUTIE X 1 FOLIE. TERMOSUDATA DIN PVC/PE X 6 OVULE + 6 APLICATOARE DIN PE
FARA CONCENTRATIE
LAB. BOUCHARA-RECORDATI
FRANTA
CUTIE X 1 FOLIE HARTIE/PE/AL/PE X 10 COMPR. VAG.
FARA CONCENTRATIE
GRANULE
FARA CONCENTRATIE
LAB. THERAMEX
NV ORGANON
FERRING GMBH
MADAUS GMBH
MONACO CUTIE X 1 BLIST. AL/PVC X 10 COMPR.
5mg
5000ui/ml
COMPR.
OLANDA
CUTIE CU 1 FIOLA CU CAPACITATEA DE 2 ML, DIN STICLA INCOLORA, CU PUNCT DE RUPERE, TIP OPC, CONTINND PULB. PT. SOL. INJ. SI 1 FIOLA CU CAPACITATEA DE 1 ML, DIN STICLA INCOLORA, CU PUNCT DE RUPERE, TIP OPC, CONTINND SOLV. PT. SOL. INJ.
GERMANIA
CUTIE X 10 FLAC. DIN STICLA INCOLORA CU LIOF. + 10 FIOLE X 1 ML SOLV. PT. SOL. INJ.
GERMANIA
CUTIE X 1 FLAC. PP X 280 G GRANULE + 1 LINGURITA DOZATOARE + 1 CALENDAR DE CONTROL + HARTIE INDICATO
Pagina 2 din 5
Prescriptie
Nr. crt
PR
cant.
UT/
Pret de
aj
(RON)
5 21.744000
5
1.396000
P-RF
5
2.638000
P-6L
20
0.400500
P-6L 100
0.286000
P-6L
30
0.343200
P-6L
30
0.463333
P-6L
30
0.617333
P-RF
50
0.497000
P-6L
20
0.886500
P-RF
5
1.448000
S
5 332.144000
P-6L
6
1.210000
P-6L
1 12.960000
P-RF
10
1.342000
P-RF
1 32.060000
P-6L
1 21.660000
P-6L
30
0.742000
P-6L
30
0.890000
P-6L
30
0.245666
P-RF
100
0.713400
S
5 29.144000
PRF
1 17.470000
P-RF
1 11.630000
PRF
1 11.630000
P-RF
1
3.470000
P-RF
1
4.640000
P-RF
1
3.470000
PRF
1
4.164000
P-RF
1 10.550000
P-RF
1
7.670000
P-RF
1 10.370000
P-RF
1
8.510000
PRF
1
8.510000
P-RF
1
9.340000
P-RF
1
6.270000
P-RF
1
3.420000
P-RF
1
7.260000
P-RF
1 26.150000
P-RF
1 26.150000
P-RF
1 21.790000
P-RF
1
8.400000
P-RF
1 27.380000
P-RF
1 124.050000
P-RF
10
0.884000
P-6L
6
6.000000
P-RF
10
2.613000
P6L
10
1.943000
S/P-RF
1 15.180000
S/P-RF
10 78.451000
P-6L
1 59.060000
P-RF

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
21.744000
1.396000
2.638000
0.400500
0.286000
0.343200
0.463333
0.617333
0.497000
0.886500
1.448000
332.144000
1.210000
12.960000
1.342000
32.060000
21.660000
0.742000
0.890000
0.245666
0.713400
29.144000
17.470000
11.630000
11.630000
3.470000
4.640000
3.470000
4.164000
10.550000
7.670000
10.370000
8.510000
8.510000
9.340000
6.270000
3.420000
7.260000
26.150000
26.150000
21.790000
8.400000
27.380000
124.050000
0.884000
6.000000
2.613000
1.943000
15.180000
78.451000
59.060000
0.000000
0.000000
0.000000
0.000000
0.000000
0.019800
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
1.186000
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
94
95
96
97
98
99
cod
ATC
H03AA03
J01DB04
DCI
COMBINATII
CEFAZOLINUM
J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM)

100 J01EB05
101 J01GB03
102 J01GB03
103 J01GB03
104 J01GB03
105 J01XB01
106 J02AC03
107 J02AC03
108 J02AC03
109 M01AA01
110 M01AB55
111 M01AB55
112 M01AB55
113 M01AB55
114 M01AB55
115 M01AB55
116 M01AB55
117 M01AE01
118 M01AE01
119 M01AE01
120 M01AE01
121 M01AE01
122 M01AE01
123 M01AE01
124 M01AE01
125 M01AE01
126 M01AE01
127 M01AE01
128 M01AE01
129 M01AE01
130 M01AE01
131 M01AE01
132 M01AE02
133 M01AE02
134 M01AE02
135 M01AE02
136 M01AE02
137 M01AE02
138 M01AG01
139 M01AH04
140 M01AH04
141 M03BB03
142 M03BB03
143 M03BB03
144 M03BX04
SULFAFURAZOLUM
GENTAMICINUM
GENTAMICINUM
GENTAMICINUM
GENTAMICINUM
COLISTINUM
VORICONAZOLUM**
VORICONAZOLUM**
VORICONAZOLUM**
PHENYLBUTAZONUM
COMBINATII
COMBINATII
COMBINATII
COMBINATII
Denumire Comerciala
NOVOTHYRAL (R) 100
LYZOLIN 1g
SULCEF 1000 mg/1000 mg
forma farm.
concentratie
Detinator APP
COMPR.
100mcg+20mcg
PULB. PT. SOL. INJ.
1g
1000mg/1000mg
1000mg/1000mg
MERCK KGAA
SC ANSAMED SRL
MEDOCHEMIE S.R.L.
MEDOCHEMIE S.R.L.
MEDOCHEMIE S.R.L.
MEDOCHEMIE S.R.L.
ARENA GROUP SA

SULFAFURAZOL ARENA 500 mg COMPR.

GENTAMICINA EIPICO 40 mg/ml SOL INJ.
GERMANIA
P-6L
Ambalaj
CUTIE X 4 BLIST. AL/PP X 25 COMPR.
ROMANIA CUTIE X 1 FLACON
PR
ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S/P-RF
1000mg/1000mg
1000mg/1000mg
ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CONTINAND PULB. PT. SOL. INJ./PERF. S
500mg
40mg/ml
E.I.P.I.CO MED S.R.L. ROMANIA CUTIE CU 3 FLAC. DIN STICLA TIP I INCOLORA CU CAPACITATEA DE 2,5 ML, CONTINAND 2 ML SOL. INJ. PRF
GENTAMICIN KRKA
GENTAMICIN KRKA
GENTAMICIN KRKA
COLISTINA ATB 1.000.000 UI
VFEND 200mg
VFEND 50mg
VFEND 40 mg/ml
FENILBUTAZONA 250 mg
TRATUL PLUS
TRATUL PLUS
40mg/ml
80mg/2ml
80mg/2ml
PULB. PT. SOL. INJ./PERF. 1000000ui
COMPR. FILM. 200mg
COMPR. FILM. 50mg
PULB. PT. SUSP. ORALA 40mg/ml
SUPOZ.
250mg
NEODOLPASSE 0,30 mg+0,12 mg/ml
SOL. PERF.
SUPOZ.
ACECLOFEN
COMBINATII (DICLOFENACUM+OMEPRAZOLUM) DICLOPRAM 75 mg/20 mg
COMBINATII (DICLOFENACUM+OMEPRAZOLUM) DICLOPRAM 75 mg/20 mg
DICLOFENACUM+MISOPROSTOLUM ARTHROTEC 75
IBUPROFENUM
PADUDEN (R) SR 300 mg
IBUPROFENUM
BRUFEN RETARD 800 mg
IBUPROFENUM
BRUFEN 400 mg
IBUPROFENUM
BRUFEN 400 mg
IBUPROFENUM
BRUFEN 400 mg
IBUPROFENUM
BRUFEN 400 mg
IBUPROFENUM
IBUPROFEN CIPLA 400
IBUPROFENUM
IBUPROFEN CIPLA 600
IBUPROFENUM
FASPIC 600
IBUPROFENUM
BRUFEN 600 mg
IBUPROFENUM
IBALGIN BABY
IBUPROFENUM
IBALGIN BABY
IBUPROFENUM
ALGIN BABY 100 mg/5 ml
IBUPROFENUM
ALGIN BABY 100 mg/5 ml
IBUPROFENUM
BRUFEN 20 mg/ml
NAPROXENUM
REUXEN 250 mg
NAPROXENUM
REUXEN 500 mg
NAPROXENUM
NALDOREX 275 mg
NAPROXENUM
NALDOREX 275 mg
NAPROXENUM
NALDOREX 550 mg
NAPROXENUM
NALDOREX 550 mg
ACIDUM MEFENAMICUM
VIDAN
PARECOXIBUM
DYNASTAT 40mg
PARECOXIBUM
DYNASTAT 40mg
CHLORZOXAZONUM
CLORZOXAZON 250 mg
CHLORZOXAZONUM
CLORZOXAZONA 250 mg
CHLORZOXAZONUM
CLORZOXAZONA ARENA 250 mg
TOLPERISONUM
MYDOCALM
Tara det.
APP
Prescriptie
Nr. crt
SOL. INJ.
SOL. INJ.
SOL. INJ.
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. P-RF
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 50 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ.
ANTIBIOTICE SA
PFIZER LIMITED
PFIZER LIMITED
PFIZER LIMITED
SINTOFARM SA
CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H.

CAPS. GASTROREZ. FARA CONCENTRATIE LANNACHER HEILMITTEL GES.M.B.H.
ROMANIA
MAREA BRITANIE
MAREA BRITANIE
MAREA BRITANIE
CUTIE CU 10 FLAC. DIN STICLA INCOLORA, NCHISE CU DOP DIN CAUCIUC HALOBUTILIC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC FLIP-OFF DIN POLIPROPILENA, CONTINND PULB. PENTRU SOL. INJ./PERF.
CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL)

CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL)
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
ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ.
AUSTRIA
AUSTRIA
AUSTRIA
S
P-RF
P-RF
P-RF
P-6L
CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L

CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L
CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 250 ML SOL. PERF.
PR
ANTIBIOTICE SA
ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL/PE X 3 SUPOZ.
P-6L
REPUBLICA CEHA
CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. ELIB. MODIFICATA
REPUBLICA CEHA
CUTIE CU BLIST. OPA-AL-PVC/AL X 60 CAPS. ELIB. MODIFICATA
P6L
P6L
CUTIE X 2 BLIST. AL X 10 COMPR. GASTROREZ. P-6L
0,30mg+0,12mg/ml FRESENIUS KABI AUSTRIA GMBH

FARA CONCENTRATIE
P-RF/S
KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ. P-RF
CAPS. ELIB. MODIF.
75mg/20mg
75mg/20mg
COMPR. GASTROREZ.
75mg+0,200mg PFIZER EUROPE MA EEIG
MAREA BRITANIE
CAPS. ELIB. PREL.
300mg
800mg
400mg
400mg
400mg
400mg
400mg
600mg
600mg
600mg
100mg/5ml
100mg/5ml
100mg/5ml
100mg/5ml
20mg/ml
250mg
500mg
275mg
275mg
550mg
550mg
500mg
40mg
40mg
250mg
250mg
250mg
150mg
TERAPIA SA
ROMANIA CUTIE X 1 BLIST. X 10 CAPS. ELIB. PREL.
ABBOTT SCANDINAVIA AB
SUEDIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. CU ELIB. PREL. P6L

SUEDIA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P-6L
SUEDIA CUTIE CU BLIST. AL/PVC X 60 COMPR. FILM. P-6L
SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L
SUEDIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L
CAPS. ELIB. MODIF.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
GRAN. PT. SOL. ORALA
GRANULE EFF.
SUSP. ORALA
SUSP. ORALA
SUSP. ORALA
SUSP. ORALA
SUSP. ORALA
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
PULB. PT. SOL. INJ.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM.
CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM.
ZAMBON S.P.A.
ITALIA
CUTIE X 30 PLICURI UNIDOZA X 3 G GRAN. PT. SOL. ORALA
ABBOTT SCANDINAVIA AB SUEDIA
ZENTIVA K.S.
CEHIA
CUTIE X 1 FLAC. DIN STICLA X 100 ML SUSP. ORALA + PIPETA DOZATOARE GRADATA
ZENTIVA K.S.
CEHIA
ZENTIVA, K.S.
REPUBLICA CEHA
ZENTIVA, K.S.
REPUBLICA CEHA
ABBOTT SCANDINAVIA AB SUEDIA
CUTIE CU 20 PLICURI DIN FOLII LAMINATE DIN HARTIE/PE/AL/PE, TERMOSUDATE, CE CONTIN GRANULE EFF.
P-6L
P6L
P6L
P-6L
P6L
P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA INCHIS CU CAPAC DIN PE X 100 ML SUSP. ORALA + PIPETA DOZATOARE GRA
P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CU CAPAC DIN PP SI O SERINGA DOZATOARE (GRADATA) DIN PEJD
PRF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 100 ML SUSP. ORALA, CU CAPAC DIN PE SI O SERINGA DOZATOARE (GRADATA) DIN PEJD
PRF
CUTIE CU 1 FLAC. DE 100 ML SUSP. ORALA, DIN PET DE CULOARE BRUNA CU CAPAC DIN AL SI SIGILIU DIN PEJD + SERINGA DOZATOARE DIN PP DE 5 ML
P6L
P-6L
P-6L
KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC/AL X 10 COMPR. FILM. P6L
VIANEX SA
PFIZER LIMITED
PFIZER LIMITED
ARENA GROUP SA
ARENA GROUP SA
GRECIA CUTIE X 3 BLIST. AL/PVC X 8 COMPR. FILM.
P-6L
MAREA BRITANIE
CUTIE X 5 FLAC. PULB. X 40 MG + 5 FIOLE X 2 ML SOLV.
S/P-RF
MAREA BRITANIE
CUTIE X 10 FLAC. X 40 MG PULB. PT. SOL. INJ.
S/P-RF
ROMANIA
ROMANIA
ROMANIA
ROMANIA
Pagina 3 din 5

P-6L
P-6L
P-6L
cant.
UT/
Pret de
aj
(RON)
100
0.300300
1
7.410000
1 23.076840
10 22.818000
50 19.939200
100 19.230700
20
0.655500
3
0.686666
10
0.740000
50
0.823999
10
0.823999
10 21.974000
28 132.002857
28 36.496071
1 2,266.130000
10
1.089000
30
0.546000
50
0.517800
10 22.722000
6
1.036666
30
2.095000
60
1.989666
20
1.482500
10
1.453000
30
0.628000
30
0.234000
60
0.234000
30
0.234000
60
0.234000
20
0.195000
20
0.380000
30
0.456000
20
0.456000
1
6.920000
1
6.920000
1
6.920000
1
6.920000
1
8.304000
20
0.751000
20
1.196500
10
1.055000
20
0.902000
10
1.511400
20
1.259500
24
0.432083
5 30.554000
10 30.123000
20
0.229500
30
0.213666
30
0.213666
30
0.504000

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.300300
7.410000
23.076840
22.818000
19.939200
19.230700
0.655500
0.686666
0.740000
0.823999
0.823999
21.974000
132.002857
36.496071
2,266.130000
1.089000
0.546000
0.517800
22.722000
1.036666
2.095000
1.989666
1.482500
1.453000
0.628000
0.234000
0.234000
0.234000
0.234000
0.195000
0.380000
0.456000
0.456000
6.920000
6.920000
6.920000
6.920000
8.304000
0.751000
1.196500
1.055000
0.902000
1.511400
1.259500
0.432083
30.554000
30.123000
0.229500
0.213666
0.213666
0.504000
0.000000
0.000000
3.103160
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.036601
0.170001
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
0.065333
0.065666
0.065333
0.065666
0.000000
0.000000
0.429333
0.088500
0.000000
0.000000
0.000000
0.000000
2.326000
0.000000
0.000000
0.000000
0.000000
0.075600
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
cod
ATC
145 M03BX04
146 M03BX04
147 M09AX01
DCI
TOLPERISONUM
TOLPERISONUM
ACIDUM HIALURONICUM
148 N02AA59 COMBINATII ( PARACETAMOLUM + CODEINUM)

149 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM)
150 N02AA59 COMBINATII ( PARACETAMOLUM+CODEINUM)
151 N02AA59 COMBINATII (IBUPROFENUM+CODEINUM)
Denumire Comerciala
MYDOCALM
MYDOCALM
HYALGAN (R)
ULTRACOD 500 mg/30 mg
PARADOREN 500mg/30mg
PARADOREN 500mg/60mg
BRUFEN PLUS 400 mg/30 mg
ALGOCALMIN (R) 500 mg
ALINDOR
SINTOCALMIN
NOVOCALMIN
178 R01AD07
179 R01ADN1
COMBINATII (BETAMETHASONUM+TETRYZOLINUM)
GERODORM (R)
CONCERTA 18 mg
CONCERTA 36 mg
CONCERTA 54 mg
PIRITINOL ARENA 100 mg
ENCEPHABOL 100 mg
ENCEPHABOL 200 mg
ENCEPHABOL 80,5 mg/5 ml
CINARIZINA ARENA 25 mg
STUGERON 25 mg
CINARIZIN 25 mg
ATRICAN 250 mg
HELMINTOX (R)
PIVALONE 0,9mg/pulverizare
BIORINIL
180 R01BA52
COMBINATII (DESLORATADINUM+ PSEUDOEPHEDRINE)
AERINAZE (vezi R06AX27) 2,5mg/120mg
181 R01BA52
COMBINATII (LORATADINUM+PSEUDOEFEDRINUM)
153 N02BB02
154 N02BB02
155 N02BB02
156 N02BB02
157 N02BB02
158 N02BB02
159 N02BB02
160 N02BB02
161 N02BB02
162 N02BB02
163 N05CD08
164 N05CD08
165 N05CD13
166 N06BA04
167 N06BA04
168 N06BA04
169 N06BX02
170 N06BX02
171 N06BX02
172 N06BX02
173 N07CA02
174 N07CA02
175 N07CA02
176 P01AX08
177 P02CC01
182 R02AB03
183 R03CA02
184 R03CA02
185 R03CA02
186 R05CB01
187 R05CB01
188 R05CB01
189 R05CB03
190 R05CB03
191 R05CB03
192 R05CB03
193 R06AD02
194 R06AE05
195 R06AX02
SOL. INJ.
COMPR.
COMPR.
COMPR.
20mg/2ml
Detinator APP
CSC PHARMACEUTICALS HANDELS GMBH
500 mg/30 mg ZENIVA K.S.
Tara det.
APP
Ambalaj
ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L
ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L
AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 2 ML

REPUBLICA CEHA
P-RF
CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. PRF
500mg+30mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR.

P-RF
500mg+60mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. X 10 COMPR.
P-RF
COMPR. FILM. 400mg/30mg BGP PRODUCTS AB SUEDIA CUTIE CU BLIST. AL/PVDC-PVC/PVDC X 30 COMPR. FILM. PRF
COMPR.
500mg
ZENTIVA S.A.
COMPR.
500mg
LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF
COMPR.
500mg
SINTOFARM SA
COMPR.
500mg
ANTIBIOTICE SA
P-RF
METAMIZOL FARMACOM 500 mg COMPR.
500mg
FARMACOM SA
ROMANIA CUTIE X 2 BLIST., PVC/AL X 10 COMPR. P-RF
ALGOBLOCK
COMPR.
500mg
BIOFARM S.A.
ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF
ALGOZONE 500mg
COMPR.
500mg
LABORMED PHARMA S.A. ROMANIA CUTIE X 2 BLIST.PVC-PVDC/AL A CATE 10 COMPR. P-RF
ALVOTOR 500 mg/ml
PIC. ORALE, SOL. 500mg/ml
P6L
ALGOCALMIN (R) 1 g/2 ml
SOL. INJ.
1g/2ml
ZENTIVA S.A.
ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF
SINTOCALMIN 300 mg
SUPOZ.
300mg
SINTOFARM SA
ROMANIA CUTIE X 2 BLIST. PVC/PE X 3 SUPOZ.
P-RF
NOVOCALMIN 300 mg
SUPOZ.
300mg
ANTIBIOTICE S.A.
ROMANIA CUTIE CU 2 FOLII TERMOSUDATE, OPACE DIN PVC X 6 SUPOZ. PRF
DORMICUM (R)
COMPR. FILM. 7,5mg
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. FILM. P-RF
MIDAZOLAM TORREX 1 mg/ml SOL. INJ.
1mg/ml
CHIESI PHARMACEUTICALS GMBH AUSTRIA CUTIE X 10 FIOLE X 5 ML SOL. INJ.
S/P-RF
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
METAMIZOLUM NATRIUM
MIDAZOLAMUM
MIDAZOLAMUM
CINOLAZEPAMUM
METHYLFENIDATUM***
METHYLFENIDATUM***
METHYLFENIDATUM***
PYRITINOLUM
PYRITINOLUM
PYRITINOLUM
PYRITINOLUM
CINNARIZINUM
CINNARIZINUM
CINNARIZINUM
TENONITROZOLUM
PYRANTELUM
TIXOCORTOLUM
152 N02BB02

COMPR. FILM. 150mg
COMPR. FILM. 50mg
Prescriptie
Nr. crt
CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 100 ML PIC. ORALE, SOL.
CLARINASE 5 mg/120 mg
FUSAFUNGINUM
BIOPAROX
EPHEDRINI HYDROCHLORIDUM EFEDRINA ARENA
EPHEDRINI HYDROCHLORIDUM EFEDRINA 50 mg/ ml
COMPR.
40mg
18mg
DRAJ.
100mg
DRAJ.
100mg
DRAJ.
200mg
SUSP. ORALA 80,5mg/5ml
CAPS.
25mg
COMPR.
25mg
COMPR.
25mg
SUSP. ORALA 125mg/2,5ml
AUSTRIA CUTIE X 3 BLIST. AL/PVDC-PVC X 10 COMPR. P-RF

BELGIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS
CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS
CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. CU ELIB. PREL. PR, PS
ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. X 10 DRAJ.
P-6L
MERCK KGAA
GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ.
P6L
MERCK KGAA
GERMANIA CUTIE CU 5 BLIST. PVC/AL X 10 DRAJ.
P6L
MERCK KGAA
GERMANIA
P6L
P-6L
TERAPIA SA
P-6L
LAROPHARM SRL ROMANIA CUTIE X 3 BLIST. X 20 COMPR.
P-6L
LAB. INNOTECH INT. FRANTA CUTIE X 1 BLIST. AL/PVC X 8 CAPS. MOI GASTROREZ. P-RF
LAB. INNOTECH INT. FRANTA CUTIE X 1 FLACON X 15 ML + LINGURITA DOZATOARE X 2,5 ML P-RF
CUTIE CU 1 FLAC. DIN STICLA BRUNA X 200 ML + 1 LINGURITA DOZATOARE DIN PP ALBA, CU GRADATII LA 1,25 ML, 2,5 ML, 5 ML
SPRAY NAZAL SUSPENSIE
0,9mg/pulverizare PFIZER EUROPE MA EEG
SPRAY NAZ.,SUSP.
0,5 mg/1 mg/ ml
2,5mg/120mg MERCK SHARP & DOHME
5mg/120mg
50mg/10ml
COMPR.
50mg
SOL. INJ.
50mg/ml
EPHEDRINI HYDROCHLORIDUM EFEDRINA ZENTIVA 50 mg/ ml SOL. INJ.
50mg/ml
ACETYLCYSTEINUM
ACC INJECT 300mg/3ml
300mg/3ml
ACETYLCYSTEINUM
FLUIMUCIL 2% PEDIATRIC SOL. ORALA 2%
ACETYLCYSTEINUM
FLUIMUCIL
300mg/3ml
CARBOCISTEINUM
RHINATHIOL 100mg/5ml pentru copii SIROP
100 mg/5 ml
CARBOCISTEINUM
HUMEX EXPECTORANT PENTRU COPII SIROP
100mg/5ml
CARBOCISTEINUM
RHINATHIOL 2% pentru copii si sugari SIROP
2%
CARBOCISTEINUM
FLUIDOL 100mg/5ml
SOL. ORALA 100mg/5ml
PROMETHAZINUM
ROMERGAN
SIROP
5mg/5ml
MECLOZINUM
EMETOSTOP
COMPR.
30mg
CYPROHEPTADINUM
PERITOL
COMPR.
4mg
THEA FARMA SPA
MAREA BRITANIE CUTIE X 1 FLACON X 10 ML + POMPA DOZATOARE + APLICATOR NAZAL
P-RF
ITALIA
CUTIE X 1 FLACON X 10 ML SPRAY NAZAL, SUSP. PREVAZUT CU NEBULIZATOR
P-RF
MAREA BRITANIE
CUTIE X 10 COMPR.FILM.ELIB.MODIF. ( BLIST.PCTFE/PVC/AL)
P-RF
COMPR. ELIB. MODIF.
MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 COMPR. ELIB. MODIF. P-6L
SPRAY BUCOFARINGIAN SI NAZAL-SOL.
FRANTA
ARENA GROUP SA
ZENTIVA S.A.
ZENTIVA S.A.
HEXAL AG
ZAMBON S.P.A.
ZAMBON S.P.A.

ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S
ROMANIA CUTIE X 5 FIOLE CU INEL DE RUPERE X 1ML SOL. INJ S
SOL. INJ./ SOL. PT. INHALAT PRIN NEBULIZATOR
SOL.INJ./INHAL.NEBULIZ./INSTILATIE ENDOTRAHEOBRON.
GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ.
ITALIA
ITALIA
SANOFI-AVENTIS OTC FRANTA
LAB. URGO
FRANTA
SANOFI-AVENTIS OTC FRANTA
TIS FARMACEUTIC SA ROMANIA
BIOFARM S.A.
ROMANIA
SPECIFAR SA
CUTIE X 1 FLACON PRESURIZAT DIN AL X 10 ML SOL. + 3 APLIC. DIN PE: 1 APLIC. BUCAL (ALB) + 2 APLIC.
S/P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SOL. ORALA + MASURA DOZATOARE (5 SI 10 ML)
P-RF
CUTIE X 5 FIOLE DIN STICLA X 3 ML SOL.INJ/SOL.PT.INHALAT PRIN NEBULIZATOR/SOL.PT.INSTILATIE ENDOTRAH
S/P-RF
CUTIE X 1 FLACON DIN STICLA INCOLORA X 125 ML SIROP + LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLACON X 125ML SIROP + MASURA DOZATOARE A 5 ML
P-RF
CUTIE X 1 FLACON DIN STICLA INCOLORA X 125 ML SIROP + LINGURITA DOZATOARE
P-RF
CUTIE X 1 FLACON DIN PVC X 100 ML SIROP + LINGURITA DUBLA GRADATA LA 2,5 SI 5 ML
P-RF
CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 ML SIROP + MASURA DOZATOARE
P-RF
GRECIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.

UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
Pagina 4 din 5
P-RF
P-RF
P-6L
cant.
UT/
Pret de
aj
(RON)
20
0.509000
30
0.252666
1 127.790000
30
0.793200
20
0.661000
20
1.028500
30
1.021000
20
0.384600
20
0.384600
20
0.342000
20
0.384600
20
0.326000
20
0.320500
20
0.353000
1 28.460000
5
1.226000
6
1.261666
12
1.253333
10
0.578000
10
1.770000
30
0.797000
30
2.966666
30
4.681333
30
6.082000
30
0.450000
50
0.540000
50
1.259200
1 42.110000
40
0.085500
40
0.093600
60
0.078000
8
1.445000
1
6.560000
1 10.880000
1 26.840000
10
2.179000
7
1.372857
1 20.770000
30
0.324666
5
1.538000
5
1.538000
5
1.566000
1 13.620000
5
1.710000
1
7.428000
1
6.190000
1
7.428000
1
4.160000
1
2.910000
10
0.373000
20
0.168500

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.509000
0.252666
127.790000
0.793200
0.661000
1.028500
1.021000
0.384600
0.384600
0.342000
0.384600
0.326000
0.320500
0.353000
28.460000
1.226000
1.261666
1.253333
0.578000
1.770000
0.797000
2.966666
4.681333
6.082000
0.450000
0.540000
1.259200
42.110000
0.085500
0.093600
0.078000
1.445000
6.560000
10.880000
26.840000
2.179000
1.372857
20.770000
0.324666
1.538000
1.538000
1.566000
13.620000
1.710000
7.428000
6.190000
7.428000
4.160000
2.910000
0.373000
0.168500
0.000000
0.000000
0.000000
0.333466
0.000000
0.000000
0.000000
0.043900
0.043900
0.000000
0.038900
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
0.129600
0.000000
0.000000
0.000000
0.088900
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
2.092000
0.000000
2.092000
0.000000
0.000000
0.000000
0.000000
cod
ATC
196 R06AX02
197 R06AX13
198 R06AX13
199 R06AX13
200 S01AA01
201 S01AA13
202 S01AA24
203 S01AA30
204 S01BA07
205 S01BC01
206 S02CA05
207 S02CA05
DCI
CYPROHEPTADINUM
LORATADINUM
LORATADINUM
LORATADINUM
CHLORAMPHENICOLUM
ACIDUM FUSIDICUM
KANAMYCINUM
COMBINATII
FLUOROMETHOLONUM
INDOMETACINUM
COMBINATII
COMBINATII
Denumire Comerciala
forma farm.
CIPROHEPTADINA ARENA 4 mg COMPR.
CLARITINE
SIROP
LORATADINA BIOFARM 5mg/5ml SIROP
LORATADINA LEK 5mg/5ml SUSP. ORALA
SIFICETINA
PULB. + SOLV. PT. SOL. OFT.
FUCITHALMIC 10mg/g
GEL OFT.
KANAMICINA SULFAT 1%
UNG. OFT.
COLBIOCIN
PULB. + SOLV. PT. SOL. OFT.
FLUMETOL S
PICATURI OFT.SUSP.
INDOCOLLYRE (R) 0,1%
PICATURI OFT.-SOL.
OTIS-T
PICATURI AURICULARE-SOL.
SOLUTIE AURICULARA CU CLORAMFENICOL SI FLUOCINOLON
concentratie
4mg
1mg/ml
5mg/5ml
5mg/5ml
4mg/ml
10mg/g
1%
FARA CONCENTRATIE
2mg/ml
0,1%
FARA CONCENTRATIE
SOL. AURICULARA FARA CONCENTRATIE
Prescriptie
Nr. crt
Tara det.
APP
Ambalaj
ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L
MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON X 120 ML + LINGURITA DOZATOARE P-6L
BIOFARM S.A.
ROMANIA
P-RF
LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA BRUNA X 120 ML SUSP. ORALA + LINGURITA DOZATOARE P-6L
Detinator APP
CUTIE CU UN FLACON DIN STICLA BRUNA X 100ML SIROP SI O MASURA DOZATOARE DIN PE, PREVAZUTA CU GRADATII DE LA 2,5 LA 20ML
S.I.F.I. SPA
ITALIA
CUTIE X 1 FLAC. STICLA BRUNA X 5 ML SOLV. + O PUNGA X UN REZERVOR CU PULB. + UN PICURATOR
P-RF
AMDIPHARM LIMITED IRLANDA CUTIE X 1 TUB AL CU CANULA APLICATOARE X 5 G GEL OFTALMIC

ANTIBIOTICE SA
ROMANIA CUTIE X 1 TUB AL X 6 G
P-RF
S.I.F.I. SPA
THEA FARMA SPA
LAB. CHAUVIN
ITALIA
CUTIE X 1 FLACON X 5 ML SOLV. + PLIC REZERVOR PULBERE + DISP. PICURARE
ITALIA
CUTIE X 1 FLACON PEJD X 10ML PIC. OFT. SUSP.
FRANTA CUTIE X 1 FLACON PICURATOR DIN POLIETILENA X 5 ML

BIOFARM SA
ROMANIA
P-6L
P-RF
P-RF
P-6L
CUTIE X 1 FLACON DIN PE X 10 ML PIC. AURICULARE, SOL. P-RF

CUTIE X 1 FLAC DIN STICLA BRUNA+APLICATOR TIP PIPETA X 10 ML SOL. AURICULARA
P-RF
Nota:
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS;
- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se face pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul
Caselor Judetene de Asigurari de Sanatate;
Medicamentele din aceast sublist corespund DCI-urilor din nomenclatorul de produse, altele dect cele din sublistele A, B, sublista C seciunea C1 i sublista D. Pentru categoriile de asigurai menionate
n aceast sublist, medicamentele corespunztoare denumirilor comune internaionale din sublista A, sublista B, seciunea C1 a sublistei C i sublista D se vor acorda n regim de compensare de 100% la
pre de referin, indiferent de indicaia pentru care sunt prevzute n aceste subliste.
Pagina 5 din 5
cant.
UT/
Pret de
aj
(RON)
30
1
1
1
1
1
1
1
1
1
1
1
0.169333
12.756000
7.350000
10.630000
20.030000
13.980000
6.640000
33.280000
33.220000
14.500000
4.212000
3.510000

beneficiaza de
compensare 100% din
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.169333
12.756000
7.350000
10.630000
20.030000
13.980000
6.640000
33.280000
33.220000
14.500000
4.212000
3.510000
0.000000
3.594000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.000000
0.948000
0.000000
ANEXA 2e
SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORM
Nr crt.
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
cod ATC
A02BA02
A02BA02
A02BA02
A02BA02
A02BA02
A02BA02
A02BA02
A02BA02
A02BA02
A02BA02
A02BA03
A02BA03
A02BA03
A02BA03
A02BA03
A02BA03
A02BA04
A02BX02
A02BX02
A03AA04
A03AA04
A03AA04
A03AA05
A03AA05
A03AA05
A03AA05
A03AA05
A03AA05
A03AA05
A03FA03
A03FA03
C01EB15
C01EB15
C01EB15
C01EB15
C01EB15
C01EB15
C01EB15
C01EB15
C01EB15
C01EB15
C04AE02
C04AE02
C04AE02
C04AE02
C04AE02
C04AE02
C04AE02
DCI
RANITIDINUM
RANITIDINUM
RANITIDINUM
RANITIDINUM
RANITIDINUM
RANITIDINUM
RANITIDINUM
RANITIDINUM
RANITIDINUM
RANITIDINUM
FAMOTIDINUM
FAMOTIDINUM
FAMOTIDINUM
FAMOTIDINUM
FAMOTIDINUM
FAMOTIDINUM
NIZATIDINUM
SUCRALFATUM
SUCRALFATUM
MEBEVERINUM
MEBEVERINUM
MEBEVERINUM
TRIMEBUTINUM
TRIMEBUTINUM
TRIMEBUTINUM
TRIMEBUTINUM
TRIMEBUTINUM
TRIMEBUTINUM
TRIMEBUTINUM
DOMPERIDONUM
DOMPERIDONUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
TRIMETAZIDINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
Denumire Comerciala
RANITIDINA ARENA 300 mg

RANITIDIN ARENA 150mg
RANITIDINA 150 mg
RANITIDIN
ZANTAC 150 mg
RANITIDINA LPH 150 mg
RANITIDINA ATB 150 MG
forma farm.
CAPS.
COMPR.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
RANITIDINA LAROPHARM 150 mg COMPR. FILM.
RANITIDINA LPH 150 mg
COMPR. FILM.
ARNETIN
FAMODIN 20 mg
FAMOTIDINA ZENTIVA 20mg
QUAMATEL 20 mg
SOL. INJ.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
FAMOTIDINA ZENTIVA 40 mg COMPR. FILM.
FAMODIN 40 mg
COMPR. FILM.
QUAMATEL 20 mg
NIZATIDIN VIM SPECTRUM 150 mg
GASTROFAIT
VENTER
DUSPATALIN 200 mg
DUSPATALIN 200 mg
COLOSPASMIN
TRIMEBUTIN 100
COLPERIN 100 mg
DEBRIDAT 100 mg
DEBRIDAT 200 mg
IBUTIN (R) 300 mg
DEBRIDAT
DEBRIDAT
MOTILIUM 10 mg
OROPERIDYS 10 mg
TRIMETAZIDINA LPH 35 mg
TRIMETAZIDINA ATB 35 mg
PREDUCTAL MR 35 mg
TRIMELUZINE 35 mg
MODUXIN MR 35 mg
MODUXIN (R) 20 mg
CAPS.
COMPR.
COMPR.
CAPS. ELIB. PREL.
CAPS. ELIB. PREL.
DRAJ.
COMPR.
COMPR.
COMPR. FILM.
COMPR. FILM.

COMPR. FILM.
COMPR. ELIB. MODIF.
COMPR. ELIB. PREL.

COMPR. ELIB. PREL.
COMPR. FILM.
TRIMETAZIDINA LPH (R) 20 mg COMPR. FILM.
PREDUCTAL 20 mg
COMPR. FILM.
DILATAN 20 mg
COMPR. FILM.
PREDUTRIM 20 mg/ml
NICERIUM (R) 15
NICERIUM (R) 30 UNO
NICERGOLINA LPH 10 mg
GRALIN 10 mg
SERMION
NICERGOLINA LPH 30 mg
GRALIN 30 mg
PIC. ORALE, SOL.

CAPS. ELIB. MODIF.
CAPS. ELIB. MODIF.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
concentratie
300mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
150mg
25mg/ml
20mg
20mg
20mg
40mg
40mg
20mg
150mg
1g
1g
200mg
200mg
100mg
100mg
100mg
100mg
200mg
300mg
24mg/5ml
24mg/5ml
10mg
10mg
35mg
35mg
35mg
35mg
35mg
20mg
20mg
20mg
20mg
20mg/ml
15mg
30mg
10mg
10mg
30mg
30mg
30mg
tara det.
APP
Detinator APP
Ambalaj

MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.
MAREA BRITANIE
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 IANUARIE 2016
P-6L
P-6L
P-6L
P-6L
CUTIE X 2 BLIST. AL/AL X 10 COMPR. FILM. P-6L
LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L
ANTIBIOTICE SA
LAROPHARM SRL

LABORMED PHARMA SA ROMANIA CUTIE CU 3 BLISTERE DIN FOLIE PVC-PVDC/AL X 10 COMPR. FILM.
P-6L
P-RF
ROMANIA
ZENTIVA S.A
ROMANIA
ZENTIVA S.A
ROMANIA

P-6L
CUTIE X 5 FLACOANE DIN STICLA INCOLORA CU PULBERE PENTRU SOLUTIE INJ./PERF. + 5 FIOLE DIN STICLA INCOLORA X 5ML SOLV. PENTRU UZ PARENTERAL

KRKA D.D.
SLOVENIA CUTIE X 5 BLIST. X 10 COMPR.
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL.
ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. X 15 CAPS. ELIB. PREL.
E.I.P.I.CO. MED SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 DRAJ.
MAGISTRA C & C
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR.
MAREA BRITANIE
MAREA BRITANIE
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
S/P-RF
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L

ZENTIVA SA
ROMANIA
P-6L
MAREA BRITANIE
CUTIE X 1 FLAC. DIN STICLA BRUNA X 76,25 G GRANULE PT. 125ML SUSP. + MASURA DOZATOARE
P-6L
MAREA BRITANIE
CUTIE X 1 FLAC. DIN STICLA BRUNA X 152,5 G GRANULE PT. 250ML SUSP. + MASURA DOZATOARE
P-6L
TERAPIA SA
P-6L
PIERRE FABRE MEDICAMENT
FRANTA
P6L
CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP.
LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. MODIF. P-6L
ANTIBIOTICE S.A.
ROMANIA
CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. CU ELIB. PREL.
FRANTA
CUTIE X 2 BLIST. AL/PVC X 30 COMPR. FILM. ELIB. MODIF. P-6L
P6L
SANDOZ S.R.L.
ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 60 COMPR. ELIB. PREL. P6L

ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. CU ELIB. PRELUNG. P6L
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L
FRANTA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM.
TERAPIA SA
ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L

ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 50 ML PIC. ORALE P6L
HEXAL AG
HEXAL AG
P-6L
GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF. P-6L

GERMANIA CUTIE X 3 BLIST. PP/AL X 10 CAPS. ELIB. MODIF. P-6L
SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM.
P-6L
P-6L
MAREA BRITANIE
CUTIE X 2 BLIST. PVC-PVDC/AL-PVC X 15 COMPR. FILM
SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM.
Pagina 1 din 3
P-6L
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
10
20
20
20
20
20
20
20
30
5
30
30
28
30
30
5
20
20
50
30
30
20
30
30
30
30
20
1
1
10
30
60
30
60
60
30
30
60
60
30
1
30
30
30
30
30
30
30
0.419850
0.209925
0.209925
0.209925
0.209925
0.209925
0.209925
0.209925
0.209925
1.470596
0.209925
0.202333
0.209925
0.267000
0.410333
3.908000
0.209925
0.305000
0.310100
0.778666
0.778666
0.389333
0.384666
0.384666
0.384666
0.769334
1.154002
6.563250
12.500000
0.104000
0.104000
0.401083
0.401000
0.401083
0.380333
0.401000
0.229190
0.229190
0.229190
0.229190
11.459521
0.450166
0.900333
0.300111
0.300111
0.900333
0.900333
0.900333
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.250150
0.025575
0.026575
0.025575
0.153575
0.025575
0.025575
0.021075
0.026408
1.157404
0.086408
0.000000
0.140075
0.000000
0.000000
0.000000
0.701575
0.000000
0.015300
0.000000
0.000000
0.056667
0.000000
0.000000
0.208000
0.355332
0.714498
3.856750
0.000000
0.352000
0.597666
0.000250
0.000000
0.196417
0.000000
0.000000
0.034143
0.034310
0.175976
0.034143
0.870479
0.514500
0.000000
0.165222
0.162555
0.440333
0.000000
0.000000

beneficiaza de
compensare 20% din
0.083970
0.041985
0.041985
0.041985
0.041985
0.041985
0.041985
0.041985
0.041985
0.294119
0.041985
0.040466
0.041985
0.053400
0.082066
0.781600
0.041985
0.061000
0.062020
0.155733
0.155733
0.077866
0.076933
0.076933
0.076933
0.153866
0.230800
1.312650
2.500000
0.020800
0.020800
0.080216
0.080200
0.080216
0.076066
0.080200
0.045838
0.045838
0.045838
0.045838
2.291904
0.090033
0.180066
0.060022
0.060022
0.180066
0.180066
0.180066
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 20%
din pretul de
referinta)
0.586030
0.193515
0.194515
0.193515
0.321515
0.193515
0.193515
0.189015
0.194348
2.333881
0.254348
0.161867
0.308015
0.213600
0.328267
3.126400
0.869515
0.244000
0.263380
0.622933
0.622933
0.368134
0.307733
0.307733
0.515733
0.970800
1.637700
9.107350
10.000000
0.435200
0.680866
0.321117
0.320800
0.517284
0.304267
0.320800
0.217495
0.217662
0.359328
0.217495
10.038096
0.874633
0.720267
0.405311
0.402644
1.160600
0.720267
0.720267
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
cod ATC
C04AE02
C04AE02
C04AE02
C04AE02
C04AX07
C04AX07
C05CA53
C10AX06
C10AX06
D06BB03
D06BB03
D06BB03
D06BB03
D06BB03
D06BB03
D06BB03
D06BB03
D06BB03
D06BB03
H05BA01
H05BA01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AC01
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M01AX17
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
M05BA06
100 M05BX03
101 N03AE01
102 N03AE01
103 N06BX03
104 N06BX03
DCI
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
NICERGOLINUM
VINCAMINUM
VINCAMINUM
DIOSMINUM (COMBINATII)**
Denumire Comerciala
GRALIN 5 mg
NICERIUM (R) 10
SINERGOLIN 30
SINERGOLIN 30
OXYBRAL SR 30 mg
VINCAMINA
DETRALEX ( R )
ACID OMEGA-3-ESTERI ETILICI 90** TEVOCOR 1000 mg
ACID OMEGA-3-ESTERI ETILICI 90** OMACOR (R)
ACICLOVIRUM
ZOVIRAX
ACICLOVIRUM
ACICLOVIR 50mg/g
ACICLOVIRUM
ACICLOVIR 50mg/g
ACICLOVIRUM
ACICLOVIR SLAVIA 50 mg/g
ACICLOVIRUM
ACICLOVIR-RICHTER 50mg/g
ACICLOVIRUM
ACICLOVIR HYPERION
ACICLOVIRUM
ACICLOVIR TIS 50mg/g
ACICLOVIRUM
ACICLOVIR SLAVIA 50 mg/g
ACICLOVIRUM
ACICLOVIR TERAPIA 50 mg/g
ACICLOVIRUM
ACICLOVIR-RICHTER 50mg/g
CALCITONINUM (SOMON)
NYLEX (R)
CALCITONINUM (SOMON)
MIACALCIC (R)
PIROXICAMUM
PIROXSAL 20 mg
PIROXICAMUM
FLAMEXIN
PIROXICAMUM
PIROXICAM ARENA 20 MG
PIROXICAMUM
PIROXICAM HELCOR 20 mg
PIROXICAMUM
FLAMEXIN
PIROXICAMUM
FLAMEXIN
PIROXICAMUM
FLAMEXIN
PIROXICAMUM
FLAMEXIN (R)
PIROXICAMUM
HOTEMIN
PIROXICAMUM
PIROXICAM ATB 20 mg
PIROXICAMUM
PIROXICAM ATB 20 mg
PIROXICAMUM
PIROXICAM SINTOFARM 20 mg
NIMESULIDUM
LEMESIL
NIMESULIDUM
NIMESULID 100 mg
NIMESULIDUM
NIMESULID SLAVIA
NIMESULIDUM
APONIL
NIMESULIDUM
APONIL
NIMESULIDUM
NIMESULID ARENA 100 mg
NIMESULIDUM
NIMELID 100 mg/plic
NIMESULIDUM
NIMELID 100 mg/plic
ACIDUM IBANDRONICUM**
ACID IBANDRONIC TEVA 150 mg
OSSICA 150 mg
QUODIXOR 150 mg
OSAGRAND 150 mg
ACID IBANDRONIC SANDOZ 150 mg
ACID IBANDRONIC AUROBINDO 150 mg
OSSICA 3 mg
ACID IBANDRONIC ACCORD 3 mg
OSAGRAND 3 mg/3 ml
BONVIVA 3mg/3ml
STRONTIUM RANELATUM
OSSEOR 2 g
CLONAZEPAMUM
RIVOTRIL
CLONAZEPAMUM
RIVOTRIL 2 mg
PIRACETAMUM
PIRACETAM ARENA 400 mg
PIRACETAMUM
PIRACETAM SLAVIA 400 mg
Prescriptie
Nr crt.
cant.
UT/
Pret de
tara det.
amba referinta / UT
laj
(RON)
APP
Detinator APP
Ambalaj
COMPR. FILM. 5mg
SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. FILM. P-6L
30
0.150055
DRAJ.
DRAJ.
DRAJ.
CAPS. ELIB. PREL.
DRAJ.
COMPR. FILM.
CAPS. MOI
CAPS. MOI
CREMA
CREMA
CREMA
CREMA
CREMA
CREMA
CREMA
CREMA
CREMA
CREMA
SOL. INJ.
SOL. INJ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR. EFF.
COMPR. EFF.
COMPR. EFF.
SOL. INJ.
SUPOZ.
SUPOZ.
SUPOZ.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
COMPR.
GRANULE PT. SUSP. ORALA
GRANULE PT. SUSP. ORALA
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
COMPR. FILM.
SOL INJ. IN SERINGA PREUMPLUTA
SOL INJ. IN SERINGA PREUMPLUTA
SOL. INJ.
COMPR.
COMPR.
CAPS.
COMPR.
10mg
30mg
30mg
30mg
10mg
500mg
1000 mg
1000mg
5%
5%
5%
50mg/g
50mg/g
50mg/g
50mg/g
50mg/g
50mg/g
50mg/g
100UI/ml
50ui/ml
20mg
20mg
20mg
20mg
20mg
20mg
20mg
20mg/plic
20mg/ml
20 mg
20 mg
20mg
100mg
100mg
100mg
100mg
100mg
100mg
100mg/plic
100mg/plic
150 mg
150mg
150mg
150mg
150mg
150mg
3mg
3mg
3mg/3ml
3mg/3ml
2g
0,5mg
2mg
400mg
400mg
HEXAL AG
SINTOFARM SA
SINTOFARM SA
GERMANIA

P-6L
P-6L
BIOFARM SA
ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 CAPS. CU ELIB. PREL.

FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM.
P-6L
ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. PRF
PRONOVA BIOPHARMA NORGE A.S.
NORVEGIA
ROMANIA
HYPERION S.A.
ROMANIA
TERAPIA S.A.
ROMANIA
P-6L
P-6L
P-6L
FALC. DIN PEID X 28 CAPS. MOI

CUTIE X 1 TUB X 5G CREMA
CUTIE X 1 TUB X 5 G CREMA
CUTIE X 1 TUB X 15 G CREMA
P-RF
CUTIE X 1 TUB DIN PEJD X 15 G CREMA
P-RF

CUTIE CU 1 TUB DIN AL X 15 G CREMA
PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML
NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML
SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST.PVC/ AL X 10 COMPR.
CHIESI FARMACEUTICI SPA ITALIA
CUTIE X 3 BLIST. PVC-PDVC/AL-LAC PVDC X 10 COMPR.
P-RF
P-RF
P-RF
P-RF
PRF
P-RF
P-RF
PRF
PRF
P-RF
P-RF
P-6L
P-6L
P-6L
ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L
ITALIA
ITALIA
ITALIA
ITALIA

ANTIBIOTICE S.A.
ANTIBIOTICE S.A.
SINTOFARM SA
MAGISTRA C & C
SLAVIA PHARM SRL
MEDOCHEMIE LTD
MEDOCHEMIE LTD
ARENA GROUP S.A.
CUTIE X 1 BLIST. AL-PE/AL X 10 COMPR. EFF. P-6L

CUTIE X 20 PLICURI DUBLU COMPARTIMENTAT X 3 G PULB. PT. SOL. ORALA
P-6L
UNGARIA CUTIE X 1 BLIST. C-PET/PE X 5 FIOLE X 1 ML SOL. INJ. P-RF

ROMANIA CUTIE CU 2 FOLII TERMOSUDATE PVC X 3 SUPOZ. P6L
ROMANIA CUTIE CU 1 FOLIE TERMOSUDATA PVC X 6 SUPOZ. P6L
ROMANIA CUTIE X 2 FOLII TERMOSUDATE X 5 SUPOZ. P-6L
GRECIA CUTIE X 2 BLIST. X 10 COMPR.

CIPRU
CIPRU
P-RF
ROMANIA
ROMANIA
CUTIE CU 10 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA
PRF
CUTIE CU 30 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA
PRF
CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT
P-RF
P-RF
P-RF
P-RF
P-RF
P6L
GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM.

ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR. FILM.
P-6L
ZENTIVA K.S.
SANDOZ S.R.L.
P6L
REPUBLICA CEHA
P-6L
ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L
MALTA
ROMANIA
CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE
P6L
P6L
MAREA BRITANIE
CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE
PR/PRF
ZENTIVA K.S.
REPUBLICA CEHA
CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ.
P6L
MAREA BRITANIE
CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC
P-6L
LES LAB. SERVIER FRANTA
CUTIE X 28 PLICURI HARTI-PE-AL/PE GRAN. PT. SUSP. ORALA
P-RF
ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 50 COMPR.
ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 30 COMPR.
P-RF

SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. DIN PVC/AL X 10 COMPR.
P-6L
Pagina 2 din 3
P-RF
P-6L
25
30
20
10
20
30
30
28
1
1
1
1
1
1
1
1
1
1
5
5
20
30
20
20
10
20
30
20
5
6
6
10
20
10
10
20
10
10
10
30
1
1
1
1
1
1
1
1
1
1
28
50
30
30
40
0.300111
0.883333
0.882000
0.961000
0.327250
0.912666
1.372333
1.557106
2.115750
2.115750
6.347250
2.115750
2.115750
6.347250
4.700000
6.347250
6.347250
6.347250
6.714000
3.600675
0.136500
0.324000
0.128000
0.222000
0.324000
0.324000
0.324000
0.324000
1.965500
0.759249
0.759249
0.732000
0.356400
0.356400
0.356400
0.356400
0.356400
0.356400
0.356400
0.356400
28.166785
28.166785
28.166785
28.166785
28.166785
28.166785
102.101625
100.840000
102.101625
102.101625
5.203214
0.069873
0.225000
0.099674
0.099674
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.083611
0.285489
0.000000
0.000000
0.000000
0.020750
0.000000
0.000000
0.554322
19.734250
3.044250
1.542750
3.474250
3.044250
0.982750
0.000000
0.612750
0.612750
1.542750
0.000000
2.331325
0.000000
0.643000
0.000000
0.000000
1.231000
1.230500
1.181000
1.031000
0.244500
0.009084
0.009084
0.000000
0.040600
0.039600
0.039600
0.039600
0.039600
0.039600
0.039600
0.039600
7.233215
7.513215
7.503215
7.513215
7.513215
6.873215
1.928375
0.000000
2.708375
50.798375
0.000000
0.071927
0.000000
0.265992
0.019326

beneficiaza de
compensare 20% din
0.030011
0.060022
0.176666
0.176400
0.192200
0.065450
0.182533
0.274466
0.311421
0.423150
0.423150
1.269450
0.423150
0.423150
1.269450
0.940000
1.269450
1.269450
1.269450
1.342800
0.720135
0.027300
0.064800
0.025600
0.044400
0.064800
0.064800
0.064800
0.064800
0.393100
0.151849
0.151849
0.146400
0.071280
0.071280
0.071280
0.071280
0.071280
0.071280
0.071280
0.071280
5.633357
5.633357
5.633357
5.633357
5.633357
5.633357
20.420325
20.168000
20.420325
20.420325
1.040642
0.013974
0.045000
0.019934
0.019934
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 20%
din pretul de
referinta)
0.203655
0.525578
0.706667
0.705600
0.768800
0.282550
0.730133
1.097867
1.800007
21.426850
4.736850
6.620550
5.166850
4.736850
6.060550
3.760000
5.690550
5.690550
6.620550
5.371200
5.211865
0.109200
0.902200
0.102400
0.177600
1.490200
1.489700
1.440200
1.290200
1.816900
0.616484
0.616484
0.585600
0.325720
0.324720
0.324720
0.324720
0.324720
0.324720
0.324720
0.324720
29.766643
30.046643
30.036643
30.046643
30.046643
29.406643
83.609675
80.672000
84.389675
132.479675
4.162572
0.127826
0.180000
0.345732
0.099066
DCI
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
PIRACETAMUM
ERDOSTEINUM**
ERDOSTEINUM**
ERDOSTEINUM**
Nr crt.
106 N06BX03
107 N06BX03
108 N06BX03
109 N06BX03
110 N06BX03
111 N06BX03
112 N06BX03
113 N06BX03
114 N06BX03
115 N06BX03
116 N06BX03
117 N06BX03
118 N06BX03
119 N06BX03
120 N06BX03
121 N06BX03
122 R05CB15
123 R05CB15
124 R05CB15
Denumire Comerciala
PIRACETAM FARMEX 400 mg
PIRACETAM MCC 400mg

PIRACETAM SINTOFARM 400 mg
PIRACETAM SINTOFARM 400 mg
PIRACETAM LAROPHARM 400 mg
LUCETAM (R) 1200 mg

NOOTROPIL 1200 mg
PIRACETAM 400 mg
LUCETAM
PIRACETAM HELCOR 400mg
PIRACETAM-RICHTER 400 mg
PIRACETAM 800 mg
LUCETAM
NOOTROPIL 800 mg
PIRACETAM HELCOR 800mg
PIRACETAM-RICHTER 800 mg
MEMOTAL1 g/5 ml
ERDOMED 300 mg
ERDOMED 225 mg
ERDOMED 175 mg/5 ml
CAPS.
300mg
225mg
175mg/5ml

Ambalaj

CUTIE X 1 FLAC. X 20 COMPR. FILM.
Prescriptie
cod ATC
105 N06BX03
tara det.
APP
Detinator APP
COMPR.
400mg
FARMEX COMPANY SRL ROMANIA
COMPR.
400mg
MAGISTRA C & C
ROMANIA
COMPR.
400mg
SINTOFARM SA
ROMANIA
COMPR.
400mg
SINTOFARM SA
ROMANIA
COMPR.
400mg
LAROPHARM SRL ROMANIA
COMPR. FILM. 1200mg
COMPR. FILM. 1200mg
U.C.B. PHARMA S.A. BELGIA
COMPR. FILM. 400mg
COMPR. FILM. 400mg
COMPR. FILM. 400mg
COMPR. FILM. 400mg
COMPR. FILM. 800mg
COMPR. FILM. 800mg
COMPR. FILM. 800mg
U.C.B. PHARMA S.A. BELGIA
COMPR. FILM. 800mg
COMPR. FILM. 800mg
SOL. INJ.
1g/5ml
ZENTIVA SA
ROMANIA
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
P-6L
CUTIE X 1 FLAC. DIN STICLA BRUNA X 60 COMPR.FILM.
P-6L

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

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

AUSTRIA CUTIE CU 20 PLICURI UNIDOZA DIN HARTIE AL/PE
AUSTRIA
CUTIE CU 1 FLAC. DIN STICLA BRUNA A 50 G PULB. PT. OBTINEREA A 100 ML SUSP. ORALA + 1 MASURA DOZATOA
NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii.
Pagina 3 din 3
P-RF
P-6L
P-6L
P-6L
cant.
UT/
Pret de
amba referinta / UT
laj
(RON)
40
20
20
40
20
20
100
20
60
20
20
20
30
90
20
20
5
10
20
1
0.099674
0.099674
0.099674
0.099674
0.099674
0.272500
0.299025
0.099674
0.099674
0.099674
0.099674
0.199349
0.199349
0.199349
0.199349
0.199349
1.862000
1.633000
1.293937
24.439999
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 100%
din pretul de
referinta)
0.011326
0.061326
0.072826
0.061826
0.212326
0.000000
0.107175
0.082326
0.021992
0.022826
0.082326
0.021651
0.021984
0.141206
0.021651
0.021651
0.000000
0.000000
0.207563
0.000001

beneficiaza de
compensare 20% din
0.019934
0.019934
0.019934
0.019934
0.019934
0.054500
0.059805
0.019934
0.019934
0.019934
0.019934
0.039869
0.039869
0.039869
0.039869
0.039869
0.372400
0.326600
0.258787
4.887999
Co-plata maxima a
asiguratului / UT
beneficiaza de
compensare 20%
din pretul de
referinta)
0.091066
0.141066
0.152566
0.141566
0.292066
0.218000
0.346395
0.162066
0.101732
0.102566
0.162066
0.181131
0.181464
0.300686
0.181131
0.181131
1.489600
1.306400
1.242713
19.552001

Ordin Nr. 1505 - 29.12.2015

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ANEXA 2a

PULB. PT. SOL. PERF. FARA CONCENTRATIE

SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ. P-6L

GEDEON RICHTER ROMANIA SA

ROMPHARM COMPANY SRL

LEK PHARMACEUTICALS D.D.

SLOVENIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS. GASTROREZ.

CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ.

DR. REDDY'S LABORATORIES

CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L

AUROBINDO PHARMA (MALTA) LIMITED

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

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

CUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ.

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

CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR.

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

CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ.

ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ.

ROMASTRU TRADING S.R.L.

CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ.

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

LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ P-6L

LEK PHARMACEUTICALS D.D.

ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L

CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ.

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATE DE 15 ML CU PULB.PT. SOL. PERF.

CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF.

CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF.

CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ.

CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ.

CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ.

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

DAR AL DAWA PHARMA S.R.L.

DR. REDDY'S LABORATORIES

DR. REDDY'S LABORATORIES

CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L

CUTIE X 4 BLIST. AL/PVC X 10 COMPR.

CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L

CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML

CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L

DR. FALK PHARMA GMBH GERMANIA

FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML

E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML

Val. maxima suportata de

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT

COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM)

LACTULOSE-MIP 650 mg/ml

MIP PHARMA GMBH GERMANIA

ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE

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

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

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

SOFARFARM S.R.L. ROMANIA

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

CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI

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